Article
Capacity limitations (Mini-ICF-APP-S) and complex post-traumatic stress disorder
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Published: | April 16, 2019 |
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Background: According to the bio-psycho-social illness concept, chronic illness manifest not only in disorder-specific symptoms but have further consequences such as illness-related capacity restrictions and disability [1].
The 11th revision to the International Classification of Diseases [2] includes a new chapter of stress-related disorders and presents two distinct sibling conditions: Posttraumatic Stress Disorder (PTSD) and complex PTSD (cPTSD). They are associated with different levels of functional impairment.
Aim: The current study therefore has the aim to supply information on PTSD and cPTSD specific differences in work-related impairment.
Method: Participants were 662 patients (mean age 50.99+/–8.99 years; 70.1% female) of a Psychosomatic Rehabilitation Clinic. Self-reported screening instruments including the Mini-ICF-APP-S, SCL-90-R, IES-R and the SkPTBS [3] were administered to participants at the beginning of their inpatient psychotherapy.
Results/findings: A multivariate analysis of variance showed that the groups differed significantly regarding the strength of impairment at the Mini-ICF-APP-S dimensions (Pillai trace: V=.179, F(26,1228)=4.647, p<.001, partial η²=.090). Significant Bonferroni-corrected differences emerged between the cPTSD group and the PTSD group (p<.001) as well as the cPTSD group and the no-PTSD group (p=< .001) among all dimensions. No significant differences were found between the PTSD group and the no-PTSD.
Discussion and conclusions: Patients with cPTSD reported stronger impairment in all capacity dimensions of the Mini ICF-APP-S than patients with PTSD or patients with no-PTSD. This confirms the theoretical construct of cPTSD and supports the need for an independent cPTSD diagnosis and own rehabilitation strategies for these group of patients.
References
- 1.
- Linden M. Definition and assessment of disability in mental disorders under the perspective of the International Classification of Functioning, Disability and Health (ICF). Behavioral Sciences & the Law. 2017;35(2):124-34.
- 2.
- WHO. The ICD-11 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 2018.
- 3.
- Dorr F, Firus C, Kramer R, Bengel J. Entwicklung und Prüfung eines Screenings zur komplexen Posttraumatischen Belastungsstörung (SkPTBS). Psychother Psych Med. 2016;66(11):441-8. DOI:10.1055/s-0042-109403