Symptoms of Posttraumatic Stress and Disturbances in Self-Organization Differentially Predict Functional Impairment in Women Veterans with Military Sexual Trauma.

Posttraumatic stress disorder (PTSD) is well-documented as impacting functional impairment (FI), and research has demonstrated that clusters of PTSD symptoms as defined by the DSM-5 are differentially associated with FI domains. However, few studies have examined PTSD and complex PTSD (CPTSD) as defined by the ICD. ICD-11 PTSD consists of three symptom clusters (re-experiencing, avoidance, and sense of threat) while CPTSD consists of the three PTSD clusters as well as disturbances in self-organization (DSO) consisting of an additional three clusters (affect dysregulation, negative self-concept, and disturbances in relationships). The current study examined the use of the International Trauma Questionnaire (ITQ) PTSD and DSO subscales as predictors of functional impairment in a women veteran sample, considering the dimensional scoring of both the PTSD and DSO subscales, as well as standard diagnostic scoring for PTSD and CPTSD. Trauma symptom total was predictive of overall impairment measured by the WHODAS 2.0, and predicted impairment in difficulties getting along with people, life activities, and participating in society. The DSO subscale of the ITQ was more predictive of difficulties getting along with others. The cumulative impact of PTSD and DSO subscales uniquely contributed to life activities. Both DSO and PTSD symptoms were uniquely predictive of difficulties participating in society. Participants whose diagnostic scores were consistent with CPTSD had significantly greater FI compared to those whose diagnostic scores were consistent with PTSD. These data suggest the potential benefit of the ITQ in assessing the relative contributions of specific types of symptoms to FI.