Childhood Maltreatment and Complex PTSD: A Systematic Literature Review

There is established evidence that childhood maltreatment is associated with Complex Posttraumatic Stress Disorder (C-PTSD), although the underlying mechanisms are not still precise. The current study aimed to systematically review empirical studies examining potential psychological factors linking childhood maltreatment to C-PTSD and the gaps in the literature. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol, 19 original studies with a total of n = 1,075 subjects were analyzed. Five mediating processes were identified: (a) Emotional Processing as approaching, accepting, symbolizing, tolerating, regulating, making meaning of, and utilizing or transforming emotions; (b) Intrapersonal Factors describing factors operating or constructs occurring within the person, such as attitudes, decisions, self-concept, self-esteem, or self-regulation; (c) Interpersonal Factors are elements that shape how individuals engage with each other, including personal characteristics, and communication dynamic; (d) Dissociation that is a defense mechanism in which conflicting impulses are kept apart or threatening ideas and feelings are separated from the rest of the psych; and (e) Social Factors are factors (e.g., attitudes) that affect thought or behavior in social contexts or that affect self-concept vis-à-vis other individuals or groups. Further research is required to examine the extent to which targeting these mediators may act as mechanisms for change in supporting individuals to heal from childhood maltreatment.