Ukrainians under continuous traumatic stress: towards increasing the diagnostic condition's clinical utility

The World Health Organization would include a diagnosis of Continuous Traumatic Stress (ConTS) Reaction or Disorder in its ICD-11 classification system if there were more empirical evidence to support it. However, research on people experiencing ongoing traumatic experiences is always difficult from an ethical standpoint. Our modest study re-examined the structural validity of the Goral et al. CTS (2021) questionnaire and some predictive relationships in samples of Ukrainians in their home country compared to externally displaced Ukrainians (to Austria).

N = 46 Ukrainians in their war-threatened homeland (mean age = 43 years) and N = 64 Ukrainian refugees in Austria (mean age = 37 years) were examined via online data collection. In addition to the ConTSR scale (ConTSR), traumatic life events (LEC-5), PTSD and CPTSD, and other major psychopathologies were examined. The structural validity of the ConTS was calculated using internal reliabilities of existing factor analyses (FA) and our own exploratory FA.

The factorial structure suggests a two-factor structure with the factors: exhaustion/rage and fear/betrayal. The theoretically more meaningful three-factor structure only achieves borderline reliabilities. Those who stay in Ukraine show higher values in the ConTS subscale exhaustion/rage (and in the single item sense of danger) compared to the values of those who escaped to Austria. The highest correlations were found between the ConTS total scale and the CPTSD cluster of disturbances in self-organization (r = .70) and depression (r = .66), while there were lower correlations with classic PTSD (r = .53) and general emotion dysregulation (r = .55).

This study with two meaningful subsamples provides new insights into the factor structure of the internationally most widely adopted ConTS concept. It indicates for the ConTS concept that it is not classic PTSD but rather CPTSD that shows conceptual similarities.