Dimensional Latent Structure of ICD-11 Posttraumatic Stress Disorder,Complex PTSD, and Adjustment Disorder: Evidence From Ghana, Kenya, and Nigeria

With the release of International Classification of Diseases, 11th Revision (ICD-11) in 2018, there has been a surge in studies examining the nosology of mental disorders, including disorders associated with stress, namely, posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), and adjustment disorder (AjD). Few studies have examined the same in low and middle-income countries that have disproportionate levels of exposure to trauma and stressors and are underresourced in mental health services. The present study examined the latent factor structure of a joint model comprising PTSD, CPTSD, and AjD symptoms and their association with stressful and traumatic life events to assess the degree of distinctiveness between these disorders. Participants were 2,524 adults in the age range of 18 and71 years (M/SD_age = 30.44/8.67) from Ghana, (n = 500; 50% female), Kenya (n = 1,006; 49.8% female), and Nigeria (n = 1,018; 50% female). Findings obtained through confirmatory factor analyses indicated that a dimensional and hierarchical second-order model comprising correlated latent factors of PTSD, DSO, and AjD provided the best goodness-of-fit indices. Furthermore, it was found that stressors were positively associated with AjD and PTSD, and traumatic life events largely with PTSD. Findings support the ICD-11 classification of related-although distinct stressrelated disorders in adults from 3 African nations.