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      PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania Translated title: TEPT y TEPT complejo: ICD −11 Actualizaciones de la CIE-11 sobre concepto y medición en el Reino Unido, EE. UU., Alemania y Lituania Translated title: PTSD 和复杂PTSD:在英国、美国、德国和立陶宛 ICD-11 对概念和测量的更新

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          ABSTRACT

          The 11th revision to the World Health Organization’s International Classification of Diseases (ICD-11) proposes two distinct sibling conditions: Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). In this paper, we aim to provide an update on the latest research regarding the conceptual structure and measurement of PTSD and CPTSD using the International Trauma Questionnaire (ITQ) as per ICD-11 proposals in the USA, UK, Germany and Lithuania. Preliminary findings suggest that CPTSD is common in clinical and population samples, although there may be variations across countries in prevalence rates. In clinical samples, preliminary evidence suggests that CPTSD is a more commonly observed condition than PTSD. Preliminary evidence also suggests that the ITQ scores are reliable and valid and can adequately distinguish between PTSD and CPTSD. Further cross-cultural work is proposed to explore differences in PTSD and CPTSD across different countries with regard to prevalence, incidence, and predictors of PTSD and CPTSD.

          La 11ª revisión de la Clasificación Internacional de Enfermedades (CIE-11) de la Organización Mundial de la Salud propone dos afecciones hermanas distintas, el trastorno por estrés postraumático (TEPT) y el TEPT Complejo (TEPT-C). En este artículo, nuestro objetivo es proporcionar una actualización sobre las últimas investigaciones relacionadas con la estructura conceptual y la medición de TEPT y TEPT-C utilizando el Cuestionario Internacional de Trauma (ITQ, siglas en inglés de International Trauma Questionnaire) según las propuestas de la CIE-11 en los Estados Unidos, el Reino Unido, Alemania y Lituania. Los hallazgos preliminares sugieren que el TEPT-C es frecuente en muestras clínicas y de población, aunque puede haber variaciones entre países en las tasas de prevalencia. En muestras clínicas, la evidencia preliminar sugiere que el TEPT-C es una condición más comúnmente observada que el TEPT. La evidencia preliminar también sugiere que las puntuaciones del ITQ son fiables y válidas y pueden distinguir adecuadamente entre TEPT y TEPT-C Se propone un trabajo intercultural adicional para explorar las diferencias en el TEPT y el TEPT-C en los diferentes países con respecto a la prevalencia, la incidencia y los predictores del TEPT y el TEPT-C

          世界卫生组织发布的第11版国际疾病分类(ICD-11)提出了两种不同但相仿的疾病:创伤后应激障碍(PTSD)和复杂PTSD(CPTSD)。在本文中,我们目标是更新关于 PTSD和 CPTSD 在概念结构和测量上的研究进展。我们在英国、美国、德国和立陶宛根据 ICD-11使用国际创伤问卷(ITQ)。初步研究发现显示 CPTSD 在临床和普通人群中普遍存在,尽管在不同国家之间的流行率可能有所不同。在临床样本中,初步证据显示 CPTSD 比 PTSD 更加常见,同时也支持ITQ 分数可以有效可靠地区分 PTSD 和 CPTSD。未来还需要横向研究探索 PTSD 和 CPTSD 在不同国家之间的流行率、发生率和预测指标的区别。

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          The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5.

          There is considerable debate about the cross-cultural applicability of the posttraumatic stress disorder (PTSD) category as currently specified. Concerns include the possible status of PTSD as a Western culture-bound disorder and the validity of individual items and criteria thresholds. This review examines various types of cross-cultural validity of the PTSD criteria as defined in DSM-IV-TR, and presents options and preliminary recommendations to be considered for DSM-5. Searches were conducted of the mental health literature, particularly since 1994, regarding cultural-, race-, or ethnicity-related factors that might limit the universal applicability of the diagnostic criteria of PTSD in DSM-IV-TR and the possible criteria for DSM-5. Substantial evidence of the cross-cultural validity of PTSD was found. However, evidence of cross-cultural variability in certain areas suggests the need for further research: the relative salience of avoidance/numbing symptoms, the role of the interpretation of trauma-caused symptoms in shaping symptomatology, and the prevalence of somatic symptoms. This review also indicates the need to modify certain criteria, such as the items on distressing dreams and on foreshortened future, to increase their cross-cultural applicability. Text additions are suggested to increase the applicability of the manual across cultural contexts: specifying that cultural syndromes-such as those indicated in the DSM-IV-TR Glossary-may be a prominent part of the trauma response in certain cultures, and that those syndromes may influence PTSD symptom salience and comorbidity. The DSM-IV-TR PTSD category demonstrates various types of validity. Criteria modification and textual clarifications are suggested to further improve its cross-cultural applicability. © 2010 Wiley-Liss, Inc.
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            [Post-traumatic stress disorder in Germany. Results of a nationwide epidemiological study].

            In a representative epidemiological study (n=2426) with a broad age range of respondents (14-93 years), prevalence rates of traumatic life events, post-traumatic stress disorder (PTSD), and partial PTSD were estimated. A standardized interview using the trauma checklist of the Composite International Diagnostic Interview and a DSM-IV PTSD symptom checklist (Modified PTSD Symptom Scale) were applied. One-month prevalence rates were 2.3% for DSM-IV PTSD and 2.7% for partial PTSD. There were no gender differences but age-group differences did appear: among persons older than 60, the prevalence of PTSD was 3.4%, whereas the prevalence was estimated at 1.3% among persons aged 14-29 years and 1.9% among those aged 30-59 years. Partial PTSD exhibited the same age distribution, with 3.8% in the elderly, 2.4% in the middle-aged, and 1.3% in young adults. The results correspond with those of other international studies taking war-related consequences for older age groups into account. Our representative study provides the first evidence of higher PTSD prevalence rates among older age groups in the German population, which is assumed to be related to consequences of World War II.
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              Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation

              Background Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated. Results Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure. Conclusion The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                ZEPT
                zept20
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8066
                2017
                15 January 2018
                : 8
                : sup7 , ESTSS Highlights 2017 – Child Maltreatment Across the Lifespan
                : 1418103
                Affiliations
                [ a ] School of Health & Social Care, Edinburgh Napier University , Edinburgh, UK
                [ b ] NHS Lothian, Rivers Centre for Traumatic Stress , Edinburgh, UK
                [ c ] School of Medicine, New York University , USA
                [ d ] National Center for PTSD, Veterans Affairs Palo Alto Health Care System , Palo Alto, CA, USA
                [ e ] Department of Psychology, Psychopathology and Clinical Interventions, University of Zurich , Zurich, Switzerland
                [ f ] Department of Clinical & Organizational Psychology, Vilnius University , Vilnius, Lithuania
                [ g ] School of Psychology, Ulster University , Derry, UK
                [ h ] School of Business, National College of Ireland , Dublin, Ireland
                [ i ] School of Medicine, Cardiff University , Cardiff, UK
                [ j ] Psychology and Counselling Directorate, Cardiff and Vale University Health Board , Cardiff, UK
                [ k ] Clinical, Education & Health Psychology, University College London , London, UK
                Author notes
                CONTACT Thanos Karatzias t.karatzias@ 123456napier.ac.uk Edinburgh Napier University , Sighthill Campus, Sighthill Court, Edinburgh EH11 4BN, Scotland UK
                Author information
                http://orcid.org/0000-0001-6925-3266
                http://orcid.org/0000-0002-6654-6220
                http://orcid.org/0000-0001-6262-5223
                Article
                1418103
                10.1080/20008198.2017.1418103
                5774423
                29372010
                41ff7823-1f63-4812-a5d6-7948db27567e
                © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 July 2017
                : 08 December 2017
                Page count
                Figures: 1, References: 26, Pages: 7
                Categories
                Short Communication
                Short Communication

                Clinical Psychology & Psychiatry
                ptsd,cptsd,itq,prevalence,icd-11,tept,tept-c,prevalencia,cie-11,流行,icd-11,• preliminary findings suggest that the itq is a reliable and valid instrument for the assessment of ptsd and cptsd as per icd-11 proposals.• cptsd is common in clinical samples and populations samples across four countries.• further cross-cultural work on cptsd is proposed.

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