The manifestations and correlates of dissociation amongst looked-after children in middle childhood

Abstract

ObjectiveTo explore the manifestations and correlates of dissociation amongst a sample of primary school-aged children looked-after children (LAC) in the care of their local authority. MethodsIn part one, the Child Dissociative Checklist (CDC), Strengths and Difficulties Questionnaire (SDQ) and Relationship Problems Questionnaire (RPQ) were administered to 91 primary school-aged LAC under the care of Five Rivers (an independent fostering agency). Variables pertaining to participants’ background and placement history were examined in relation to CDC scores. In part two, a subsample of children (n=34) with identified psychosocial difficulties were administered the Story Stems Assessment Procedure (SSAP). Relationships between dissociative symptoms and SSAP constructs were explored using Spearman's correlation and K-means clustering. ResultsPart 1. Forty-one LAC (45%) scored on or above the CDC's clinical threshold suggestive of sustained pathological dissociation. Children who had experienced sexual abuse were more likely than others to display dissociative behaviours, as were children placed alone compared to those placed with a related sibling. Total CDC scores were positively correlated with SDQ total difficulties, and RPQ disinhibited and inhibited subscores. Part 2. Dissociative symptoms were negatively correlated with features of attachment security and positive parent representations in children's narratives. Three clusters were identified in the dataset: two groups showed clinically significant levels of dissociation but differed with respect to their representations. ConclusionsChildren who have suffered maltreatment are at high risk of pathological dissociation, especially those who have experienced sexual abuse. Placing LAC with their siblings may mitigate against dissociative symptoms. Dissociation covaries with psychosocial problems, yet dissociative children are a heterogenous group. High levels of dissociation may be accompanied by the relative absence of positive or negative attachment representations, or by the dominance of negative representations, including features of disorganisation.