Zerach Gadi, Shevlin Mark, Cloitre Marylene, Solomon Zahava
Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel.
School of Psychology, Ulster University, Coleraine Campus, Coleraine, Northern Ireland.
Eur J Psychotraumatol. 2019 May 28;10(1):1616488. doi: 10.1080/20008198.2019.1616488. eCollection 2019.
: The World Health Organization(WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a new trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD), separate and distinct from posttraumatic stress disorder (PTSD). However, to date, no study has examined CPTSD over time. : This prospective study aimed to examine predictors and outcomes of latent classes of PTSD and CPTSD following war captivity. : A sample of 183 Israeli former prisoners of the 1973 Yom Kippur War (ex-POWs) participated in a 24-year longitudinal study with three waves of measurements (T1: 1991, T2: 2008, and T3: 2015). Participants completed validated self-report measures, and their cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). : Estimated rates of PTSD and CPTSD were high at all waves, with PTSD rates higher than CPTSD. A Latent Class Analysis (LCA) identified three main classes at T2: (1) a small class with low probability to meet PTSD and CPTSD clusters criteria (15.26%); (2) a class high only in PTSD symptoms (42.37%) and (3) a class high only in CPTSD symptoms (42.37%). Importantly, higher levels of psychological suffering in captivity at T1 were associated with higher odds of being in the CPTSD class at T2. In addition, CPTSD at T2 was more strongly associated with low self-rated health, functional impairment, and cognitive performance at T3, compared to the PTSD only class. : Adulthood prolonged trauma of severe interpersonal intensity such as war captivity is related to CPTSD, years after the end of the war. Exposure to psychological suffering in captivity is a risk factor for future endorsement of CPTSD symptoms. CPTSD among ex-POWs is a marker for future dire mental health and functional consequences.
世界卫生组织(WHO)《国际疾病分类》第11版(ICD - 11)提出了一种与创伤后应激障碍(PTSD)不同的、新的与创伤相关的复杂创伤后应激障碍(CPTSD)诊断。然而,迄今为止,尚无研究对CPTSD进行长期研究。 本前瞻性研究旨在探讨战争囚禁后PTSD和CPTSD潜在类别预测因素和结果。 183名1973年赎罪日战争的以色列前战俘(前战俘)样本参与了一项为期24年的纵向研究,进行了三轮测量(T1:1991年,T2:2008年和T3:2015年)。参与者完成了经过验证的自我报告测量,并使用蒙特利尔认知评估(MoCA)评估了他们的认知表现。 所有测量轮次中PTSD和CPTSD的估计发生率都很高,PTSD发生率高于CPTSD。潜在类别分析(LCA)在T2时确定了三个主要类别:(1)一个小类别,符合PTSD和CPTSD集群标准的可能性较低(15.26%);(2)一个仅PTSD症状较高的类别(42.37%)和(3)一个仅CPTSD症状较高的类别(42.37%)。重要的是,T1时囚禁期间较高的心理痛苦水平与T2时处于CPTSD类别的较高几率相关。此外,与仅PTSD类别相比,T2时的CPTSD与T3时较低的自评健康、功能损害和认知表现更密切相关。 成年期长期遭受严重人际强度创伤(如战争囚禁)与战争结束多年后的CPTSD有关。囚禁期间遭受心理痛苦是未来认可CPTSD症状的一个风险因素。前战俘中的CPTSD是未来严重心理健康和功能后果的一个标志。
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