Trauma exposure, prevalence and associated factors of complex PTSD in mainland China: a cross-sectional survey

<b>Background:</b> The ICD-11 distinguishes Complex Post-Traumatic Stress Disorder (CPTSD) as a separate trauma-related disorder from PTSD. While numerous studies have examined these conditions globally, no nationwide research has yet investigated their one-month prevalence and associated factors in the general population of China.<b>Objective:</b> This study aimed to determine the one-month prevalence of ICD-11 CPTSD and identify associated factors within a general adult sample in mainland China.<b>Methods:</b> A total of 2,115 adults living in mainland China participated in an online survey. PTSD and CPTSD were assessed using the International Trauma Questionnaire (ITQ) based on ICD-11 criteria. Trauma exposure was measured via the International Trauma Exposure Measure (ITEM). Multinomial logistic regression identified associated factors for PTSD and CPTSD.<b>Results:</b> Among participants, 88.2% reported at least one traumatic exposure. The prevalence of PTSD and CPTSD was 4.9% and 4.5%, respectively. Shared predictors for both conditions included a greater number of siblings, broader interpersonal trauma exposure during adolescence, and more frequent and recent index trauma events. Specific predictors for CPTSD included female gender, older age, being left behind by migrant parents, lower socioeconomic status, and broader trauma exposure in adulthood.<b>Conclusion:</b> This study provides the first estimates of ICD-11 PTSD and CPTSD prevalence in the general population of mainland China, revealing relatively high rates compared to other mental disorders. Findings highlight key associated factors and offer intervention recommendations for at-risk groups.