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Clinical Psychology Review Nov 2019Dissociative experiences and symptoms have sparked intense scrutiny and debate for more than a century. Two perspectives, the trauma model (TM), which postulates a... (Review)
Review
Dissociative experiences and symptoms have sparked intense scrutiny and debate for more than a century. Two perspectives, the trauma model (TM), which postulates a direct and potent causal link between trauma and dissociation, and the sociocognitive model (SCM), which emphasizes social and cognitive variables (e.g., fantasy-proneness, media influences, suggestibility, suggestion, cognitive failures), currently vie for support. The intensive focus on controversies has stymied progress in understanding dissociation as much, if not more, than it has inspired research that transcends a single perspective. We assess strengths and limitations of these two perspectives and contend that neither provides a complete account of dissociation symptoms, which occur in the presence of many disorders. We provide a novel, narrative review of the link between dissociation and dissociative disorders and sleep disruptions, hyperassociativity, set shifts, deficits in meta-consciousness, and impaired self-regulation. We suggest that these transtheoretical variables (a) play a role in disorders that covary extensively with dissociative disorders (i.e., borderline personality disorder, schizophrenia spectrum disorders) and (b) provide the basis for overlapping foci of interests and potential collaborations among proponents of competing theoretical camps. Finally, we discuss limitations in knowledge and unresolved issues for future workers in the field to pursue.
Topics: Dissociative Disorders; Humans; Metacognition; Models, Psychological; Personality Disorders; Schizophrenia; Self-Control; Sleep Wake Disorders
PubMed: 31494349
DOI: 10.1016/j.cpr.2019.101755 -
The Israel Journal of Psychiatry and... 2015Post traumatic patients experience a wide range of symptoms, some of them existential in nature which we term "dissociative being." Many varied psychotherapeutic... (Review)
Review
Post traumatic patients experience a wide range of symptoms, some of them existential in nature which we term "dissociative being." Many varied psychotherapeutic approaches are available for the treatment of post traumatic patients. Nevertheless, in view of this disorder's complexity, therapists face shortcomings when employing each of these therapeutic interventions. In order to understand this, we posit the principle we call "dissociative reality" for the treatment of trauma survivors. Our proposed method "speaks the patient's own language," harnessing dissociative elements to help individuals recall, re-enact and integrate traumatic experiences, where words are insufficient, while still upholding reality. We believe that this may be seen as an effective part of the therapeutic dialogue, and suggest that therapists may consider supplementing this approach in their treatment "toolkit" for patients with post traumatic stress and other trauma related disorders, irrespective of their declared therapeutic approach.
Topics: Dissociative Disorders; Humans; Psychotherapy; Stress Disorders, Post-Traumatic
PubMed: 25841110
DOI: No ID Found -
Journal of Trauma & Dissociation : the... 2017During the 19th century, high hypnotizability was considered to be a form of psychopathology that was inseparable from hysteria. Today, hypnotizability is considered to... (Review)
Review
During the 19th century, high hypnotizability was considered to be a form of psychopathology that was inseparable from hysteria. Today, hypnotizability is considered to be a normal trait that has no meaningful relationship with psychopathology. Psychiatric patients generally manifest medium to low hypnotizability. Nevertheless, several psychiatric diagnoses are marked by an unexpectedly large proportion of patients with high hypnotizability. This is especially true of the diagnostic categories that were subsumed by the 19th-century concept of hysteria: dissociative identity disorder, somatization disorder, and complex conversion disorders. These hysteria-related modern diagnoses are also highly dissociative. A review and analysis of the literature regarding the relationship between hypnotizability and dissociation indicates that high hypnotizability is almost certainly a necessary diathesis for the development of a severe dissociative disorder. Such a diathesis has significant implications for (a) the psychiatric nosologies of the American Psychiatric Association and the World Health Organization, (b) the hypnosis field, and (c) the etiology and construct validity of dissociative identity disorder and other severe dissociative disorders. Specifically, the dissociative disorders (excepting depersonalization disorder, which is not classified as a dissociative disorder by the World Health Organization) are manifestations of hypnotic pathology.
Topics: Conversion Disorder; Depersonalization; Dissociative Disorders; Humans; Hypnosis; Somatoform Disorders
PubMed: 27216366
DOI: 10.1080/15299732.2016.1191579 -
The International Journal of Social... Nov 2022Dissociative/conversion disorders affect almost 31% of children and adolescents in a clinical setting. These children experience significant impairments in their...
Dissociative/conversion disorders affect almost 31% of children and adolescents in a clinical setting. These children experience significant impairments in their academics, and daily functioning, with high chances of developing other psychiatric comorbidities such as anxiety and depression. However, there are no studies that explore the experiences of suffering from dissociative/conversion disorders from perspective of the sufferer. Therefore, the paper has aimed at exploring the subjective experiences of dissociative and conversion disorders among adolescents in the Indian context by examining their understanding about the illness and the reason they ascribe to the cause of their illness. The study used a qualitative semi-structured interview to understand their illness. In total, 10 adolescents of age group between 12 and 16 years participated. Eight out of the 10 participants were female and the mean age was 12 years. All of them were in-patients in the department of Child and Adolescent Psychiatry, NIMHANS, which is the tertiary mental health care Institute India and pioneer Institute of mental health in Asia. All participants have had at least one or more consultation history either with a traditional healer or/and physician. Thematic analysis identified vital themes such as (1) Adolescents' attributing factors of the illness, (2) Cognitive and emotional appraisal of stressful situation/s, (3) Adolescents' appraisal of different explanatory model, (4) Living with the Impact of the illness. This analysis about dissociative/conversion disorders from adolescents' perspective has a major contribution in enhancing the clinical knowledge and practice in planning and managing children/adolescents diagnosed with dissociative/conversion disorders.
Topics: Adolescent; Adolescent Psychiatry; Anxiety Disorders; Child; Comorbidity; Conversion Disorder; Dissociative Disorders; Female; Humans; Male
PubMed: 34387515
DOI: 10.1177/00207640211036178 -
Early Intervention in Psychiatry Dec 2022Sleep disturbances have frequently been associated with the full spectrum of psychosis, from psychotic-like experiences (PLEs) to individuals who meet diagnostic...
BACKGROUND
Sleep disturbances have frequently been associated with the full spectrum of psychosis, from psychotic-like experiences (PLEs) to individuals who meet diagnostic criteria for schizophrenia. Similarly, dissociative experiences have been linked to both sleep disturbances and PLEs.
AIM
The aim of this study was to examine the role of dissociation in the relationship between sleep quality and PLEs.
METHODS
PLEs, dissociative symptoms, and sleep quality were examined in 1677 young adults using self-report measures. A mediation analysis was performed to examine whether dissociative experiences account for some of the relationship between sleep quality and PLEs.
RESULTS
Dissociative symptoms significantly mediated the relationship between sleep quality and PLEs, with both age and gender used as covariates.
CONCLUSION
These findings suggest that dissociation may be a key contributor to the relationship between disrupted sleep and PLEs, which could have treatment and identification implications.
Topics: Young Adult; Humans; Psychotic Disorders; Sleep; Self Report; Sleep Wake Disorders; Dissociative Disorders; Surveys and Questionnaires
PubMed: 35333007
DOI: 10.1111/eip.13284 -
Comprehensive Psychiatry Nov 2023To determine whether dissociative experiences moderate online problem gambling treatment effectiveness, and to characterize the temporal persistence of the relationship...
AIMS
To determine whether dissociative experiences moderate online problem gambling treatment effectiveness, and to characterize the temporal persistence of the relationship between dissociation and problem gambling.
DESIGN
Repeatedly measured self-report data on a guided online cognitive behavioral therapy for problem gambling collected on four occasions: before treatment, after treatment, and at 6- and 12-month follow-ups.
SETTING AND PARTICIPANTS
The data (N = 1243, 59.2% males) were collected in Finland between 2019 and 2021.
MEASUREMENTS
The primary outcome variable was the self-reported level of problem gambling. The predictors were the treatment phase and dissociative experiences, their interaction, and the demographic covariates of age, education, income, and gender.
FINDINGS
Problem gambling scores and dissociative experiences declined significantly following treatment and remained low through the follow-ups (retention rates: 52.6% [post-treatment], 26.3% [at the 6-month follow-up], and 16.1% [at the 12-month follow-up]). However, the treatment was significantly less effective in reducing problem gambling for individuals who kept experiencing dissociation after the treatment.
CONCLUSIONS
Dissociation is an integral sign of problem gambling severity and sustained dissociative experiences may significantly reduce the long-term effectiveness of online problem gambling treatments. Treatment efforts should be customized to account for individual differences in dissociative tendencies, and future research should broaden the study of dissociative experiences to other behavioral addictions.
Topics: Male; Humans; Female; Gambling; Cognitive Behavioral Therapy; Self Report; Treatment Outcome; Dissociative Disorders
PubMed: 37688936
DOI: 10.1016/j.comppsych.2023.152414 -
Journal of Interpersonal Violence Feb 2021Childhood trauma is common among survivors and perpetrators of intimate partner violence (IPV). Although symptoms of posttraumatic stress disorder (PTSD) and...
Childhood trauma is common among survivors and perpetrators of intimate partner violence (IPV). Although symptoms of posttraumatic stress disorder (PTSD) and dissociative disorders (DDs) are predictors of IPV victimization and perpetration, few studies explore IPV among those with DDs. The present study examined IPV and symptoms as predictors among participants in the Treatment of Patients With Dissociative Disorders (TOP DD) Network study, an educational intervention for individuals with DDs and their clinicians. Both clinicians and patients reported on patients' history of physical, emotional, and sexual IPV as both victims and perpetrators. Patients self-reported dissociative, posttraumatic (PTSD), and emotion dysregulation symptoms, as well as IPV-specific dissociative symptoms. According to patients and clinicians, patients were frequently victims of IPV, most commonly emotional IPV. Dissociative symptoms predicted IPV exposure, whereas dissociative and emotion dysregulation symptoms predicted IPV-specific dissociative symptoms.
Topics: Bullying; Crime Victims; Dissociative Disorders; Humans; Intimate Partner Violence; Stress Disorders, Post-Traumatic
PubMed: 29295027
DOI: 10.1177/0886260517746943 -
Epilepsy & Behavior : E&B Jun 2018Dissociative seizures are a common and often elusive differential diagnosis in epilepsy centers. Considering their high prevalence, long diagnostic delays, and... (Review)
Review
Dissociative seizures are a common and often elusive differential diagnosis in epilepsy centers. Considering their high prevalence, long diagnostic delays, and disappointing rates of treatment response, scientific research dedicated to dissociative seizures is surprisingly scarce. In order to chart the scientific landscape of dissociative seizures and to visualize thematic clusters and trends in research, a comprehensive bibliometric analysis was performed. The Web of Science database was examined to identify relevant English language documents from the last half-century. A total of 1751 documents with titles referring to dissociative seizures were identified. Automated textual analysis of all titles and abstracts revealed that research clusters around three major topics: differential diagnosis in epilepsy centers, management and treatment, and psychopathology. Time analysis of term networks revealed that the focus of clinical research has moved from diagnostic procedures to treatment approaches. Furthermore, interest within etiological research is shifting from an emphasis on early life trauma and personality traits to the role of anxiety and emotion regulation. With respect to individual contributing authors, a relatively small network of prolific scientists with a remarkable degree of collaboration emerges. By mapping relevant publications, it becomes evident that dissociative seizures still represent a subject mostly within the realm of neurology and epileptology, with a tendency to settle in the latter domain. This analysis sheds light on an important niche subject and highlights trends in research focus and output.
Topics: Bibliometrics; Biomedical Research; Conversion Disorder; Diagnosis, Differential; Dissociative Disorders; Emotions; Epilepsy; Humans; Seizures
PubMed: 29705627
DOI: 10.1016/j.yebeh.2018.03.041 -
Consciousness and Cognition Nov 2016According to recent findings stressful experiences may influence various physiological disturbances and also neuroanatomical changes and some studies also show that... (Review)
Review
According to recent findings stressful experiences may influence various physiological disturbances and also neuroanatomical changes and some studies also show that psychotherapy and meditation may influence brain functions. Traumatic stress is frequently related to a dissociative response that disintegrates conscious experience. In this context, self-reflection is an essential principle in the process of posttraumatic growth related to spiritual experiences and meditation states that enable mental integration and create the novel integrated self. According to recent findings there is no widely accepted evidence about specific neural mechanisms of processes related to mental integration linked to the spiritual experiences and meditation. Nevertheless there is growing evidence that these integrative experiences are related to various alterations in the brain's physiology and morphology. These findings provide a new paradigm for understanding of mental disorders and emphasize the fundamental role of mental integration and integrated self in the therapy of psychiatric disorders.
Topics: Brain; Dissociative Disorders; Humans; Meditation; Stress Disorders, Traumatic
PubMed: 27677049
DOI: 10.1016/j.concog.2016.09.008 -
Behavioral Sleep Medicine 2022The core symptoms of narcolepsy such as excessive daytime sleepiness and cataplexy are well known. However, there is mounting evidence for a much broader symptom...
INTRODUCTION
The core symptoms of narcolepsy such as excessive daytime sleepiness and cataplexy are well known. However, there is mounting evidence for a much broader symptom spectrum, including psychiatric symptoms. Disordered sleep has previously been linked with dissociative symptoms, which may imply that patients with narcolepsy are more prone to develop such symptoms.
OBJECTIVES
To investigate the frequency of dissociative symptoms in adult patients with narcolepsy type 1 compared to population controls.
METHODS
In a retrospective case control study, sixty adult patients fulfilling the criteria for narcolepsy type 1 and 120 matched population control subjects received a structured interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) to assess dissociative symptoms and disorders.
RESULTS
A majority of narcolepsy patients reported dissociative symptoms, and even fulfilled the DSM-IV-TR criteria of a dissociative disorder (62% vs 1% in controls, < .001). Most frequently reported symptoms were "dissociative amnesia" (37% vs 1%, < .001) and "dissociative disorder of voluntary movement" (32% vs 1%, < .001).
CONCLUSION
Dissociative symptoms are strikingly prevalent in adult patients with narcolepsy type 1. Although a formal diagnosis of dissociation disorder should not be made as the symptoms can be explained by narcolepsy as an underlying condition, the findings do illustrate the extent and severity of the dissociative symptoms. As for the pathophysiological mechanism, there may be symptom overlap between narcolepsy and dissociation disorder. However, there may also be a more direct link between disrupted sleep and dissociative symptoms. In either case, the high frequency of occurrence of dissociative symptoms should result in an active inquiry by doctors, to improve therapeutic management and guidance.
Topics: Adult; Case-Control Studies; Cataplexy; Dissociative Disorders; Humans; Narcolepsy; Retrospective Studies
PubMed: 33594925
DOI: 10.1080/15402002.2021.1888729