Is dissociation a fundamental component of ICD-11 Complex Posttraumatic Stress Disorder?

Philip Hyland, Ruby Hamer, Robert Fox, Frédérique Vallières, Thanos Karatzias, M Shevlin, Marylene Cloitre

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
48 Downloads (Pure)


ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a disorder of six symptom clusters including reexperiencing, avoidance, sense of threat, affective dysregulation, negative self-concept, and disturbed relationships. Unlike earlier descriptions of complex PTSD, ICD-11 CPTSD does not list dissociation as a unique symptom cluster. We tested whether the ICD-11 CPTSD symptoms can exist independently of dissociation in a nationally representative sample of adults (N = 1,020) who completed self-report measures. Latent class analysis was used to identify unique subsets of people with distinctive symptom profiles. The best fitting model contained four classes including a “low symptoms” class (48.9%), a “PTSD” class (14.7%), a “CPTSD” class (26.5%), and a “CPTSD + Dissociation” class (10.0%). These classes were related to specific adverse childhood experiences, notably experiences of emotional and physical neglect. The “PTSD,” “CPTSD,” and “CPTSD + Dissociation” classes were associated with a host of poor health outcomes, however, the “CPTSD + Dissociation” class had the poorest mental health and highest levels of functional impairment. Findings suggest that ICD-11 CPTSD symptoms can occur without corresponding dissociative experiences, however, when CPTSD symptoms and dissociative experiences occur together, health outcomes appear to be more severe.
Original languageEnglish
Pages (from-to)45-61
Number of pages17
JournalJournal of Trauma and Dissociation
Issue number1
Early online date4 Jul 2023
Publication statusPublished online - 4 Jul 2023

Bibliographical note

Funding Information:
The author(s) reported there is no funding associated with the work featured in this article.

Publisher Copyright:
© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.


  • complex PTSD
  • ICD-11 CPTSD
  • dissociation
  • trauma


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