Complex PTSD latent dimensions: The role of posttraumatic cognitions in an active-duty military and police combatant sample

Complex posttraumatic stress disorder (CPTSD) is marked by core PTSD symptoms and disturbances in self-organization (DSO). While the ICD-11 defines CPTSD through two higher-order factors, emerging evidence supports alternative models to the traditional structure. The present study aimed to: (1) identify the best-fitting model of CPTSD symptoms in Filipino combat-exposed military and police combatants and (2) examine how posttraumatic cognitions contribute to the expression of these symptoms. Study 1 investigated competing models using confirmatory factor analysis. In Study 2, posttraumatic cognitions were tested as predictors of each CPTSD symptom cluster in the best-fitting model. The correlated six-factor model demonstrated superior fit compared to alternative models. Posttraumatic cognitions significantly predicted symptoms across both PTSD (intrusions, avoidance, threat) and DSO (affective dysregulation, negative self-concept, relational disturbance). While negative cognitions predicted DSO symptoms, significant associations with PTSD symptoms were also observed. These findings support the conceptual and empirical utility of the six-factor model and suggest that posttraumatic cognitions exert a differential but residual influence across CPTSD symptom clusters. Results align with the Memory & Identity (M&I) theory, which posits that trauma-related cognitions affect both trauma memory processing and self-identity, contributing uniquely to symptom expression.