Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samples

Background: Although trauma-related symptoms (e.g. complex PTSD and dissociative symptoms) and psychotic symptoms often co-occur, little is known about the complex relationships among these symptoms over time.Objective: This study examined the bidirectional relationships among complex PTSD symptoms,...

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Main Authors: Hong Wang Fung, Anson Kai Chun Chau, Stanley Kam Ki Lam, Grace Wing Ka Ho, Colin A. Ross, Ming Yu Claudia Wong, Edward K. S. Wang, Wai Tong Chien, Janet Yuen-Ha Wong
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:European Journal of Psychotraumatology
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Online Access:https://www.tandfonline.com/doi/10.1080/20008066.2025.2458364
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author Hong Wang Fung
Anson Kai Chun Chau
Stanley Kam Ki Lam
Grace Wing Ka Ho
Colin A. Ross
Ming Yu Claudia Wong
Edward K. S. Wang
Wai Tong Chien
Janet Yuen-Ha Wong
author_facet Hong Wang Fung
Anson Kai Chun Chau
Stanley Kam Ki Lam
Grace Wing Ka Ho
Colin A. Ross
Ming Yu Claudia Wong
Edward K. S. Wang
Wai Tong Chien
Janet Yuen-Ha Wong
author_sort Hong Wang Fung
collection DOAJ
description Background: Although trauma-related symptoms (e.g. complex PTSD and dissociative symptoms) and psychotic symptoms often co-occur, little is known about the complex relationships among these symptoms over time.Objective: This study examined the bidirectional relationships among complex PTSD symptoms, dissociative symptoms, and positive symptoms of psychosis.Methods: This study analyzed available longitudinal data from two convenience samples (Sample 1: N = 214, Chinese-speaking adults; Sample 2: N = 301, English-speaking adults). Participants in both samples completed validated measures of ICD-11 complex PTSD (that included measurement of ‘classical’ PTSD), dissociation, and positive symptoms of psychosis at baseline and follow-up, six months (Sample 1) or 12 months (Sample 2) apart. A cross-lagged panel model was used to examine the longitudinal relationship between trauma-related symptoms and psychotic symptoms in each sample.Results: In Sample 1, baseline dissociative symptoms significantly predicted positive symptoms of psychosis at follow-up. In Sample 2, no significant longitudinal relationships between trauma-related and psychotic symptoms were observed. In both samples, baseline disturbances in self-organization (DSO) symptoms predicted ‘classical’ PTSD symptoms at follow-up.Conclusion: This study made the first attempt to examine the longitudinal relationships among ICD-11 complex PTSD symptoms, dissociative symptoms, and psychotic symptoms. The inconsistent findings point to the importance of further research on the longitudinal relationships between trauma-related and psychotic symptoms. Moreover, our results indicate that addressing DSO symptoms may be important in the prevention and treatment of PTSD symptoms.
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spelling doaj-art-9b95f4d78e724aadb8227ea9d992df272025-08-20T03:05:34ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2458364Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samplesHong Wang Fung0Anson Kai Chun Chau1Stanley Kam Ki Lam2Grace Wing Ka Ho3Colin A. Ross4Ming Yu Claudia Wong5Edward K. S. Wang6Wai Tong Chien7Janet Yuen-Ha Wong8School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong KongDepartment of Psychiatry, the University of Hong Kong, Pokfulam, Hong KongNethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong KongSchool of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong KongThe Colin A. Ross Institute for Psychological Trauma, Richardson, TX, USADepartment of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong KongMassachusetts General Hospital, Harvard Medical School, Boston, MA, USANethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong KongSchool of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong KongBackground: Although trauma-related symptoms (e.g. complex PTSD and dissociative symptoms) and psychotic symptoms often co-occur, little is known about the complex relationships among these symptoms over time.Objective: This study examined the bidirectional relationships among complex PTSD symptoms, dissociative symptoms, and positive symptoms of psychosis.Methods: This study analyzed available longitudinal data from two convenience samples (Sample 1: N = 214, Chinese-speaking adults; Sample 2: N = 301, English-speaking adults). Participants in both samples completed validated measures of ICD-11 complex PTSD (that included measurement of ‘classical’ PTSD), dissociation, and positive symptoms of psychosis at baseline and follow-up, six months (Sample 1) or 12 months (Sample 2) apart. A cross-lagged panel model was used to examine the longitudinal relationship between trauma-related symptoms and psychotic symptoms in each sample.Results: In Sample 1, baseline dissociative symptoms significantly predicted positive symptoms of psychosis at follow-up. In Sample 2, no significant longitudinal relationships between trauma-related and psychotic symptoms were observed. In both samples, baseline disturbances in self-organization (DSO) symptoms predicted ‘classical’ PTSD symptoms at follow-up.Conclusion: This study made the first attempt to examine the longitudinal relationships among ICD-11 complex PTSD symptoms, dissociative symptoms, and psychotic symptoms. The inconsistent findings point to the importance of further research on the longitudinal relationships between trauma-related and psychotic symptoms. Moreover, our results indicate that addressing DSO symptoms may be important in the prevention and treatment of PTSD symptoms.https://www.tandfonline.com/doi/10.1080/20008066.2025.2458364TraumaPTSDcomplex PTSDdissociationpsychosisTrauma
spellingShingle Hong Wang Fung
Anson Kai Chun Chau
Stanley Kam Ki Lam
Grace Wing Ka Ho
Colin A. Ross
Ming Yu Claudia Wong
Edward K. S. Wang
Wai Tong Chien
Janet Yuen-Ha Wong
Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samples
European Journal of Psychotraumatology
Trauma
PTSD
complex PTSD
dissociation
psychosis
Trauma
title Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samples
title_full Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samples
title_fullStr Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samples
title_full_unstemmed Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samples
title_short Bidirectional relationships among complex PTSD, dissociation, and psychotic symptoms in two samples
title_sort bidirectional relationships among complex ptsd dissociation and psychotic symptoms in two samples
topic Trauma
PTSD
complex PTSD
dissociation
psychosis
Trauma
url https://www.tandfonline.com/doi/10.1080/20008066.2025.2458364
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