Exploring emotional regulation difficulties in CPTSD: Qualitative and quantitative analyses

The first objective of this mixed-methods study is to explore how patients with a complex posttraumatic stress disorder (CPTSD) manage emotion regulation difficulties, focusing on four themes: identification of emotions, strategies and associated behaviors, difficulties, need, and perceived effectiveness of emotion regulation. The second objective is to examine the links between these qualitative findings and quantitative measures of emotion regulation difficulties, posttraumatic, and dissociative symptoms. We recruited 30 participants diagnosed with CPTSD by a psychiatrist. They completed semi-structured interviews conducted by a trained clinician and filled out self-report questionnaires assessing emotion regulation difficulties, dissociative symptoms, and posttraumatic symptoms. Data were analyzed using a mixed qualitative approach and a correlational design. Correlations between qualitative and quantitative data were identified. Eighty-three percent of our participants reported difficulties in emotion regulation due to intrusive thoughts, and 70% explained having impaired emotional abilities. The main strategies reported were strategies of suppression and passivity (83%). These strategies were more strongly associated with overall CPTSD symptoms than other strategies (r ranging from .44 to .51). These findings reinforce the central role of emotion regulation difficulties in CPTSD, offering a richer understanding and characterization of how these challenges shape patients’ lived experiences and their associations with complex posttraumatic symptoms.