Publications of Interest

Summer 2016 Publications

Kazlauskas E, Javakhishvilli J, Meewisse M, Merecz-Kot D, Şar V, Schäfer I, Schnyder U, Gersons BP. (2016). “Trauma treatment across Europe: where do we stand now from a perspective of seven countries.” European Journal of Psychotraumatology. 2016 Mar 18;7:29450. doi: 10.3402/ejpt.v7.29450. eCollection 2016. PubMed PMID: 26996534; PubMed Central PMCID: PMC4800285. There is a lack of knowledge about the state of affairs of the trauma treatments in Europe. To start to fill in this gap, key persons from seven European countries-Georgia, Germany, Lithuania, the Netherlands, Poland, Switzerland, and Turkey-accepted the invitation to give their expert opinion on the state of affairs in their country at an invited panel discussion at the XIV 2015 ESTSS Conference in Vilnius, Lithuania. Brief reports from the seven countries reveal significant diversities among different European countries in terms of awareness of health problems related to trauma, the availability of trauma treatments, and treatment approaches. Political and economic differences across the European countries contribute to the diversities in the developments of trauma treatments. European national psychotrauma societies are active in establishing training curricula and dissemination of trauma-focused treatments. Despite the growing acknowledgment of trauma and dissemination of trauma-focused treatments, there is a lack of Europe-wide policies to ensure availability of trauma treatment in Europe for trauma survivors. The need for more detailed analysis of trauma treatment in all European countries and development of European-level trauma-informed health care policies is outlined. Reprints: Department of Clinical and Organizational Psychology, Vilnius University, Vilnius, Lithuania Email:   Hyland P, Shevlin M, Elklit A, Murphy J, Vallières F, Garvert DW, Cloitre M. (2016). “An Assessment of the Construct Validity of the ICD-11 Proposal for Complex Posttraumatic Stress Disorder.” Journal of Psychological Trauma. 2016 Mar 7. [Epub ahead of print] PubMed PMID: 26950013. BACKGROUND: A new diagnosis, complex posttraumatic stress disorder (CPTSD), is set to be introduced in the 11th revision to the International Classification of Diseases (ICD-11). Studies have supported a unique group of trauma-exposed individuals who exhibit symptoms consistent with CPTSD proposals. No studies have yet tested the proposed latent symptom structure of CPTSD proposed for ICD-11. This study tests the factorial validity of CPTSD and assesses the role of a range of risk factors to predict CPTSD. METHOD: A large sample (N = 453) of treatment-seeking adult victims of childhood sexual abuse completed self-report measures of CPTSD. Confirmatory factor analysis (CFA) was used to compare a set of alternative factor models of CPTSD. RESULTS: Just less than half of the sample met the diagnostic criteria for CPTSD (42.8%). CFA results supported the factorial validity of the ICD-11 proposals for CPTSD. Being female and experiencing a greater number of sexual abuse acts during childhood were more strongly associated with PTSD than CPTSD symptoms. Regarding symptoms, anxiety was more strongly associated with PTSD than CPTSD, whereas higher levels of dysthymia were more strongly associated with CPTSD than PTSD symptoms. CONCLUSIONS: Results provide initial evidence regarding the factorial validity of the proposed ICD-11 model of CPTSD. In addition, current results support the proposals of the ICD-11 that exposure to abuse during early development is associated with a greater likelihood of CPTSD than PTSD. The study contributes to a growing body of empirical data supporting the construct validity of CPTSD as a unique diagnostic entity.   Knefel M, Garvert DW, Cloitre M, Lueger-Schuster B. (2015) “Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): a latent profile analysis.” European Journal of Psychotraumatology. 2015 Jan 2;6:25290. doi: 10.3402/ejpt.v6.25290. eCollection 2015. PubMed PMID: 25557561; PubMed Central PMCID: PMC4283031. BACKGROUND: The World Health Organization (WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD) separate and distinct from posttraumatic stress disorder (PTSD). OBJECTIVE: To determine whether the symptoms endorsed by individuals who had experienced childhood institutional abuse form classes that are consistent with diagnostic criteria for ICD-11 CPTSD as distinct from PTSD. METHODS: A latent profile analysis (LPA) was conducted on 229 adult survivors of institutional abuse using the Brief Symptom Inventory and the PTSD Checklist-Civilian Version to assess current psychopathological symptoms. RESULTS: The LPA revealed four classes of individuals: (1) a class with elevated symptoms of CPTSD (PTSD symptoms and disturbances in self-organization); (2) a class with elevated symptoms of PTSD and low disturbances in self-organization; (3) a class with elevated disturbances in self-organization symptoms and some elevated PTSD symptoms; and (4) a class with low symptoms. CONCLUSIONS: The results support the existence of a distinct group in our sample, that could be described by the proposed diagnostic category termed CPTSD more precisely than by normal PTSD. In addition, there seems to be a group of persons that do not fulfill the criteria for a trauma-related disorder but yet suffer from psychopathological symptoms. Reprints: Faculty of Psychology, University of Vienna, Vienna, Austria Email: If you have published an article or know of an article that you think should be included in this column, please send the complete citation, and if possible, reprint address and email, to Dan Nothmann, Psy.D., 20 Crossroads Dr., Ste. 103, Owings Mills, MD 21117 or email it to Copies of complete articles are especially welcome.