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Background:  The 2019 coronavirus disease (COVID-19) outbreak is currently putting a strain on the mental health resilience of the world's population. Specifically, it is likely to elicit an intense response to fear and to act as a risk factor for the onset of posttraumatic stress disorder (PTSD). Some individuals may be more at risk than others, with pathological personality variables being a potential candidate as a central vulnerability factor. In addition, the pathways that lead the pathological personality to PTSD and intense fear responses to COVID-19 are likely to be explained by poor emotion regulation capacities, as well as by dissociative mechanisms.   Aims:  This study aimed to shed light on vulnerability factors that may account for the onset of PTSD and intense responses of fear in response to COVID-19 outbreak and to test the mediating role of emotion dysregulation and dissociation proneness in these pathways.   Methods:  We used a longitudinal design of research administered to a sample of community individuals ( N  = 308; mean age  = 35.31, SD = 13.91; 22.7% were male). Moreover, we used self-report questionnaires to measure pathological personality, emotion regulation capacities, dissociative proneness at the beginning of the lockdown, and PTSD symptoms and fear of COVID-19 at the end of the Italian lockdown (from March 9 to May 18, 2020). Structural equation modeling was used to test the hypotheses.   Results:  We found that pathological personality levels longitudinally predicted PTSD and fear of COVID-19 levels. Moreover, the associations between emotion dysregulation and dissociation were shown to significantly and totally mediate the relationship between pathological personality and PTSD, whereas no significant mediation effects were observed in relation to fear of COVID-19.   Conclusions:  Individuals with pathological personality traits may be more vulnerable to the onset of negative psychological consequences related to COVID-19 outbreak, such as PTSD symptomatology and fear levels. Emotion regulation capacities appear to be relevant targets of interventions for PTSD symptomatology. Future research should explore the mediating variables linking pathological personality to intense fear responses to COVID-19.

A Fear of COVID-19 and PTSD Symptoms in Pathological Personality: The Mediating Effect of Dissociation and Emotion Dysregulation