Abstract
Emotion dysregulation is a core feature of chronic complex dissociative disorders (DD), as it is for borderline personality disorder (BPD). Chronic complex DD include dissociative identity disorder (DID) and the most common form of dissociative disorder not otherwise specified (DDNOS, type 1), now known as Other Specified Dissociative Disorders (OSDD, type 1). BPD is a common comorbid disorder with DD, although preliminary research indicates the disorders have some distinguishing features as well as considerable overlap. This article focuses on the epidemiology, clinical presentation, psychological profile, treatment, and neurobiology of chronic complex DD with emphasis placed on the role of emotion dysregulation in each of these areas. Trauma experts conceptualize borderline symptoms as often being trauma based, as are chronic complex DD. We review the preliminary research that compares DD to BPD in the hopes that this will stimulate additional comparative research.
Highlights
Emotion dysregulation is a core feature of chronic complex dissociative disorders (DD), as it is for borderline personality disorder (BPD)
Despite many researchers proposing that dissociation serves as a protection from overwhelming affect related to trauma [12,13,14,15,16], surprisingly few studies have empirically examined the relationship between trauma, dissociation, and emotion regulation
The most common type of disorder not otherwise specified (DDNOS), which has been replaced in the Diagnostic and Statistical Manual of Mental Disorders-5, called other specified dissociative disorder (OSDD), is typically found to be the most prevalent DD in general population and clinical studies with a prevalence rates up to 8.3% in the community reviewed in [23]
Summary
Emotion dysregulation may be a mechanism linking trauma to dissociation. It is an important feature of DD and BPD. To enhance our understanding of the similarities and differences between DD and BPD, and to lead to research that can clarify causal mechanisms and yield more targeted treatments, future research needs to study the range of trauma exposure as well as the range of dissociation, dissociation that occurs during treatment sessions, using clinical and community samples. This knowledge will help to develop interventions that are most effective for the treatment of dissociation as well as improve our understanding of how specific interventions, such as improving affect regulation, can be employed for patients with a range of dissociative psychopathology.
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