The contributions of emotion regulation difficulties and dissociative symptoms to functional impairment among civilian inpatients with posttraumatic stress symptoms

Psychol Trauma. 2020 Oct;12(7):739-749. doi: 10.1037/tra0000576. Epub 2020 Mar 23.


Background: Functional impairment among individuals with posttraumatic stress disorder (PTSD) represents a significant factor in recovery. Critically, functional impairment appears to persist following remission of PTSD symptoms. To date, work investigating functional impairment among individuals with PTSD has focused on PTSD symptom clusters, excluding other relevant symptoms, including emotion regulation difficulties and dissociative symptoms. Emerging work suggests that these symptoms may serve as important predictors of functional impairment among individuals with PTSD.

Objective and methods: The present study investigated the contributions of difficulties with emotion regulation, dissociative symptoms, and individual PTSD symptom clusters to functional impairment among an inpatient civilian sample who completed self-report assessments of PTSD symptoms, functional impairment, emotion regulation difficulties, and dissociative symptoms, upon admission to the program. Participants met criteria for probable PTSD as per the PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and reported high rates of exposure to childhood abuse and neglect.

Results: Emotion regulation difficulties contributed significantly, while dissociative symptoms and PTSD arousal and reactivity symptoms showed a signal toward contributing significantly to a model accounting for variance in functional impairment among individuals with probable PTSD. Differential patterns of contributors emerged for the various domains of functional impairment measured.

Conclusions: These findings add to a growing body of literature highlighting the importance of emotion regulation difficulties, dissociative symptoms, and arousal and reactivity symptoms in contributing to functional impairment in this disorder. Recovery to premorbid functional status in PTSD may require interventions that target directly these symptoms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

MeSH terms

  • Adult
  • Dissociative Disorders / psychology*
  • Emotional Regulation*
  • Female
  • Functional Status*
  • Hospitalization
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stress Disorders, Post-Traumatic / physiopathology
  • Stress Disorders, Post-Traumatic / psychology*