Can subjective perceptions of trauma differentiate between ICD-11 PTSD and complex PTSD? A cross-cultural comparison of three African countries.

Yuval Palgi, Thanos Karatzias, Philip Hyland, Mark Shevlin, Menachem Ben-Ezra

Research output: Contribution to journalArticlepeer-review


Background: The primary aim of the current study was to establish the cutoffs scores for the Subjective Traumatic Outlook (STO), a relatively new tool that examines the introspective worldview of those exposed to traumatic events. This tool was developed as a complementary scale to be used in conjunction with the observed-phenomenological measures of posttraumatic stress disorder (PTSD) complex PTSD (CPTSD). The present study examines the predictive power of STO for distinguishing between PTSD and CPTSD in African countries. Method: A national representative (based on age and gender) sample of 2,554 participants was drawn from 3 African countries (Nigeria, Kenya, and Ghana) who completed the International Trauma Questionnaire (ITQ) and the STO. We conducted a set of analyses examining that alignment of ITQ probable PTSD and CPTSD and different STO cutoff scores. Results: Results suggest that the STO single-factor structure was stable across countries, had a strong association with PTSD and CPTSD levels, and had predictive utility in differentiating between PTSD and CPTSD. Moreover, we found that there are different cutoffs for the STO in the different countries. Conclusion: There is a strong but distinctive association between the introspective and the observed-phenomenological approaches of PTSD and CPTSD. Our findings call for more integrative approaches for the assessment of PTSD and CPTSD and suggest that there are cultural differences in STO. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Clinical Impact Statement—This study provided evidence for the Subjective Traumatic Outlook (STO) cutoffs for predicting posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). This is a short and easy to handle self-report tool that can help clinicians broaden their understanding of the severity and characteristics of one's inner traumatic experience. By combining information collected with the STO and conventional PTSD/CPTSD assessments, clinicians may have better and deeper understanding of the impact of traumatic events.

Original languageAmerican English
Pages (from-to)142-148
Number of pages7
JournalPsychological Trauma: Theory, Research, Practice, and Policy
Issue number2
StatePublished - Feb 2021


  • Adult
  • Africa
  • Cross-Cultural Comparison
  • Diagnostic Self Evaluation
  • Female
  • Ghana
  • Humans
  • ICD-11
  • International Classification of Diseases
  • Kenya
  • Male
  • Nigeria
  • Psychological Trauma/classification
  • Self Report
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic/classification
  • Young Adult
  • complex PTSD
  • subjective traumatic outlook
  • trauma

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Social Psychology


Dive into the research topics of 'Can subjective perceptions of trauma differentiate between ICD-11 PTSD and complex PTSD? A cross-cultural comparison of three African countries.'. Together they form a unique fingerprint.

Cite this