The complexity of trauma exposure and response: Profiling PTSD and CPTSD among a refugee sample

Psychol Trauma. 2019 Feb;11(2):165-175. doi: 10.1037/tra0000408. Epub 2018 Oct 22.


Objective: This study investigated the latent dimensional and categorical structure of ICD-11 complex posttraumatic stress disorder (CPTSD) within a refugee sample.

Method: A subsample that identified as refugee (n = 308) was selected from the National Epidemiological Survey on Alcohol and Related Conditions. Factor mixture modeling (FMM) was employed to establish the dimensional structure of CPTSD symptomology and the categorical distribution of these dimensions. It was then evaluated whether trauma history could differentiate between the distribution of trauma response profiles.

Results: A correlated 6-factor model with 5 latent classes was the best fitting model. Two classes were characterized by symptom profiles that were consistent with ICD-11 CPTSD and PTSD formulations. The remaining classes were characterized by nonspecific variation across dimensions. CPTSD class membership was predicted by traumas that were predominantly interpersonal in nature (serious neglect, physical assault, and sexual assault), whereas PTSD class membership was predicted by situational traumatic experiences (unarmed civilian in a conflict environment and a serious accident). A distinct dose-response effect was evident between cumulative traumatic exposure and CPTSD class membership.

Conclusion: FMM class profiles distinguished between PTSD and CPTSD symptom formulations. Moreover, class membership was determined by specific trauma-exposure histories. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Exposure to Violence
  • Female
  • Humans
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Refugees / psychology*
  • Sex Offenses
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology*
  • Stress Disorders, Post-Traumatic / psychology
  • United States
  • Young Adult