Association of Childhood Complex Trauma and Dissociation With Complex Posttraumatic Stress Disorder Symptoms in Adulthood
Abstract
This study replicates and extends prior research on the relationship of childhood complex trauma (CCT) and complex posttraumatic stress disorder (cPTSD) in adulthood, examining the role of psychoform and somatoform dissociation as a potential mediator. CCT, dissociation, and cPTSD were assessed in a large sample of adult psychiatric inpatients. Almost two thirds of participants reported having experienced CCT. Path analyses with bootstrap confidence intervals demonstrated a relationship between CCT, psychoform (but not somatoform) dissociation, and cPTSD. In addition, psychoform dissociation partially mediated the relationship between CCT and adult cPTSD symptoms. Dissociation (pathological or nonpathological psychoform and somatoform symptoms) warrants further clinical and scientific study as a potential link between CCT and the presence of adult cPTSD symptoms and/or the dissociative subtype of PTSD.
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BPD is primarily associated with under-regulation of emotion associated with a fear of abandonment, while cPTSD (as defined by DESNOS) involves alternating states of under-regulation of emotion combined with trauma-related positive dissociative symptoms or over-regulated emotion combined with negative dissociative symptoms.
“BPD was found to be primarily associated with under-regulation of emotion associated with a fear of abandonment, while cPTSD (as defined by DESNOS) involved alternating states of under-regulation of emotion combined with trauma-related positive dissociative symptoms (i.e., flashbacks, identity fragmentation) or over-regulated emotion combined with negative dissociative symptoms (i.e., derealiz”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [176]
In a study with adult mental health patients, psychoform (but not somatoform) dissociation partially mediates the relationship between a history of childhood maltreatment and cPTSD (assessed using DESNOS criteria).
“In a study with adult mental health patients, psychoform (but not somatoform) dissociation partially mediated the relationship between a history of childhood maltreatment and cPTSD (assessed using DESNOS criteria) [176]”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [176]
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Wegen, K. S., van Dijke, A., Aalbers, A., & Zedlitz, A. M. E. E. (2017) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2017.06.001 · Cited by 7 · see citing works
Forensic implications of changes in DSM-5 criteria for responses to trauma and stress
Milchman, M. S. (2016) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2016.10.004 · Cited by 7 · see citing works
Rossi, R., Jannini, T. B., Socci, V., Pacitti, F., Rossi, A., & Lorenzo, G. D. (2025) · General Psychiatry · doi:10.1136/gpsych-2023-101277 · Cited by 6 · see citing works
Childhood Maltreatment and Complex PTSD: A Systematic Literature Review
Omidbakhsh, Z., Mohammadi, Z., & Soltanabadi, S. (2025) · Trauma Violence & Abuse · doi:10.1177/15248380251320985 · Cited by 6 · see citing works
Kovács, G., van Dijke, A., Leontjevas, R., & Enders‐Slegers, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710803 · Cited by 5 · see citing works
van Dijke, A., & Lenstra, S. (2016) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000271 · Cited by 4 · see citing works
How-To Study Dissociative Symptoms in a Broad Range of Mental Disorders: A Methodological Primer
Danböck, S. K., Mertens, Y. L., Kulla, P., Seitz, K. I., & Schalinski, I. (2025) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2025.2481474 · Cited by 4 · see citing works
Eckhardt, A., Zambrano, E. A., & Nilsson, D. K. (2018) · Journal of Child and Adolescent Mental Health · doi:10.2989/17280583.2018.1553780 · Cited by 4 · see citing works
Development and initial evaluation of a measure of positive beliefs about dissociative experiences
Marsden, L., Longden, E., Parry, S. L., Morrison, A. P., & Varese, F. (2021) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2020.1869641 · Cited by 2 · see citing works
The impact of childhood trauma on the emergence and development of dissociative disorders
ČR, P. Ú. A., Schmidtová, J., Štěpánek, P., & Čermák, I. (2021) · Ceskoslovenska psychologie · doi:10.51561/cspsych.65.2.178 · Cited by 2 · see citing works
Connors, K. J. (2017) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2018.1379855 · Cited by 2 · see citing works
Videoconferencing Psychotherapy in an App Environment for Trauma-Related Psychopathology
van Dijke, A., & van Lankveld, J. J. D. M. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.86364 · Cited by 2 · see citing works
Eibl, M., & Turliuc, M. N. (2025) · Psychology Health & Medicine · doi:10.1080/13548506.2025.2561738 · Cited by 1 · see citing works
Kim, D., Kim, D., & Kim, E. K. (2023) · Psychosis · doi:10.1080/17522439.2023.2176536 · Cited by 1 · see citing works
Childhood Relational Trauma and Dissociative Symptoms Across the Lifespan
Ford, J. D. (2025) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2025.2550049 · Cited by 1 · see citing works
Self-citationTraumata und psychotische Psychopathologie
Tschöke, S., Grieb, B., & Steinert, T. (2017) · Trauma und Gewalt · doi:10.21706/tg-11-3-180
FRUSTRATION TOLERANCE IN STUDENTS WITH COMPLEX POSTTRAUMATIC STRESS
Cheremiskina, I. I., Викторовна, К. Т., & Belkina, A. (2023) · Человеческий капитал. · doi:10.25629/hc.2023.04.32
Scene construction deficits in adolescent PTSD are in sensory, rather than spatial, imagery
Marlatte, H., Ryan, J. D., & Gilboa, A. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1589756
Nie, H., Liu, M., & Wu, X. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251396893
Krause-Utz, A., & van Dijke, A. (2026) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2026.2695585
Ahn, H., Hong, J. S., & Han, D. H. (2026) · Discover Psychology · doi:10.1007/s44202-026-00815-3
- Authors
- van Dijke, A., Ford, J. D., Frank, L. E., & van der Hart, O.
- Affiliations
- Utrecht University (NL)
- ORCID
- Frank, Laurence E.
- Venue
- Journal of Trauma & Dissociation
- Publisher
- Informa UK Limited
- Published
- 2015-04-23
- Volume
- 16
- Issue
- 4
- Pages
- 428-441
- ISSN
- 1529-9732 (ISSN-L)
- 1529-9740
- OpenAlex
- W1811163185
- Cited by
- 53
- References
- 71
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 4
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Trauma & Dissociation (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- complex PTSD, dissociation, somatoform dissociation, mediation, psychiatric inpatients, dissociative subtype of PTSD
- MeSH terms
- Psychological Trauma, Adult, Mental Disorders, Child, Dissociative Disorders, Female, Humans, Life Change Events, Male, Middle Aged, Models, Psychological, Psychotherapy, Stress Disorders, Post-Traumatic, Comorbidity
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