Childhood Interpersonal Trauma Research Articles

Moderators of treatment efficacy in a randomized controlled trial of trauma-sensitive yoga as an adjunctive treatment for posttraumatic stress disorder.

This study is a follow-up to van der Kolk et al. (2014), a trial conducted through the Trauma Center at Justice Resource Institute, which demonstrated treatment efficacy and remains the only randomized controlled trial of trauma-sensitive yoga. The present process study extends the outcomes study by examining treatment moderators of the original trial. Sixty-four women with childhood interpersonal trauma histories and posttraumatic stress disorder participated in the interventions: Trauma Center Trauma-Sensitive Yoga (TCTSY) versus active control (women's health education). Analyses explored if adult-onset interpersonal trauma and baseline psychological measures (clinician-rated and self-reported PTSD, dissociation, depression, psychological functioning) moderated PTSD changes. Three of six measures had small effects in moderating the relationship between adult-onset interpersonal trauma and TCTSY efficacy, in which TCTSY was most efficacious for those with fewer adult-onset interpersonal traumas. Within this subgroup, various levels of all baseline measures except depression indicated that TCTSY was more effective in reducing PTSD than the active control condition. By delineating client characteristics most associated with PTSD improvements, practitioners may best target yoga interventions to increase effectiveness. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Risk factors associated with general and specific dimensions of psychosis in a nationally representative sample of adults from the United States

ABSTRACT General and specific dimensions of psychosis have been identified in both clinical and general population samples. Demographic and clinical correlates, however, have only been explored within models derived from clinical data. Data were drawn from Wave 3 of the National Epidemiological Survey on Alcohol and Related Conditions (N = 36,309). Confirmatory factor analysis and confirmatory bifactor modelling were used to determine the optimal measurement model of psychosis symptoms among this sample. Structural equation modelling was used to identify variables correlated with the different psychosis dimensions, as per the best fitting measurement model. Measurement modelling results indicated that the latent structure of psychosis was best represented by a bifactor model including a general dimension orthogonal to four specific dimensions representing “Positive”, “Negative”, “Mania”, and “Disorganized” symptoms. Childhood interpersonal trauma, lack of social support, lower socio-economic status and suicidal attempts were associated with higher scores on the general dimension. These results provide further support for the validity of a bifactor model of psychosis in the general population and identify unique risk correlates of specific and general factors of psychosis.

Posttraumatic stress symptomology and non-suicidal self-injury: The role of intrusion and arousal symptoms

BackgroundPrevious evidence has shown a strong relation between Posttraumatic Stress Disorder (PTSD) symptomology and Non-Suicidal Self-Injury (NSSI). The current study aimed to extend prior research by investigating the relationship between PTSD symptom clusters (arousal and intrusion) and NSSI, and putative moderators of this association within a large-scale adult sample in England. MethodA subsample of participants with experiences of trauma in adulthood (n = 2,480) from the Adult Psychiatric Morbidity Survey 2007 (APMS 2007) was utilised to examine the relations among PTSD intrusion and arousal symptom clusters, childhood interpersonal trauma, perceived social support and lifetime NSSI. ResultsArousal symptoms were consistently associated with NSSI, even when adjusting for multiple covariates, and had a stronger relationship than intrusion symptoms. Childhood interpersonal trauma was independently and significantly associated with lifetime NSSI after adjusting for covariates. The moderating effects of childhood interpersonal trauma and perceived social support were not statistically significant. LimitationsThe study was cross-sectional and utilised self-report assessments to measure PTSD, NSSI, and childhood interpersonal trauma. ConclusionFindings support the role of PTSD arousal and childhood interpersonal trauma in relation to NSSI. The moderating role of childhood interpersonal trauma and perceived social support lacks supporting evidence. Findings highlight the need for NSSI screening as well as for specific interventions that target the complex needs of those who exhibit elevated PTSD arousal symptoms, especially those with a history of childhood interpersonal trauma.

Childhood determinants of suicidality in men recently transitioned from regular military service.

Rates of suicidality are higher in military than comparable civilian populations. The period of transition from regular military service may be a time of particular vulnerability. In order to best inform early intervention and prevention strategies, we sought to investigate the childhood determinants (trauma and disorder) of self-reported past-year suicidality (thoughts, plans or attempts) in a population of Australian Defence Force men who had recently (in the previous 5 years) transitioned from regular military service. We analysed self-report, and detailed interview, cross-sectional data to investigate the association between retrospectively reported past-year suicidality and childhood factors (disorder and trauma) and whether these relationships were independent of each other and adult-onset trauma and disorder. We utilised logistic regression techniques and generalised structural equation modelling. The prevalence of suicidality in transitioned men was 21.6% (95% confidence interval [CI]: [19.9, 23.3]). Suicidality was associated with childhood-onset interpersonal trauma and anxiety and adult-onset anxiety and depression. Generalised structural equation modelling demonstrated that the pathway between childhood interpersonal trauma and suicidality was not fully mediated by childhood anxiety. Restricting the analyses to those previously deployed demonstrated that suicidality had a direct and significant association with childhood-onset factors (anxiety and interpersonal trauma) and adult-onset trauma (deployment and non-deployment related). This study sheds light onto the significance of childhood factors (interpersonal trauma and anxiety) in a population undergoing transition that may revive pre-existing vulnerabilities. These findings have the potential to aid early intervention and prevention strategies in identifying those at risk prior to transition. These findings also imply that early interventions targeting anxiety and interventions to reduce social instability during the transition period may be useful in reducing suicidality during this time. Further prospective studies are needed to further explore these novel findings.

Exposure to childhood interpersonal trauma and mental health service urgency

BackgroundChildren and youth with a history of maltreatment experience different developmental, psychiatric and health problems. Ensuring there is streamlined access to services is imperative to recovery. Yet, few reports of standardized methods for directing and prioritizing risk for children seeking services exist. ObjectiveThe current study aims to address this gap and explore how mental health personnel triage highly vulnerable cases. Specifically, the goal of the current study is to examine whether experiencing childhood interpersonal trauma predicts service urgency. Participants and settingParticipants were 19,645 children and youth, ages 4–18 years (M = 11.1 SD = 3.4) who completed the interRAI Child and Youth Mental Health Screener (ChYMH-S) at various community-based and residential children’s mental health facilities across Ontario. MethodsRetrospective data collected from the ChYMH-S was used to explore differences in maltreatment history, gender, and legal guardianship and their impact on service prioritization. ResultsChildren and youth who were exposed to some form of interpersonal trauma were more likely to have mental health issues requiring urgent follow-up service compared to those who were not exposed. Findings also suggested that gender and legal guardianship impact service urgency. ConclusionsChildren and youth who have experienced maltreatment are significantly more likely to score high on mental health service urgency than those who did not. This provides valuable insight that can support the development of appropriate system-level changes to policy and practice when servicing children and youth with mental health needs in Canada.

Childhood determinants of past-year anxiety and depression in recently transitioned military personnel

BackgroundAnxiety and depression may hamper a smooth transition from military to civilian life and may be important predictors of longer-term health and functioning. However, it is as yet unclear to what extent they are determined by childhood factors in a recently transitioned population. MethodsWe utilised logistic regression and Generalised Structural Equation Modelling to analyse associations of ICD-10 past-year anxiety and depression with childhood trauma and disorder in a recently transitioned population using detailed interview data from the ADF (Australian Defence Force) Transition and Wellbeing Research Programme. ResultsPast-year anxiety (including PTSD) was prevalent (36.4%, 95% CI, 31.9-41.1) and associated with childhood anxiety (but not other types of childhood disorder), childhood interpersonal trauma (but not other childhood trauma) and adult-onset trauma. Childhood anxiety had a direct and significant association with past-year anxiety. The pathway between childhood interpersonal trauma and past-year anxiety was fully mediated by childhood anxiety. Past-year depression was less prevalent (11.3%, 95% CI, 8.7-14.5) and had no association with childhood disorder or trauma variables. LimitationsThe main predictor variables utilized in this analysis were childhood experiences recalled from adulthood, thus rendering the responses vulnerable to autobiographical bias. ConclusionsPast-year anxiety was highly prevalent in the period of transition and had strong associations with childhood and military factors, suggesting predictability and potentially preventability.

Sexual satisfaction improvement in patients seeking sex therapy: evaluative study of the influence of traumas, attachment and therapeutic alliance

Sex therapy patients report high rates of childhood interpersonal trauma (CIT) and insecure attachment, which may negatively influence the quality of their alliance with the therapist. Poor therapeutic alliance is associated with weaker progress during treatment. However, the effect of CIT, attachment and alliance on progress in therapy has not yet been documented in patients consulting for sexual difficulties. With a pre and post-test design, a total of 74 adults (39 women; 35 men) seeking sex therapy completed questionnaires assessing CIT, attachment representations, and therapeutic alliance. The main outcome measure was evolution of sexual satisfaction over the course of therapy. Results showed that, on average, patients experienced an improvement in their sexual satisfaction. Patients showing the largest improvement reported less attachment anxiety and higher levels of therapeutic alliance at pre-test. Furthermore, although participants reporting four or more types of CIT showed lower sexual satisfaction at pre-test, they reached a level similar to patients with less CIT at post-test, and thus, they demonstrated the greatest level of improvement. These findings support the beneficial effect of sex therapy for patients with a CIT history, and that, with a strong therapeutic relationship and attachment, all patients can develop a more positive and enjoyable sexuality.

Dwelling on verbal but not pictorial threat cues: An eye-tracking study with adult survivors of childhood interpersonal violence.

Previous studies have found evidence of an attentional bias for trauma-related stimuli in posttraumatic stress disorder (PTSD) using eye-tracking (ET) technlogy. However, it is unclear whether findings for PTSD after traumatic events in adulthood can be transferred to PTSD after interpersonal trauma in childhood. The latter is often accompanied by more complex symptom features, including, for example, affective dysregulation and has not yet been studied using ET. The aim of this study was to explore which components of attention are biased in adult victims of childhood trauma with PTSD compared to those without PTSD. Female participants with (n = 27) or without (n = 27) PTSD who had experienced interpersonal violence in childhood or adolescence watched different trauma-related stimuli (Experiment 1: words, Experiment 2: facial expressions). We analyzed whether trauma-related stimuli were primarily detected (vigilance bias) and/or dwelled on longer (maintenance bias) compared to stimuli of other emotional qualities. For trauma-related words, there was evidence of a maintenance bias but not of a vigilance bias. For trauma-related facial expressions, there was no evidence of any bias. At present, an attentional bias to trauma-related stimuli cannot be considered as robust in PTSD following trauma in childhood compared to that of PTSD following trauma in adulthood. The findings are discussed with respect to difficulties attributing effects specifically to PTSD in this highly comorbid though understudied population. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Tuning Relationships With Music™: An Intervention for Parents With an Interpersonal Trauma History and Their Adolescents

Childhood interpersonal trauma has profound effects on future relationships, including parent-adolescent relationships. However, the effects of an interpersonal trauma history on parenting are not well understood or effectively addressed in existing evidence-based family and parent-child therapies. This paper describes a systemic intervention, entitled Tuning Relationships with Music™ (TRM), for parents with a history of childhood abuse or neglect and their adolescent who are experiencing high levels of conflict in their relationship. A previously published pilot randomised controlled trial of TRM found that parent-adolescent dyads who received the intervention reported significantly reduced conflict, and that parents were observed to be more responsive and less reactive compared with a wait-list group. Written for counsellors, psychotherapists and others working therapeutically with parents and adolescents, the current paper outlines the key principles and core tasks covered in TRM and describes what is covered in sessions. Considerations for therapists, and future directions for research are also discussed.

Examining the Discriminant Validity of Complex Posttraumatic Stress Disorder and Borderline Personality Disorder Symptoms: Results From a United Kingdom Population Sample.

Complex posttraumatic stress disorder (CPTSD) was added to the diagnostic nomenclature in the 11th revision of the International Classification of Diseases (ICD-11). Although considerable evidence exists supporting the construct validity of CPTSD, the distinguishability of CPTSD symptoms from those of borderline personality disorder (BPD) has been questioned. The present study examined the discriminant validity of CPTSD and BPD symptoms among a trauma-exposed population sample from the United Kingdom (N = 546). Participants completed self-report measures of CPTSD and BPD symptoms, and their latent structure was assessed using exploratory structural equation modeling (ESEM). A three-factor model with latent variables reflecting PTSD, disturbances in self-organization (DSO), and BPD symptoms provided the best fit of the data, χ2 (399, N = 546) = 1,650, p < .001; CFI = .944; TLI = .930; RMSEA = .077, 90% CI [.073, .081]. We identified multiple symptoms distinctive to individual constructs (e.g., disturbed relationships and suicidality) as well as symptoms shared across the constructs (e.g., affective dysregulation). The PTSD, β = .24; DSO, β = .23; and BPD, β = .27, latent variables were positively and significantly associated with childhood interpersonal trauma. The current findings support the discriminant validity of CPTSD and BPD symptoms and highlight various phenomenological signatures of each construct as well as demonstrate how these constructs share important similarities in symptom composition and exogenous correlates.

The Current Status of EMDR Therapy Involving the Treatment of Complex Posttraumatic Stress Disorder

Complex posttraumatic stress disorder (CPTSD) is a diagnostic entity that will be included in the forthcoming edition of the International Classification of Diseases, 11th Revision (ICD-11). It denotes a severe form of PTSD, comprising not only the symptom clusters of PTSD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV-TR]), but also clusters reflecting difficulties in regulating emotions, disturbances in relational capacities, and adversely affected belief systems about oneself, others, or the world. Evidence is mounting suggesting that first-line trauma-focused treatments, including eye movement desensitization and reprocessing (EMDR) therapy, are effective not only for the treatment of PTSD, but also for the treatment of patients with a history of early childhood interpersonal trauma who are suffering from symptoms characteristic of CPTSD. However, controversy exists as to when EMDR therapy should be offered to people with CPTSD. This article reviews the evidence in support of EMDR therapy as a first-line treatment for CPTSD and addresses the fact that there appears to be little empirical evidence supporting the view that there should be a stabilization phase prior to trauma processing in working with CPTSD.

Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective.

Background: A growing body of research underlines that interpersonal trauma in childhood leads to heightened susceptibility for substance use disorders (SUDs) in later life. Little research has been conducted on parenting experiences of mothers in recovery from substance use, taking into account their own upbringing as a child and the potential aftermath of interpersonal childhood trauma. Methods: Through in-depth qualitative interviews, 23 mothers with SUDs reflected on parenting experiences and parent-child bonding, related to both their children and parents. Interviews were transcribed verbatim and data were analyzed adopting thematic analysis. Results: Throughout the narratives, consequences of trauma on mothers’ sense of self and its subsequent impact on parenting arose as salient themes. Five latent mechanisms of intergenerational trauma transmission were identified: 1) early interpersonal childhood trauma experiences in mothers; 2) trauma as a precursor of substance use; 3) substance use as a (self-fooling) enabler of parental functioning; 4) continued substance use impacting parental functioning; and 5) dysfunctional parental functioning and its relational impact upon offspring. Discussion: Findings suggest disruptive attachment can increase the vulnerability for SUDs on the one hand, but can be an expression of underlying trauma on the other, hence serving as a covert mechanism by which trauma can be transmitted across generations. Results indicate the need for preventive, attachment-based and trauma-sensitive interventions targeted at disruptive intergenerational patterns.

Self-Selected Music for Relational Trauma: Commentary on the Psychotherapy Case of "James"

This commentary discusses Dr. Paul Blimling’s (2019) composite case of James, a patient with a history of severe childhood interpersonal trauma, who responded remarkably well to individual psychotherapy augmented with the targeted use of self-selected music. I describe how music and psychotherapy both have their origins in the shamanistic practices of our hunter-gatherer ancestors, such that combining psychotherapy and music together is a reconciliation of sorts. The Case of James demonstrates how music can be used in psychotherapy with a counter-dependent patient, to help the patient to access sensitive, vulnerable feelings that normally would never be expressed to another person. In this case, the therapist’s keen sensitivity to the patient’s disorganized attachment style created an environment in which the patient eventually felt safe lowering his defenses and expressing his emotions in the treatment—with the help of five songs. Aside from the direct, visceral benefits of the music itself, the process of asking a relationally traumatized patient to select a song has other potential benefits. For example, it supports the patient’s sense of self (which, in the relationally traumatized patient, is likely fragmented), and it may reduce the "hot seat" feeling with a self-conscious patient, by shifting focus from the patient to the song. Songs selected by patients in advance of a session versus songs selected during a session may provide different types of information, and may have different types of benefits. If I were working with a patient such as James, two additional possibilities I would consider are (a) helping the patient to develop practical skills for managing overwhelming emotions, and (b) making the patient’s goals a more prominent focus throughout the treatment.

Risk factors and comorbidity of ICD-11 PTSD and complex PTSD: Findings from a trauma-exposed population based sample of adults in the United Kingdom.

Following the recently published 11th version of the WHO International Classification of Diseases (ICD-11), we sought to examine the risk factors and comorbidities associated with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). Cross-sectional and retrospective design. The sample consisted of 1,051 trauma-exposed participants from a nationally representative panel of the UK adult population. A total of 5.3% (95% confidence interval [CI] = 4.0-6.7%) met the diagnostic criteria for PTSD and 12.9% (95% CI = 10.9-15.0%) for CPTSD. Diagnosis of PTSD was independently associated with being female, being in a relationship, and the recency of traumatic exposure. CPTSD was independently associated with younger age, interpersonal trauma in childhood, and interpersonal trauma in adulthood. Growing up in an urban environment was associated with the diagnosis of PTSD and CPTSD. High rates of physical and mental health comorbidity were observed for PTSD and CPTSD. Those with CPTSD were more likely to endorse symptoms reflecting major depressive disorder (odds ratio [OR] = 21.85, 95 CI = 12.51-38.04) and generalized anxiety disorder (OR = 24.63, 95 CI = 14.77-41.07). Presence of PTSD (OR = 3.13, 95 CI = 1.81-5.41) and CPTSD (OR = 3.43, 95 CI = 2.37-4.70) increased the likelihood of suicidality by more than three times. Nearly half the participants with PTSD and CPTSD reported the presence of a chronic illness. CPTSD is a more common, comorbid, debilitating condition compared to PTSD. Further research is now required to identify effective interventions for its treatment.

Childhood Interpersonal Trauma and Sexual Satisfaction in Patients Seeing Sex Therapy: Examining Mindfulness and Psychological Distress as Mediators

Mindful attention and awareness may promote sexual satisfaction. However, experiencing cumulative childhood interpersonal trauma (CCT; sexual abuse, neglect, etc.) is associated with distress, which might interfere with dispositional mindfulness and lead to lower sexual satisfaction. Although the concept of mindfulness emerged as an interesting variable to understand sexual difficulties, little empirical data are available on this topic. This study tested an integrative mediation model of the relation between CCT, psychological distress, dispositional mindfulness, and sexual satisfaction within a clinical sample of 410 adult patients consulting in sex therapy. Patients completed questionnaires assessing CCT, psychological distress, dispositional mindfulness, and sexual satisfaction. Results showed that the majority of patients reported experiences of childhood interpersonal trauma. Path analyses highlighted three distinct significant paths from CCT to sexual satisfaction. First, dispositional mindfulness mediated the relationship between CCT and sexual satisfaction. Second, psychological distress also mediated the relationship between CCT and sexual satisfaction. Third, the effect of CCT on sexual satisfaction was sequentially mediated through greater levels of psychological distress and lower levels of dispositional mindfulness. The model explained 19% of the variance in sexual satisfaction. Findings suggest that dispositional mindfulness and psychological distress are key processes explaining sexual satisfaction in CCT survivors.

Childhood trauma and the impact of deployment on the development of mental disorder in military males.

Childhood adversity is associated with mental disorder following military deployment. However, it is unclear how different childhood trauma profiles relate to developing a post-deployment disorder. We investigated childhood trauma prospectively in determining new post-deployment probable disorder. In total, 1009 Regular male ADF personnel from the Australian Defence Force (ADF) Middle East Area of Operations (MEAO) Prospective Study provided pre- and post-deployment self-report data. Logistic regression and generalised structural equation modelling were utilised to examine associations between childhood trauma and new post-deployment probable disorder and possible mediator pathways through pre-deployment symptoms. There were low rates of pre-deployment probable disorder. New post-deployment probable disorder was associated with childhood trauma, index deployment factors (combat role and deployment trauma) and pre-deployment symptoms but not with demographic, service or adult factors prior to the index deployment (including trauma, combat or previous deployment). Even after controlling for demographic, service and adult factors prior to the index deployment as well as index deployment trauma, childhood trauma was still a significant determinant of new post-deployment probable disorder. GSEM demonstrated that the association between interpersonal childhood trauma and new post-deployment probable disorder was fully mediated by pre-deployment symptoms. This was not the case for those who experienced childhood trauma that was not interpersonal in nature. To determine the risk of developing a post-deployment disorder an understanding of the types of childhood trauma encountered is essential, and pre-deployment symptom screening alone is insufficient.

Ghosts from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life

Objectives: Research suggests that vulnerability for anxiety and depression in late life results from a complex interaction between (neuro)biological and environmental factors. In this context, there is growing evidence for the role of childhood trauma on vulnerability for both anxiety and depression throughout the course of life, mainly through its effects on attachment as a biologically based neurodevelopmental stress regulation system. Yet, the impact of childhood trauma on depression and anxiety in late life specifically remains unclear. The current study therefore aims to investigate the association between retrospectively reported childhood interpersonal trauma, attachment dimensions and levels of anxiety and depression in late life.Method: A sample of 81 community dwelling older adults completed measures of early and current adversity, attachment dimensions, and levels of anxiety and depression.Results: The occurrence and frequency of childhood trauma, but not later negative adult life events, was associated with late life anxiety and depression. Both attachment anxiety and avoidance were related to anxiety and depression. Only attachment anxiety affected the association between childhood trauma, and emotional neglect in particular, and late life anxiety and depression.Conclusion: Childhood trauma may be associated with anxiety and depression in late life. Part of this association is probably indirect, via the effect of insecure attachment and high levels of attachment anxiety in particular.

The Relation between Childhood Inter personal Trauma Experience and Early Adulthood Relationship Addiction: The Dual Mediating Effects of Psychological Acceptance and Traumatized Self-System

The Relation between Childhood Inter personal Trauma Experience and Early Adulthood Relationship Addiction: The Dual Mediating Effects of Psychological Acceptance and Traumatized Self-System

Pilot randomized controlled trial of Tuning Relationships with Music: Intervention for parents with a trauma history and their adolescent

For parents who have experienced childhood interpersonal trauma, the challenges of parenting an adolescent may trigger memories of abuse, intensifying conflict, resulting in negative cycles of relating and poorer responsiveness to emotions when parenting. This study examined whether Tuning Relationships with Music, a dyadic therapy for parents and adolescents, increased responsive parent-adolescent interactions and parent emotion coaching whilst reducing conflict and adolescent mental health difficulties. Twenty-six parent-adolescent dyads were recruited if parents had a trauma history and the dyad were currently having high levels of conflict. Dyads were randomly allocated into intervention or wait-list control and completed questionnaires and observation assessments at baseline and 4-month post-baseline follow-up. Those allocated to the intervention condition participated in 8 sessions of Tuning Relationships with Music. Trial registration: ANZCTR: 12615000814572. Parents and adolescents reported significant reductions in conflict. Parents in the intervention condition were observed to significantly improve their nonverbal communication, emotional responsiveness and non-reactivity toward their adolescent. Although parents reported they were less dismissive and punitive, and more encouraging of their adolescent’s emotions, and both parents and adolescents reported improvements in the adolescent’s mental health, these were not statistically significant. Findings suggest Tuning Relationships with Music may assist parents with a history of childhood interpersonal trauma and their adolescent to reduce conflict and increase responsive ways of relating that may positively impact the young person’s mental health. Future trials with a larger sample are warranted.

Cumulative childhood interpersonal trauma is associated with reduced cortical differentiation between threat and non-threat faces in posttraumatic stress disorder adults.

Posttraumatic stress disorder and childhood trauma frequently co-occur. Both are associated with abnormal neural responses to salient emotion stimuli. As childhood trauma is a risk factor for posttraumatic stress disorder, differentiating between their neurophysiological effects is necessary to elucidate the neural pathways by which childhood trauma exposure contributes to increased posttraumatic stress disorder risks. Face-specific N170 evoked response potentials for backward-masked (non-conscious) and conscious threat (fear, angry) and non-threat (happy) faces were measured in 77 adults (18-64 years old, 64% women, 78% right-handed) symptomatic for posttraumatic stress disorder. Differences in N170 peak amplitudes for fear-versus-happy and angry-versus-happy faces at bilateral temporo-occipital (T5, T6) sites were computed. The effect of cumulative exposure to childhood interpersonal trauma, other childhood trauma, adult trauma, depression and posttraumatic stress disorder symptom severity on the N170 response was assessed using hierarchical multiple regression analyses. T5 N170 peak amplitudes for non-conscious fear-versus-happy faces were inversely related to cumulative childhood interpersonal trauma after accounting for socio-demographic, clinical symptom and other trauma factors. Posttraumatic stress disorder Avoidance was positively associated with N170 peak amplitudes for non-conscious fear-versus-happy faces, primarily due to reduced N170 responsivity to happy faces. Childhood interpersonal trauma exposure is associated with reduced discrimination between fear and happy faces, while avoidance symptom severity is associated with dampened responsivity to automatically processed happy faces in posttraumatic stress disorder adults. Results are discussed in terms of the likely contributions of impaired threat discrimination and deficient reward processing during neural processing of salient emotion stimuli, to increased risks of posttraumatic stress disorder onset and chronicity in childhood interpersonal trauma-exposed adults.