A network analysis exploring the relationship between ICD-11 Complex Post Traumatic Stress Disorder (CPTSD) symptoms and emotion regulation strategies in women intimate partner violence survivors in Spain

Complex posttraumatic stress disorder (CPTSD) was introduced in ICD-11 in 2018 and there has been limited research on the association between CPTSD and emotional regulation (ER) strategies. It is important to understand how the constituent dimensions of CPTSD (PTSD and Disturbances in Self-Organisation (DSO)) are associated with different ER strategies in order to help inform the development of interventions to aid recovery from this debilitating condition. This study investigated the network structure of PTSD and DSO symptoms of CPTSD and components of ‘Cognitive Reappraisal’ and ‘Suppressive Expression’ emotion regulation strategies based on a sample of Spanish women who had experienced intimate partner violence (N = 317). The results showed that the most central symptom was "feeling distant or cut off from others". In addition, other DSO symptoms were positively associated with the maladaptive strategies of expressive suppression and negatively associated with the cognitive reappraisal strategies. In the case of affective dysregulation symptoms, hypoactivation was found to play a more central role than hyperactivation. Future research is now required to examine whether targeting emotional regulation strategies such as hypoactivation affect dysregulation symptoms can have a positive impact on the DSO symptoms.