Childhood Trauma,Posttraumatic Stress Disorder,and Dissociation: Preliminary Validation of a Five-Factor Model of PTSD Using the Posttraumatic Stress Disorder Symptom Severity Scale–Forensic Version (EGS-F) in Women Survivors of Intimate Partner Violence

Abstract

Violence is widely recognized as a critical public health issue, with posttraumatic stress disorder (PTSD) among the possible psychological consequences. Exposure to high levels of interpersonal trauma significantly increases the risk of developing PTSD. This study aimed to evaluate the psychometric properties of the Forensic Version of the Posttraumatic Stress Disorder Symptom Severity Scale (EGS-F) in a sample of Ecuadorian women. Specifically, we assessed a five-factor model to examine whether the dissociation subdimension proposed by the EGS-F functions as a complementary component in the assessment of PTSD and examined the association between childhood trauma and PTSD symptomatology. A nonprobabilistic convenience sample of 298 Ecuadorian women (M_age= 35.84, SD = 11.66) who had experienced intimate partner violence participated in this study. Confirmatory factor analyses supported both first- and second-order five-factor models, indicating satisfactory model fit. Structural equation modeling (SEM) further demonstrated a significant association between childhood trauma and PTSD symptom severity. Findings support the reliability and validity of the EGS-F and suggest its utility for assessing PTSD symptoms in forensic and clinical settings within the Ecuadorian context. The findings also highlight the importance of cross-cultural validation of PTSD assessment tools. However, further research is needed to refine and validate the simulation subscale.

Plain Language Summary

This study evaluated the psychometric properties of EGS-F in Ecuadorian women who had experienced intimate partner violence (IPV) and were undergoing judicial processes. The results indicate that EGS-F adequately measures PTSD symptoms (intrusion, behavioral-cognitive avoidance, negative alterations in cognitions or mood, and hyperarousal), including dissociation. While these findings support the idea that traumas occurring during childhood affect the severity of PTSD symptoms in adulthood, the symptom simulation subscale did not function as expected in this group of women.

Keywords

posttraumatic stress disorder trauma confirmatory factor analysis validation forensic

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References

American Psychiatric Association. (2014). DSM-5: Manual diagnóstico y estadístico de los trastornos mentales: DSM5. Editorial Medica Panamericana.

American Psychiatric Association. (2022). DSM-5: Diagnostic and Statistical Manual of mental Disorders: DSM-5-TR. Editorial American Psychiatric Association.

Appelbaum

Cooper

Kline

R. B.

Mayo-Wilson

Nezu

A. M.

Rao

S. M.

(2018). Journal article reporting standards for quantitative research in psychology: The APA publications and communications board task force report. American Psychologist, 73(1), 3–25. https://doi.org/10.1037/amp0000191

Arbach

Barboni

Mercurio

(2024). Psychological assessment practices in legal contexts: A survey to professionals from Latin-America. Ciencias Psicológicas, 18(1), 3652. https://doi.org/10.22235/cp.v18i1.3652

Arce

Marcos

Sanmarco

Fariña

(2024). Is the self-reported information by male sentenced of violence against women in the intervention phase valid? Anuario de Psicología Jurídica, 34(1), 23–30. https://doi.org/10.5093/apj2023a3

Armour

Karstoft

K. I.

Richardson

J. D.

(2014). The co-occurrence of PTSD and dissociation: Differentiating severe PTSD from dissociative-PTSD. Social Psychiatry and Psychiatric Epidemiology, 49(8), 1297–1306. https://doi.org/10.1007/s00127-014-0819-y

Auslander

Tlapek

S. M.

Threlfall

Edmond

Dunn

(2018). Mental health pathways linking childhood maltreatment to interpersonal revictimization during adolescence for girls in the child welfare system. Journal of Interpersonal Violence, 33(7), 1169–1191. https://doi.org/10.1177/0886260515614561

Baley

T. D.

Brand

B. L.

(2017). Traumatic dissociation: Theory, research, and treatment. Clinical Psychology: Science and Practice, 24(2), 170–185. https://doi.org/10.1111/cpsp.12195

Bernstein

D. P.

Stein

J. A.

Newcomb

M. D.

Walker

Pogge

Ahluvalia

Stokes

Handelsman

Medrano

Desmond

, …, Zule

(2003). Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse & Neglect, 27(2), 169–190. https://doi.org/10.1016/S0145-2134(02)00541-0

10.

Bisson

J. I.

Cosgrove

Lewis

Roberts

N. P.

(2015). Post-traumatic stress disorder. Bmj, 351, Article h6161. https://doi.org/10.1136/bmj.h6161

11.

Blevins

C. A.

Weathers

F. W.

Witte

T. K.

(2014). Dissociation and posttraumatic stress disorder: A latent profile analysis. Journal of Traumatic Stress, 27(4), 388–396. https://doi.org/10.1002/jts.21933

12.

Brand

B. L.

Schielke

H. J.

Brams

J. S.

DiComo

R. A.

(2017). Assessing trauma-related dissociation in forensic contexts: Addressing trauma-related dissociation as a forensic psychologist, part II. Psychological Injury and Law, 10(4), 298–312. https://doi.org/10.1007/s12207-017-9305-7

13.

Brand

B. L.

Webermann

A. R.

Frankel

A. S.

(2016). Assessment of complex dissociative disorder patients and simulated dissociation in forensic contexts. International Journal of law and Psychiatry, 49(Pt. 2), 197–204. https://doi.org/10.1016/j.ijlp.2016.10.006

14.

Caramanica

Brackbill

R. M.

Stellman

S. D.

Farfel

M. R.

(2015). Posttraumatic stress disorder after hurricane sandy among persons exposed to the 9/11 disaster. International Journal of Emergency Mental Health, 17(1), 356. https://doi.org/10.4172/1522-4821.1000173

15.

Cheung

G. W.

Cooper-Thomas

H. D.

Lau

R. S.

Wang

L. C.

(2024). Reporting reliability, convergent and discriminant validity with structural equation modeling: A review and best-practice recommendations. Asia Pacific Journal of Management, 41, 745–783. https://doi.org/10.1007/s10490-023-09871-y

16.

Clark

D. A.

Bowles

R. P.

(2018). Model fit and item factor analysis: Overfactoring, underfactoring, and a program to guide interpretation. Multivariate Behavioral Research, 53(4), 544–558. https://doi.org/10.1080/00273171.2018.1461058

17.

Cloitre

Hyland

Prins

Shevlin

(2021). The international trauma questionnaire (ITQ) measures reliable and clinically significant treatment-related change in PTSD and complex PTSD. European Journal of Psychotraumatology, 12(1), 1–12. https://doi.org/10.1080/20008198.2021.1930961

18.

Comprehensive Organic Law to Prevent and Eradicate Violence Against Women. (2018). Official Registry Supplement 175. https://www.igualdad.gob.ec/wp-content/uploads/downloads/2018/05/ley_prevenir_y_erradicar_violencia_mujeres.pdf

19.

Costa

E. C. V.

Botelheiro

A. A. L. P.

(2020). The impact of intimate partner violence on psychological wellbeing: Predictors of posttraumatic stress disorder and the mediating role of insecure attachment styles. European Journal of Trauma & Dissociation, 5(1), 1–10. https://doi.org/10.1016/j.ejtd.2020.100151

20.

Costa

E. C. V.

Guimarães

Ferreira

Pereira

M. G.

(2019). Resource loss moderates the association between child abuse and current PTSD symptoms among women in primary-care settings. Journal of Interpersonal Violence, 34(17), 3614–3636. https://doi.org/10.1177/0886260516670883

21.

Costa-Gomes

S. C.

Costa-Veiga

(2024). Posttraumatic stress disorder, childhood trauma and health behaviors in victims of intimate partner violence. Análise Psicológica, 42(2), 179–196. https://doi.org/10.14417/ap.2039

22.

Dalenberg

Carlson

E. B.

(2012). Dissociation in posttraumatic stress disorder part II: How theoretical models fit the empirical evidence and recommendations for modifying the diagnostic criteria for PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 4(6), 551–559. https://doi.org/10.1037/a0027900

23.

Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardeña, E., Frewen, P. A., Carlson, E. B., & Spiegel, D. (2012). Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychological Bulletin, 138(3), 550–588. https://doi.org/10.1037/a0027447

24.

Daniunaite

Cloitre

Karatzias

Shevlin

Thoresen

Zelviene

Kazlauskas

(2021). PTSD And complex PTSD in adolescence: Discriminating factors in a population-based cross-sectional study. European Journal of Psychotraumatology, 12(1), 1–8. https://doi.org/10.1080/20008198.2021.1890937

25.

Da Silva

H. C.

Vilete

Coutinho

E. S. F.

Luz

M. P.

Mendlowicz

Portela

C. M.

Figueira

Ventura

Mari

J. J.

Quintana

M. I.

Ribeiro

W. S.

Andreoli

S. B.

Berger

(2024). The role of childhood cumulative trauma in the risk of lifetime PTSD: An epidemiological study. Psychiatry Research, 336, 115887. https://doi.org/10.1016/j.psychres.2024.115887

26.

Deen

Biedermann

S. V.

Lotzin

Krüger-Gottschalk

Dyer

Knaevelsrud

, …, & Schäfer

(2022). The dissociative subtype of PTSD in trauma-exposed individuals: a latent class analysis and examination of clinical covariates. European journal of psychotraumatology, 13(1), Article 2031591. https://doi.org/10.1080/20008198.2022.2031591

27.

Dekel

Shaked

O. Z.

Ben-Porat

Itzhaky

(2019). Posttraumatic stress disorder upon admission to shelters among female victims of domestic violence: An ecological model of trauma. Violence and Victims, 34(2), 329–345. https://doi.org/10.1891/0886-6708.VV-D-16-00200

28.

DePrince

A. P.

Freyd

J. J.

(2002). The intersection of gender and betrayal in trauma. In Kimerling

Ouimette

Wolfe

(Eds.), Gender and PTSD (pp. 98–113). The Guilford Press.

29.

De Tychey

Laurent

Lighezzolo-Alnot

Garnier

Vandelet

(2015). Prevalence of sexual abuse in childhood: Some critical methodological reflections. Journal of Child Sexual Abuse, 24(4), 401–411. https://doi.org/10.1080/10538712.2015.1029105

30.

DiStefano

McDaniel

H. L.

Zhang

Shi

Jiang

(2019). Fitting large factor analysis models with ordinal data. Educational and Psychological Measurement, 79(3), 417–436. https://doi.org/10.1177/0013164418818242

31.

Echeburúa

Amor

P. J.

Munoz

J. M.

Sarasua

Zubizarreta

(2017). Escala de gravedad de síntomas del trastorno de estrés postraumático según el DSM-5: Versión forense (EGS-F). Anuario de Psicología Jurídica, 27(1), 67–77. https://doi.org/10.1016/j.apj.2017.02.005

32.

Echeburúa

Amor

P. J.

Sarasua

Zubizarreta

Holgado-Tello

F. P.

Muñoz

J. M.

(2016). Escala de gravedad de síntomas revisada (EGS-R) del trastorno de estrés postraumático según el DSM-5: Propiedades psicométricas. Terapia Psicológica, 34(2), 111–128. https://doi.org/10.4067/S0718-48082016000200004

33.

Echeburúa

Muñoz

J. M.

Loinaz

(2011). La evaluación psicológica forense frente a la evaluación clínica: Propuestas y retos de futuro. International Journal of Clinical and Health Psychology, 11(1), 141–159.

34.

Elm

E. V.

Altman

D. G.

Egger

Pocock

S. J.

Gøtzsche

P. C.

Vandenbroucke

J. P.

, …, Collins

(2025). The STROBE reporting checklist. In The EQUATOR network reporting guideline platform. The UK EQUATOR Centre.

35.

Facer-Irwin

Blackwood

Bird

MacManus

(2023). Trauma, post-traumatic stress disorder and violence in the prison population: Prospective cohort study of sentenced male prisoners in the UK. BJPsych Open, 9(2), e47, 1-8. https://doi.org/10.1192/bjo.2022.639

36.

Fereidooni

Daniels

J. K.

Krause-Utz

A. D.

Hagenaars

M. A.

Smeets

Heins

, …, Lommen

M. J.

(2023). Childhood maltreatment and adulthood victimization: An evidence-based model. Journal of Psychiatric Research, 167, 46–62. https://doi.org/10.1016/j.jpsychires.2023.10.007

37.

Flora

D. B.

(2020). Your coefficient alpha is probably wrong, but which coefficient omega is right? A tutorial on using R to obtain better reliability estimates. Advances in Methods and Practices in Psychological Science, 3(4), 484–501. https://doi.org/10.1177/2515245920951747

38.

Fossion

Leys

Kempenaers

Braun

Verbanck

Linkowski

(2015). Beware of multiple traumas in PTSD assessment: The role of reactivation mechanism in intrusive and hyper-arousal symptoms. Aging & Mental Health, 19(3), 258–263. https://doi.org/10.1080/13607863.2014.924901

39.

Fox

K. A.

Vincent

J. P.

(2020). Types of malingering in PTSD: Evidence from a psychological injury paradigm. Psychological Injury and Law, 13(1), 90–104. https://doi.org/10.1007/s12207-019-09367-5

40.

Freyd, J. J. (1991, August). Memory repression, dissociative states, and other cognitive control processes involved in adult sequelae of childhood trauma. In Second annual conference on psychodynamics-cognitive science interface, University of California, San Francisco.

41.

Freyd

J. J.

(1994). Betrayal trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics & Behavior, 4(4), 307–329. https://doi.org/10.1207/s15327019eb0404_1

42.

Freyd

J. J.

(1996). Betrayal trauma: The logic of forgetting childhood abuse. Harvard University Press.

43.

Gagnon

K. L.

Lee

M. S.

DePrince

A. P.

(2019). Victim–perpetrator dynamics through the lens of betrayal trauma theory. In The abused and the abuser (pp. 131–140). Routledge.

44.

Garrido

L. E.

Abad

F. J.

Ponsoda

(2016). Are fit indices really fit to estimate the number of factors with categorical variables? Some cautionary findings via Monte Carlo simulation. Psychological Methods, 21(1), 93–111. https://doi.org/10.1037/met0000064

45.

Generelo

T. C.

Gutiérrez

L. C.

de Diego Ruiz

(2019). Trastorno por estrés agudo y postraumático. Medicine-Programa de Formación Médica Continuada Acreditado, 12(84), 4918–4928. https://doi.org/10.1016/j.med.2019.07.002

46.

Gobin

Iverson

Mitchell

Vaughn

(2013). The impact of childhood maltreatment on PTSD symptoms among female survivors of intimate partner violence. Violence and Victims, 28(6), 984. https://doi.org/10.1891/0886-6708.vv-d-12-00090

47.

Gomez

Stavropoulos

Vance

(2019). Psychometric properties of the autism Spectrum quotient: Children’s version (AQ-child). Journal of Autism and Developmental Disorders, 49(2), 468–480. https://doi.org/10.1007/s10803-018-3713-8

48.

Hansen

Hyland

Armour

Andersen

T. E.

(2019). Assessing the existence of dissociative PTSD in sub-acute patients of whiplash. Journal of Trauma & Dissociation, 20(1), 16–31. https://doi.org/10.1080/15299732.2018.1451805

49.

Heilbrun

Rogers

Otto

R. K.

(2002). Forensic assessment. In Taking psychology and law into the twenty-first century (pp. 119–146). Springer.

50.

Herman

J. L.

(2015). Trauma and recovery: The aftermath of violence–from domestic abuse to political terror. Hachette uK.

51.

Hernández

Gallardo-Pujol

Pereda

Arntz

Bernstein

D. P.

Gaviria

A. M.

Gutiérrez-Zotes

J. A.

(2013). Initial validation of the spanish childhood trauma questionnaire-short form: Factor structure, reliability and association with parenting. Journal of Interpersonal Violence, 28(7), 1498–1518. https://doi.org/10.1177/0886260512468240

52.

Hernández-Guzmán

del Palacio

Freyre

Alcázar-Olán

(2011). La perspectiva dimensional de la psicopatología. Revista mexicana de Psicología, 28(2), 111–120.

53.

Hietamäki

Husso

Arponen

Lahtinen

H. M.

(2024). Differences between girls and boys in the disclosure of sexual violence. Journal of Interpersonal Violence, 39(11), 2629–2654. https://doi.org/10.1177/08862605231221283

54.

Bentler

P. M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118

55.

Integral Protection Code for Children and Adolescents (Lay 100, Official Register 737). Consejo Nacional para la Igualdad Intergeneracional. https://www.igualdad.gob.ec/wp-content/uploads/downloads/2017/11/codigo_ninezyadolescencia.pdf

56.

Jones

M. S.

Peck

B. M.

Sharp

S. F.

McLeod

D. A.

(2021). Childhood adversity and intimate partner violence in adulthood: the mediating influence of PTSD in a sample of women prisoners. Journal of interpersonal violence, 36(15-16), NP8590–NP8614. https://psycnet.apa.org/doi/https://doi.org/10.1177/0886260519844277

57.

Kim

Lee

Cho

Min

J. Y.

Kim

S. H.

(2019). Prevalence and clinical correlates of dissociative subtype of posttraumatic stress disorder at an outpatient trauma clinic in South Korea. European Journal of Psychotraumatology, 10(1), 1657372. https://doi.org/10.1080/20008198.2019.1657372

58.

Kira

I. A.

Lewandowski

Templin

Ramaswamy

Ozkan

Mohanesh

(2008). Measuring cumulative trauma dose, types, and profiles using a development-based taxonomy of traumas. Traumatology, 14(2), 62–87. https://doi.org/10.1177/1534765608319324

59.

Kleinman

S. B.

Martell

(2015). Failings of trauma-specific and related psychological tests in detecting post-traumatic stress disorder in forensic settings. Journal of Forensic Sciences, 60(1), 76–83. https://doi.org/10.1111/1556-4029.12606

60.

Köhnken

, Manzanero

& Scott

(2015). Statement validity assessment: Myths and limitations. Anuario de Psicología Jurídica, 25(1), 13–19. https://doi.org/10.1016/j.apj.2015.01.004

61.

Landy

M. S.

Wagner

A. C.

Brown-Bowers

Monson

C. M.

(2015). Examining the evidence for complex posttraumatic stress disorder as a clinical diagnosis. Journal of Aggression, Maltreatment & Trauma, 24(3), 215–236. https://doi.org/10.1080/10926771.2015.1002649

62.

Lanius

R. A.

Vermetten

Loewenstein

R. J.

Brand

Schmahl

Bremner

J. D.

Spiegel

(2010). Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. American Journal of Psychiatry, 167(6), 640–647. https://doi.org/10.1176/appi.ajp.2009.09081168

63.

Liang

(2023). The effect of childhood trauma on complex posttraumatic stress disorder: the role of self-esteem. European Journal of Psychotraumatology, 14(2), Article 2272478. https://doi.org/10.1080/20008066.2023.2272478

64.

López-Castro

Saraiya

Hien

D. A.

(2017). Women, trauma, and PTSD. In Kendall-Tackett

Ruglass

L. M.

(Eds.), Women’s mental health across the lifespan (pp. 175–193). Routledge.

65.

López-Miquel

Pujol-Robinat

(2020). Análisis descriptivo de la simulación de síntomas psicológicos en una muestra forense. Revista Española de Medicina Legal, 46(4), 175–182. https://doi.org/10.1016/j.reml.2020.01.001

66.

Mennman-Moore

T. L.

Bhuptani

P. H.

(2017). A review of the long-term impact of child maltreatment on posttraumatic stress disorder and its comorbidities: An emotion dysregulation perspective. Clinical Psychology: Science and Practice, 24(2), 154–169. https://doi.org/10.1111/cpsp.12193

67.

Molina-Coloma

Lara-Machado

López-Vallejo

Vargas-Núñez

Pacheco

D. B.

(2026). Experiencias traumáticas a edades tempranas: Un estudio comparativo entre un grupo de mujeres privadas de la libertad y un grupo de mujeres víctimas de violencia en México y Ecuador. Revista Española de Medicina Legal, 52(2), 500514. https://doi.org/10.1016/j.reml.2026.500514

68.

Neal

T. M.

Grisso

(2014). Assessment practices and expert judgment methods in forensic psychology and psychiatry: An international snapshot. Criminal Justice and Behavior, 41(12), 1406–1421. https://doi.org/10.1177/0093854814548449

69.

Pan

Lin

Liu

Zhang

Zeng

Chen

(2021). Prevalence of childhood sexual abuse among women using the childhood trauma questionnaire: A worldwide meta-analysis. Trauma, Violence, & Abuse, 22(5), 1181–1191. https://doi.org/10.1177/1524838020912867

70.

Personal Data Protection Organic Law. (2021). Official Registry Supplement 459. https://www.finanzaspopulares.gob.ec/wp-content/uploads/2021/07/ley_organica_de_proteccion_de_datos_personales.pdf

71.

Pill

Day

Mildred

(2017). Trauma responses to intimate partner violence: A review of current knowledge. Aggression and Violent Behavior, 34, 178–184. https://doi.org/10.1016/j.avb.2017.01.014

72.

Pole

Fields

D’Andrea

(2016). Psychopathology and health. In Norcross

VandenBos

Freedheim

(Eds.), APA Handbook of clinical psychology (pp. 97–133). American Psychological Association.

73.

Putnam

F. W.

(1991). Dissociative disorders in children and adolescents: A developmental perspective. Psychiatric Clinics of North America, 14(3), 519–531. https://doi.org/10.1016/S0193-953X(18)30287-9

74.

Rameckers

S. A.

van Emmerik

A. A. P.

Bachrach

Lee

C. W.

Morina

Arntz

(2021). The impact of childhood maltreatment on the severity of childhood- related posttraumatic stress disorder in adults. Child Abuse & Nelgect, 120, 105208. https://doi.org/10.1016/j. chiabu.2021.105208

75.

Rasmussen

Verkuilen

Jayawickreme

McCluskey

S. T.

(2019). When did posttraumatic stress disorder get so many factors? Confirmatory factor models since DSM–5. Clinical Psychological Science, 7(2), 234–248. https://doi.org/10.1177/2167702618809370

76.

Rezigalla

A. A.

Eleragi

A. M. E. S. A.

Elhussein

A. B.

Alfaifi

ALGhamdi

M. A.

Al Ameer

A. Y.

, …, Adam

M. I. E.

(2024). Item analysis: The impact of distractor efficiency on the difficulty index and discrimination power of multiple-choice items. BMC Medical Education, 24(1), 445. https://doi.org/10.1186/s12909-024-05433-y

77.

Risola

Mandarelli

Grattagliano

Cassano

Valerio

Barbieri

Catanesi

(2024). Dissimulation in forensic psychiatric evaluations, a case-control study of the millon clinical multiaxial inventory-III. Forensic Sciences Research, 9(1), 1–6. https://doi.org/10.1093/fsr/owad054

78.

Sellbom

Tellegen

(2019). Factor analysis in psychological assessment research: Common pitfalls and recommendations. Psychological Assessment, 31(12), 1428–1441. https://doi.org/10.1037/pas0000623

79.

Sideridis

G. D.

Jaffari

(2022). An R function to correct fit indices and omnibus tests in confirmatory factor analysis. Measurement and Evaluation in Counseling and Development, 55(1), 48–70. https://doi.org/10.1080/07481756.2021.1906159

80.

Soares de Lima

(2023). Mala praxis pericial. El uso de las técnicas proyectivas en el ámbito forense. Revista Pensamiento Penal, 460, 1–13.

81.

Starcevic

(Ed.). (2019). Psychological trauma. BoD–Books on Demand.

82.

Stein

D. J.

Koenen

K. C.

Friedman

M. J.

Hill

McLaughlin

K. A.

Petukhova

Kessler

R. C.

(2012). Dissociation in posttraumatic stress disorder: Evidence from the world mental health surveys. Biological Psychiatry, 73(4), 302–312. https://doi.org/10.1016/j.biopsych.2012.08.022

83.

Stöckl

Devries

Rotstein

Abrahams

Campbell

Watts

Moreno

C. G.

(2013). The global prevalence of intimate partner homicide: A systematic review. The Lancet, 382(9895), 859–865. https://doi.org/10.1016/S0140-6736(13)61030-2

84.

St. Vil

N. M.

Carter

Johnson

(2018). Betrayal trauma and barriers to forming new intimate relationships among survivors of intimate partner violence. Journal of Interpersonal Violence, 36(7-8), 1–15. https://doi.org/10.1177/0886260518779596

85.

Tabachnick

B. G.

Fidell

L. S.

(2012). Using multivariate statistics (6thed.). Pearson.

86.

Turner

H. A.

, Finkelhor

, & Ormrod

(2006). The effect of lifetime victimization on the mental health of children and adolescents. Social Science & Medicine, 62(1), 13–27. https://doi.org/10.1016/j.socscimed.2005.05.030

87.

Van der Meer

C. A. I.

Bakker

Smit

A. S.

van Buschbach

den Dekker

Westerveld

G. J.

Olff

(2017). Gender and age differences in trauma and PTSD among Dutch treatment-seeking police officers. Journal of Nervous & Mental Disease, 205(2), 87–92. https://doi.org/10.1097/NMD.0000000000000562

88.

Vilariño

Arce

Fariña

(2013). Forensic-clinical interview: Reliability and validity for the evaluation of psychological injury. The European Journal of Psychology Applied to Legal Context, 5(1), 1–21.

89.

Vonderlin

Kleindienst

Alpers

G. W.

Bohus

Lyssenko

Schmahl

(2018). Dissociation in victims of childhood abuse or neglect: A meta-analytic review. Psychological Medicine, 48(15), 2467–2476. https://doi.org/10.1017/S0033291718000740

90.

Webermann

A. R.

Brand

B. L.

Kumar

S. A.

(2017). Intimate partner violence among patients with dissociative disorders. Journal of Interpersonal Violence, 36(3-4), 1–22. https://doi.org/10.1177/0886260517746943

91.

Webermann

A. R.

Murphy

C. M.

(2018). Childhood trauma and dissociative intimate partner violence. Violence Against Women, 25(2), 148–166. https://doi.org/10.1177/1077801218766628

92.

White

H. R.

Frisch-Scott

N. E.

(2023). Childhood victimization and adult incarceration: A review of the literature. Trauma, Violence, & Abuse, 24(3), 1543–1559. https://doi.org/10.1177/15248380211073841

93.

Wolf

E. J.

Lunney

C. A.

Miller

M. W.

Resick

P. A.

Friedman

M. J.

Schnurr

P. P.

(2012). The dissociative subtype of PTSD: A replication and extension. Depression and Anxiety, 29(8), 679–688. https://doi.org/10.1002/da.21946

94.

Wolf

E. J.

Mitchell

K. S.

Sadeh

Hein

Fuhrman

Pietrzak

R. H.

Miller

M. W.

(2015). The dissociative subtype of PTSD scale: Initial evaluation in a national sample of trauma-exposed veterans. Assessment, 24(4), 503–516. https://doi.org/10.1177/1073191115615212

95.

World Health Organization. (2019). International classification of diseases and related health problems, 11th revision. https://icd.who.int/ct/icd11_mms/es/release

96.

World Health Organization. (2021). Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. https://www.who.int/publications/i/item/9789240022256

97.

World Health Organization. (2023). PTSD. https://applications.emro.who.int/docs/WHOEMMNH235E-eng.pdf?ua=1

98.

World Medical Asociation. ( 2024, December, 31). Declaración de helsinki de la amm – principios éticos para las investigaciones médicas en seres humanos. https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/

99.

Yan

Karatzias

(2020). Childhood abuse and current intimate partner violence: A population study in Hong Kong. Journal of Interpersonal Violence, 35(1-2), 233–251. https://doi.org/10.1177/0886260516682521

100.

Zwienenberg

Symphor

Peraud

Décamps

(2024). Childhood trauma, PTSD/CPTSD and chronic pain: A systematic review. PLoS ONE, 19(8), 1–24. https://doi.org/10.1371/journal.pone.0309332