Hyperactivation and hypoactivation affective dysregulation symptoms are integral in complex posttraumatic stress disorder: Results from a nonclinical Israeli sample

Objectives: The current study sought to further assess the nature of the affect dysregulation (AD) cluster of the International Classification of Diseases-11 (ICD-11) proposal for complex posttraumatic stress disorder (CPTSD) in a nonclinical sample. Methods: An online survey sample from Israel (n = 618) completed a disorder-specific measure (International Trauma Questionnaire) of PTSD and CPTSD along with the Life Events Checklist and the World Health Organization Well-Being Index. Results: Estimated prevalence rates of PTSD and CPTSD were 9.2% and 1.0%, respectively. Confirmatory factor analysis results indicated that AD symptoms are better conceived as two correlated dimensions of hyperactivation and hypoactivation symptoms. Latent class analysis results indicated that CPTSD was clearly distinguishable from PTSD. CPTSD class membership was associated with higher levels of traumatization and poorer psychological well-being scores. Conclusions: Findings support the discriminant validity of the ICD-11 proposals for PTSD and CPTSD in a nonclinical sample using a disorder-specific measure. The results provide further evidence that the final symptom profile for CPTSD in ICD-11 should model the AD cluster using both hyperactivation and hypoactivation symptoms.