Unhealed Wounds: From Complex Trauma Exposure to Wellbeing and the Role of Coping

Abstract

Complex Posttraumatic Stress Disorder (cPTSD) emerged as a theoretical construct reflecting symptoms beyond our current conceptualization of posttraumatic stress. Research examining its validity is still ongoing and cross-cultural research on the matter is emerging. An important risk factor to developing cPTSD is the experience of complex trauma, which constitutes experiences that reflect interpersonal violations of bodily boundary and integrity or betrayal (e.g., sexual assault and emotional abuse). There is still a gap in the literature linking complex trauma exposure to wellbeing or positive functioning in general. Survivors’ style of coping with trauma might influence later adjustment. With a sample of trauma survivors from Saudi Arabia, the present study evaluated the construct validity of cPTSD as well as examined the relationship between complex trauma and wellbeing as moderated by styles of coping. Results showed that all conceptualizations of complex trauma significantly predicted decreased wellbeing, but that such associations were not moderated by active nor passive style of coping. Factor and network analyses provided evidence for the construct validity of cPTSD, with the 6 first-order correlated factors model representing the best fit for the data, χ2 (155) = 431.373, p < .001, CFI = .941, TLI = .928, RMSEA = .064, 90% CI [.057, .071], SRMR = .041. Exploratory network analyses yielded 4-factor solutions distinguishing boundaries between PTSD, disturbance in self-organization (DSO), depression, and anxiety. Collectively, these findings call for systemic efforts to help increase access to well-researched and effective interventions as well as provide suggestions for central symptoms in these networks, and offer practitioners evidence for cPTSD validity and an assessment tool to utilize in Arabic.