Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in DSM-5 and ICD-11 : Clinical and Behavioral Correlates

The American Psychiatric Association and the World Health Organisation provide distinct trauma-based psychiatric diagnoses in the Diagnostic and Statistical Manual, fifth edition (DSM-5), and the 11th version of the International Classification of Diseases (ICD-11), respectively. DSM-5 conceptualises posttraumatic stress disorder (PTSD) as a single, broad diagnosis, whereas two ‘sibling-disorders’ of PTSD and Complex PTSD (CPTSD) are proposed for ICD-11. The objectives of the current study were to (1) compare prevalence rates based on each diagnostic system, (2) identify clinical and behavioural factors that distinguish ICD-11 CPTSD and PTSD diagnoses, and (3) examine the comorbidity rates associated with ICD-11 CPTSD and DSM-5 PTSD. A predominately female, clinical sample (N = 106) completed self-report scales to measure ICD-11 PTSD and CPTSD, DSM-5 PTSD, depression, anxiety, borderline personality disorder (BPD), dissociation, reckless behaviour, and suicidal ideation and self-injurious behaviour (SI/SIB). Significantly more people met diagnostic status as per the DSM-5 guidelines compared to the ICD-11 (90.4% vs 79.8%). An ICD-11 CPTSD diagnosis was distinguishable from an ICD-11 PTSD diagnosis by higher levels of dissociation, depression, and BPD. Comorbidity rates were higher for ICD-11 CPTSD compared to DSM-5 PTSD. The clinical and theoretical implications of these findings are discussed.