Psychological trauma at different developmental stages and ICD-11 CPTSD: The role of dissociation

Abstract

Background: Dissociation is commonly reported by individuals who meet criteria for posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD). However, the association between the age of trauma exposure, dissociation, and CPTSD is not well understood. This study aimed to test whether dissociation mediated the relationship between the developmental stage of trauma exposure and CPTSD symptoms.Method: A nationally representative sample from Ireland (N = 1020) completed self-report measures on trauma exposure in childhood, adolescence, adulthood, current trauma symptomatology, and dissociation symptoms. A mediation analysis was conducted.Results: Childhood, adolescent, and adulthood trauma exposure were all related to dissociation and ICD-11 CPTSD symptom clusters. Dissociation mediated the effect of developmental stage of trauma exposure on PTSD and disturbances in selforganization(DSO). The direct and indirect effect models provided the best fit of the data. Childhood trauma exposure was the only developmental stage that was directly associated with both PTSD and DSO symptoms in our sample.Conclusion: Dissociation mediates the relationship between reported trauma exposure and the presence of ICD-11 CPTSD symptom clusters, and this relationship appears at its strongest when trauma occurs in childhood. CPTSD interventions should also promote dissociation management to aid recovery from this debilitating condition.

A network analysis of ICD-11 Complex PTSD, emotional processing, and dissociative experiences in the context of psychological trauma at different developmental stages

“…This community displays undefined boundaries with significant connections between symptoms of different communities. Based on our findings in this research, traumatic experiences, dissociative experiences, and emotional processing can all contribute to the formation of the more general class of DSO, which is supported by previous reports ( 1 , 20 , 76 ).…”

“…Dissociation helps the person abandon such events or at least keep them far away to become emotionally unavailable ( 18 ). Although dissociation has not been defined as a core criterion of CPTSD, symptoms such as reliving the trauma in the here and now (part of the re-experiencing cluster) and emotional numbing (part of the affective dysregulation cluster) fall into this category ( 4 , 19 , 20 ). The relationship between dissociation and trauma is clinically significant ( 21 ).…”

The Relationship Between Dissociation and Complex Post-Traumatic Stress Disorder: A Scoping Review

“…In addition, three studies examined the mediating role of dissociation scores in CPTSD (Jowett et al, 2021; Van Dijke et al, 2015, 2018). All of them reported that dissociation scores were a significant mediator of the relationship between childhood trauma and CPTSD symptoms, but these studies used a cross-sectional design.…”

“…Participants were from different countries/regions, including the United States (n = 5), the United Kingdom (n = 4), the Netherlands (n = 3), Austria (n = 2), Canada (n = 2), Ireland (n = 2), South Korea (n = 2), and one in each of the additional countries-Australia, China, Denmark, Germany, Israel, and Italy. In terms of study settings, most studies recruited participants from clinical settings or treatment-seeking people (n = 18); three studies recruited participants in shelters or foster care settings (Haselgruber et al, 2020(Haselgruber et al, , 2021Shin et al, 2021); three used nonclinical samples reporting at least one traumatic event or childhood adversity (Bürgin et al, 2021;Choi et al, 2021;Tian et al, 2020); one used an online sample (Frewen et al, 2019); and the remaining study used a nationally representative sample (Jowett et al, 2021).…”

Posttraumatic symptoms and poor sleep are independent pathways to agency disruptions and dissociation: A longitudinal study with objective sleep assessment.

“…CPTSD symptoms are considered more complicated than those of PTSD, in that the former includes affect dysregulation, negative self-concept, and disturbed relationships (World Health Organization, 2019). In some studies, dissociation has been related more strongly to PTSD (Haselgruber et al, 2020;Knefel et al, 2016) and in others, to CPTSD (Hyland et al, 2018(Hyland et al, , 2020Jowett et al, 2022;van der Hart et al, 2005), but a consensus exists that dissociation plays a significant role in both of these expressions of posttraumatic stress. Thus, we aimed to assess both constructs, and on an exploratory basis examine whether one is more important than the other as determinants of dissociation and the sense of agency.…”