Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees

• Published in: Journal of traumatic stress 2019-12, Vol.32 (6), p.822-832
• Main Authors: Liddell, Belinda J., Nickerson, Angela, Felmingham, Kim L., Malhi, Gin S., Cheung, Jessica, Den, Miriam, Askovic, Mirjana, Coello, Mariano, Aroche, Jorge, Bryant, Richard A.
• Format: Article
• Language: English
• Subjects: Post traumatic stress disorder; Refugees
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.22453

Although it is well documented that exposure to severe, cumulative trauma and postdisplacement stress increases the risk for posttraumatic stress symptom disorder (PTSD), less is known about the representation and predictors of complex PTSD (CPTSD) symptoms in refugee populations. We examined PTSD and CPTSD symptom profiles (co‐occurring PTSD and disturbances in self‐organization [DSO] symptoms) and their premigration, postmigration, and demographic predictors, using latent class analysis (LCA), in a cohort of 112 refugees resettled in Australia. The LCA identified a four‐factor model as the best fit to the data, comprising classes categorized as: (a) CPTSD, exhibiting high levels of PTSD and DSO symptoms (29.5%); (b) PTSD only (23.5%); (c) high affective dysregulation (AD) symptoms (31.9%); and (d) low PTSD and DSO symptoms (15.1%). Membership in the CPTSD and PTSD classes was specifically associated with cumulative traumatization, CPTSD OR = 1.56, 95% CI [1.15, 2.12], and PTSD OR = 1.64, 95% CI [1.15, 2.34]; and female gender, CPTSD OR = 14.18, 95% CI [1.66, 121.29], and PTSD OR = 16.84, 95% CI [1.78, 159.2], relative to the low‐symptom class. Moreover, CPTSD and AD class membership was significantly predicted by insecure visa status, CPTSD OR = 7.53, 95% CI [1.26, 45.08], and AD OR = 7.19, 95% CI [1.23, 42.05]. These findings are consistent with the ICD‐11 model of CPTSD and highlight the contributions of cumulative trauma to CPTSD and PTSD profiles as well as of contextual stress from visa uncertainty to DSO symptom profiles in refugee cohorts, particularly those characterized by AD. Resumen Spanish s by Asociación Chilena de Estrés Traumático (ACET) Perfiles de Síntomas de Trastorno de Estrés Postraumático Complejo en Refugiados Traumatizados PERFILES DE SÍNTOMAS DE TEPT COMPLEJO EN REFUGIADOS TRAUTATIZADOS Aunque está bien documentado que la exposición a trauma severo y acumulativo y el estrés posterior al desplazamiento en poblaciones de refugiados aumenta el riesgo de trastorno por síntomas de estrés postraumático (TEPT), se conoce menos acerca de la representación y los predictores de síntomas del TEPT complejo (TEPT‐C). Examinamos los perfiles de síntomas de TEPT y TEPT‐C (TEPT concurrente y síntomas de alteraciones en la auto‐organización [DSO en su sigla en inglés]) y su pre‐migración, post‐migración y predictores demográficos, utilizando el análisis de clases latentes (ACL), en una cohorte de 112 refugiados reasentados en Australia. El ACL ide