van der Kolk · The American journal of psychiatry 1996 · cross-sectional observational study · n=520

Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma.

Cited 894 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional observational field trial comparing symptom clusters across trauma-exposed groups

PubMed 8659645 · doi:10.1176/ajp.153.7.83 · record verified 2026-08-31

What was done

Data were analyzed from the DSM-IV field trial for PTSD involving 520 trauma-exposed individuals (395 treatment-seeking and 125 non-treatment-seeking). The study examined associations between trauma characteristics (nature of trauma, age at onset) and clinical features, including PTSD diagnosis, dissociation, somatization, and affect dysregulation.

What was found

PTSD, dissociation, somatization, and affect dysregulation were highly interrelated. Participants with lifetime (but not current) PTSD scored significantly lower on these symptom domains than those with current PTSD, but significantly higher than trauma-exposed individuals who never developed PTSD. Individuals with childhood trauma had significantly more symptoms than those exposed to adult interpersonal trauma, who in turn had significantly more symptoms than disaster victims. No exact numbers, test statistics, or p-values are reported in the abstract.

Why it matters

This study provides empirical support for complex post-traumatic adaptations, demonstrating that early and interpersonal trauma can produce extensive somatic and affect-regulation difficulties beyond traditional PTSD criteria.

Limits

The abstract provides no numerical data, effect sizes, or confidence intervals. The cross-sectional design cannot confirm longitudinal symptom trajectories, retrospective reporting of trauma is subject to recall bias, and the sample is heavily weighted toward treatment-seeking individuals.

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