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To understand the etiology of complex PTSD (CPTSD), we used data from the Syrian internally displaced ( N  = 891) and measures for trauma, CPTSD, and COVID-19 stressors. We performed hierarchical regression and path analyses. Type III trauma (continuous traumatic stressors) was the strongest predictor of CPTSD, compared to types 1 and II. Intersected discrimination (type III-a trauma) was the strongest predictor of CPTSD, followed by early childhood adversities (type III-b) and COVID-19 stressors. Cumulative stressors and traumas predicted CPTSD with a slightly larger effect size. There were three amplification/proliferation bi-directional loops between intersected discrimination and childhood traumas, COVID-19, and intergroup conflict. The conceptual and clinical implications were discussed.

The Etiology of Complex PTSD in the COVID-19 and Continuous Traumatic Stressors Era: A Test of Competing and Allied Models