Many trauma survivors seem to be reluctant to seek professional help. The aim of the current review was to synthesize relevant literature, and to systematically classify trauma survivors' perceived barriers and facilitators regarding mental health service utilization. The systematic search identified 19 studies addressing military personnel and 17 studies with trauma survivors of the general population. The data analysis revealed that the most prominent barriers included concerns related to stigma, shame and rejection, low mental health literacy, lack of knowledge and treatment-related doubts, fear of negative social consequences, limited resources, time, and expenses. Perceived facilitators lack attention in research, but can be influential in understanding mental health service use. Another prominent finding was that trauma survivors face specific trauma-related barriers to mental health service use, especially concerns about re-experiencing the traumatic events. Many trauma survivors avoid traumatic reminders and are therefore concerned about dealing with certain memories in treatment. These perceived barriers and facilitators were discussed regarding future research and practical implications in order to facilitate mental health service use among trauma survivors.

Objective: ICD‐11 introduces post‐traumatic stress disorder (PTSD) and complex PTSD (CPTSD) as two distinct trauma‐related disorders. Using the International Trauma Questionnaire (ITQ) as disorder‐specific measure, this study is the first to examine the factorial and construct validity of ICD‐11 PTSD, CPTSD and the ITQs’ applicability in children.Methods: Two hundred and eight Austrian foster children completed a set of standardized measures. Excluding participants who reported not having experienced any kind of trauma, a final sample of 136 children completed the ITQ. Factorial and construct validity of ICD‐11 CPTSD and psychometric properties of ITQ scales were assessed by factor analysis and latent class analysis.Results: Confirmatory factor analysis supported the two‐factor higher‐order model of ICD‐11 CPTSD in children by high factor loadings and excellent model fit. Reliability and regression analysis evidenced psychometric adequacy and discriminant validity of ITQ scales. Latent class analysis substantiated construct validity of ICD‐11 CPTSD, identifying a CPTSD (22.8%), PTSD (31.6%) and low symptoms class (45.6%). The CPTSD class showed highest rates of childhood trauma, comorbid psychopathology and functional impairment.Conclusion: Factorial and construct validity of ICD‐11 CPTSD was evidenced in children for the first time using precise descriptions of ICD‐11 symptom content, supporting the reliability and validity of the ITQ in children.

An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse