Journal
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY
Volume 58, Issue 2, Pages 160-168Publisher
WILEY
DOI: 10.1111/jcpp.12640
Keywords
Complex posttraumatic stress disorder; Trauma-Focused Cognitive Behavioral Therapy; International Classification of Diseases; diagnostic category
Categories
Funding
- German Ministry of Education and Research [01GY1141]
- European Commission
- German Federal Ministry of Education and Research
- German Federal Ministry for Families, Youth and Elderly People
- German Federal Ministry of Health
- Mucoviscidosis Institute
- Kinderherzstiftung
- Deutsche Kinderkrebsnachsorge Stiftung
- Deutsche Krebshilfe
- Jose Carreras Stiftung
- Vertex Pharmaceuticals Inc.
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BackgroundTo evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). MethodsLatent classes analysis (LCA) was used to explore the symptom profiles of the clinical baseline assessment of N=155 children and adolescents participating in a randomized controlled trial of TF-CBT. The treatment outcomes of patients with posttraumatic stress disorder (PTSD) and of patients with CPTSD were compared by a t-test for depended samples and a repeated-measures ANOVA. ResultsThe LCA revealed two distinct classes: a PTSD class characterized by elevated core symptoms of PTSD (n=62) and low symptoms of disturbances in self-organization versus a complex PTSD class with elevated PTSD core symptoms and elevated symptoms of disturbances in self-organization (n=93). The Group x Time interaction regarding posttraumatic stress symptoms was not significant. Pre-post effect sizes regarding posttraumatic stress symptoms were large for both groups (PTSD: d=2.81; CPTSD: d=1.37). For disturbances in self-organization in the CPTSD class, we found medium to large effect sizes (d=0.40-1.16) after treatment with TF-CBT. ConclusionsThe results provide empirical evidence of the ICD-11 CPTSD and PTSD distinction in a clinical sample of children and adolescents. In terms of relative improvement from their respective baseline posttraumatic stress symptoms, patients with PTSD and CPTSD responded equally to TF-CBT; however, those with CPTSD ended treatment with clinically and statistically greater symptoms than those with PTSD.
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