Predicting PTSD and complex PTSD from interpersonal violence in Japanese school-based extracurricular sports activities: using the International Trauma Questionnaire (ITQ)

Abstract

Introduction: Victims of interpersonal violence in sports show various mental health concerns. However, no studies have quantitatively examined their primary complaints, considering psychological symptoms such as denial of self-concept and interpersonal challenges not captured by conventional post-traumatic stress disorder (PTSD). Recently, an association between interpersonal violence victimization and complex PTSD (CPTSD) has been noted in Japanese sports coaching situations, specifically for extracurricular sports activities. This study aimed to examine the applicability of the International Trauma Questionnaire (ITQ) and determine whether interpersonal violence victimization and related risk factors predicted PTSD and CPTSD in extracurricular sports activities in Japan.

Methods: This study included 651 adults aged 18-25 who had previously participated in extracurricular sports activities in junior high and high school. The ITQ was examined using confirmatory factor analysis with maximum likelihood with robust standard errors, fit indices comparisons, a graded response model, differential item functioning, and rank correlation designs. A binomial logistic regression model with robust standard errors examined the association of PTSD and CPTSD with interpersonal violence victimization and related risk factors.

Results: The optimal factor structure, measurement precision, and validity of the ITQ were confirmed. Physical and psychological violence victimization and the ITQ were positively correlated with PTSD, difficulties in emotion regulation, self-disgust, and interpersonal problems subscales, respectively. A high frequency of psychological and physical violence victimization experiences and self-identified LGB (lesbian, gay, or bisexual) were associated with PTSD and CPTSD diagnosability. Additionally, being a woman and in school life away from parents were associated solely with PTSD diagnosability.

Discussion: This is the first quantitative study to examine CPTSD in a study on interpersonal violence in sports. Our findings can provide insights into desirable victim support and enhanced clinical care in interpersonal violence in a sports context.

Keywords: ITQ; complex post-traumatic stress disorder; corporal punishment; extracurricular sports activities; interpersonal violence; mental health; post-traumatic stress disorder; safe sport.

Figure 1

Candidate optimal models for confirmatory factor analysis.