Cultural concepts of distress and complex PTSD: Future directions for research and treatment

Complex post-traumatic stress disorder (CPTSD) was introduced as a new diagnostic category in ICD-11. It encompasses PTSD symptoms along with disturbances in self-organisation (DSO), i.e., affect dysregulation, negative self-concept, and disturbances in relationships. Quantitative research supports the validity of CPTSD across different cultural groups. At the same time, evidence reveals cultural variation in the phenomenology of PTSD, which most likely translates into cultural variation with regard to DSO. This theoretical review aims to set the ground for future research on such cultural aspects in the DSO. It provides a theoretical introduction to cultural clinical psychology, followed by a summary of evidence on cultural research related to PTSD and DSO. This evidence suggests that the way how DSO symptoms manifest, and the underlying etiological processes, are closely intertwined with cultural notions of the self, emotions, and interpersonal relationships and interpersonal relationships. We propose directions for future research and implications for culturally sensitive clinical practice

The International Grief Questionnaire (IGQ): A new measure of ICD-11 Prolonged Grief Disorder.

Prolonged grief disorder (PGD) is included in the 11th version of the International Statistical Classification of Diseases and Related Health Problems (ICD‐11). This study sought to test the validity and reliability of a new brief measure to screen for ICD‐11 PGD—the International Grief Questionnaire (IGQ). The psychometric properties of the IGQ were tested using data collected from two bereaved samples of adults from the United Kingdom (n = 1,012) and Ireland (n = 1,011). Confirmatory factor analysis demonstrated that a correlated two‐factor model best captured the latent dimensionality of the IGQ in both samples. Estimates of internal reliability were high, whereas the convergent and concurrent validity of the scale were supported through strong associations with external measures. Measurement invariance and differential item functioning testing showed no statistically significant difference in the latent structure of the IGQ nor the functioning of the IGQ items by age, sex, and nationality. For participants who were bereaved for more than 6 months, the rates of probable PGD derived from the IGQ were 10.9% and 15.3% for the Irish and U.K. samples, respectively. The IGQ is a brief, easy‐to‐use, self‐report screening measure that captures all diagnostic criteria of PGD set forth in the ICD‐11. Findings from this study provide initial support for the validity, measurement invariance, and reliability of the IGQ among two national samples

The relationship between interpersonal trauma and substance misuse in pregnancy – a narrative review of the literature

BackgroundThere is a strong body of evidence supporting associations between interpersonal trauma (IPT) and substance use; however, this tends to focus on associations between childhood trauma and substance use in non-pregnant populations. Neonatal and obstetric outcomes are poorer among pregnant women with problematic substance use, yet few studies have explored IPT as a possible mechanism underlying their use of substances.AimTo explore the literature regarding the relationship between IPT and substance misuse among pregnant women.MethodA systematic search of relevant databases was conducted and a narrative review of the literature was undertaken. Titles, abstracts and full articles were screened against inclusion criteria. Data were extracted and quality assessed.FindingsA total of 15 studies were identified that suggested associations between negative life events and substance misuse in pregnant women/new mothers.ConclusionsAlthough a link between IPT and substance misuse is suggested, this review has highlighted a number of important gaps in the literature that warrant further investigation. These include a paucity of UK-based studies, and a lack of research that fully explores possible associations between IPT and substance use in pregnant women. Moreover, research to date has employed quantitative methodology

Introduction to the Special Section on Complex Posttraumatic Stress Disorder (CPTSD): The Evolution of a Disorder

The inclusion of complex posttraumatic stress disorder (CPTSD) in the 11th revision of the International Classification of Diseases is an important development in the field of psychotraumatology. Complex PTSD was developed as a response to a clinical need to describe difficulties commonly associated with exposure to traumatic stressors that are predominantly of an interpersonal nature. With this special section, we bring attention to this common condition following exposure to traumatic stressors that only recently has been designated an official diagnosis. In this introduction, we review the history of CPTSD as a new condition and we briefly introduce the papers for the special section in the present issue of the Journal of Traumatic Stress. It is our hope that the work presented in the special section will add to an ever?expanding evidence base. We also hope that this work inspires further research on the cultural validity of CPTSD, its assessment, and treatment

Is Posttraumatic Stress Disorder Meaningful in the Context of the COVID-19 Pandemic? A Response to Van Overmeire's Commentary on Karatzias et al. (2020)

In a recently published study in this journal that used a population‐based sample in the Republic of Ireland (Karatzias et al., 2020), we concluded that 17.7% of the sample met the diagnostic requirements for COVID‐19–related posttraumatic stress disorder (PTSD). Subsequently, Van Overmeire (2020) has raised concerns about the validity of our findings, arguing that simply experiencing the COVID‐19 pandemic is not sufficient to meet the trauma exposure criterion for a PTSD diagnosis and, consequently, our estimated PTSD prevalence figure was inflated. In this response, we provide (a) an explanation for why the COVID‐19 pandemic can be reasonably considered to be a traumatic event, (b) evidence that PTSD in response to the COVID‐19 pandemic is a meaningful construct, and (c) an argument for why our estimated prevalence rate is not unreasonably high

Personally meaningful recovery in people with psychological trauma:initial validity and reliability of the Individual Recovery Outcomes Counter (I.ROC)

Individual Recovery Outcomes Counter (I.ROC) is a brief tool measuring personal recovery designed for collaborative use within support. This study aimed to investigate the psychometric properties of a self‐report version of the I.ROC within a trauma population. A total of 107 adults attending trauma interventions in an NHS service in Scotland completed I.ROC alongside measures of self‐esteem, mental illness symptoms, and functional impairment. Scores on each measure were compared to evaluate the convergent validity of I.ROC. Internal consistency and factor analytical techniques were also used to assess the structural validity and reliability of the measure. Results of internal consistency, convergent validity, and factor analysis provide preliminary support for I.ROC’s validity within a trauma population. Previously proposed models were a poor fit for the current sample; principal components analysis suggested a three‐factor structure with acceptable internal consistency, comprising ten of the original twelve items (I.ROC‐10). Correlations with all measures reached significance for the original and modified I.ROC and its subscales. I.ROC appears to be a valid and reliable tool for use in measuring recovery within a trauma population, but further research is needed to examine the structural validity of I.ROC

The experiences of family carers in the delivery of invasive clinical interventions for young people with complex intellectual disabilities: policy disconnect or policy opportunity?

Aims and objectives. To explore the experiences of family carers in the delivery of invasive clinical interventions within community settings. Background. Many young people with intellectual disabilities present with complex health needs and require clinical interventions to sustain life. As the population lives into older age there is growing demand for the delivery of these interventions within the community setting. Design. An interpretivist qualitative design. Methods. Ten family carers of children with intellectual disabilities and complex care needs requiring invasive clinical interventions participated in semi-structured interviews. Results. There are barriers identified regarding the delivery of invasive clinical interventions in the home setting by social care support workers. These include a reluctance to carry out invasive clinical interventions both for family carers and staff, anxiety, a lack of knowledge and training and difficulties in recruiting appropriate staff. Conclusions. There needs to be strategic policy developments focusing on this population who are cared for in the community and require invasive clinical interventions. Relevance to clinical practice. Registered Nurses have a key role in educating and preparing families and social care support workers to safely deliver invasive clinical interventions in community settings for both children and adults with intellectual disabilities