Untangling Relational Trauma: A Symptom Network Model of Complex Posttraumatic Stress Disorder within a Relational Framework

The recent inclusion of complex posttraumatic stress disorder (CPTSD) within the International Classification of Diseases, eleventh edition (ICD-11) prompted scholars to re-evaluate treatment guidelines for traumatic disorders. The present study aimed to conceptualize dyadic, community, and systemic connections within the context of ICD-11 traumatic disorders and investigate unique associations between factors capturing relational quality. The current study additionally utilized a novel network modeling approach to explore the CPTSD symptom network structure using a college sample of trauma survivors. Consistent with generations of theory and research, relational quality factors associated with the disturbances in self-organization (DSO) symptom cluster, and anticipated discrimination associated with both relational disturbance and sense of threat. Affect dysregulation, re-experiencing, and relational engagement emerged as most central within the CPTSD symptom network, providing evidence towards the role of affect regulation in relational functioning, while intersectional discrimination associated with both the PTSD and DSO symptom clusters. Findings from the present study provide context to the potential application of a relational and systems focused intervention.