Complex posttraumatic stress disorder (CPTSD) following captivity: a 24-year longitudinal study

Figures & data

Figure 1. Latent class model for PTSD and CPTSD in 2008 with predictors (1991) and distal outcomes (2015).

Table 1. Items representing PTSD and CPTSD.

	Symptom cluster	Questionnaire item
PTSD	Re-experiencing	PTSD-I no. 2.	Recurrent nightmares about captivity
		PTSD-I no. 3.	Feeling as though the event is happening again
	Avoidance	PTSD-I no.5.	Avoiding thoughts and feelings associated with captivity
		PTSD-I no.6	Avoiding activities that remind you of captivity
	Sense of threat	PTSD-I no. 16	Hypervigilance or feeling on guard
		PTSD-I no. 17	Jumpy or easily startled
CPTSD	Affect dysregulation	SCL-90 no.24/BSI no.13.	Temper outbursts
		SCL-90 no.34/BSI no.20.	Your feelings being easily hurt
	Negative self-concept	SCL-90 no.79/BSI no.50.	Feelings of worthlessness
		SCL-90 no.89/BSI no.52.	Feelings of guilt
	Interpersonal disturbances	SCL-90 no.88/BSI no.44.	Never feeling close to another person
		SCL-90 no.77/BSI no.14.	Feeling lonely even when you are with people

Table 2. Rates of Endorsement of each PTSD and DSO Symptom Clusters.

	Count	%
Re-experiencing (RE)	149	84.2
Avoidance (AV)	138	78.9
Sense of Threat (SoT)	157	88.7
Affective Dysregulation (AD)	85	49.7
Negative Self-Concept (NSC)	48	28.6
Disturbed Relationships (DR)	79	46.5

Table 3. Fit Statistics for Latent Class Analysis of PTSD and DSO Symptom Clusters.

Classes	Log-likelihood	AIC	BIC	ssaBIC	LMR-A p	Entropy
1	−566.440	1144.881	1163.937	1144.937
2	−473.876	973.752	1015.042	973.873	180.157 .000	.770
3	−451.349	942.699	1006.222	942.885	43.843 .000	.860
4	−444.803	943.605	1029.361	943.857	12.742 .188	.875
5	−440.551	949.103	1057.092	949.420	8.274 .034	.941
6	−438.119	958.237	1088.460	958.620	4.735 .037	.913

AIC = Akaike Information Criteria, BIC = Bayesian Information Criteria, ssaBIC = Sample-size adjusted Bayesian Information Criteria, LMR-A = Lo-Mendell-Rubin adjusted likelihood ratio test.

Figure 2. Three-class LCA profile plot.

Table 4. Results from multinomial logistic regression predicting latent classes (2008).

Predictors (1981)	Class 2: PTSD OR (95% CI)	Class 3: CPTSD OR (95% CI)
Age	1.74 (0.87–3.49)	0.77 (0.62–0.97)
Physical suffering	1.16 (0.54–2.48)	0.61 (0.25–1.49)
Psychological suffering	0.82 (0.32–2.11)	3.00 (1.13–7.95)
Combat severity	1.49 (0.51–4.35)	1.91 (0.56–6.46)
UCLA Loneliness	1.02 (0.92–1.14)	2.61 (0.8–8.53)
Stressful life events	1.74 (0.87–3.49)	0.99 (0.89–1.11)

Table 5. Distal Outcome Differences across Latent Classes.

	Physical Health	Functional Impairment	Loneliness	Montreal Cognitive Assessment	Dissociation
	Mean (se)	Mean (se)	Mean (se)	Mean (se)	Mean (se)
Baseline (Class 1)	2.85 (.18)	1.48 (.11)	2.44 (.16)	25.11 (.41)	1.66 (.11)
PTSD (Class 2)	3.12 (.10)	2.12 (.09)	2.63 (.09)	24.72 (.24)	2.06 (.09)
CPTSD (Class 3)	3.65 (.10)	2.85 (.13)	3.35 (.09)	23.48 (.31)	2.98 (.17)
	χ^2 (df) p	χ^2 (df) p	χ^2 (df) p	χ^2 (df) p	χ^2 (df) p
Overall test	20.82 (2) .00	59.42 (2) .00	40.50 (2).00	12.93 (2) .00	41.828 (2) .00
Class 1 vs. 2	1.54 (1) .21	17.83 (1) .00	1.05 (1) .30	0.64 (1) .42	07.406 (1) .00
Class 1 vs. 3	14.08 (1) .00	59.14 (1) .00	23.86 (1) .00	9.72 (1) .00	41.820 (1) .00
Class 2 vs. 3	13.43 (1) .00	18.91 (1) .00	30.61 (1) .00	9.48 (1) .00	23.035 (1) .00