Vulnerability to trauma – Complex PTSD and Emotion Dysregulation as a consequences

Vulnerability to trauma – Complex PTSD and Emotion Dysregulation as a consequences
Bojana Pejuskovic1,2, Marija Lero1, Viktor Pavlovic1, Milica Lazic1, Mila Arsenijevic1, Neda Ognjanovic1, Bojana Lukic1
1 Institute of Mental Health, Belgrade, Serbia
2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Introduction: Emotion dysregulation is a key mechanism linking early adversity and trauma to mental health outcomes. The objective of this study was to examine the relative contributions of emotional distress, childhood adversity, and trauma-related symptoms in predicting difficulties in emotion regulation.
Methods: The sample consisted of 89 patients (Mage = 45.09, SD = 2.51, 60.7% were female, 39.3% were male) hospitalised at the Clinical Department of Crisis and Affective Disorders, Institute of Mental Health, Belgrade. After the informed consent of patients, the following assessment tools were administered: A socio-demographic questionnaire, Difficulties in Emotion Regulation Scale (DERS-SF), the International Trauma Questionnaire (ITQ), the Depression Anxiety Stress Scales (DASS-21) and the Adverse Childhood Experiences Questionnaire (ACE-Q).
Results: A hierarchical multiple regression was used to identify predictors of emotion dysregulation. Emotional distress (depression, anxiety, stress) explained 53.8% of the variance, with anxiety emerging as the strongest predictor (β = .499, p = .009). Adding childhood adversity (ACE-Q) significantly improved the model (ΔR² = .032, p < .05), though its contribution became non-significant in later steps. In the third block, complex PTSD features—negative self-concept, affective dysregulation, and relational disturbances—further improved the model (ΔR² = .059, p < .05). Disturbances in relationships were a significant predictor (β = .223, p < .05), suggesting they may mediate the link between early adversity and emotion dysregulation. PTSD-specific symptoms (avoidance, re-experiencing, threat) did not significantly enhance the model (ΔR² = .011, p = .573). The final model accounted for 64.1% of the variance in emotion dysregulation.
Conclusions: After accounting for emotional distress and adversity, CPTSD symptoms explained additional variance in emotion dysregulation, while traditional PTSD symptoms did not. Disturbances in self-concept and relationships may be more central than re-experiencing or avoidance.

Bojana Pejuskovic