Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples

Figures & data

Table 1 Items representing PTSD and CPTSD

Factor	Cluster	Test items
PTSD	Re-experiencing	HTQ 3. Recurrent nightmares
		HTQ 2. Feeling as though the event is happening again
	Avoidance	HTQ 15. Avoiding thought or feelings associated with the traumatic or hurtful events
		HTQ 11. Avoiding activities that remind you of the traumatic or hurtful event
	Sense of threat	HTQ 9. Feeling on guard
		HTQ 6. Being jumpy or easily startled
Complex PTSD	Affect dysregulation	TSC 16. Temper outburst that you could not control
		TSC 14. Crying easily
	Negative self-concept	TSC 28. Feelings of inferiority or insecurity
		TSC 29. Blaming yourself
	Interpersonal problems	TSC 6. Feeling isolated from other people
		HTQ 27. Feeling that you have no one to rely upon

Table 2 Example items from the Trauma Symptom Checklist subscales

Item	Subscale
Low sex drive	Depression
Uncontrollable crying
Feelings of inferiority	Anxiety
Having trouble breathing
Feeling that things are “unreal”	Dissociation
“Spacing out”—going away in your mind
Restless sleep	Sleep disturbances
Waking up early in the morning and can't get back to sleep
Headaches	Somatisation
Stomach problems
Trouble getting along with others	Interpersonal sensitivity
Loneliness
Trouble controlling temper	Aggression
Desire to hurt others physically

Table 3 Frequencies and percentages of symptom endorsement for PTSD and DSO symptoms

Group	HTQ 2	HTQ 3	HTQ 15	HTQ 11	HTQ 9	HTQ 6	TSC 16	TSC 14	TSC 28	TSC 29	TSC 6	HTQ 27
Bereaved parents	108	39	54	76	202	174	69	63	43	47	38	57
	33.5%	15.8%	13.5%	19.7%	33.5%	32.4%	27.9%	26.0%	22.3%	21.7%	25.9%	19.8%
Physical assault	66	42	71	80	135	85	34	32	26	30	24	49
	20.5%	17.0%	17.8%	20.7%	22.4%	15.8%	13.8%	13.2%	13.5%	13.8%	16.3%	17.0%
Sexual trauma	148	166	275	230	266	278	144	147	124	140	85	182
	46.0%	67.2%	68.8%	59.6%	44.1%	51.8%	58.3%	60.7%	64.2%	64.5%	57.8%	63.2%
Total	322	247	400	386	603	537	247	242	193	217	147	288
χ^2	34.98	152.98	330.91	194.09	91.87	114.36	75.15	87.88	89.19	107.34	42.35	142.87
df	2	2	2	2	2	2	2	2	2	2	2	2
P	<.01	<.01	<.01	<.01	<.01	<.01	<.01	<.01	<.01	<.01	<.01	<.01

Note: HTQ items were endorsed if a response was 3 or greater; TSC items were endorsed if a response was 2 or greater.

Fig. 1 Profile plot of estimates from latent class analysis of complex PTSD symptoms: sudden infant death sample.

Table 4 Fit statistics for latent class analysis of CPTSD symptoms: bereaved parents sample

Classes	Loglikelihood	AIC	BIC	ssaBIC	LMRA-LRT	BS LRT
1	−2645.088	5314.176	5367.019	5328.922
2	−2282.240	4614.481	4724.570	4645.201	717.082**	725.696**
3	−2218.991	4513.983	4681.318	4560.678	124.996**	126.498**
4	−2192.378	4486.756	4711.339	4549.426	52.595	53.226**
5	−2175.759	4479.518	4761.347	4558.163	32.844*	33.238
6	−2162.437	4478.874	4817.950	4573.494	26.327	26.644

Note: Statistical significance:

** p<.0005

* p<.05. AIC=Akaike information criterion, BIC=Bayesian information criterion, ssaBIC=sample-size-adjusted BIC, LMRA-LRT=Lo–Mendell–Rubin adjusted likelihood ratio test. Best model in bold.

Fig. 2 Profile plot of estimates from latent class analysis of complex PTSD symptoms: sexual trauma sample.

Table 5 Fit Statistics for latent class analysis of complex PTSD symptoms: sexual trauma sample

Classes	Loglikelihood	AIC	BIC	ssaBIC	LMRA- LRT	BS LRT
1	−3381.803	6787.607	6836.891	6798.807
2	−2888.374	5826.747	5929.423	5850.082	974.584**	986.859**
3	−2819.851	5715.702	5871.769	5751.171	135.341**	137.045**
4	−2802.246	5706.493	5915.951	5754.097	34.771	35.209*
5	−2787.336	5702.672	5965.522	5762.411	29.450	29.821
6	−2773.165	5700.331	6016.571	5772.203	27.989	28.341

Note: Statistical significance:

** p<.0005

* p<.05. AIC=Akaike information criterion, BIC=Bayesian information criterion, ssaBIC=sample-size-adjusted BIC, LMRA-LRT=Lo–Mendell–Rubin adjusted likelihood ratio test. Best model in bold.

Fig. 3 Profile plot of estimates from latent class analysis of complex PTSD symptoms: physical assault sample.

Table 6 Fit statistics for latent class analysis of complex PTSD symptoms: physical assault sample

Classes	Loglikelihood	AIC	BIC	ssaBIC	LMRA-LRT	BS LRT
1	−1331.473	2686.946	2727.338	2689.313
2	−1081.286	2212.573	2296.722	2217.504	493.301**	500.373**
3	−1044.629	2165.257	2293.164	2172.752	72.280	73.316**
4	−1026.864	2155.728	2327.393	2165.786	35.027	35.529**
5	−1013.742	2155.483	2370.906	2168.106	25.873	26.244
6	−999.597	2153.194	2412.374	2168.380	27.650	28.047

Note: Statistical significance:

** p<.0005. AIC=Akaike information criterion, BIC=Bayesian information criterion, ssaBIC=sample-size-adjusted BIC, LMRA-LRT=Lo–Mendell–Rubin adjusted likelihood ratio test. Best model in bold.

Table 7 Tests of differences of means of TSC subscales across classes: bereaved parents

	Depression	Anxiety	Dissociation	Sleep disturbance	Somatisation	Interpersonal sensitivity	Aggression
Class 1: CPTSD	2.11 (.06)	1.82 (.06)	1.90 (.07)	2.00 (.09)	1.98 (.07)	2.07 (.06)	1.66 (.06)
Class 2: PTSD	1.63 (.03)	1.44 (.03)	1.42 (.03)	1.58 (.05)	1.49 (.04)	1.49 (.03)	1.30 (.02)
Class 3: Low PTSD/CPTSD	1.39 (.02)	1.17 (.01)	1.20 (.01)	1.29 (.02)	1.24 (.01)	1.32 (.01)	1.16 (.01)
Overall test^ (Wald χ ^2)	208.70*	180.04*	155.12*	93.69*	147.52*	175.54*	106.28*
Pairwise tests^^ (Wald χ ^2)
Class 1 vs. 2	38.14*	59.67*	41.69*	26.87*	37.61*	27.52*	26.21*
Class 1 vs. 3	49.44*	28.51*	38.02*	14.00*	32.38*	67.80*	31.00*
Class 2 vs. 3	150.64*	104.88*	100.84*	55.29*	93.86*	133.77*	72.46*

Note:

^^ all tests df=2

^ all tests df=1. Statistical significance

* p<.01.

Table 8 Tests of differences of means of TSC subscales across classes: sexual trauma victims

	Depression	Anxiety	Dissociation	Sleep disturbance	Somatisation	Interpersonal sensitivity	Aggression
Class 1: CPTSD	2.82 (.06)	2.59 (.07)	2.65 (.07)	2.93 (.08)	2.60 (.07)	2.39 (.70)	2.28 (.08)
Class 2: PTSD	2.14 (.04)	1.88 (.04)	1.92 (.04)	2.20 (.06)	1.88 (.04)	1.89 (.04)	1.78 (.05)
Class 3: Low PTSD/CPTSD	1.47 (.03)	1.31 (.03)	1.36 (.03)	1.50 (.05)	1.32 (.03)	1.40 (.03)	1.26 (.03)
Overall test^ (Wald χ ^2)	259.83*	239.48*	218.65*	162.06*	183.81*	163.69*	118.10*
Pairwise tests^^ (Wald χ ^2)
Class 1 vs. 2	77.88*	85.33*	74.55*	46.04*	69.14*	36.98*	25.94*
Class 1 vs. 3	362.89*	318.65*	282.93*	217.48*	259.42*	180.39*	135.40*
Class 2 vs. 3	163.05*	148.64*	122.72*	77.20*	108.00*	90.53*	87.24*

Note:

^^ all tests df=2

^ all tests df=1. Statistical significance

* p<.01.

Table 9 Tests of differences of means of TSC subscales across classes: physical assault victims

	Depression	Anxiety	Dissociation	Sleep disturbance	Somatisation	Interpersonal sensitivity	Aggression
Class 1: CPTSD	2.71 (.12)	2.55 (.11)	2.57 (.15)	2.88 (.15)	2.66 (.12)	2.34 (.11)	2.11 (.13)
Class 2: PTSD	1.85 (.07)	1.77 (.06)	1.62 (.06)	1.97 (.09)	1.79 (.07)	1.64 (.05)	1.49 (.05)
Class 3: Low PTSD/CPTSD	1.32 (.04)	1.27 (.03)	1.25 (.03)	1.32 (.05)	1.30 (.04)	1.38 (.03)	1.23 (.03)
Overall test^^ (Wald χ ^2)	70.53*	91.90*	43.38*	61.53*	72.11*	50.03*	35.17*
Pairwise tests^ (Wald χ ^2)
Class 1 vs. 2	40.00*	52.40*	28.88*	37.17*	34.20*	17.47*	35.17*
Class 1 vs. 3	111.54*	124.75*	66.51*	89.54*	108.78*	72.26*	45.30*
Class 2 vs. 3	36.32*	38.06*	30.21*	23.77*	36.21*	35.09*	20.27*

Note:

^^ all tests df=2

^ all tests df=1. Statistical significance

* p<.01.