The relationship between complex PTSD and dissociation: longitudinal findings across Western and South Asian female samples
Year: 2026
Type: article
Study design: Observational Study
Abstract: PURPOSE: Post-traumatic stress disorder (PTSD) and dissociation are common responses to trauma, especially interpersonal and betrayal trauma. Dissociation has been proposed to be a core concept in understanding PTSD. However, little is known about the bidirectional relationship between dissociation and ICD-11 complex PTSD (CPTSD) symptoms. This study examined the relationship between classical PTSD, disturbances in self-organization (DSO), and dissociative symptoms across two culturally different samples. METHODS: Participants from Western and South Asian countries completed validated measures of PTSD, DSO, and dissociation two times, approximately six months apart. RESULTS: Across the Western (N = 101) and South Asian (N = 160) samples, at baseline, 71.7% to 84.2% of participants with probable CPTSD exhibited co-occurring dissociative symptoms, while 70.0% to 72.3% of participants with dissociative symptoms had probable PTSD or CPTSD. Dissociative symptoms were less common in participants with probable PTSD (20.0% to 28.6%). In addition, dissociative symptoms predicted subsequent levels of classical PTSD symptoms across the two samples (β = 0.241 to 0.246, p < .01). The predictive role of dissociative symptoms on DSO symptoms was only observed in the South Asian sample (β = 0.231, p = .011). Neither PTSD nor DSO symptoms predicted dissociative symptoms in both samples. CONCLUSION: This study provides updated and cross-cultural data showing that dissociation is associated with an increase in PTSD symptoms over time, though its association with DSO symptoms is less clear. Assessment, prevention, and treatment of PTSD should take dissociative symptoms into consideration.
Authors: Hong Wang Fung, Celinene M. Lay, Guangzhe Frank Yuan, Anson Kai Chun Chau, Marc Eric S. Reyes, Edo S. Jaya, Firdaus Mukhtar, Amos En Zhe Lian, Görkem Derin, Peejay D. Bengwasan, Georgekutty Kochuchakkalackal Kuriala, Kadir Uludag, Steffi Hartanto, Nimaz Indryastuti Dewantary, Riangga Novrianto, Zoe Jiwen Zhang, Chak Hei Ocean Huang, Shao-Cheng Wang, Stanley Kam Ki Lam
Institutions: Hong Kong Polytechnic University, Yale University, Leshan Normal University, University of Hong Kong, University of Santo Tomas, University of Indonesia, Universiti Putra Malaysia, Raffles University Iskandar, Columbia International University, Istanbul University-Cerrahpaşa, Istanbul University, De La Salle University, Newman College, Shanghai Jiao Tong University, Universitas Gadjah Mada, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung Municipal Ta-Tung Hospital, Hong Kong Metropolitan University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $4,390
Funder: Hong Kong Polytechnic University
OpenAlex ID: W7129011838