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. 2025 Dec;16(1):2445368.
doi: 10.1080/20008066.2024.2445368. Epub 2025 Jan 3.

ICD-11 posttraumatic stress disorder and complex PTSD: prevalence, predictors, and construct validity in Swiss older adults

Myriam V Thoma  1   2 , Enya Redican  3 , Nathanael Adank  1 , Valerie B Schneemann  1 , Mark Shevlin  3 , Andreas Maercker  1 , Shauna L Rohner  1   4
Affiliations

ICD-11 posttraumatic stress disorder and complex PTSD: prevalence, predictors, and construct validity in Swiss older adults

Myriam V Thoma et al. Eur J Psychotraumatol. 2025 Dec.

Abstract
in English, Spanish

Background: This study assessed the prevalence rates, construct validity, predictors, and psychosocial factors linked to ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD), as assessed by the International Trauma Questionnaire (ITQ) in a German-speaking sample of Swiss older adults.Method: Participants were N = 1526 older adults aged 65+ (Mage = 72.34; SD = 6.20 years; age range = 65-95; female = 72.0%). Confirmatory factor analysis (CFA) tested alternative models of the latent structure of the ITQ. Risk factors and psychological outcomes associated with the ITQ subscales were also examined.Results: From the total sample, 86.2% had experienced at least one potentially traumatic event (PTE), with a median of three PTEs per person. Probable PTSD and CPTSD prevalence was 0.4% and 2.4%, respectively. CFA results indicated that a two-factor second-order model best captured the latent structure of the ITQ. Female gender and specific traumas, such as physical and sexual assault, were uniquely associated with PTSD. Fewer, non-specific factors were linked to disturbances in self-organization (DSO; encompassing affective dysregulation, a negative self-view, and difficulties in relationships). The PTSD and CPTSD factors were significantly associated with loneliness, anxiety, depression, and well-being.Conclusions: Results found that despite high trauma exposure among Swiss older adults, the prevalence of ICD-11 PTSD and CPTSD was low, with no significant gender differences. A two-factor second-order model provided the best fit for the ITQ. These findings indicate significant trauma exposure in Swiss older adults and the need for targeted interventions that address the trauma-specific and associated psychosocial challenges (i.e. loneliness, anxiety, depression, well-being) facing older adults.

Antecedentes: Este estudio evaluó las tasas de prevalencia, la validez de constructo, los predictores y los factores psicosociales relacionados con el trastorno de estrés postraumático (TEPT) y el trastorno de estrés postraumático complejo (TEPTC) de la CIE-11, evaluados mediante el Cuestionario Internacional de Trauma (ITQ por sus siglas en ingles) en una muestra de habla alemana de adultos mayores suizos.

Método: Los participantes fueron N = 1.526 adultos mayores de 65 años (Mage = 72.34; DE = 6.20 años; rango de edad = 65–95; mujeres = 72.0%). El análisis factorial confirmatorio («CFA», por sus siglas en inglés) probó modelos alternativos de la estructura latente del ITQ. También se examinaron los factores de riesgo y los resultados psicológicos asociados a las subescalas del ITQ.

Resultados: Del total de la muestra, el 86.2% había experimentado al menos un acontecimiento potencialmente traumático («PTE por sus siglas en inglés»), con una mediana de tres PTE por persona. La prevalencia probable de TEPT y TEPTC fue del 0.4% y el 2.4%, respectivamente. Los resultados del CFA indicaron que un modelo de segundo orden de dos factores era el que mejor reflejaba la estructura latente del ITQ. El género femenino y los traumas específicos, como las agresiones físicas y sexuales, se asociaron de forma exclusiva con el TEPT. Un menor número de factores no específicos se relacionaron con las alteraciones en la autoorganización (AAO; que engloban la desregulación afectiva, una visión negativa de uno mismo y dificultades en las relaciones). Los factores TEPT y TEPTC se asociaron significativamente con la soledad, la ansiedad, la depresión y el bienestar.

Conclusiones: Los resultados encontraron que, a pesar de la alta exposición al trauma entre los adultos mayores suizos, la prevalencia de TEPT y TEPTC de la CIE-11 fue baja, sin diferencias significativas de género. Un modelo de segundo orden de dos factores proporcionó el mejor ajuste para el ITQ. Estos hallazgos indican una exposición significativa al trauma en los adultos mayores suizos y la necesidad de intervenciones dirigidas que aborden los desafíos psicosociales asociados y específicos del trauma (es decir, soledad, ansiedad, depresión, bienestar) que enfrentan los adultos mayores.

Keywords: CIE-11; Complex posttraumatic stress disorder; Cuestionario Internacional de Trauma; ICD-11; International Trauma Questionnaire; Suiza; Switzerland; construct validity; trastorno de estrés postraumático complejo; trauma; validez de constructo.

Plain language summary

Most (86.2%) Swiss adults aged 65 + reported having experienced at least one potentially traumatic event in their lifetime.Rates of probable ICD-11 PTSD (0.4%) and Complex PTSD (2.4%) were low in older Swiss adults.Gender and specific trauma types predicted PTSD, with fewer factors linked to Complex PTSD symptoms.Confirmatory factor analysis supported the ITQ structure in assessing ICD-11 PTSD and Complex PTSD in older adults.PTSD and Complex PTSD symptoms strongly correlated with loneliness, anxiety, depression, and well-being.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

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