Emotional processing deficits mediate the association between adverse childhood experiences and CPTSD symptoms: the moderating role of perceived social support

Background Adverse childhood experiences (ACEs) are robust predictors of adult psychopathology and have been strongly associated with complex post-traumatic stress disorder (CPTSD). While the association between ACEs and CPTSD is well established, the specific psychological mechanisms and external interpersonal protective factors shaping this developmental association remain insufficiently understood. Methods This study examined the mediating role of emotional processing deficits (EPD) and the moderating role of perceived social support (PSSS) in the associations between early cumulative adversity and adult CPTSD dimensions. Data were collected from a non-clinical sample of 5, 771 Chinese university students using a cross-sectional survey. A latent moderated structural equation modeling (LMS) approach was employed to examine the proposed relationships. Results Results indicated that emotional processing deficits significantly mediated the positive association between cumulative childhood adversity and both the core PTSD and Disturbances in Self-Organization (DSO) symptom clusters. Furthermore, perceived social support served as a modest but statistically significant moderator in the second stage of the mediation process; high levels of interpersonal support partially attenuated the positive association between EPD and subclinical CPTSD symptoms. Finally, while cumulative adversity showed a statistically stronger unstandardized association with DSO than with core PTSD symptoms, the standardized effect sizes were comparable (β = 0.151 vs. 0.152). This indicates that while there is a statistically significant absolute difference on the psychometric scale, the relative magnitude of the associations is parallel across both CPTSD dimensions. Conclusions These findings highlight emotional processing deficits as a pivotal correlate linking early adversity to CPTSD symptoms. Importantly, the protective efficacy of social support is not universal; while interpersonal resources may partially buffer the association between internal psychological vulnerabilities and subclinical symptoms, this effect is contingent upon the individual’s trauma history and the qualitative source of support, with peer networks potentially offering unique compensatory value in trauma recovery.