Clinical Phenomenology of Child and Adolescent Dissociative Disorders: Gender and Age Effects

Abstract

Clinicians have noted age and gender differences in the presentations of children and adolescents with dissociative disorders. This study uses a composite sample of 177 cases to explore developmental and gender differences in youth with pathologic dissociation. Females proved to be more symptomatic than males in five areas: anxiety and phobic symptoms, post-traumatic stress disorder symptoms, sleep problems, sexual acting out, and somatization. In general, there were more dissociative and comorbid symptoms with increasing age, although most age differences did not achieve statistical significance. Internalized auditory hallucinations, conversion symptoms, amnesias, suicidal ideation, and self-mutilation increased significantly with age. Preschool cases were essentially equally divided between males and females. By late adolescence, 83% of cases were female. Cases diagnosed with dissociative identity disorder/multiple personality disorder were significantly more symptomatic than those diagnosed with dissociative disorder not otherwise specified.