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

Published version
Peer-reviewed

Type

Article

Change log

Authors

Elliott, Rachel 
McKinnon, Anna 
Dixon, Clare 
Boyle, Adrian 
Murphy, Fionnuala 

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.

Description

Keywords

Complex PTSD, International Classification of Diseases, Post-traumatic stress disorder, adolescent, child, trauma, Adolescent, Child, Diagnostic and Statistical Manual of Mental Disorders, Humans, International Classification of Diseases, Prevalence, Prospective Studies, Stress Disorders, Post-Traumatic

Journal Title

J Child Psychol Psychiatry

Conference Name

Journal ISSN

0021-9630
1469-7610

Volume Title

62

Publisher

Wiley
Sponsorship
Wellcome Trust (via University of Oxford) (107496/Z/15/Z?)
Economic and Social Research Council (ES/R010781/1)
Medical Research Council (MC_U105559837)
Medical Research Council (MC_UU_00005/10)
Wellcome Trust (104908/Z/14/Z)