ICD-11 PTSD and Complex PTSD in the United States: A population-based study

Marylène Cloitre, Philip Hyland, Jonathan I. Bisson, C. R. Brewin, N Roberts, Thanos Karatzias, M Shevlin

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The primary aim of this study was to provide an assessment of the current prevalence rates of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) among the adult population of the United States and to identify characteristics and correlates associated with each disorder. A total of 7.2% of the sample met criteria for either PTSD or CPTSD where the prevalence rate for PTSD was 3.4% and for CPTSD was 3.8%. Females were more likely than males to meet criteria for both PTSD and CPTSD. Cumulative adulthood trauma was associated with PTSD and CPTSD, however cumulative childhood trauma was more strongly associated with CPTSD than PTSD. Among traumatic stressors occurring in childhood, sexual and physical abuse by caregivers were identified as events associated with risk for CPTSD while sexual assault (by non-caregiver) and abduction were risk factors for PTSD. Adverse childhood events (ACEs) were associated with both PTSD and CPTSD and equally so. Those with CPTSD reported substantially higher psychiatric burden and lower psychological well-being compared to those with PTSD, and with neither diagnosis.
Original languageEnglish
Pages (from-to)833-842
Number of pages10
JournalJournal of Traumatic Stress
Issue number6
Early online date4 Dec 2019
Publication statusPublished (in print/issue) - 31 Dec 2019


  • posttraumatic stress disorder (PTSD)
  • ; complex PTSD (CPTSD)
  • ; cumulative trauma
  • ; childhood trauma;
  • prevalence.


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