-
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 -
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 -
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 -
Psychological Trauma : Theory,... Jan 2022Schematic self-knowledge consists of internal representations that shape perceptions of how the self is related to one's surroundings and other people. These...
OBJECTIVE
Schematic self-knowledge consists of internal representations that shape perceptions of how the self is related to one's surroundings and other people. These representations may include dysfunctional implicit self-evaluations, such as associations of the self with negative attributes like shame, in trauma-spectrum disorders. The current study examines whether a negative relational self-association, that is, linking the self with rejection, characterizes dissociation.
METHOD
One hundred six community participants with diverse early interpersonal experiences and mental health outcomes were recruited. Implicit relational self-evaluation was assessed by single-target implicit association tests. Dissociation and common psychopathological and psychosocial correlates such as anxiety, depression, self-esteem, and adverse interpersonal experiences were measured using standardized scales.
RESULTS
Individuals with more dissociative symptoms responded faster when pairing self-pronouns with rejection-related words than with acceptance-related words. The correlation between dissociation and this self-rejection association remained significant when statistically controlling for adverse interpersonal experiences and for depression, anxiety, and self-esteem.
CONCLUSION
A self-association with being rejected characterized individuals prone to dissociation. This dysfunctional implicit self-evaluation may bias perceptions of other people's attitudes toward themselves, prompting maladaptive social behaviors that can hinder the development and maintenance of relationships in dissociative people. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Anxiety; Diagnostic Self Evaluation; Dissociative Disorders; Humans; Self Concept; Shame
PubMed: 33600204
DOI: 10.1037/tra0001017 -
The Kurume Medical Journal Nov 2022We developed a Subclinical Dissociation Scale by comparing healthy controls with patients with post-traumatic stress disorder (PTSD) or dissociative disorder. The...
We developed a Subclinical Dissociation Scale by comparing healthy controls with patients with post-traumatic stress disorder (PTSD) or dissociative disorder. The Dissociative Experiences Scale, Subclinical Dissociation Scale, and General Health Questionnaire were completed by 441 healthy Japanese adolescents (mean age, 19.9 years) and 23 psychiatric inpatients (mean age, 28.8 years) diagnosed with PTSD or dissociative disorder. The initial Subclinical Dissociation Scale included 52 items grouped into five factors: F1, absentmindedness (14 items); F2, immersion or preoccupation (15 items); F3, temporary amnesia (10 items); F4, feelings of unreality (eight items); and F5, feelings of alienation (five items). Factor and correlation analyses revealed the validity and reliability of the Subclinical Dissociation Scale. The final version of the scale that comprised three factors (F1, F2, and F4) and 37 items underwent logistic regression and receiver operating characteristic (ROC) curve analyses to compare healthy controls with patients with PTSD or dissociative disorder. The ROC curve analysis using the Youden Index indicated a cut-off score of 18 for the borderline or abnormal range, which was calculated using the following formula: "(F1) + (F4) - (F2)." This study provides evidence of the partial test-retest reliability and con current validity of the Subclinical Dissociation Scale.
Topics: Adolescent; Humans; Young Adult; Adult; Reproducibility of Results; Psychiatric Status Rating Scales; Dissociative Disorders; Stress Disorders, Post-Traumatic
PubMed: 36288960
DOI: 10.2739/kurumemedj.MS6723002 -
Rivista Di Psichiatria 2023In bipolar disorder (BD) patients, trauma has been associated with emotional dysregulation, potentially leading to an increase in impulsivity and dissociative...
UNLABELLED
In bipolar disorder (BD) patients, trauma has been associated with emotional dysregulation, potentially leading to an increase in impulsivity and dissociative symptomatology. We aimed to investigate the relationship between childhood trauma, impulsivity, and dissociative symptomatology in BD with a special focus on the role of impulsivity as a mediator between childhood trauma and dissociative symptomatology.
METHODS
We administered the Childhood Trauma Questionnaire (CTQ), Barratt Impulsivity Scale (BIS-11), Dissociative Experience Scale (DES-II), and Alda scale. Spearman correlation analysis assessed the independent variables associated with CTQ and DES-II. We performed a mediation analysis using the bootstrapping technique to verify the hypothesis that impulsivity represented an intervening variable between childhood trauma and dissociation.
RESULTS
CTQ and DES-II scores in 100 BD patients were both significantly associated with the number of lifetime affective episodes, a clinical course of mania-depression-euthymia, suicidal ideation, a history of antidepressant-induced manic switch, poor response to mood stabilizers, mixed features, psychotic symptoms, aggressive behavior, and BIS-11 (p<0.01). At the regression analysis, CTQ was associated with DES-II (p<0.001), while DES-II was associated with the CTQ (p<0.001) and BIS-11 (p< 0.001), as well as with aggression (p=0.002). The mediation analysis showed that impulsivity significantly mediated the effect of childhood trauma on dissociative symptomatology (z=25.71; 0.930-1.084).
CONCLUSIONS
Impulsivity might play a key role in onset and prognosis of BD patients. Our findings may help in increasing the knowledge about the possible association between impulsivity, childhood traumatic experiences and dissociative symptomatology. BD patients with dissociative symptoms might benefit from a tailored treatment which could include a training based on emotional and behavioral regulation.
Topics: Humans; Bipolar Disorder; Adverse Childhood Experiences; Psychotic Disorders; Impulsive Behavior; Surveys and Questionnaires; Dissociative Disorders
PubMed: 37070335
DOI: 10.1708/4022.39978 -
European Journal of Psychotraumatology 2023Dysfunctional cognitions play a central role in the development of post-traumatic stress disorder (PTSD). However the role of specific dissociation-related beliefs about...
OBJECTIVE
Dysfunctional cognitions play a central role in the development of post-traumatic stress disorder (PTSD). However the role of specific dissociation-related beliefs about memory has not been previously investigated. This study aimed to investigate the role of dissociation-related beliefs about memory in trauma-focused treatment. It was hypothesized that patients with the dissociative subtype of PTSD would show higher levels of dissociation-related beliefs, dissociation-related beliefs about memory would decrease after trauma-focused treatment, and higher pre-treatment dissociation-related beliefs would be associated with fewer changes in PTSD symptoms.
METHOD
Post-traumatic symptoms, dissociative symptoms, and dissociation-related beliefs about memory were assessed in a sample of patients diagnosed with PTSD (= 111) or the dissociative subtype of PTSD ( = 61). They underwent intensive trauma-focused treatment consisting of four or eight consecutive treatment days. On each treatment day, patients received 90 min of individual prolonged exposure (PE) in the morning and 90 min of individual eye movement desensitization and reprocessing (EMDR) therapy in the afternoon. The relationship between dissociation-related beliefs about memory and the effects of trauma-focused treatment was investigated.
RESULTS
Dissociation-related beliefs about memory were significantly associated with PTSD and its dissociative symptoms. In addition, consistent with our hypothesis, patients with the dissociative subtype of PTSD scored significantly higher on dissociation-related beliefs about memory pre-treatment than those without the dissociative subtype. Additionally, the severity of these beliefs decreased significantly after trauma-related treatment. Contrary to our hypothesis, elevated dissociation-related beliefs did not negatively influence treatment outcome.
CONCLUSION
The results of the current study suggest that dissociation-related beliefs do not influence the outcome of trauma-focused treatment, and that trauma-focused treatment does not need to be altered specifically for patients experiencing more dissociation-related beliefs about memory because these beliefs decrease in association with treatment.
Topics: Humans; Dissociative Disorders; Stress Disorders, Post-Traumatic; Treatment Outcome; Eye Movement Desensitization Reprocessing
PubMed: 37846662
DOI: 10.1080/20008066.2023.2265182 -
Journal of Trauma & Dissociation : the... 2020The dissociative subtype of posttraumatic stress disorder (PTSD) is estimated to characterize about 12-30% of those with PTSD. Some research links this subtype with...
The dissociative subtype of posttraumatic stress disorder (PTSD) is estimated to characterize about 12-30% of those with PTSD. Some research links this subtype with increased severity of PTSD symptoms compared to samples with "classic" PTSD. However, prevalence and severity rates reported in the literature have varied. One possible explanation for these discrepancies could be related to where the populations were sampled. Therefore, we investigated whether these differences are still observed when holding level of care constant. We collected data from 104 women at a partial and residential psychiatric hospital program focused on trauma-related disorders. Participants completed self-report questionnaires assessing trauma exposure, symptoms and provisional diagnosis of PTSD, trauma-related thoughts and beliefs, and feelings of shame. All participants reported a history of childhood and/or adulthood trauma exposure. Eighty-eight (85%) met criteria for PTSD, and of those, seventy-three (83%) met criteria for the dissociative subtype as assessed by the Dissociative Subtype of PTSD Scale. A series of independent t-tests revealed no significant differences between the "classic" and dissociative PTSD groups with respect to lifetime or childhood trauma exposure, posttraumatic cognitions, shame, or overall PTSD severity. Our results suggest that samples with classic PTSD and the dissociative subtype may not differ in some types of symptom severity when holding level of care constant. Importantly, however, we found at partial/residential level of care the majority of patients with PTSD were dissociative. Given the elevated prevalence rate in this sample, these findings support the need to assess dissociative symptoms, particularly in more acute psychiatric settings.
Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Dissociative Disorders; Female; Hospitals, Psychiatric; Humans; Middle Aged; Prevalence; Psychiatric Status Rating Scales; Psychotherapy; Risk Factors; Self Report; Shame; Stress Disorders, Post-Traumatic; Surveys and Questionnaires
PubMed: 31607239
DOI: 10.1080/15299732.2019.1678214 -
Journal of Trauma & Dissociation : the... 2023This study aimed to examine prevalence, clinical symptoms, and psychological characteristics of D-PTSD in a sample of Chinese prisoners with probable PTSD. A total of...
This study aimed to examine prevalence, clinical symptoms, and psychological characteristics of D-PTSD in a sample of Chinese prisoners with probable PTSD. A total of 1458 male prisoners were recruited from a large prison in Guangdong, China. Participants completed self-administrated questionnaires that assessed PTSD and dissociative symptoms, psychopathology, emotion regulation, emotional expressivity, social pleasure, traumatic events, and social support. According to DSM-5 criteria, participants were classified into four groups: D-PTSD, PTSD only, derealization/depersonalization (DD) only, and neither. The proportions of D-PTSD, PTSD only, DD only and neither were 2.5%, 4.7%, 2.4%, and 92.2%, respectively. PTSD symptoms and emotion regulation difficulties were distinguishing for the four groups: PTSD symptoms declined gradually in the order of D-PTSD, PTSD only, DD only, and neither, while emotion regulation difficulties declined in an order from D-PTSD, DD only, and PTSD only to neither, all < .001. D-PTSD and DD only had higher depressive and dissociative symptoms than PTSD only and the neither groups, all < .001. D-PTSD also had more borderline personality symptoms, emotion regulation difficulties, and more negative emotional expressivity than PTSD only and DD only, all < .05. Logistic regressions indicated that D-PTSD reported lower social support compared to PTSD only (OR = 0.95, p < .01), DD only (OR = 0.96, p < .05) and neither (OR = 0.93, p < .001). D-PTSD is common in probable PTSD in prisoners and is associated with complex clinical presentations as well as emotional processing. Social support is an important protective factor of D-PTSD.
Topics: Humans; Male; Stress Disorders, Post-Traumatic; Prevalence; East Asian People; Emotions; Dissociative Disorders; Prisoners
PubMed: 35611661
DOI: 10.1080/15299732.2022.2079797