Emotional Dysregulation in Complex Post-Traumatic Stress Disorder: a Narrative Review

Emotional Dysregulation (ED) refers to difficulties in managing emotions effectively, leading to a wide range of manifestations, including outbursts of anger, overwhelming sadness, and emotional numbness. Being part of the disturbances of self-organisation, ED is a core symptom of Complex Post-Traumatic Stress Disorder (cPTSD), and it severely affects patients’ functioning and overall quality of life.

This narrative review explores the intricate relationship between ED and cPTSD. To this end, the concept of ED will be defined, including how it can be assessed, its contribution to the disorder’s symptoms, and an examination of ED’s role in the development and maintenance of cPTSD.  Furthermore, an assessment of its physiological effects and importance for enhancing treatment outcomes will also be outlined.

ED also has an important role in explaining the comorbidities of cPTSD. These include substance use disorder, suicidality, depression, and anxiety, whose association might be mediated by ED, which serves as a key proxy for patients’ worse clinical outcomes. As such, it may be helpful for clinicians to recognise, assess, and treat ED but also to target and treat its comorbidities simultaneously.

Awareness of the link between ED and cPTSD is crucial to consider when developing treatment plans tailored to the patient’s characteristics. This can be aided by the availability of various rapid ED assessment tools, some of which may be suitable for deployment in multiple settings, ranging from primary care to scientific research.