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Psychological Medicine Jul 2022The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders... (Meta-Analysis)
Meta-Analysis Review
The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria ( = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5-45.0%) across all samples, 45.5% (95% CI 37.7-53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8-32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0-61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.
Topics: Adult; Child; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans; Prevalence; Stress Disorders, Post-Traumatic
PubMed: 35734787
DOI: 10.1017/S0033291722001647 -
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 -
Nature Reviews. Neuroscience Dec 2020
Topics: Dissociative Disorders; Humans
PubMed: 33024319
DOI: 10.1038/s41583-020-00394-9 -
Medical Hypotheses May 2021Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients demonstrate characteristic multistage progression and movement disorders, which are analogous to... (Review)
Review
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients demonstrate characteristic multistage progression and movement disorders, which are analogous to hystero-epilepsy in Jean-Martin Charcot's Tuesday Lessons. First, based on a review of the Tuesday Lessons recorded by Charcot's pupils, we hypothesized that there were patients with anti-NMDAR encephalitis among those diagnosed with hystero-epilepsy in the nineteenth century. We found acute-onset multiple neuropsychiatric manifestations resembling anti-NMDAR encephalitis among patients with hystero-epilepsy. Patients with drug withdrawal syndrome, dissociative and conversion disorders and patients under hypnosis from the modern point of view were also identified. These results suggested that hystero-epilepsy in the Tuesday Lessons could encompass dissociative and conversion disorders, hypnosis, drug withdrawal syndrome, and anti-NMDAR encephalitis-like manifestations. Based on Charcot's observations and current progress in molecular biology, such as the identification of glutamate/NMDAR system dysfunction in drug withdrawal syndrome, we then hypothesized that patients with dissociative and conversion disorders and those under hypnosis could also have hypofunction of the glutamatergic system. The NMDAR hypofunction hypothesis is emerging as a pathogenesis of schizophrenia. NMDAR antagonists are known to evoke symptoms similar to schizophrenia, anti-NMDAR encephalitis and near-death experiences. In current clinical reports, spectrum disorders such as dissociative disorder and conversion disorder have been observed in patients with anti-NMDAR encephalitis. Our hypothesis will offer an expansion of the NMDAR hypofunction hypothesis from psychosis to functional neurological disorders and normal specific situations, such as hypnosis, thanatosis, and near-death experiences.
Topics: Anti-N-Methyl-D-Aspartate Receptor Encephalitis; Dissociative Disorders; Epilepsy; Humans; Receptors, Glutamate; Receptors, N-Methyl-D-Aspartate
PubMed: 33799161
DOI: 10.1016/j.mehy.2021.110567 -
Consciousness and Cognition Jul 2024Some dissociative experiences may be related, in part, to REM intrusion into waking consciousness. If so, some aspects of dream content may be associated with daytime...
Some dissociative experiences may be related, in part, to REM intrusion into waking consciousness. If so, some aspects of dream content may be associated with daytime dissociative experiences. We tested the hypothesis that some types of dream content would predict daytime dissociative symptomology. As part of a longitudinal study of the impact of dreams on everyday behavior we administered a battery of survey instruments to 219 volunteers. Assessments included the Dissociative Experiences Scale (DES), along with other measures known to be related to either REM intrusion effects or dissociative experiences. We also collected dream reports and sleep measures across a two-week period from a subgroup of the individuals in the baseline group. Of this subgroup we analyzed two different subsamples; 24 individuals with dream recall for at least half the nights in the two-week period; and 30 individuals who wore the DREEM Headband which captured measures of sleep architecture. In addition to using multiple regression analyses to quantify associations between DES and REM intrusion and dream content variables we used a split half procedure to create high vs low DES groups and then compared groups across all measures. Participants in the high DES group evidenced significantly greater nightmare distress scores, REM Behavior Disorder scores, paranormal beliefs, lucid dreams, and sleep onset times. Validated measures of dreamed first person perspective and overall dream coherence in a time series significantly predicted overall DES score accounting for 26% of the variance in dissociation. Dream phenomenology and coherence of the dreamed self significantly predicts dissociative symptomology as an individual trait. REM intrusion may be one source of dissociative experiences. Attempts to ameliorate dissociative symptoms or to treat nightmare distress should consider the stability of dream content as a viable indicator of dissociative tendencies.
Topics: Humans; Dreams; Dissociative Disorders; Adult; Female; Male; Young Adult; Longitudinal Studies; Middle Aged; Sleep, REM; Adolescent
PubMed: 38821030
DOI: 10.1016/j.concog.2024.103708 -
Journal of Trauma & Dissociation : the... 2023This systematic review and meta-analysis aimed to investigate the relationship between dissociation and obsessive-compulsive symptoms (OCS) and disorder (OCD).... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to investigate the relationship between dissociation and obsessive-compulsive symptoms (OCS) and disorder (OCD). Specifically, the study aimed to (a) estimate the pooled prevalence of dissociative disorders among individuals with OCD; (b) systematically review the prevalence of OCD among individuals with dissociative disorders; (c) compare the severity of dissociative symptoms between individuals with OCD and non-clinical controls; (d) estimate the association between OCS and dissociative symptoms in the clinical and non-clinical populations. A systematic search was carried out in biomedical databases from inception to January 2022 according to PRISMA guidelines. A total of 41 studies met inclusion criteria ( = 9,438, 34.3% males). The pooled prevalence of dissociative disorders in adult samples with OCD was 8% (95% CI [3, 15], = 5). Studies on adolescent and adult patients with dissociative disorders found that 17-32% reported comorbid OCD, while a prospective study of patients with early-onset dissociative disorders found no evidence of association with OCD. Individuals affected by OCD reported more dissociative symptoms than non-clinical controls ( = .67, 95% CI [.18, 1.16], = 9). A moderate correlation between dissociative symptoms and OCS was detected ( = .43, 95% CI [.36, .51], = 18). Sensitivity analyses showed small/moderate correlations between dissociative experiences and specific types of obsessions and compulsions. Findings suggest that dissociative symptoms are moderately related to OCS in both clinical and non-clinical populations. Interventions aimed to reduce dissociation might improve treatment response of patients suffering from OCD.
Topics: Adult; Male; Adolescent; Humans; Female; Obsessive-Compulsive Disorder; Prospective Studies; Comorbidity; Dissociative Disorders; Prevalence
PubMed: 36820493
DOI: 10.1080/15299732.2023.2181477 -
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 -
European Journal of Psychotraumatology 2022Dissociative disorder (DD) patients report high rates of self-injury. Previous studies have found dissociation and self-injury to be related to emotional distress. To...
BACKGROUND
Dissociative disorder (DD) patients report high rates of self-injury. Previous studies have found dissociation and self-injury to be related to emotional distress. To the best of our knowledge, however, the link between emotion dysregulation and self-injury has not yet been examined within a DD population.
OBJECTIVE
The present study investigated relations between emotion dysregulation, dissociation, and self-injury in DD patients, and explored patterns of emotion dysregulation difficulties among DD patients with and without recent histories of self-injury.
METHOD
We utilized linear and logistic regressions and -test statistical methods to examine data from 235 patient-clinician dyads enrolled in the TOP DD Network Study.
RESULTS
Analyses revealed emotion dysregulation was associated with heightened dissociative symptoms and greater endorsement of self-injury in the past six months. Further, patients with a history of self-injury in the past six months reported more severe emotion dysregulation and dissociation than those without recent self-injury. As a group, DD patients reported the greatest difficulty engaging in goal-directed activities when distressed, followed by lack of emotional awareness and nonacceptance of emotional experiences. DD patients demonstrated similar patterns of emotion dysregulation difficulties irrespective of recent self-injury status.
CONCLUSIONS
Results support recommendations to strengthen emotion regulation skills as a means to decrease symptoms of dissociation and self-injury in DD patients.
Topics: Adult; Aged; Cross-Sectional Studies; Dissociative Disorders; Emotional Regulation; Female; Humans; Male; Middle Aged; Self-Injurious Behavior; Surveys and Questionnaires
PubMed: 35145611
DOI: 10.1080/20008198.2022.2031592 -
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 -
Journal of Trauma & Dissociation : the... 2023The aim of the current study was to explore how the social stigmatization of dissociative identity disorder (DID) compared to that of schizophrenia and depressive... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of the current study was to explore how the social stigmatization of dissociative identity disorder (DID) compared to that of schizophrenia and depressive disorders. Using a between-subjects experimental design, a total of 139 participants (126 usable data [39 men, 84 women, 3 other]) from the general population were randomly assigned to either a DID, schizophrenia, or depressive disorders experimental condition and responded to an adapted version of the Prejudice Toward People With Mental Illness (PPMI) Scale. Results suggested that, overall, depressive disorders were stigmatized against the least, schizophrenia was stigmatized against the most, and DID was intermediate, with its PPMI score being closer to schizophrenia than that of depressive disorders. We also found the same pattern for most of the subscales of the PPMI. At least relative to other well-known disorders, there is negative stigma associated with having DID.
Topics: Male; Humans; Female; Social Stigma; Schizophrenia; Dissociative Identity Disorder; Stereotyping; Depressive Disorder
PubMed: 36062713
DOI: 10.1080/15299732.2022.2119459