Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)

This letter to the editor responds to a recent EJPT editorial and following commentary which express concerns about the validity of the ICD-11 complex PTSD (CPTSD) diagnosis. Achterhof and colleagues caution that latent profile analyses and latent class analyses, which have been frequently used to d...

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Main Authors: Marylène Cloitre, Chris R. Brewin, Jonathan I. Bisson, Philip Hyland, Thanos Karatzias, Brigitte Lueger-Schuster, Andreas Maercker, Neil P. Roberts, Mark Shevlin
Format: Article
Language:English
Published: Taylor & Francis Group 2020-12-01
Series:European Journal of Psychotraumatology
Subjects:
Online Access:http://dx.doi.org/10.1080/20008198.2020.1739873
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spelling doaj-b989afd8f9b4435bae6dcdfb380719842021-06-25T11:10:02ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662020-12-0111110.1080/20008198.2020.17398731739873Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)Marylène Cloitre0Chris R. Brewin1Jonathan I. Bisson2Philip Hyland3Thanos Karatzias4Brigitte Lueger-Schuster5Andreas Maercker6Neil P. Roberts7Mark Shevlin8VA Palo Alto Health Care SystemUniversity College LondonCardiff UniversityMaynooth UniversityRivers Centre for Traumatic StressUniversity of ViennaUniversity of ZurichCardiff & Vale University Health BoardUlster UniversityThis letter to the editor responds to a recent EJPT editorial and following commentary which express concerns about the validity of the ICD-11 complex PTSD (CPTSD) diagnosis. Achterhof and colleagues caution that latent profile analyses and latent class analyses, which have been frequently used to demonstrate the discriminative validity of the ICD-11 PTSD and CPTSD constructs, have limitations and cannot be relied on to definitively determine the validity of the diagnosis. Ford takes a broader perspective and introduces the concept of ‘cPTSD’ which describes a wide ranging set of symptoms identified from studies related to DSM-IV, DSM-V and ICD-11 and proposes that the validity of the ICD-11 CPTSD is in question as it does not address the multiple symptoms identified from previous trauma-related disorders. We argue that ICD-11 CPTSD is a theory-driven, empirically supported construct that has internal consistency and conceptual coherence and that it need not explain nor resolve the inconsistencies of past formulations to demonstrate its validity. We do agree with Ford and with Achterhof and colleagues that no one single statistical process can definitively answer the question of whether CPTSD is a valid construct. We reference several studies utilizing many different statistical approaches implemented across several countries, the overwhelming majority of which have supported the validity of ICD-11 as a unique construct. We conclude with our own cautions about ICD-11 CPTSD research to date and identify important next steps.http://dx.doi.org/10.1080/20008198.2020.1739873icd-11complex ptsdcptsd
collection DOAJ
language English
format Article
sources DOAJ
author Marylène Cloitre
Chris R. Brewin
Jonathan I. Bisson
Philip Hyland
Thanos Karatzias
Brigitte Lueger-Schuster
Andreas Maercker
Neil P. Roberts
Mark Shevlin
spellingShingle Marylène Cloitre
Chris R. Brewin
Jonathan I. Bisson
Philip Hyland
Thanos Karatzias
Brigitte Lueger-Schuster
Andreas Maercker
Neil P. Roberts
Mark Shevlin
Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)
European Journal of Psychotraumatology
icd-11
complex ptsd
cptsd
author_facet Marylène Cloitre
Chris R. Brewin
Jonathan I. Bisson
Philip Hyland
Thanos Karatzias
Brigitte Lueger-Schuster
Andreas Maercker
Neil P. Roberts
Mark Shevlin
author_sort Marylène Cloitre
title Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)
title_short Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)
title_full Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)
title_fullStr Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)
title_full_unstemmed Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020)
title_sort evidence for the coherence and integrity of the complex ptsd (cptsd) diagnosis: response to achterhof et al., (2019) and ford (2020)
publisher Taylor & Francis Group
series European Journal of Psychotraumatology
issn 2000-8066
publishDate 2020-12-01
description This letter to the editor responds to a recent EJPT editorial and following commentary which express concerns about the validity of the ICD-11 complex PTSD (CPTSD) diagnosis. Achterhof and colleagues caution that latent profile analyses and latent class analyses, which have been frequently used to demonstrate the discriminative validity of the ICD-11 PTSD and CPTSD constructs, have limitations and cannot be relied on to definitively determine the validity of the diagnosis. Ford takes a broader perspective and introduces the concept of ‘cPTSD’ which describes a wide ranging set of symptoms identified from studies related to DSM-IV, DSM-V and ICD-11 and proposes that the validity of the ICD-11 CPTSD is in question as it does not address the multiple symptoms identified from previous trauma-related disorders. We argue that ICD-11 CPTSD is a theory-driven, empirically supported construct that has internal consistency and conceptual coherence and that it need not explain nor resolve the inconsistencies of past formulations to demonstrate its validity. We do agree with Ford and with Achterhof and colleagues that no one single statistical process can definitively answer the question of whether CPTSD is a valid construct. We reference several studies utilizing many different statistical approaches implemented across several countries, the overwhelming majority of which have supported the validity of ICD-11 as a unique construct. We conclude with our own cautions about ICD-11 CPTSD research to date and identify important next steps.
topic icd-11
complex ptsd
cptsd
url http://dx.doi.org/10.1080/20008198.2020.1739873
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