PTSD and complex PTSD assessed with the International Trauma Interview across three trauma-affected clinical samples - 24/10/26

Doi : 10.1016/j.ejtd.2026.100777

Hinuga Sandahl ^a,^b,^d,^e,^⁎ , Maja Bruhn ^a,^c, Sofie Folke ^g, Lars Ravnborg Nissen ^g, Caroline Fabricius ^a, Charlotte Sonne ^a, Anna Bolette Lund Nielsen ^a,^c, Laura Eybye Fonnesbaek ^c,^f, Jessica Carlsson ^a,^b,^c

^a Competence Centre for Transcultural Psychiatry, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark

^b Centre for Culture and the Mind, University of Copenhagen, Copenhagen, Denmark

^c Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

^d Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

^e Department of Occupational and Social Medicine, Holbæk University Hospital, Holbæk, Denmark

^f Psychotherapeutic Unit, Copenhagen University Hospital – Herlev and Gentofte, Herlev, Denmark

^g Department of Military Psychology, Danish Veterans Centre, Copenhagen, Denmark

^⁎ Corresponding author:

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Saturday 24 October 2026

Abstract

Background

Complex post-traumatic stress disorder (CPTSD) is an ICD-11 diagnosis characterised by symptoms of disturbances in self-organisation (DSO) in addition to symptoms of post-traumatic stress disorder (PTSD). This study compared PTSD and CPTSD across three trauma-affected clinical samples.

Methods

The study included veterans ( n = 123), outpatients with a migrant background ( n = 50), and psychiatric outpatients ( n = 50). PTSD and CPTSD were assessed with the International Trauma Interview (ITI). First, the three samples were compared regarding characteristics. Second, CPTSD subsamples were compared across samples. Third, participants with CPTSD were compared with those with PTSD or no diagnosis in a pooled outpatient sample and separately in the veteran sample.

Results

The samples differed in trauma exposure and sociodemographic characteristics. War-related trauma predominated in the veteran and outpatients with a migrant background samples, whereas sexual assault was most frequent in the psychiatric outpatient sample. A high proportion of participants met ITI criteria for CPTSD across all three samples. Among participants with CPTSD, total symptom severity was similar across samples, but symptom profiles differed: veterans and outpatients with a migrant background showed relatively higher DSO symptoms, whereas psychiatric outpatients showed relatively higher PTSD symptoms. CPTSD was associated with greater functional impairment and more severe depressive symptoms and sexual assault was more frequently reported among participants with CPTSD than among those with PTSD or no diagnosis.

Discussion

A high proportion of participants met ITI criteria for CPTSD across all three trauma-affected clinical samples, although the observed proportions should be interpreted in light of differences in recruitment and clinical context. Symptom profiles varied across samples, and differences between participants with PTSD and CPTSD were observed in functional impairment, depressive symptoms, and trauma exposure. These findings suggest that CPTSD presentation may vary in relation to not only trauma exposure but broader clinical and contextual characteristics.

Le texte complet de cet article est disponible en PDF.

Keywords : International trauma Interview, Posttraumatic stress disorder, Complex posttraumatic stress disorder, ICD-11, migrant