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. 2025 Dec;16(1):2447182.
doi: 10.1080/20008066.2024.2447182. Epub 2025 Jan 6.

Validation of the International Trauma Interview (ITI) among treatment-seeking people with adverse childhood experiences in South Korea

Hyunjung Choi  1 , Hae Seong Lee  1 , Neil P Roberts  2   3
Affiliations

Validation of the International Trauma Interview (ITI) among treatment-seeking people with adverse childhood experiences in South Korea

Hyunjung Choi et al. Eur J Psychotraumatol. 2025 Dec.

Abstract
in English, Spanish

Background: The International Trauma Interview (ITI) is a clinician-administered assessment that has been newly developed for the International Classification of Diseases (ICD-11) diagnoses of posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD).Objective: The current study evaluated the psychometric properties of the ITI for treatment-seeking people with adverse childhood experiences (ACE) in South Korea, with the aims of verifying the validity and reliability of ITI as well as examining the differentiation of ICD-11 CPTSD and borderline personality disorder (BPD).Methods: In total, data of 103 people were analysed. Clinical psychologists conducted the ITI and the structured interview for BPD. Along with the International Trauma Questionnaire (ITQ), self-report measurements on ACE, adulthood trauma, emotion dysregulation, dissociation, depression, adult attachment, BPD symptoms, self-harm, self-compassion, and quality of life were collected. A confirmatory factor analysis (CFA) was conducted to examine the factorial validity and a structural equation model (SEM) was used to evaluate the convergent and discriminant validity.Results: The CFA supported the second-order two-factor model of ICD-11 CPTSD. However, we determined that the alternatively suggested second-order two-factor model of reexperience avoidance combined PTSD and DSO described the data the best. As was hypothesized, ITI PTSD and DSO showed convergent and discriminant validity, and ITI DSO also showed distinctive features with BPD. Interrater reliability and composite reliability were both found to be acceptable. Agreement and consistency between ITQ and ITI were also fair although tentative.Conclusions: The ITI is determined to be a valid and reliable method for the assessment and diagnosis of ICD-11 PTSD and CPTSD, and it is considered to be promising for the differential diagnosis of BPD in South Korean treatment-seeking people with ACE. Future research should aim to assess the agreement between ITI and ITQ while also seeking alternative criteria for ITI PTSD across variant trauma memory features.

Antecedentes: La Entrevista Internacional de Trauma (ITI en su sigla en inglés) es una evaluación administrada por clínicos que se ha desarrollado recientemente para los diagnósticos de trastorno de estrés postraumático (TEPT) y TEPT complejo (TEPTC) de la Clasificación Internacional de Enfermedades (CIE-11).

Objetivo: El presente estudio evaluó las propiedades psicométricas de la ITI en personas con experiencias adversas en la infancia (ACE en su sigla en inglés) en busca de tratamiento en Corea del Sur, con el objetivo de verificar la validez y confiabilidad de la ITI, así como examinar la diferenciación entre el TEPTC de la CIE-11 y el trastorno límite de personalidad (TLP).

Métodos: En total, se analizaron los datos de 103 personas. Los psicólogos clínicos llevaron a cabo la ITI y la entrevista estructurada para el TLP. Junto con el Cuestionario Internacional de Trauma (ITQ en su sigla en inglés), se recogieron mediciones de autoinforme sobre ACE, trauma en la adultez, desregulación emocional, disociación, depresión, apego en la adultez, síntomas de TLP, autolesión, autocompasión y calidad de vida. Se realizó un análisis factorial confirmatorio (AFC) para examinar la validez factorial y se utilizó un modelo de ecuación estructural (SEM en su sigla en inglés) para evaluar la validez convergente y discriminante.

Resultados: El AFC respaldó el modelo de dos factores de segundo orden del TEPT complejo según la CIE-11. Sin embargo, determinamos que el modelo de dos factores de segundo orden sugerido de manera alternativa, evitación de la reexperimentación combinada de TEPT y síntomas DSO (por su sigla en inglés) describió mejor los datos. Como se había planteado, el TEPT ITI y los síntomas DSO mostraron validez convergente y discriminante, y el DSO ITI también mostró características distintivas con el TLP. Se encontró que la confiabilidad entre evaluadores y la confiabilidad compuesta eran aceptables. El acuerdo y la consistencia entre el ITQ y la ITI también fueron aceptables, aunque provisionalmente.

Conclusiones: Se ha determinado que la ITI es un método válido y fiable para la evaluación y el diagnóstico del TEPT y el TEPT complejo según la CIE-11, y se considera prometedor para el diagnóstico diferencial del TLP en personas surcoreanas que buscan tratamiento con ACE. Las investigaciones futuras deberían apuntar a evaluar la concordancia entre la ITI y el ITQ, al tiempo que se buscan criterios alternativos para el TEPT según la ITI en las distintas características de la memoria traumática.

Keywords: CIE-11; Entrevista Internacional de Trauma; ICD-11; International Trauma Interview; adverse childhood experience; assessment; borderline personality disorder; complex posttraumatic stress disorder; evaluación; experiencia adversa en la infancia; trastorno de estrés postraumático complejo; trastorno límite de la personalidad.

Plain language summary

The ITI is a valid and reliable method for the assessment and diagnosis of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in Korean people.The ITI is capable of differentiating borderline personality disorder (BPD) symptom features from ICD-11 CPTSD.

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Conflict of interest statement

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

Figures

Figure 1.
Figure 1.
Alternative models for International Trauma Interview.
Figure 2.
Figure 2.
Standardized factor loadings and correlations for the final models of International Trauma Interview. *p<.05, ***p<.001.
See this image and copyright information in PMC

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