Unravelling the Complexities of Traumatic Stress Disorders: The ICD-11 Perspective

Traumatic stress disorders, particularly Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD), have long been the subject of intense research. The unique blend of individual psychological responses, societal factors, and neurobiological processes makes these conditions intricate puzzles. Recently, the International Classification of Diseases 11th Revision (ICD-11) proposed a fresh framework to better understand and delineate these disorders, bringing forth exciting and insightful alternatives.

In a study titled “Alternative models of disorders of traumatic stress based on the new ICD-11 proposals,” by Shevlin et al. (2017), researchers sought to validate the factorial distinction between PTSD and CPTSD proposed by ICD-11. They attempted to fill the gap in literature by using a broader range of symptoms and standardized measures, rather than simply focusing on individual scales.

Method and Findings

The study was conducted among individuals referred to a National Health Service (NHS) trauma centre in Scotland, totalling 195 participants. They completed measures covering stressful life events, DSM-5 PTSD, emotion dysregulation, self-esteem, and interpersonal difficulties.

Results revealed that the best-fit model incorporated six primary factors: re-experiencing, avoidance of traumatic reminders, sense of threat, affective dysregulation, negative self-concept, and disturbances in relationships. These fell into two secondary categories: PTSD and disturbances in self-organisation (DSO). Importantly, the model presented good concurrent validity.

Interestingly, childhood trauma was found to correlate more strongly with DSO than with PTSD. This finding highlights the critical impact of early life experiences on the development of complex trauma responses.

Concluding Insights

Overall, the study results provide robust support for the ICD-11 proposals for PTSD and CPTSD, underscoring the value of a nuanced, multi-factorial approach to understanding disorders of traumatic stress. This approach not only improves diagnostic clarity but also provides a solid foundation for creating more tailored and effective therapeutic interventions.

The exploration of trauma’s intricate landscape is a journey, and this study offers a significant step forward. As we continue to unravel the complexities of PTSD and CPTSD, we come closer to a future where trauma-informed care is more precise, personalised, and effective than ever before.


Shevlin, M., Hyland, P., Karatzias, T., Fyvie, C., Roberts, N., Bisson, J. I., Brewin, C. R., & Cloitre, M. (2017). Alternative models of disorders of traumatic stress based on the new ICD-11 proposals. Acta Psychiatrica Scandinavica. https://doi.org/10.1111/acps.12695

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