Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees

Journal of Traumatic Stress
2019

Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees (Article)

Liddell B.J.* , Nickerson A. , Felmingham K.L. , Malhi G.S. , Cheung J. , Den M. , Askovic M. , Coello M. , Aroche J. , Bryant R.A.

^a School of Psychology, University of New South Wales–Sydney, Sydney, Australia
^b School of Psychology, University of New South Wales–Sydney, Sydney, Australia
^c School of Psychological Sciences, University of Melbourne, Melbourne, Australia
^d Department of Psychiatry, Sydney Medical School–Northern, University of Sydney, Sydney, Australia
^e School of Psychology, University of New South Wales–Sydney, Sydney, Australia
^f School of Psychology, University of New South Wales–Sydney, Sydney, Australia
^g NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
^h NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
ⁱ NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
^j School of Psychology, University of New South Wales–Sydney, Sydney, Australia

Abstract

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. © 2019 International Society for Traumatic Stress Studies

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Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074593355&doi=10.1002%2fjts.22453&partnerID=40&md5=37daeff95d85b385bf0eb583d729cae8

DOI: 10.1002/jts.22453

ISSN: 08949867

Original Language: English