Prevalence and predictive value of ICD-11 posttraumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single-event trauma

Rachel Elliott, Anna McKinnon, Clare Dixon, Adrian Boyle, Fionnuala Murphy, Theresa Dahm, Emma Travers-Hill, Cari‐lène Mul, Sarah-Jane Archibald, Patrick Smith, Tim Dalgleish, Richard Meiser-Stedman, Caitlin Hitchcock

Research output: Contribution to journalArticle

5 Citations (Scopus)
9 Downloads (Pure)

Abstract

Background:
The 11th edition of the International Classification of Diseases (ICD‐11) made a number of significant changes to the diagnostic criteria for post‐traumatic stress disorder (PTSD). We sought to determine the prevalence and 3‐month predictive values of the new ICD‐11 PTSD criteria relative to ICD‐10 PTSD, in children and adolescents following a single traumatic event. ICD‐11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD‐11 CPTSD features following exposure to a single‐incident trauma.

Method:
Data were analysed from a prospective cohort study of youth aged 8–17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post‐trauma, allowing us to calculate and compare the prevalence and predictive value of ICD‐10 and ICD‐11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions.

Results:
At Week 9, 15 participants (7%) were identified as experiencing ICD‐11 PTSD, compared to 23 (11%) experiencing ICD‐10 PTSD. There was no significant difference in comorbidity rates between ICD‐10 and ICD‐11 PTSD diagnoses. Ninety per cent of participants with ICD‐11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria.

Conclusions:
Reduced prevalence of PTSD associated with the use of ICD‐11 criteria is likely to reduce identification of PTSD relative to using ICD‐10 criteria but not relative to DSM‐4 and DSM‐5 criteria. Diagnosis of CPTSD is likely to be infrequent following single‐incident trauma.
Original languageEnglish
Pages (from-to)270-276
Number of pages7
JournalJournal of Child Psychology and Psychiatry
Volume62
Issue number3
Early online date28 Apr 2020
DOIs
Publication statusPublished - Mar 2021

Keywords

  • Complex PTSD
  • International Classification of Diseases
  • Post-traumatic stress disorder
  • adolescent
  • child
  • trauma

Cite this