Differential Pathways of Emotion Regulation Difficulties Linking Childhood Maltreatment to Disturbances in Self-Organisation in Adolescents

Childhood maltreatment (CM) is associated with disturbances in self-organisation (DSO), a core component of Complex Post-Traumatic Stress Disorder. Although difficulties in emotion regulation (DER) may contribute to this relationship, limited research has examined the differential indirect associations of specific DER dimensions with DSO, particularly among adolescents in non-Western contexts. This study examined these associations among 444 adolescents aged 14–17 years recruited from clinical and community settings across Kerala and Karnataka, India. CM, DER, and DSO were assessed using the Childhood Trauma Questionnaire, Difficulties in Emotion Regulation Scale, and International Trauma Questionnaire, respectively. Structural equation modeling was used to examine direct and indirect associations. CM was significantly associated with DSO and all six DER dimensions. However, significant indirect associations with DSO were observed only through impulse control difficulties, difficulties engaging in goal-directed behavior, and limited access to emotion regulation strategies. Non-acceptance of emotional responses, lack of emotional awareness, and unclear emotional experiences did not demonstrate significant indirect associations. These findings indicate that the association between CM and DSO may be differentially related to specific behavioral and functional aspects of emotion regulation rather than generalized dysregulation, highlighting the importance of a multidimensional approach to understanding trauma-related difficulties among adolescents.