Complex PTSD in asylum-seekers living in a humanitarian setting in Africa. A latent class analysis

Objective: This study investigated ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) symptom profiles and their premigration, postmigration, and demographic predictors in a treat- ment-seeking sample of asylum-seekers in Agadez (Niger). Method: Participants were 126 asylum-seekers hosted in a large, isolated reception camp in the desert surroundings of Agadez (humanitarian site) or in a number of small urban hosting facilities (cases de passages) who completed measures of trauma exposure and PTSD/CPTSD symptoms. Latent class analysis (LCA) was used to identify symptom profiles, and pre- dictors of class membership were identified via multinomial logistic regression. Results: More asylum seekers met the criteria for CPTSD (74.6%) than PTSD (19.8%) and no gender differences were observed. LCA results identified two distinct groups: (a) a CPTSD class (69.0%); and (b) a PTSD class (31.0%). Membership in the CPTSD class was significantly predicted by the early age of the first traumatic event, levels of functional impairment and reception conditions. Specifically, those in the CPTSD class were more likely to live in the humanitarian site compared with those in the PTSD class. Conclusion: This study sup- ported the validity of the ICD-11 construct of CPTSD in an asylum-seeker sample living in a low-income country. Moreover, the findings suggest that not only premigration factors (i.e., the early age of the first trauma) but also postmigration stressors (i.e., precarious reception conditions in large, isolated facilities) are important predictors of CPTSD symptoms with important implications regarding reception policies and the prevention of trauma-related mental disorders in asylum seekers and refugees.