Relative effects of childhood trauma, intimate partner violence, and other traumatic life events on complex posttraumatic stress disorder symptoms.

Abstract

Complex posttraumatic stress disorder (CPTSD) follows persistent and repeated trauma and is a serious mental health problem among women. One of the strongest predictors of CPTSD symptoms is childhood trauma, especially child abuse and neglect, both of which are traumas that tend to be persistent and repeated. CPTSD is also associated with intimate partner violence (IPV; physical, emotional, and/or sexual violence in an intimate relationship), a trauma that, similar to child abuse and neglect, is also persistent and repeated. However, it is unclear how child abuse/neglect and IPV may jointly influence CPTSD symptoms vis-à-vis other traumatic events. In this study, we examined the relative effects of child abuse/ neglect and IPV on CPTSD symptoms over and above other traumatic events in a sample of women (N = 553) using a partial least squares approach to multiple regression and structural equation modeling. Results indicated that in general childhood trauma was the strongest predictor of CPTSD symptoms. However, when we analyzed specific aspects of child abuse, child neglect, and IPV, we found that childhood emotional abuse was the primary predictor of CPTSD symptoms over and above the effects of other traumatic life events, with sexual and emotional IPV also having small effects. These results highlight the salient effects of childhood emotional trauma on CPTSD symptoms among women, underscoring the importance of assessing for this in women presenting for treatment of CPTSD.

The influence of betrayal trauma on complex posttraumatic stress disorder symptoms.

“…Findings suggest that for all people, interpersonal trauma, including but not limited to betrayal trauma, was associated with complex PTSD symptoms. This is consistent with the theory that complex PTSD is a result of interpersonal trauma, although this is truer for women than men (Cloitre et al, 2009; Gallagher et al, 2022). One reason for men having a broader range of traumas associated with complex PTSD symptoms is that men (at least in this sample) experienced more (nonbetrayal) interpersonal and noninterpersonal traumas than women.…”

“…Complex PTSD captures the diagnostic complexity following traumas beyond the narrow scope of what is included in a PTSD diagnosis such as chronic and repetitive traumas (Courtois, 2008;Ford & Courtois, 2020;Herman, 1992). Consistent with this, research suggests that traumas that tend to be prolonged and recurring (e.g., childhood abuse, intimate partner violence) are associated with complex PTSD symptoms over and above other traumas that tend to occur in isolation (e.g., vehicular accidents; Cloitre et al, 2009;Gallagher et al, 2022). However, there are other ways to think about differential trauma severity.…”

Influence of trauma and personality on posttraumatic cognitions in military veterans.

“…However, in this study, we modified the LEC-5 by changing the rating anchors to a 5-point scale to assess the number of experiences (ranging from zero to four or more times ), and therefore the frequency of trauma experienced. Research suggests that the LEC-5 with modified scoring has high internal consistency (α = .93) and strong criterion validity with respect to complex PTSD symptoms (see Gallagher et al, 2022). We asked participants to focus on experience during their time in the military only.…”

“…These findings are consistent with a robust literature on the influence between personality traits and posttraumatic psychopathology, with neuroticism having the strongest (positive) effect and agreeableness and extraversion having smaller (negative) effects of PTSD and related problems (Kotov et al, 2010; for review, see Lahey, 2009; Sauer-Zavala & Barlow, 2021). However, the differential influence of personality traits on posttraumatic cognitions with respect to military trauma has not yet been examined (see Gallagher et al, 2022; Yalch et al, 2021 for studies on the influence of personality on posttraumatic cognitions in women exposed to intimate partner violence and sexual assault, respectively).…”

Childhood Trauma Questionnaire-Short Form: Evaluation of Factor Structure and Measurement Invariance

“…Childhood trauma is often correlated with insecure attachment styles (Bederian-Gardner et al, 2018;Cooke et al, 2019;Ensink et al, 2020;Murase et al, 2021;Widom et al, 2018), and insecure attachment styles elevate the risk for a broad range of psychological disorders and somatic syndromes in adults (Alonso et al, 2018;Bo, & Kongerslev, 2017;Green et al, 2017;McWilliams, 2017). This line of research has identified the cumulative effects of trauma in adults resulting from repeated abuse and neglect and increasingly defined them as a distinct type of Developmental and Complex Trauma Gallagher et al, 2022;Karatzias et al, 2021;Musicaro et al, 2019;van Dijke et al, 2018) that is associated with traumatic interruptions during sensitive developmental periods.…”