Restricted accessResearch articleFirst published online 2026
A Network Analysis Exploring the Relationship Between ICD-11 Complex Post-Traumatic Stress Disorder (CPTSD) Symptoms and Emotion Regulation Strategies in Women Survivors of Intimate Partner Violence in Spain
Complex post-traumatic stress disorder (CPTSD) was introduced in ICD-11 in 2018, and there has been limited research on the association between CPTSD and emotion 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 examined the network structure of PTSD and DSO symptoms of CPTSD, along with components of emotion regulation strategies (cognitive reappraisal and expressive suppression), in 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 needed to examine whether targeting emotion regulation strategies may contribute to changes in affective dysregulation (particularly hypoactivation) and other DSO symptoms.
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