The relationship between Complex PTSD symptoms and functional impairment in individuals with attachment trauma and comorbid mental illness

Abstract

Background

Individual with histories of complex attachment (relational) trauma and comorbid mental illness often have significant treatment needs. The current study sought to explore the relative contribution of Complex PTSD symptom clusters on functional impairment in this population.

Methods

A convenience sample of 74 individuals admitted to a specialty treatment service for trauma-related disorders completed the International Trauma Questionnaire to assess Complex PTSD symptoms and functional impairment.

Results

Meeting diagnostic criteria for any of the Complex PTSD symptom clusters was significantly associated with meeting the functional impairment criterion. Nevertheless, the strength of associations differed between symptom clusters. Individuals endorsing diagnostic criteria for affective dysregulation or disturbances in relationships had a higher risk/probability of meeting criteria for DSO functional impairment, while those endorsing avoidance or sense of threat having a higher risk/probability of meeting criteria for PTSD functional impairment. Dimensional severity of all Complex PTSD symptom clusters was significantly associated with dimensional severity of functional impairments; however, only negative self-concept, disturbances in relationships and avoidance were found to be significant predictors of DSO or PTSD related severity of functional impairment when controlling for other symptom clusters.

Conclusions

Trauma symptoms have differential impacts on functional impairment. Prioritizing the most impactful symptoms may be critical for providing timely and efficient treatment of Complex PTSD. Negative self-concept, disturbances in relationships and avoidance stemming from traumatic experiences may be particularly crucial targets in interventions for individuals with histories of attachment trauma, Complex PTSD symptoms and comorbid mental illness.