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Complex posttraumatic stress disorder in treatment-seeking refugees: the role of trauma history, post-migration stressors and comorbid symptoms.

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Title: Complex posttraumatic stress disorder in treatment-seeking refugees: the role of trauma history, post-migration stressors and comorbid symptoms.
Alternate Title: Trastorno de estrés postraumático complejo en refugiados que buscan tratamiento: el rol de la historia de trauma, los factores de estrés post-migración y los síntomas comórbidos.
Authors: Steil, Regina (AUTHOR), Preiss, Hannah (AUTHOR), Rueger, Mirjam Sophie (AUTHOR), Ehring, Thomas (AUTHOR), Morina, Nexhmedin (AUTHOR), Kuck, Sascha (AUTHOR), Mewes, Ricarda (AUTHOR), Giesebrecht, Julia (AUTHOR), Johow, Johannes (AUTHOR), Weise, Cornelia (AUTHOR), Wittenberg, Michael (AUTHOR), Lechner-Meichsner, Franziska (AUTHOR)
Source: European Journal of Psychotraumatology. Dec2025, Vol. 16 Issue 1, p1-15. 15p.
Subjects: Post-traumatic stress disorder, Refugees, Forced migration, Historical trauma, Medical history taking, Symptom burden, International Statistical Classification of Diseases & Related Health Problems, Comorbidity
Abstract (English): Background: Complex posttraumatic stress disorder (cPTSD) was recently added to the ICD-11. Refugees might be particularly vulnerable to develop this disorder, due to key risk factors including trauma history, comorbid symptoms, and post-migration stressors. However, most prevalence estimates rely on self-report questionnaires, which are less reliable than clinical interviews. This study aimed to assess PTSDICD-11 and cPTSD prevalence in treatment-seeking refugees using clinician ratings, and to examine risk factors influencing diagnostic status and symptom severity. Method: N = 104 treatment-seeking refugees were assessed for cPTSD and PTSDICD-11, as well as symptom severity and single symptom endorsement using a new clinical interview, the Complex PTSD Item Set Additional to the CAPS. Trauma history, comorbid symptoms (dissociation, sleep problems, somatic symptoms, anxiety, depression, social impairment), and post-migration stressors were investigated as predictors for cPTSD diagnostic status and symptom severity using Wilcoxon Rank sum tests, logistic and linear regression. Results: Prevalences for cPTSD and PTSDICD-11 were 14.42% (n = 15) and 63.46% (n = 66), respectively. Participants with and without cPTSD did not differ regarding the frequency of traumatic events experienced. However, cPTSD symptom severity was significantly positively associated with the frequency of experienced traumatic events. In regression analyses, comorbid symptoms were significantly associated with cPTSD diagnostic status and symptom severity with depressive symptoms being a significant predictor. Post-migration stressors were associated with cPTSD diagnostic status and symptom severity, and the perception of the present financial situation was a significant predictor for cPTSD severity. Discussion: The prevalence of cPTSD was relatively low in this refugee sample. This discrepancy to earlier prevalence estimates could be due to the assessment since we used a clinical interview instead of a self-report questionnaire. More investigations into cPTSD diagnostic assessments are needed, and clinical interviews should be used more often. HIGHLIGHTS: Investigation of cPTSD and PTSD diagnostic status, symptom severity and related risk factors in treatment-seeking refugees using a clinical interview. Clinical interviews might provide more reliable cPTSD prevalence estimates than self-reports. Trauma history, comorbid symptoms, and post-migration stressors impacted cPTSD symptom severity. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Antecedentes:El Trastorno de Estrés Postraumático Complejo (TEPTc) fue recientemente agregado a la CIE-11. Los refugiados podrían ser particularmente vulnerables a desarrollar este trastorno debido a factores clave de riesgo, que incluyen la historia de trauma, los síntomas comórbidos y los factores de estrés post-migración. Sin embargo, la mayoría de las estimaciones de prevalencia se basan en cuestionarios de autoinforme, que son menos confiables que las entrevistas clínicas. Este estudio tuvo como objetivo evaluar la prevalencia de TEPTc y TEPT según la CIE-11 en refugiados que buscan tratamiento, utilizando valoraciones clínicas, y examinar los factores de riesgo que influyen en el estado diagnóstico y la severidad de los síntomas. Método: Se evaluaron 104 refugiados que buscaban tratamiento para TEPTc y TEPT según CIE-11, así como la severidad de los síntomas y el endoso de un solo síntoma mediante una nueva entrevista clínica, el conjunto de ítems del TEPT complejo adicional al CAPS. Se investigaron la historia de trauma, los síntomas comórbidos (disociación, problemas de sueño, síntomas somáticos, ansiedad, depresión, deterioro social) y los factores de estrés post-migración como predictores del estado diagnóstico de TEPTc y la severidad de los síntomas, utilizando pruebas de suma de rangos de Wilcoxon, regresión logística y lineal. Resultados: Las prevalencias de TEPTc y TEPT según la CIE-11 fueron 14.42% (n = 15) y 63.46% (n = 66), respectivamente. Los participantes con y sin TEPTc no mostraron diferencias en cuanto a la frecuencia de los eventos traumáticos experimentados. Sin embargo, la severidad de los síntomas de TEPTc se asoció significativamente y de manera positiva con la frecuencia de los eventos traumáticos experimentados. En los análisis de regresión, los síntomas comórbidos se asociaron significativamente con el estado diagnóstico de TEPTc y la severidad de los síntomas, siendo los síntomas depresivos un predictor significativo. Los factores de estrés post-migración se asociaron con el estado diagnóstico de TEPTc y la severidad de los síntomas, y la percepción de la situación financiera actual fue un predictor significativo para la severidad del TEPTc. Discusión: La prevalencia de TEPTc fue relativamente baja en esta muestra de refugiados. Esta discrepancia con las estimaciones previas de prevalencia podría deberse a la evaluación, ya que utilizamos una entrevista clínica en lugar de un cuestionario de autoinforme. Se necesitan más investigaciones sobre las evaluaciones diagnósticas de TEPTc, y las entrevistas clínicas deberían ser utilizadas con mayor frecuencia. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Complex posttraumatic stress disorder in treatment-seeking refugees: the role of trauma history, post-migration stressors and comorbid symptoms.
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  Data: Trastorno de estrés postraumático complejo en refugiados que buscan tratamiento: el rol de la historia de trauma, los factores de estrés post-migración y los síntomas comórbidos.
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  Data: <searchLink fieldCode="AR" term="%22Steil%2C+Regina%22">Steil, Regina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Preiss%2C+Hannah%22">Preiss, Hannah</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rueger%2C+Mirjam+Sophie%22">Rueger, Mirjam Sophie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ehring%2C+Thomas%22">Ehring, Thomas</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Morina%2C+Nexhmedin%22">Morina, Nexhmedin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kuck%2C+Sascha%22">Kuck, Sascha</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mewes%2C+Ricarda%22">Mewes, Ricarda</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Giesebrecht%2C+Julia%22">Giesebrecht, Julia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Johow%2C+Johannes%22">Johow, Johannes</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Weise%2C+Cornelia%22">Weise, Cornelia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wittenberg%2C+Michael%22">Wittenberg, Michael</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lechner-Meichsner%2C+Franziska%22">Lechner-Meichsner, Franziska</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Psychotraumatology%22">European Journal of Psychotraumatology</searchLink>. Dec2025, Vol. 16 Issue 1, p1-15. 15p.
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22Post-traumatic+stress+disorder%22">Post-traumatic stress disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Refugees%22">Refugees</searchLink><br /><searchLink fieldCode="DE" term="%22Forced+migration%22">Forced migration</searchLink><br /><searchLink fieldCode="DE" term="%22Historical+trauma%22">Historical trauma</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+history+taking%22">Medical history taking</searchLink><br /><searchLink fieldCode="DE" term="%22Symptom+burden%22">Symptom burden</searchLink><br /><searchLink fieldCode="DE" term="%22International+Statistical+Classification+of+Diseases+%26+Related+Health+Problems%22">International Statistical Classification of Diseases & Related Health Problems</searchLink><br /><searchLink fieldCode="DE" term="%22Comorbidity%22">Comorbidity</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Background: Complex posttraumatic stress disorder (cPTSD) was recently added to the ICD-11. Refugees might be particularly vulnerable to develop this disorder, due to key risk factors including trauma history, comorbid symptoms, and post-migration stressors. However, most prevalence estimates rely on self-report questionnaires, which are less reliable than clinical interviews. This study aimed to assess PTSDICD-11 and cPTSD prevalence in treatment-seeking refugees using clinician ratings, and to examine risk factors influencing diagnostic status and symptom severity. Method: N = 104 treatment-seeking refugees were assessed for cPTSD and PTSDICD-11, as well as symptom severity and single symptom endorsement using a new clinical interview, the Complex PTSD Item Set Additional to the CAPS. Trauma history, comorbid symptoms (dissociation, sleep problems, somatic symptoms, anxiety, depression, social impairment), and post-migration stressors were investigated as predictors for cPTSD diagnostic status and symptom severity using Wilcoxon Rank sum tests, logistic and linear regression. Results: Prevalences for cPTSD and PTSDICD-11 were 14.42% (n = 15) and 63.46% (n = 66), respectively. Participants with and without cPTSD did not differ regarding the frequency of traumatic events experienced. However, cPTSD symptom severity was significantly positively associated with the frequency of experienced traumatic events. In regression analyses, comorbid symptoms were significantly associated with cPTSD diagnostic status and symptom severity with depressive symptoms being a significant predictor. Post-migration stressors were associated with cPTSD diagnostic status and symptom severity, and the perception of the present financial situation was a significant predictor for cPTSD severity. Discussion: The prevalence of cPTSD was relatively low in this refugee sample. This discrepancy to earlier prevalence estimates could be due to the assessment since we used a clinical interview instead of a self-report questionnaire. More investigations into cPTSD diagnostic assessments are needed, and clinical interviews should be used more often. HIGHLIGHTS: Investigation of cPTSD and PTSD diagnostic status, symptom severity and related risk factors in treatment-seeking refugees using a clinical interview. Clinical interviews might provide more reliable cPTSD prevalence estimates than self-reports. Trauma history, comorbid symptoms, and post-migration stressors impacted cPTSD symptom severity. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Antecedentes:El Trastorno de Estrés Postraumático Complejo (TEPTc) fue recientemente agregado a la CIE-11. Los refugiados podrían ser particularmente vulnerables a desarrollar este trastorno debido a factores clave de riesgo, que incluyen la historia de trauma, los síntomas comórbidos y los factores de estrés post-migración. Sin embargo, la mayoría de las estimaciones de prevalencia se basan en cuestionarios de autoinforme, que son menos confiables que las entrevistas clínicas. Este estudio tuvo como objetivo evaluar la prevalencia de TEPTc y TEPT según la CIE-11 en refugiados que buscan tratamiento, utilizando valoraciones clínicas, y examinar los factores de riesgo que influyen en el estado diagnóstico y la severidad de los síntomas. Método: Se evaluaron 104 refugiados que buscaban tratamiento para TEPTc y TEPT según CIE-11, así como la severidad de los síntomas y el endoso de un solo síntoma mediante una nueva entrevista clínica, el conjunto de ítems del TEPT complejo adicional al CAPS. Se investigaron la historia de trauma, los síntomas comórbidos (disociación, problemas de sueño, síntomas somáticos, ansiedad, depresión, deterioro social) y los factores de estrés post-migración como predictores del estado diagnóstico de TEPTc y la severidad de los síntomas, utilizando pruebas de suma de rangos de Wilcoxon, regresión logística y lineal. Resultados: Las prevalencias de TEPTc y TEPT según la CIE-11 fueron 14.42% (n = 15) y 63.46% (n = 66), respectivamente. Los participantes con y sin TEPTc no mostraron diferencias en cuanto a la frecuencia de los eventos traumáticos experimentados. Sin embargo, la severidad de los síntomas de TEPTc se asoció significativamente y de manera positiva con la frecuencia de los eventos traumáticos experimentados. En los análisis de regresión, los síntomas comórbidos se asociaron significativamente con el estado diagnóstico de TEPTc y la severidad de los síntomas, siendo los síntomas depresivos un predictor significativo. Los factores de estrés post-migración se asociaron con el estado diagnóstico de TEPTc y la severidad de los síntomas, y la percepción de la situación financiera actual fue un predictor significativo para la severidad del TEPTc. Discusión: La prevalencia de TEPTc fue relativamente baja en esta muestra de refugiados. Esta discrepancia con las estimaciones previas de prevalencia podría deberse a la evaluación, ya que utilizamos una entrevista clínica en lugar de un cuestionario de autoinforme. Se necesitan más investigaciones sobre las evaluaciones diagnósticas de TEPTc, y las entrevistas clínicas deberían ser utilizadas con mayor frecuencia. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/20008066.2025.2538264
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