Personality dysfunction and complex posttraumatic stress disorder among chronically traumatized Bosnian refugees

Area of Science:

• Psychiatry
• Clinical Psychology
• Trauma Studies

Background:

• Complex posttraumatic stress disorder (CPTSD) is proposed for ICD-11.
• Disorders of extreme stress not otherwise specified (DESNOS) require further investigation.
• Refugee populations experience high rates of trauma-related disorders.

Purpose of the Study:

• To investigate the overlap between DESNOS and Axis I/II disorders in Bosnian refugees.
• To examine the relationship between DESNOS, personality disorders (PDs), and childhood maltreatment.
• To evaluate the proposed CPTSD symptom constellation in the context of trauma-related symptomatology.

Main Methods:

• Self-report questionnaires administered to 116 treatment-seeking Bosnian refugees.
• Assessment of DESNOS, Axis I syndromes, and Axis II (personality) disorders.
• Analysis of symptom overlap and demographic factors (sex, history of maltreatment).

Main Results:

• High prevalence of DESNOS overlapped significantly with schizotypal and paranoid personality disorders.
• A substantial prevalence of Axis I syndromes was also observed in the refugee sample.
• DESNOS and PD-like states were present even in refugees without a history of childhood maltreatment.
• No significant sex differences were found between DESNOS and PD presentations.

Conclusions:

• DESNOS in this refugee sample exhibited characteristics of both Axis I and Axis II disorders.
• The findings partially support the proposed symptom constellation for CPTSD in ICD-11.
• CPTSD may share considerable resemblance with personality disorders, warranting further research.