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Complex posttraumatic stress disorder (CPTSD) following captivity: a 24-year longitudinal study.
Gadi Zerach1, Mark Shevlin2, Marylene Cloitre3,4
1Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel.
European Journal of Psychotraumatology
|June 14, 2019
Summary
This study reveals that prolonged wartime captivity leads to complex posttraumatic stress disorder (CPTSD) years later. Psychological suffering during captivity predicts CPTSD, which is linked to poorer long-term health and cognitive function.
Area of Science:
- Psychiatry
- Psychology
- Trauma Studies
Background:
- The ICD-11 introduces complex posttraumatic stress disorder (CPTSD) as distinct from posttraumatic stress disorder (PTSD).
- Longitudinal studies on CPTSD development and outcomes are lacking.
- War captivity represents a severe form of prolonged interpersonal trauma.
Purpose of the Study:
- To investigate predictors and outcomes of latent classes of PTSD and CPTSD.
- To examine these trajectories in a cohort of former prisoners of war (ex-POWs).
- To understand the long-term impact of war captivity on mental health.
Main Methods:
- A 24-year prospective longitudinal study with 183 Israeli ex-POWs from the 1973 Yom Kippur War.
- Three waves of data collection (1991, 2008, 2015) using validated self-report measures.
- Latent Class Analysis (LCA) and cognitive assessments (MoCA) were employed.
Main Results:
- High rates of both PTSD and CPTSD were observed across all measurement waves.
- Latent Class Analysis identified three distinct classes: low symptom, PTSD-only, and CPTSD-only.
- Psychological suffering during captivity predicted higher odds of belonging to the CPTSD class.
- CPTSD at T2 was a stronger predictor of adverse outcomes (health, function, cognition) at T3 than the PTSD-only class.
Conclusions:
- Prolonged, severe interpersonal trauma like war captivity is associated with CPTSD.
- Captivity-related psychological suffering is a significant risk factor for developing CPTSD.
- CPTSD in ex-POWs serves as a marker for future negative mental health and functional consequences.
Keywords:
Complex PTSDICD-11PTSDex-POWsprolonged traumawar• We examined predictors and outcomes of latent classes of PTSD and CPTSD among ex-POWs.• A Latent Class Analysis (LCA) identified three main classes.• Psychological suffering in captivity was associated with higher odds of being in the CPTSD.• CPTSD was more strongly associated with low self-rated health, functional and cognitive impairment.
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