Assessing the application of latent class and latent profile analysis for evaluating the construct validity of complex posttraumatic stress disorder: cautions and limitations

Achterhof, R., Huntjens, R. J. C., Meewisse, M-L. & Kiers, H. A. L., 31-Dec-2019, In : European Journal of Psychotraumatology. 10, 1, 11 p., 1698223.

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Background: The diagnosis of complex posttraumatic stress disorder (CPTSD) has been suggested for inclusion in the 11th version of the International Classification of Diseases (ICD-11), with support for its construct validity coming from studies employing Latent Class Analysis (LCA) and Latent Profile Analysis (LPA).Objective: The current study aimed to critically evaluate the application of the techniques LCA and LPA as applied in previous studies to substantiate the construct validity of CPTSD.Method: Both LCA and LPA were applied systematically in one sample (n = 245), replicating the setup of previous studies as closely as possible. The interpretation of classes was augmented with the use of graphical visualization.Results: The LCA and LPA analyses indicated divergent results in the same dataset. LCA and LPA partially supported the existence of classes of patients endorsing different PTSD and CPTSD symptom patterns. However, further inspection of the results with scatterplots did not support a clear distinction between PTSD and CPTSD, but rather suggested that there is much greater variability in clinical presentations amongst adult PTSD patients than can be fully accounted for by either PTSD or CPTSD.Discussion: We argue that LCA and LPA may not be sufficient methods to decide on the construct validity of CPTSD, as different subgroups of patients are identified, depending on the statistical exact method used and the interpretation of the fit of different models. Additional methods, including graphical inspection should be employed in future studies. Antecedentes: El diagnostico de Trastorno por Estres Postraumatico Complejo (TEPTC) ha sido sugerido para su inclusion en la 11 version de la Clasificacion Internacional de Enfermedades (CIE-11), con el respaldo de su validez de constructo proveniente de estudios que emplean Analisis de Clases Latentes (LCA) y Analisis de Perfil Latente (APL).Objetivo: El presente estudio tuvo como objetivo evaluar criticamente la aplicacion de las tecnicas LCA y APL, utilizadas en estudios anteriores, para corroborar la validez de constructo del TEPTC.Metodo: Se aplicaron sistematicamente, tanto la tecnica LCA como la tecnica APL, en una muestra (n = 245), que busco replicar lo mas fielmente posible las configuraciones empleadas en estudios previos. La interpretacion de las clases se potencio con el uso de visualizacion grafica.Resultados: Los analisis LCA y APL indicaron resultados divergentes en el mismo conjunto de datos. LCA y APL apoyaron parcialmente la existencia de clases de pacientes que validan diferentes patrones de sintomas para el TEPT y el TEPTC. Sin embargo, una mayor inspeccion de los resultados con diagramas de dispersion no respaldo una distincion clara entre el TEPT y el TEPTC, sino que sugirieron que existe una variabilidad mucho mayor en las presentaciones clinicas entre los pacientes adultos con TEPT de lo que pueda explicarse ya sea por el TEPT o el TEPTC.Discusion: Proponemos que los analisis LCA y APL pueden ser metodos insuficientes para decidir sobre la validez de constructo del TEPTC, ya que se identifican diferentes subgrupos de pacientes, que depende del metodo estadistico utilizado y la interpretacion del ajuste de diferentes modelos. En futuros estudios deben emplearse metodos adicionales que incluyan la inspeccion grafica.

??: ?????????? (CPTSD) ??????????11?> (ICD-11) , ?????????? (LCA) ??????? (LPA) ?????????????: ????????LCA?LPA???????CPTSD?????????????: ???245????????LCA?LPA, ????????????????????????????????: LCA?LPA???????????????? LCA?LPA???????PTSD?CPTSD????????????, ???????????????PTSD?CPTSD????????, ??????PTSD???????????????PTSD?CPTSD?????????????: ????, LCA?LPA??????CPTSD?????, ????????????????????????, ???????????????????????, ???????

Original languageEnglish
Article number1698223
Number of pages11
JournalEuropean Journal of Psychotraumatology
Issue number1
Early online date10-Dec-2019
Publication statusPublished - 31-Dec-2019


  • Posttraumatic stress disorder, complex PTSD, trauma, ICD-11, DSM-5, latent class analysis, latent profile analysis, trastorno de estres postraumatico, TEPT complejo, CIE-11, analisis de clases latentes, analisis de perfil latente, ???????, ???PTSD, ??, ??????, center dot The necessity of Complex PTSD (CPTSD) as a separate diagnosis is under debate, center dot We evaluated the contribution of latent modelling techniques to this debate, center dot Results indicated that these techniques are insufficient for settling this debate, NUMBER, PTSD, CLASSIFICATION, ADOLESCENTS, VALIDATION, PROPOSALS, MODEL

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