{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:24:35Z","timestamp":1789691075575,"version":"4.0.1"},"reference-count":55,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Complex post-traumatic stress disorder (CPTSD) is a severely debilitating recently added symptom cluster in the International Classification of Diseases (ICD-11). So far, only limited information on mental health treatment-uptake and -satisfaction of individuals with CPTSD is available. The aim of this study is to investigate these aspects in a representative sample of the German general population. Methods: Participants completed the International Trauma Questionnaire (ITQ) to identify participants with CPTSD, as well as questionnaires on mental health treatment uptake and satisfaction, adverse childhood experiences, anxiety, depression, working ability, personality functioning, and epistemic trust. Results: Of the included n = 1918 participants, n = 29 (1.5%) fulfilled the criteria for CPTSD. Participants with CPTSD had received mental health treatment significantly more often than participants with PTSD or depression (65.5% vs. 58.8% vs. 31.6%; p = 0.031) but reported significantly less symptom improvement (52.9% vs. 78.0% vs. 80.0%; p = 0.008). Lower levels of epistemic trust were associated with higher CPTSD symptoms (p &lt; 0.001). Conclusions: Our study shows that while the vast majority of individuals with CPTSD had received mental health treatment, subjective symptom improvement rates are not satisfactory. CPTSD was associated with a broad number of comorbidities and impairments in functioning. Lower levels of epistemic trust may partially explain worse treatment outcomes.<\/jats:p>","DOI":"10.3390\/jcm13102735","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T06:53:27Z","timestamp":1715064807000},"page":"2735","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Utilization of Mental Health Provision, Epistemic Stance and Comorbid Psychopathology of Individuals with Complex Post-Traumatic Stress Disorders (CPTSD)\u2014Results from a Representative German Observational Study"],"prefix":"10.3390","volume":"13","author":[{"given":"David","family":"Riedl","sequence":"first","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research, 1100 Vienna, Austria"},{"name":"University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5213-0179","authenticated-orcid":false,"given":"Hanna","family":"Kampling","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Nolte","sequence":"additional","affiliation":[{"name":"Anna Freud National Centre for Children and Families, London N1 9JH, UK"},{"name":"Research Department for Clinical, Educational and Heath Psychology University College London, London WC1E 6BT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Kirchhoff","sequence":"additional","affiliation":[{"name":"University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, 35392 Giessen, Germany"},{"name":"Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, 35037 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric","family":"Sachser","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry\/Psychotherapy, Ulm University, 89075 Ulm, Germany"},{"name":"German Center for Mental Health (DZPG), Partner Site Ulm, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg M.","family":"Fegert","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry\/Psychotherapy, Ulm University, 89075 Ulm, Germany"},{"name":"German Center for Mental Health (DZPG), Partner Site Ulm, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"G\u00fcndel","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2648-2728","authenticated-orcid":false,"given":"Elmar","family":"Br\u00e4hler","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"},{"name":"Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4421-2449","authenticated-orcid":false,"given":"Vincent","family":"Grote","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research, 1100 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6345-0813","authenticated-orcid":false,"given":"Michael J.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research, 1100 Vienna, Austria"},{"name":"VAMED Rehabilitation Center Kitzbuehel, 6370 Kitzbuehel, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Lampe","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research, 1100 Vienna, Austria"},{"name":"VAMED Rehabilitation Montafon, 6780 Schruns, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/jts.2490050305","article-title":"Complex PTSD: A syndrome in survivors of prolonged and repeated trauma","volume":"5","author":"Herman","year":"1992","journal-title":"J. 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