From child maltreatment to ICD-11 complex post-traumatic stress symptoms: The role of emotion regulation and re-victimisation

J Clin Psychol. 2019 Mar;75(3):392-403. doi: 10.1002/jclp.22655. Epub 2018 Jun 22.


Objective: Complex post-traumatic stress disorder (CPTSD) will be introduced in ICD-11 and comprises symptoms of PTSD and disturbances in self-organisation (DSO). The association of trauma with PTSD and DSO is not yet fully understood. We investigated the path from child maltreatment to PTSD and DSO and examined the mediating role of emotion regulation (ER) and adult interpersonal re-victimisation.

Method: Adult patients (N = 193) from a Scottish National Health Service clinic participated in the project. Participants completed measures of life events, ICD-11 PTSD and CPTSD, and ER. Path analysis was used to assess possible direct and indirect effects from childhood trauma on current post-traumatic psychopathology.

Results: Overall results indicate that the path from child maltreatment to PTSD is a direct one, while the path to DSO is indirectly mediated by ER.

Conclusions: Future research should address the potentially beneficial effect of treatment protocols for CPTSD explicitly aiming at reducing ER difficulties.

Keywords: ICD-11; child maltreatment; complex PTSD; emotion regulation; path analysis.

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse*
  • Adverse Childhood Experiences*
  • Crime Victims*
  • Emotional Regulation / physiology*
  • Female
  • Humans
  • International Classification of Diseases*
  • Male
  • Middle Aged
  • Stress Disorders, Post-Traumatic / physiopathology*