Psychological trauma at different developmental stages and ICD-11 CPTSD: The role of dissociation

Sally Jowett Jowett, Thanos Karatzias, M Shevlin, Philip Hyland

Research output: Contribution to journalArticlepeer-review


Background: Dissociation is commonly reported by individuals who meet criteria for PTSD and Complex PTSD. However, the association between the age of trauma exposure, dissociation and CPTSD is not well understood. The current study aimed to test whether dissociation mediated the relationship between the developmental stage of trauma exposure and CPTSD symptoms.
Method: A nationally representative sample from Ireland (N = 1,020) completed self-report measures on trauma exposure in childhood, adolescence, and adulthood, current trauma symptomatology, and dissociation symptoms. A mediation analysis was conducted.
Results: Childhood, Adolescent, and Adulthood trauma exposure were all related to Dissociation and ICD-11 Complex PTSD symptom clusters. Dissociation mediated the effect of developmental stage of trauma exposure on PTSD and DSO. The direct and indirect effects model provided the best fit of the data. Childhood trauma exposure was the only developmental stage which was directly associated with both PTSD and DSO symptoms in our sample.
Conclusion: Dissociation mediates the relationship between reported trauma exposure and the presence of ICD-11 CPTSD symptom clusters, and this relationship appears at its strongest when trauma occurs in childhood. CPTSD interventions should also promote dissociation management to aid recovery from this debilitating condition.
Original languageEnglish
JournalJournal of Trauma and Dissociation
Publication statusAccepted/In press - 25 Jan 2021


  • Dissociation
  • Complex PTSD
  • Trauma
  • Childhood trauma
  • Population


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