<p>Disturbances in Self-Organization (DSO), a core dimension of Complex PTSD (posttraumatic stress disorder), includes (a) affective dysregulation, (b) negative self-concept, and (c) disturbed relationships as per the ICD-11 definition. Global research has identified several psychosocial risk factors for CPTSD; however, empirical understanding of DSO in the Global South, particularly in India, is limited. This cross-sectional study examined this gap by exploring the associations between childhood emotional maltreatment (CEM, including emotional abuse and emotional neglect), adult depression, loneliness, and DSO, among trauma-exposed adults at an urban wellness centre in India. A total of 465 trauma-exposed English-speaking, participants completed validated self-assessments of adverse childhood experiences (ACEs), loneliness, and depression. Once the self-assessment forms were filled, interviews were conducted to (a) document the frequency and qualitative aspects of CEM and (b) assess DSO using the International Trauma Questionnaire (ITQ). Structural Equation Modelling (SEM) identified that CEM was significantly associated with adults’ loneliness (β = 0.313, <i>p</i> &lt; .01) and DSO (β = 0.426, <i>p</i> &lt; .01), but not directly with adult depression (β = −0.019, <i>p</i> = .721). Loneliness was significantly associated with depression for both males and females; however, its association with DSO was evident only among females. The final model accounted for 50% of the variance in DSO symptoms. The findings highlighted the importance of understanding the implications of CEM and loneliness in trauma-affected adults seeking help for mental health in the Indian context. Longitudinal studies and broader geographic expansion are recommended to expand the generalization of the findings.</p>