Dissociative Symptoms in Complex Posttraumatic Stress Disorder: A Systematic Review

ABSTRACT

The 11^th revision of the International Classification of Diseases (ICD-11) introduced Complex Posttraumatic Stress Disorder (CPTSD) as a sibling disorder to PTSD. Dissociative symptoms have been implicated in the severity of ICD-11 CPTSD; however, no reviews have investigated how dissociation has been measured in studies investigating CPTSD, nor the relationship between CPTSD and dissociation. This systematic review aimed to identify measures used to assess dissociative symptoms in studies that have assessed CPTSD according to ICD-11 criteria and to synthesize the relationship between these constructs. PsycINFO, PubMed, Scopus and Web of Science were searched on March 31, 2021. Seventeen articles met inclusion criteria. CPTSD was most frequently measured by a version of the International Trauma Questionnaire. Twelve measures were used to assess for dissociative symptoms, the most common being the Dissociative Symptoms Scale and the Dissociative Experiences Scale. The relationship between CPTSD and dissociative symptoms was moderate-to-strong, but inconsistently reported. Further research is needed to determine the most appropriate measure(s) of dissociation in CPTSD.

KEYWORDS:

• Complex PTSD
• complex trauma
• dissociation
• ICD-11
• systematic review

Acknowledgments

We thank Mr. David Bradley at Swinburne University of Technology for his assistance in finalizing the systematic review search strategy. We also thank Professor Glen Bates and Ms. Catherine Brennan for their feedback on an earlier draft of this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data supporting findings of this study are available within this article and supplementary materials.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/15299732.2023.2293785

Systematic review registration

PROSPERO CRD42021246261

Notes

¹ The Screening for Complex PTSD does not measure PTSD symptoms. The Global Psychotrauma Screen was developed in accordance with ICD-11 criteria but is not yet validated. At the time of writing, the Global Collaboration on Traumatic Stress was working to validate it.

Additional information

Funding

The authors did not receive any funding for this study.