Complex posttraumatic stress disorder and emotion dysregulation: A better understanding of the literature through a systematic review.

Abstract

OBJECTIVE: This Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review aimed to clarify and summarize what is known about the role of emotion dysregulation (ED) in complex posttraumatic stress disorder (CPTSD) from both cross-sectional and longitudinal perspectives by (a) exploring the links between CPTSD and ED symptoms in trauma-exposed individuals; (b) comparing the intensity of ED phenomena between measures of CPTSD and posttraumatic stress disorder symptoms; (c) characterizing the underlying correlates, observable manifestations, and strategies of emotion regulation; and (d) identifying assessment tools that measure ED in CPTSD. METHOD: ; used quantitative data to evaluate emotional regulation and CPTSD symptoms; employed cross-sectional or longitudinal designs; and utilized samples with significant trauma exposure. RESULTS: A total of 33 studies were included, demonstrating a significant link between ED and CPTSD symptoms and showing a greater frequency of ED symptoms in CPTSD compared to posttraumatic stress disorder. Avoidance responses such as emotion suppression, dissociation, and self-destructive behaviors were frequently reported, ranging from emotional hypoactivation to hyperactivation. Findings on underlying correlates and observable manifestations varied widely. CONCLUSIONS: Despite the diversity of correlates, manifestations, and strategies, this systematic review shows that ED is a central feature of CPTSD and contributes to symptom severity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).