Complex PTSD symptom trajectories in trauma-exposed adolescents: a five-year longitudinal study

Abstract

Background: Complex posttraumatic stress disorder (PTSD) symptom profile, prevalence, and risk factors have been studied in various populations across the lifespan. However, the longitudinal course of complex PTSD symptoms is unknown.Objective: The current study aimed to investigate the ICD-11 PTSD and complex PTSD symptom trajectories and trauma disorders diagnostic changes in a longitudinal study of a trauma-exposed community sample of adolescents.Method: The five-year, three-wave longitudinal study included 156 adolescents (58.3% girls, 40.4% boys, and 1.3% non-binary); age M(SD) = 17.10(0.43) years, who completed self-report questionnaires. The Repeated Measures ANOVA was used to identify changes in complex PTSD symptom clusters in adolescents meeting diagnostic criteria for PTSD, complex PTSD, or no trauma disorder at wave 3.Results: 21 diagnostic pathways of PTSD, complex PTSD, and no trauma disorder were observed across the three biannual study waves. Almost half of the participants (46.8%) met diagnostic criteria for PTSD or complex PTSD at least at a single wave over the course of the study. However, complex PTSD (2.6%) or PTSD (0.6%) diagnostic pathways across all three waves were rare. In adolescents with complex PTSD at the last wave, all symptom cluster trajectories were elevated through time in comparison to the no current trauma disorder status group. Also, the stability in time of affect dysregulation and disturbed relationships symptoms was indicated in adolescents with complex PTSD status in wave 3.Conclusions: The longitudinal study of complex PTSD symptom trajectories reveals heightened complex PTSD symptoms across five years of the study in participants meeting diagnostic criteria for complex PTSD at the last study wave. These findings reveal the importance of early recognition of complex PTSD symptom patterns in adolescents to provide trauma care and treatment. Further studies are needed to explore complex PTSD symptom trajectories in other adolescent populations.