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Cited by 80Posttraumatic Stress Disorder ResearchChild Abuse and TraumaPersonality Disorders and Psychopathology

Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

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van Dijke, Annemiek, Hopman, Juliette A. B., Ford, Julian D.·2018·European Journal of Psychotraumatology
DOI 10.1080/20008198.2017.1400878PMC PMC5795767
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Abstract

Objective: Complex posttraumatic stress disorder (CPTSD) as defined by the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) formulation is associated with childhood relational trauma and involves relational impairment, affect dysregulation, and identity alterations. However, the distinct contributions of relational impairment (operationalized in the form fears of closeness or abandonment), affect dysregulation (operationalized in the form of overregulation and under-regulation of affect), and identity alterations (operationalized in the form of positive or negative psychoform or somatoform dissociation) to the relationship between childhood trauma and CPTSD/DESNOS have not been systematically tested.Method and Results: In a clinical sample of adults diagnosed with severe and chronic psychiatric and personality disorders (n = 472; M = 34.7 years, SD = 10.1), structural equation modelling with bootstrap 95% confidence intervals demonstrated that the association between childhood trauma and CPTSD/DESNOS symptoms in adulthood was partially mediated by under-regulation of affect, negative psychoform dissociation, and adult relational fears of closeness and of abandonment. These results also were independent of the effects of borderline personality disorder (BPD) symptoms.Conclusions: Some, but not all, hypothesized components of the DESNOS formulation of CPTSD statistically mediate the relationship between childhood trauma and adult CPTSD/DESNOS. These relationships appear specific to CPTSD/DESNOS and not to the effects of another potential sequelae of childhood trauma BPD. Replication with prospective longitudinal studies is needed.

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  • Dissociation is problematic for a sub-set of individuals diagnosed with BPD, PTSD, and cPTSD, both as freestanding disorders and when comorbid with one another.

    “Dissociation has been shown to be problematic for a sub-set of the individuals who are diagnosed with BPD, PTSD, and cPTSD, both as freestanding disorders and when comorbid with one another [95, 179, 180].”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [180]

    The Discussion (page unavailable) identifies dissociation as a domain associated with BPD and CPTSD/DESNOS, and mentions the dissociative subtype of PTSD. It does not establish that dissociation is problematic across all three diagnoses both separately and in every comorbid combination. (LLM, conf=0.84)

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  • The comorbidity of cPTSD and BPD was reported for the DESNOS version of cPTSD in a Dutch inpatient psychiatric sample: BPD was comorbid in 79% of cPTSD cases and cPTSD was comorbid in 40.5% of BPD cases.

    “The comorbidity of cPTSD and BPD was reported for the DESNOS version of cPTSD in a Dutch inpatient psychiatric sample [180]: BPD was comorbid in 79% of cPTSD cases and cPTSD was comorbid in 40.5% of BPD cases.”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [180]

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Research works printed but not linked: 3

  1. Ford J. D. (2017a). Complex trauma and complex PTSD In Cook J., Gold S., & Dalenberg C. (Eds.), Handbook of trauma psychology (Vol. 2, pp. 322– 349). Washington, DC: American Psychological Association.
  2. Muthén L. K., & Muthén B. O. (1998-2011). Mplus user’s guide (5th ed.). Los Angeles, CA: Author.
  3. Van Dijke A. (2008). The clinical assessment of attachment trauma related self - and affect dysregulation In A. Vingerhoets, I. Nyklicek, & J. Denollet (Eds.), Affect regulation: Conceptual and clinical issues (pp. pp 150– 169). Springer: New York, NY.

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Authors
van Dijke, A., Hopman, J. A. B., & Ford, J. D.
Affiliations
  • Yulius Academy/Yulius/COLK Centre for Psychosomatics Yulius
  • Erasmus MC (NL)
  • Department of Psychiatry, University of Connecticut Health Center
Venue
European Journal of Psychotraumatology
Publisher
Informa UK Limited
Published
2018-01
Volume
9
Issue
1
Pages
1400878-1400878
ISSN
2000-8066 (ISSN-L)
DOI
10.1080/20008198.2017.1400878
PMC
PMC5795767
OpenAlex
W2792928199
Cited by
80
References
51
Citations by year
2026: 9 · 2025: 14 · 2024: 9 · 2023: 8 · 2022: 8 · 2021: 14 · 2020: 9 · 2019: 6 · 2018: 2 · 2017: 1
FWCI
9.11
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Psychotraumatology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • RePub (Erasmus University Rotterdam) (submittedVersion)
  • VU Research Portal (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
complex PTSD, childhood trauma, affect dysregulation, somatoform dissociation, borderline personality disorder, mediation

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