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Journal of Trauma & Dissociation : the... 2020In the field of trauma and dissociation, culture has a significant influence on the clinical presentation of patients. A growing body of literature addresses the...
In the field of trauma and dissociation, culture has a significant influence on the clinical presentation of patients. A growing body of literature addresses the relationship between culture and dissociation. Studies of this relationship though, evoke the important, but at the same time extremely sensitive issue of cross-cultural comparisons. In this editorial, I provide a limited overview of various ways in which cultural influences have been addressed in the field of trauma and dissociation. Most studies have examined the occurrence of dissociative disorders in clinical populations in different cultures and countries. Some have focused on normative dissociation as a response to traumatic events in non-clinical samples from different cultures. This editorial also explores the concepts of double consciousness and black consciousness, which have emerged from the fields of social psychology and black psychology; and how these concepts influence our thinking about non-clinical dissociation. Culture-related challenges in the field of trauma and dissociation create opportunities for training in cultural competence for therapists. Qualitative research methods might be best suited to future research on the relationship between culture, trauma and dissociation. The chances of reaching a thorough and deep understanding of the influence of culture on trauma and dissociation might be best if the entire spectrum of dissociation is studied - from normal to pathological dissociation, and in its different manifestations from universal to those unique to certain cultural groups.
Topics: Cross-Cultural Comparison; Culture; Dissociative Disorders; Humans; Stress Disorders, Post-Traumatic
PubMed: 31891334
DOI: 10.1080/15299732.2020.1675134 -
Early Intervention in Psychiatry Dec 2019Increasing evidence suggests that childhood trauma and dissociation are associated with psychotic symptoms and disorders. Significant rates of dissociative disorders and...
AIM
Increasing evidence suggests that childhood trauma and dissociation are associated with psychotic symptoms and disorders. Significant rates of dissociative disorders and clinical levels of dissociative symptoms are found in chronic schizophrenia. To date, no studies have examined the prevalence of these in a first episode psychosis (FEP) group. This study aimed to investigate the prevalence of dissociative disorders and symptoms in a FEP sample as well as the prevalence of severe dissociative symptoms in those with or without experiences of childhood trauma.
METHODS
Sixty-six young people with FEP completed a research interview which included the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I Disorders, Childhood Trauma Questionnaire and the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised.
RESULTS
Dissociative symptoms at clinical levels were found in 36.4% of the sample. Furthermore, 13.6% of the sample met diagnostic criteria for a lifetime dissociative disorder. Significant differences in the frequency of clinical dissociative symptoms between those with or without childhood trauma were also found.
CONCLUSIONS
Dissociative symptoms should be routinely assessed for in early intervention settings, especially in cases where childhood trauma is disclosed or suspected. Where present, dissociative symptoms should also be incorporated into subsequent case formulation and treatment planning.
Topics: Adolescent; Adult; Adult Survivors of Child Adverse Events; Australia; Case-Control Studies; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Female; Humans; Male; Prevalence; Psychotic Disorders; Surveys and Questionnaires; Young Adult
PubMed: 30585427
DOI: 10.1111/eip.12773 -
Journal of Trauma & Dissociation : the... 2024The 11 revision of the International Classification of Diseases (ICD-11) introduced Complex Posttraumatic Stress Disorder (CPTSD) as a sibling disorder to PTSD.... (Review)
Review
The 11 revision of the International Classification of Diseases (ICD-11) introduced Complex Posttraumatic Stress Disorder (CPTSD) as a sibling disorder to PTSD. Dissociative symptoms have been implicated in the severity of ICD-11 CPTSD; however, no reviews have investigated how dissociation has been measured in studies investigating CPTSD, nor the relationship between CPTSD and dissociation. This systematic review aimed to identify measures used to assess dissociative symptoms in studies that have assessed CPTSD according to ICD-11 criteria and to synthesize the relationship between these constructs. PsycINFO, PubMed, Scopus and Web of Science were searched on March 31, 2021. Seventeen articles met inclusion criteria. CPTSD was most frequently measured by a version of the International Trauma Questionnaire. Twelve measures were used to assess for dissociative symptoms, the most common being the Dissociative Symptoms Scale and the Dissociative Experiences Scale. The relationship between CPTSD and dissociative symptoms was moderate-to-strong, but inconsistently reported. Further research is needed to determine the most appropriate measure(s) of dissociation in CPTSD.
Topics: Humans; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; International Classification of Diseases; Dissociative Disorders
PubMed: 38112306
DOI: 10.1080/15299732.2023.2293785 -
The Permanente Journal 2020People who live with dissociative disorders and a history of childhood trauma are less rare than commonly thought and can be challenging for unfamiliar medical...
People who live with dissociative disorders and a history of childhood trauma are less rare than commonly thought and can be challenging for unfamiliar medical practitioners. Many of us present as apparently normal people and live full and satisfying lives. But under the stress of a medical situation, we can become unpredictable. On the basis of my own experiences, I offer, in this article, some instructive anecdotes and tips for health care practitioners on how to work with patients with a trauma-related diagnosis such as a dissociative disorder.
Topics: Adult Survivors of Child Abuse; Aged; Dissociative Disorders; Female; Humans
PubMed: 31852054
DOI: 10.7812/TPP/19.094 -
Journal of Trauma & Dissociation : the... 2023Depersonalization-Derealization disorder (DDD) is a psychiatric condition characterized by persistent feelings of detachment from one's self and of unreality about the... (Review)
Review
Depersonalization-Derealization disorder (DDD) is a psychiatric condition characterized by persistent feelings of detachment from one's self and of unreality about the outside world. This review aims to examine the prevalence of DDD amongst different populations. A systematic review protocol was developed before literature searching. Original articles were drawn from three electronic databases and included only studies where prevalence rates of DDD were assessed by standardized diagnostic tools. A narrative synthesis was conducted. Twenty-three papers were identified and categorized into three groups of participants: general population, mixed in/outpatient samples, and patients with specific disorders. The prevalence rates ranged from 0% to 1.9% amongst the general population, 5-20% in outpatients and 17.5-41.9% in inpatients. In studies of patients with specific disorders, prevalence rates varied: 1.8-5.9% (substance abuse), 3.3-20.2% (anxiety), 3.7-20.4% (other dissociative disorders), 16.3% (schizophrenia), 17% (borderline personality disorder), ~50% (depression). The highest rates were found in people who experienced interpersonal abuse (25-53.8%). The prevalence rate of DDD is around 1% in the general population, consistent with previous findings. DDD is more prevalent amongst adolescents and young adults as well as in patients with mental disorders. There is also a possible relationship between interpersonal abuse and DDD, which merits further research.
Topics: Adolescent; Young Adult; Humans; Depersonalization; Prevalence; Dissociative Disorders; Substance-Related Disorders
PubMed: 35699456
DOI: 10.1080/15299732.2022.2079796 -
Fortschritte Der Neurologie-Psychiatrie Apr 2023Dissociative phenomena are not only encountered in everyday life, but increasingly require neurological as well as psychiatric attention in practice and clinic in order...
Dissociative phenomena are not only encountered in everyday life, but increasingly require neurological as well as psychiatric attention in practice and clinic in order to recognize and diagnose corresponding phenomena at an early stage and to provide patients with appropriate treatment. In this article, dissociative disorders, taking into account the new classification of the ICD-11, are presented and corresponding diagnostics and therapeutic measures are described.
Topics: Humans; Dissociative Disorders; International Classification of Diseases
PubMed: 37055014
DOI: 10.1055/a-1898-5283 -
Journal of Child Sexual Abuse Jul 2022The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and...
The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.
Topics: Amnesia; Child; Child Abuse, Sexual; Dissociative Disorders; Dissociative Identity Disorder; Humans; Inpatients; Psychiatric Status Rating Scales
PubMed: 35437119
DOI: 10.1080/10538712.2022.2067096 -
European Journal of Psychotraumatology 2023The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced the dissociative subtype of posttraumatic stress disorder (D-PTSD). To...
The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced the dissociative subtype of posttraumatic stress disorder (D-PTSD). To assess this subtype, the Dissociative Subtype of PTSD Scale (DSPS), a 15-item self-report measure to identify lifetime and current dissociative symptoms of D-PTSD, was developed. However, so far, the scale has only been validated in war veterans. Moreover, criterion validity and diagnostic utility have not been examined yet. We aimed to validate the DSPS in two samples of civilian trauma-exposed German-speaking participants. In Study 1, a pre-registered online study, participants with and without PTSD symptoms ( = 558) answered questionnaires about traumatic experiences, dissociation, PTSD, depression, generalized anxiety disorder, somatic symptom disorder, alcohol use disorder, absorption, and dissociative responding to trauma-related questionnaires. In Study 2, which used secondary data of a pre-registered clinical study, participants with a PTSD diagnosis ( = 71) answered questionnaires about traumatic experiences, dissociation, PTSD, depression, generalized anxiety disorder, somatic symptom disorder, and dissociative responding to standardized trauma exposure. Moreover, PTSD, D-PTSD, and other diagnoses were assessed with structured clinical interviews. Analyses confirmed a three-factor structure as well as high internal consistency, and high convergent, discriminant, and criterion validity of the DSPS. Moreover, the scale was able to identify a latent D-PTSD group and individuals with D-PTSD diagnosis. The DSPS constitutes a reliable and valid tool to assess D-PTSD symptoms in clinical practice and research and thereby may contribute to a better understanding of these debilitating symptoms.
Topics: Humans; Stress Disorders, Post-Traumatic; Medically Unexplained Symptoms; Psychometrics; Dissociative Disorders; Anxiety Disorders
PubMed: 37593980
DOI: 10.1080/20008066.2023.2238492 -
Journal of Trauma & Dissociation : the... 2019Frontal EEG asymmetry (FEA) has been studied as both state and trait parameter in emotion regulation and affective disorders. Its significance in borderline personality...
Frontal EEG asymmetry (FEA) has been studied as both state and trait parameter in emotion regulation and affective disorders. Its significance in borderline personality disorder (BPD) remains largely unknown. Twenty-six BPD patients and 26 healthy controls underwent EEG before and after mood induction using aversive images. A slight but significant shift from left- to right-sided asymmetry over prefrontal electrodes occurred across all subjects. In BPD baseline FEA over F7 and F8 correlated significantly with childhood trauma and functional neurological "conversion" symptoms as assessed by respective questionnaires. Regression analysis revealed a predictive role of both childhood trauma and dissociative neurological symptoms. FEA offers a relatively stable electrophysiological correlate of BPD psychopathology that responds only minimally to acute mood changes. Future studies should address whether this psychophysiological association is universal for trauma- and dissociation-related disorders, and whether it is responsive to psychotherapy.
Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Borderline Personality Disorder; Case-Control Studies; Dissociative Disorders; Electroencephalography; Female; Humans; Hydrocortisone; Male; Middle Aged; Predictive Value of Tests; Psychiatric Status Rating Scales; Psychometrics; Saliva
PubMed: 29543578
DOI: 10.1080/15299732.2018.1451808 -
Epilepsy & Behavior : E&B Oct 2020There is considerable debate in the literature regarding what to call functional seizures, with terms such as pseudoseizures, nonepileptic attack disorder (NEAD), and...
There is considerable debate in the literature regarding what to call functional seizures, with terms such as pseudoseizures, nonepileptic attack disorder (NEAD), and dissociative seizures being used. Provision of an accurate diagnosis and coherent explanation is a vital first step in the management of functional seizures and can result in cessation or reduced frequency for some individuals. This study investigated preferences for and offensiveness of terms used to describe functional seizures, and expectations for recovery with psychological treatment. A sample of 87 healthy adults completed an online survey, in which eight different diagnostic terms were ranked in order of preference (1 - most preferred, 8 - least preferred): functional nonepileptic attacks (FNEA), dissociative seizures, functional seizures, psychogenic seizures, NEAD, pseudoseizures, conversion disorder, and hysteria. Replicating Stone and colleagues protocol, each term was investigated for five connotations. Offense scores were calculated from the number of participants who selected 'yes' to at least one of the negative connotations ('Putting it on', 'Mad', and 'Imagining Symptoms'). Expectations about the possibility of recovering through medical or psychological treatment were also recorded. Functional nonepileptic attack was ranked the highest preferred term with dissociative seizures and functional seizures closely following. Nonepileptic attack disorder was the least offensive term, with FNEA and functional seizures joint second. Unsurprisingly, the three least preferred terms were also the most offensive: pseudoseizures, conversion disorder, and hysteria. Expectations of nonrecovery from psychological treatment were lowest for terms implicating a psychological cause: pseudoseizures, dissociative seizures, psychogenic seizures, and hysteria. The results suggest that either the terms FNEA or functional seizures should be adopted by healthcare professionals and patients, as they are the most preferred, least offensive, and expectations for nonrecovery with psychological treatment were moderate compared with the other terms. Limitations and areas for future research are discussed.
Topics: Adolescent; Adult; Conversion Disorder; Dissociative Disorders; Female; Humans; Male; Seizures; Students; Surveys and Questionnaires; Terminology as Topic; Universities; Young Adult
PubMed: 32535370
DOI: 10.1016/j.yebeh.2020.107183