Using Latent Class Analysis to Support the ICD-11 Complex Posttraumatic Stress Disorder Diagnosis in a Sample of Homeless Adults.
Adult
Adult Survivors of Child Abuse
/ psychology
Aged
Aged, 80 and over
Exposure to Violence
/ psychology
Female
Ill-Housed Persons
/ psychology
Humans
International Classification of Diseases
Latent Class Analysis
Male
Middle Aged
Psychological Distress
Sex Offenses
/ psychology
Stress Disorders, Post-Traumatic
/ classification
Journal
Journal of traumatic stress
ISSN: 1573-6598
Titre abrégé: J Trauma Stress
Pays: United States
ID NLM: 8809259
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
05
03
2018
revised:
07
09
2019
accepted:
11
09
2019
pubmed:
13
6
2020
medline:
31
8
2021
entrez:
13
6
2020
Statut:
ppublish
Résumé
The 11th revision of the International Classification of Diseases (ICD-11), ratified at the World Health Assembly in May 2019, introduced revised diagnostic guidelines for posttraumatic stress disorder (PTSD) as well as a separate diagnosis of complex PTSD (CPTSD). We aimed to test the new ICD-11 symptom structure for PTSD and CPTSD in a sample of individuals who have experienced homelessness. Experiences of trauma exposure and the associated mental health outcomes have been underresearched in this population. A sample of adults experiencing homelessness (N = 206) completed structured and semi-structured interviews that collected information about trauma exposure and symptoms of PTSD and CPTSD. We conducted a latent class analysis (LCA) using six symptom clusters (three PTSD symptom clusters that are components of CPTSD and three CPTSD symptom clusters). All participants reported trauma exposure, with 88.6% having experienced at least one event before 16 years of age. Four distinct classes of participants emerged in relation to the potential to meet the diagnosis: LCA CPTSD (n = 122, 59.8%), LCA no diagnosis (n = 27: 13.2%), LCA PTSD (n = 33; 16.2%), and LCA disturbance in self-organization (DSO; n = 22; 10.8%). Of note, participants with an ICD-11 CPTSD as well as those with an ICD-11 PTSD diagnosis fell into the LCA CPTSD class. Our findings provide some support for the distinction between CPTSD and PTSD within this population specifically but potentially have broader implications. Clear diagnoses will allow targeted PTSD and CPTSD treatment development.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
677-687Subventions
Organisme : MIND
Pays : International
Informations de copyright
© 2020 International Society for Traumatic Stress Studies.
Références
Akaike, H. (1973). Maximum likelihood identification of Gaussian autoregressive moving average models. Biometrika, 60(2), 255-265. https://doi.org/10.1093/biomet/60.2.255
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: Author.
Bandelow, B., Krause, J., Wedekind, D., Broocks, A., Hajak, G., & Rüther, E. (2005). Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Research, 134(2), 169-179. https://doi.org/10.1016/j.psychres.2003.07.008
Beltran, R. O., Silove, D., & Llewellyn, G. M. (2009). Comparison of ICD-10 diagnostic guidelines and research criteria for enduring personality change after catastrophic experience. Psychopathology, 42(2), 113-118. https://doi.org/10.1159/000204761
Buhrich, N., Hodder, T., & Teesson, M. (2000). Lifetime prevalence of trauma among homeless people in Sydney. Australian & New Zealand Journal of Psychiatry, 34(6), 963-966. https://doi.org/10.1080/000486700270
Burstein, M., Georgiades, K., Lamers, F., Swanson, S. A., Cui, L., He, J.-P., … Merikangas, K. R. (2012). Empirically derived subtypes of lifetime anxiety disorders: Developmental and clinical correlates in US Adolescents. Journal of Consulting and Clinical Psychology, 80(1), 102. https://doi.org/10.1037/a0026069
Chamberlain, C., & Johnson, G. (2001). The debate about homelessness. Australian Journal of Social Issues, 36(1), 35-50. https://doi.org/10.1002/j.1839-4655.2001.tb01312.x
Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013). Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis. European Journal of Psychotraumatology, 4. https://doi.org/10.3402/ejpt.v4i0.20706
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, complex PTSD, and borderline personality disorder: A latent class analysis. European journal of psychotraumatology, 5. https://doi.org/10.3402/ejpt.v5.25097
Cloitre, M., Stolbach, B. C., Herman, J. L., van der Kolk, B., Pynoos, R., Wang, J., & Petkova, E. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress, 22(5), 399-408. https://doi.org/10.1002/jts.20444
Courtois, C. A., & Ford, J., D. (Eds.). (2009). Treating Complex Traumatic Stress Disorders: An evidence-based guide. New York: Guilford Press. https://doi.org/10.1017/S1352465810000147.
Elklit, A., Hyland, P., & Shevlin, M. (2014). Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. European Journal of Psychotraumatology, 5. https://doi.org/10.3402/ejpt.v5.24221
Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing Post-Traumatic Stress Disorder. Journal of Traumatic Stress, 6(4), 459-473. https://doi.org/10.1002/jts.2490060405
Ford, J. D., & Kidd, P. (1998). Early childhood trauma and disorders of extreme stress as predictors of treatment outcome with chronic posttraumatic stress disorder. Journal of Traumatic Stress, 11(4), 743. https://doi.org/10.1023/A:1024497400891
Ford, J. D., Stockton, P., Kaltman, S., & Green, B. L. (2006). Disorders of extreme stress (DESNOS) symptoms are associated with type and severity of interpersonal trauma exposure in a sample of healthy young women. Journal of Interpersonal Violence, 21(11), 1399-1416. https://doi.org/10.1177/0886260506292992
Galatzer-Levy, I. R., Nickerson, A., Litz, B. T., & Marmar, C. R. (2013). Patterns of lifetime PTSD comorbidity: A Latent Class Analysis. Depression & Anxiety, 30(5), 489-496. https://doi.org/10.1002/da.22048
Herman, J. (1992). Trauma and recovery: The aftermath of violence-from domestic abuse to political terror. New York: Basic Books.
Karatzias, T., Shevlin, M., Fyvie, C., Hyland, P., Efthymiadou, E., Wilson, D., … Cloitre, M. (2016). An initial psychometric assessment of an ICD-11 based measure of PTSD and complex PTSD (ICD-TQ): Evidence of construct validity. Journal of Anxiety Disorders, 44, 73-79. https://doi.org/10.1016/j.janxdis.2016.10.009
Kim, Y., Bender K., Ferguson K. M., Begun S., DiNitto D. M. (2018). Trauma and Posttraumatic Stress Disorder Among Homeless Young Adults: The Importance of Victimization Experiences in Childhood and Once Homeless. Journal of Emotional and Behavioral Disorders, 26, (3), 131-142. https://doi.org/10.1177/1063426617710239.
Knefel, M., Garvert, D. W., Cloitre, M., & Lueger-Schuster, B. (2015). Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): A latent profile analysis. European Journal of Psychotraumatology, 6, 1-6. https://doi.org/10.3402/ejpt.v6.25290
Kramer, M. D., Arbisi, P. A., Thuras, P. D., Krueger, R. F., Erbes, C. R., & Polusny, M. A. (2016). The class-dimensional structure of PTSD before and after deployment to Iraq: Evidence from direct comparison of dimensional, categorical, and hybrid models. Journal of Anxiety Disorders, 39, 1-9. https://doi.org/10.1016/j.janxdis.2016.02.004
Lo, Y., Mendell, N. R., & Rubin, D. B. (2001). Testing the number of components in a normal mixture. Biometrika, 88(3), 767-778. https://doi.org/10.1093/biomet/88.3.767
Lubke, G., & Muthén, B. O. (2007). Performance of factor mixture models as a function of model size, covariate effects, and class-specific parameters. Structural Equation Modeling, 14(1), 26-47.
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., Ommeren, M., Jones, L. M., … Rousseau, C. (2013). Diagnosis and classification of disorders specifically associated with stress: Proposals for ICD-11. World Psychiatry, 12(3), 198-206.
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., Reed, G. M., van Ommeren, M., … Llosa, A. E. (2013). Proposals for mental disorders specifically associated with stress in the International Classification of Diseases-11. The Lancet, 381(9878), 1683-1685. https://doi.org/10.1016/S0140-6736(12)62191-6
Mills, K. L., McFarlane, A. C., Slade, T., Creamer, M., Silove, D., Teesson, M., & Bryant, R. (2011). Assessing the prevalence of trauma exposure in epidemiological surveys. Australian and New Zealand Journal of Psychiatry.
Murphy, S., Elklit, A., Dokkedahl, S., & Shevlin, M. (2016). Testing the validity of the proposed ICD-11 PTSD and complex PTSD criteria using a sample from Northern Uganda. European Journal of Psychotraumatology, 7. https://doi.org/10.3402/ejpt.v7.32678.
Muthén, B., & Muthén, L. K. (2000). Integrating person-centered and variable-centered analyses: Growth mixture modeling with latent trajectory classes. Alcoholism: Clinical and experimental research, 24(6), 882-891.
Muthén, L. K., & Muthén, B. O. (2012). Mplus (Version 7): Muthén and Muthén Los Angeles, CA.
Muthén, L. K., & Muthén, B. O. (2017). Mplus (Version 25.0): Muthén and Muthén Los Angeles, CA.
Palic, S., Zerach, G., Shevlin, M., Zeligman, Z., Elklit, A., & Solomon, Z. (2016). Evidence of complex posttraumatic stress disorder (CPTSD) across populations with prolonged trauma of varying interpersonal intensity and ages of exposure. Psychiatry Research, 246, 692-699.
Pelcovitz, D., van der Kolk, B. A., Roth, S., Mandel, F., Kaplan, S., & Resick, P. (1997). Development of a criteria set and a structured interview for disorders of extreme stress (SIDES). Journal of Traumatic Stress, 10(1), 3-16.
Perkonigg, A., Höfler, M., Cloitre, M., Wittchen, H.-U., Trautmann, S., & Maercker, A. (2016). Evidence for two different ICD-11 posttraumatic stress disorders in a community sample of adolescents and young adults. European Archives Of Psychiatry And Clinical Neuroscience, 266(4), 317-328.
Ramaswamy, V., DeSarbo, W. S., Reibstein, D. J., & Robinson, W. T. (1993). An empirical pooling approach for estimating marketing mix elasticities with PIMS data. Marketing Science, 12(1), 103-124.
Robinson, C. (2005). Persistent homelessness/persistent trauma. Parity, 18(7), 4.
Rosenberger, W. F., & Lachin, J. M. (2015). Randomization in Clinical Trials: Theory and Practice, 2, : John Wiley & Sons.
Schwarz, G. (1978). Estimating the dimension of a model. The Annals of Statistics, 6(2), 461-464. https://doi.org/10.1214/aos/1176344136.
Scoboria, A., Ford, J., Lin, H., & Frisman, L. (2008). Exploratory and confirmatory factor analyses of the Structured Interview for Disorders of Extreme Stress. Assessment, 15(4), 404-425. https://doi.org/10.1177/1073191108319005
Taylor, K. M., & Sharpe, L. (2008). Trauma and post-traumatic stress disorder among homeless adults in Sydney. The Australian and New Zealand Journal of Psychiatry, 42(3), 206-213. https://doi.org/10.1080/00048670701827218
Terr, L. C. (1991). Childhood traumas: An outline and overview. The American Journal of Psychiatry, 148(1), 10-20. https://doi.org/10.1176/foc.1.3.322
Tsai, J., Edens, E. L., & Rosenheck, R. A. (2011). A typology of childhood problems among chronically homeless adults and its association with housing and clinical outcomes. Journal of Health Care for the Poor and Underserved, 22(3), 853-870. https://doi.org/10.1353/hpu.2011.0081
Whitbeck, L. B., Armenta, B. E., & Welch-Lazoritz, M. L. (2015). Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities. Social Psychiatry and Psychiatric Epidemiology, 50(8), 1285-1291. https://doi.org/10.1007/s00127-015-1066-6
Wolf, E. J., Miller, M. W., Kilpatrick, D., Resnick, H. S., Badour, C. L., Marx, B. P., … Friedman, M. J. (2015). ICD-11 Complex PTSD in US national and veteran samples prevalence and structural associations with PTSD. Clinical Psychological Science, 3(2), 215-229.
World Health Organization. (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research: World Health Organization. https://www.who.int/classifications/icd/icdonlineversions/en/.
World Health Organization. (1996). Composite International Diagnostic Interview (CIDI): Traumatic Events List (Vol. CIDI 2.0). Geneva: World Health Organization.
World Health Organization. (2018). International Classification of Diseases 11th Revision: The global standard for diagnostic health information Retrieved 17 July 2018, from https://icd.who.int/