Initial Insights into ICD-11 Complex PTSD and Emotional Distress in Emerging Adults in India: Prevalence, Predictors, and Psychosocial Correlates

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Background: The increasing emotional distress among emerging adults highlights the importance of examining trauma-related factors, particularly complex trauma. This study investigates post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder (C-PTSD), and emotional distress, emphasizing the predictive role of disturbances in self-organization (DSO) as defined by the International Classification of Diseases (11th revision) (ICD-11). Methods: A cross-sectional study was conducted among 538 college-going emerging adults (aged 15-29 years). The study received ethical clearance from the institute and informed consent from the participants, who completed validated measures: the International Trauma Questionnaire and Depression, Anxiety, and Stress Scale-21. Quantitative data were analyzed using descriptive statistics, Mann-Whitney/Kruskal-Wallis tests, Pearson's correlation, and multiple linear regression. Thematic analysis was used to explore self-reported traumatic experiences. Results: Prevalence rates were 15.2% for C-PTSD, 20.8% for PTSD, 53.9% for depression, 66.5% for anxiety, and 36.2% for stress. DSO showed the strongest associations with all three domains of emotional distress. Thematic analysis revealed multidimensional trauma themes, including career anxiety, relational issues, abuse, loss, and social exclusion. Gender and psychiatric history significantly moderated distress levels, while rural-urban background showed no difference. Conclusions: Among the variables, DSO demonstrated the strongest and most consistent associations with depression, anxiety, and stress, pointing to its close link with complex trauma responses. Results highlight the need for trauma-informed screening and interventions in Indian academic settings and support ICD-11's distinction between PTSD and C-PTSD. A tiered intervention model is recommended for early detection and tailored care.

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