Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.
Hertfordshire Partnership University NHS Foundation Trust, St Albans, UK.
J Child Psychol Psychiatry. 2024 Jun;65(6):822-831. doi: 10.1111/jcpp.13918. Epub 2023 Nov 22.
Complex PTSD (CPTSD) is a relatively new diagnosis. The objective of the present study was to investigate how trauma characteristics, comorbid psychopathology and cognitive and social factors experienced by children and adolescents with a posttraumatic stress disorder (PTSD) diagnosis following exposure to multiple traumatic events differs between those who meet the criteria for CPTSD and those who do not.
The present research used baseline data from the DECRYPT trial (BMJ Open, 2021, 11, e047600). Participants (n = 120) were aged 8-17 years and had exposure to multiple traumas and a PTSD diagnosis. The data collected comprised self-report and parent/caregiver-report questionnaires and interviews. Three primary analyses were conducted, comparing number of trauma types, prevalence of sexual trauma and prevalence of intrafamilial abuse between the CPTSD and PTSD-only groups. A range of comorbid psychopathology and cognitive and social factors were compared between the groups in an exploratory secondary analysis. All analyses were preregistered.
The CPTSD group (n = 72, 60%) had a significantly higher frequency of sexual trauma than the PTSD-only group (n = 48, 40%). The groups did not significantly differ on number of trauma types or prevalence of intrafamilial abuse. From the secondary analysis, the CPTSD group were found to have significantly higher scores on measures of negative post-traumatic cognitions, depression and panic. These results were replicated in correlation analyses using a continuous measure of CPTSD symptoms.
A large proportion of youth exposed to multiple traumatic events met criteria for CPTSD. Sexual trauma appears to be related to CPTSD symptoms. Youth with CPTSD appear to have greater severity of comorbid depression and panic symptoms, as well as more negative post-traumatic cognitions. Further investigation could focus on the directionality and mechanisms for these associations.
复杂性创伤后应激障碍（CPTSD）是一种相对较新的诊断。本研究的目的是调查经历多次创伤性事件后被诊断为创伤后应激障碍（PTSD）的儿童和青少年中，符合 CPTSD 标准与不符合 CPTSD 标准者之间，创伤特征、合并症精神病理学以及认知和社会因素有何不同。
本研究使用了 DECRYPT 试验（BMJ Open，2021，11，e047600）的基线数据。参与者（n=120）年龄在 8-17 岁之间，经历了多次创伤和 PTSD 诊断。收集的数据包括自我报告和父母/照顾者报告的问卷和访谈。进行了三项主要分析，比较 CPTSD 组和 PTSD 组之间的创伤类型数量、性创伤发生率和家庭内虐待发生率。在探索性二次分析中比较了两组之间的一系列合并症精神病理学以及认知和社会因素。所有分析均预先注册。
CPTSD 组（n=72，60%）性创伤发生率明显高于 PTSD 组（n=48，40%）。两组在创伤类型数量或家庭内虐待发生率上无显著差异。从二次分析中发现，CPTSD 组在创伤后消极认知、抑郁和惊恐等方面的评分明显更高。使用 CPTSD 症状的连续测量值进行相关分析，结果得到了复制。
很大一部分经历多次创伤事件的青少年符合 CPTSD 标准。性创伤似乎与 CPTSD 症状有关。CPTSD 青少年似乎有更严重的合并症抑郁和惊恐症状，以及更多的创伤后消极认知。进一步的研究可以集中在这些关联的方向性和机制上。
