Dissociative Experiences Scale Research Articles

Disorganized Attachment as Partial Mediator of Relationship Between Childhood Sexual Abuse and Dissociation:

Childhood sexual abuse (CSA) is a major social problem with various negative outcomes for a person’s life, such as dissociation. Previous research has shown that insecure attachment styles, especially disorganized attachment, play a role in mediating the effect of childhood sexual abuse on dissociation. However, most of these studies have not considered several abuse characteristics, such as relationship to the perpetrator, to play a role in determining the effect of childhood sexual abuse on outcomes such as dissociation. Our study borrows from betrayal trauma theory that states the effects of a traumatic event vary considerably based on one’s relationship to perpetrator, with more severe consequences for those traumatized at the hands of someone close to them. Therefore, this study aimed to analyze the mediating role of attachment styles on the relationship between child sexual abuse and dissociation in terms of the relationship to the perpetrator. A sample of 258 adult men and women between the ages of 18 to 55 years was selected via convenience sampling. Individuals completed questions from Childhood Trauma Questionnaire, Dissociative Experiences Scale, and Relationship Scales Questionnaire. Based on their relationship to perpetrators, participants were divided into two groups. Two mediation analyses were performed in each group to evaluate the mediating effects of attachment styles on the association between childhood sexual abuse and dissociation. Mediation analyses showed that fearful avoidant (disorganized) attachment partially mediated the relationship between CSA and dissociation (indirect = 0.10, 95% CI [0.0284–0.1833]) only in participants whose perpetrator was someone within their family. Results are discussed in terms of the role of victim-perpetrator relationship and attachment styles in pathways to dissociation.

Illness perception in functional neurological disorder: low illness coherence and personal control

IntroductionIllness perception refers to patients’ subjective representations and appraisals of somatic and mental symptoms. These are relevant for self-management and outcome. In clinical practice, patients with functional neurological disorder (FND)...

Mediator Role of Dissociative Experiences in the Effect of Childhood Traumas on Emotion Regulation Difficulty and Parental Child-Containing Function.

The aim of this study is to examine the mediating role of dissociation in emotional regulation and parental child-containing function skills of mothers exposed to childhood trauma. The research was conducted with 400 mothers between the ages of 20-60 who had childhood trauma and currently have children between the ages of 0-18. The relational screening model, one of the general screening models, was used in the research. The sample of the research was selected using the convenient sampling method and the simple random method. Research data were collected with the Sociodemographic Information Form, Childhood Trauma Scale (CTS), Parental Child-Containing Function Scale (PCCFS), Emotion Regulation Difficulty Scale (ERDS), and Dissociative Experiences Scale (DES). According to the results obtained in the study, physical abuse (β = 0.197; 95% CI [0.124; 0.268]), physical neglect (β = 0.232; 95% CI [0.161; 0.306]), emotional abuse (β = 0.238; 95% CI [0.169; 0.309]), emotional neglect (β = 0.210; 95% CI [0.150; 0.275]), and sexual abuse (β = 0.139; 95% CI [0.058; 0.220]) were found to have a significant indirect effect on emotion regulation difficulties through dissociative experiences. In addition, physical abuse (β = 0.122; 95% CI [0.071; 0.181]), physical neglect (β = 0.151; 95% CI [0.084; 0.228]), emotional abuse (β = 0.158; 95% CI [0.086; 0.238]), emotional neglect (β = 0.159; 95% CI [0.093; 0.235]), and sexual abuse (β = 0.086; 95% CI [0.039; 0.150] was found to have a significant indirect effect on parental child-containing function skills through dissociative experiences.

An Investigation of Dissociative Symptoms and Related Factors in Autistic Adolescents.

Despite exposure to trauma and adverse life events being frequently reported in Autism Spectrum Disorder (ASD), few studies have examined the relationship between these factors and dissociative symptoms in the autistic population. The aim of the study is to investigate symptoms of dissociation in autistic adolescents, and to explore factors that could be associated with dissociative symptoms in ASD. This cross-sectional study involved 59 autistic adolescents between 12 and 18years old, with the mean age of 14.3 ± 1.8. Dissociation, autism characteristics, childhood traumas, peer bullying, and Post-Traumatic Stress Disorder (PTSD) symptoms were assessed using the Adolescent Dissociative Experiences Scale (ADES), the Childhood Autism Rating Scale (CARS), the Childhood Trauma Questionnaire (CTQ), the Nine-Item Child-Adolescent Bullying Screen (CABS-9), and the Child Posttraumatic Stress Reaction Index (CPTS-RI), respectively. Results from the ADES revealed that 12.5% of the participants scored above the threshold for dissociative disorders. In the linear regression model constructed to evaluate factors associated with dissociative symptoms, an increase in dissociative symptoms was statistically significantly associated with an increase in the total CTQ score (p = 0.002) and age (p = 0.006). The findings of the study indicate that dissociative symptoms may occur in autistic adolescents. It is suggested that dissociative symptoms observed in autistic adolescents may particularly be associated with childhood traumas and increasing age. Further research into dissociative symptoms in ASD is warranted, requiring larger sample sizes, specialized measurement scales, and structured interviews.

Relationships between psychotic and affective symptoms, schizotypal and dissociative phenomena, and adverse life events among individuals with psychotic disorders

Background: Psychotic symptoms and self-rated schizotypal phenomena have similar dimensional structures. Additionally, dissociative phenomena have conceptual links with psychosis/schizotypy and all of these phenotypes are associated with adverse life events (ALEs). The relationships between these factors among individuals with psychotic disorders are not well established and were investigated in this study. Method: 76 participants with any psychotic disorder were recruited from mental health services in West Yorkshire, UK. Lifetime psychotic and affective symptoms were assessed by research interviews and case record review. The self-rated Schizotypal Personality Questionnaire (SPQ) with additional questions regarding inappropriate affect, Dissociative Experiences Scale (DES), and questionnaires regarding cumulative adverse life events in childhood (CLEQ) and in the year before clinical onset (BLEQ) were also administered. Relationships between factors were assessed using Spearman correlations and linear regression analysis. Results: Correlations with relevant psychotic symptoms ranged from ~0.3 for some positive and negative SPQ subdomains to ~0 for disorganised subdomains. In contrast, SPQ and DES were highly correlated (~0.7). In univariate analysis, ALEs were associated with depression, DES, and positive and disorganised SPQ subdomains. In multivariable analysis, ALEs in childhood and before onset were independently associated with the SPQ Unusual perceptual experiences subdomain. Conclusion: Among individuals with psychotic disorders, neither SPQ nor DES questionnaire responses are likely to be useful proxies for psychotic symptoms. However, particularly questionnaire-based unusual perceptual experiences may be useful when assessing the range of phenomena associated with adverse life events.

Information Processing Biases and Attachment Styles in Adolescents with Dissociative Disorders

Background: Dissociative disorders invade and interfere with the person’s continuity of normal psychological functioning and exhibit slower or impaired processing of threat-related information and attachment styles play a significant role in their psychopathology. The present study assessed the type of attachment style and information processing biases and their relationship in adolescents with dissociative disorders. Methods: This was a hospital-based study, with a cross-sectional design based on purposive sampling. The study consisted of 50 participants between 11 and 17 years of age. Twenty-five of them were adolescents diagnosed with dissociative disorders and 25 were healthy adolescent controls. The Adolescent Dissociative Experiences Scale was used to assess the severity of dissociative disorders in adolescents. Emotional Stroop, Emotion Face dot-probe task and attachment style questionnaires were administered. Results: Findings suggested an association between the scores in the attachment style dimension of discomfort with closeness and information-processing biases in both the dot-probe and emotional Stroop tasks. There was also an association between the processing bias in the dot-probe task and relationships as a secondary attachment dimension. There was a difference in the two groups of adolescents with dissociative disorders and matched healthy adolescents with respect to the discomfort with closeness attachment style and information-processing bias scores of the dot-probe task. Conclusion: The study provides interesting insights into how information-processing biases correlate to attachment styles in adolescents with dissociative disorders. Results indicate extensive resources for future management.

The Link Between Somatization and Dissociation and PTSD Severity in Veterans Who Sought Help From the IDF Combat Stress Reaction Unit.

This study aimed to examine the relationships between dissociative and somatic symptoms and how they might contribute to PTSD severity among ex-soldiers who sought help from the IDF Combat Stress Reaction Unit (CSRU). This cross-sectional study included 1,305 former compulsory, career, and reserve soldiers, who filled out self-report questionnaires on admission for evaluation at the CSRU. The study's dependent variables included two posttraumatic stress disorder measures (CAPS and PCL-5). The independent variables were the Dissociative Experience Scale and Brief Symptom Inventory. Background and service-related variables were also examined. Spearman correlation revealed that the higher the level of somatization is, the higher the level of PTSD via PCL and CAPS. A significant positive association was found between somatization and dissociation (r = 0.544; P < 0.001). The higher the somatization level, the more severe the dissociation. A multivariate logistic regression analysis to predict severe PTSD revealed that the longer the time elapsed from the traumatic event (OR = 1.019, P = 0.015), the higher the risk for severe PTSD. The most prominent variables were dissociation (OR = 6.420, P < 0.001) and somatization (OR = 4.792, P < 0.001). The entire model reached 40.8% of the shared variance in the regression. While there is direct reference to dissociation in the clinical assessment by PCL or CAPS, there is no such reference to somatization. Highly functioning combatants sometimes express their distress somatically. Our findings suggest regarding severe somatic symptoms as diagnostic criteria for PTSD.

Dissociative Experiences, Borderline Personality Disorder Features, and Childhood Trauma: Generating Hypotheses from Data-Driven Network Analysis in an International Sample

ABSTRACT Dissociation is a multifaceted phenomenon that occurs in various mental disorders, including borderline personality disorder (BPD), but also in non-clinical populations. Severity of childhood trauma (abuse, neglect) plays an important role in the development of dissociation and BPD. However, the complex interplay of different dissociative symptoms, BPD features, and self-reported childhood trauma experiences is not yet fully understood. Graph-theoretical network analysis can help to better understand such multivariate interrelations. Objective: This study aimed to investigate associations between self-reported dissociation, BPD features, and childhood trauma experiences using a graph-theoretical approach. Data was collected online via international mental health platforms and research sites. N = 921 individuals (77.4% female) were included; 40% reported pathological levels of dissociation. Variables were assessed with established psychometric scales (Dissociative Experiences Scale; Personality Assessment Inventory Borderline Features Scale; Childhood Trauma Questionnaire) and analyzed within a partial correlation network. Positive bivariate correlations between all variables were found. When accounting for their mutual influence on each other, dissociation was predominantly connected to BPD features with effect sizes between rp = .028 and rp = .126, while still showing a slight unique relationship with physical neglect (rp = .044). Findings suggest close associations between dissociative experiences and BPD features. While childhood trauma plays an important role in the development of dissociation and BPD, its recall may not fully explain their current co-occurrence. Prospective studies are needed to shed more light on causal pathways to better understand which factors contribute to dissociation and its link to BPD (features).

Dissociation in mothers with borderline personality disorder: a possible mechanism for transmission of intergenerational trauma? A scoping review

BackgroundDissociation is a feature of Borderline Personality Disorder (BPD), but rarely a focus for research, particularly in the perinatal literature. BPD partly has its aetiology in childhood and is characterised by emotional changes and difficulty with self-coherence that impacts on the processes of caregiving.MethodsA scoping review was conducted to synthesise current perspectives on the effect of dissociation in caregivers with BPD, particularly regarding the impact of caregiver dissociation on the interactional quality of relationship within parent–child dyads. Studies were included if they explicitly mentioned dissociation in the target population, or if dissociation was implied. A thematic analysis was conducted.Results20 studies were included; 10 experimental or quasi-experimental; 2 presenting case material; and 8 non-systematic review articles. 4 studies used the Dissociative Experiences Scale (DES) to measure dissociation, while 2 studies included a ‘dissociative behaviour’ subscale as part of an observational measure. The remaining studies did not measure dissociation but referenced directly or indirectly a concept of dissociation.ConclusionsFindings suggested there was some evidence that dissociation plays a unique role in BPD caregivers’ interactions with their offspring, however any findings should be interpreted with caution as the concept has been poorly operationalised and defined.

Pathways to care and barriers in treatment among patients with Dissociative disorders

IntroductionDissociative disorder patients often present with sudden and embarrassing symptoms, and it is difficult for the patient and care giver to understand initially, recognize the need for help and reach for appropriate treatment timely. This can result in high risk of engaging in dangerous behaviors such as self-harm and suicidal acts, impaired global functioning, and poor quality of life. Knowledge about the types of barriers which are there in treatment seeking, can help in planning strategies for their removal and to facilitate the treatment process. MethodsCross-sectional study among patients (n=133) with Dissociative disorders which were recruited from January 2023 to June 2023 in a tertiary care hospital. Pathways to care and barriers in treatment for Dissociative disorders were assessed by interviewing patients using semi-structured proforma. The Dissociative Experience Scale and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)) were used to assess disease severity and impact of illness on various domains of life respectively. Group comparison was made to assess differences in social- clinical profile of patients choosing different modalities of treatment. Results133 patients of Dissociative disorders with mean age 29.6±9.2, showed their first-choice of help seeking from general practitioner/ neurologist (40.6%), traditional faith healers (35.3%), psychiatrist (18.1%) and 5.2% preferred alternative treatments. This trend changed with 2nd and 3rd contact of help seeking with greater preference for psychiatrist in their 2nd (n=45, 33.8%) and 3rd (n=69, 51.8%) contact. The median duration of untreated illness was 56 weeks (IQR 24–182 weeks). Social-clinical profile of patients varied with their choice of treatment, having lower education level (P = 0.013), longer duration of untreated illness (p=0.003), more severity of symptoms (p=0.032) and greater disability scores(p=0.002) in patients whose first treatment choice was traditional faith healers. More than 70% patients faced availability barriers, stigma, unawareness about mental illness and influence of others in treatment of choice as barriers in initiating and continuing treatment. ConclusionPatients with Dissociative disorders seek treatment from a multitude of healthcare providers including traditional faith healers, general physicians, and alternative medicine practitioners before reaching psychiatrist and undergoes various barriers in treatment. There is need to implement necessary measures for sensitization and awareness about Dissociative disorders to prevent prolonged and undue delays in initiation of appropriate management.

Beyond abuse and neglect: validation of the childhood interpersonal trauma inventory in a community sample of adults.

Childhood trauma is not restricted to abuse or neglect and other potentially traumatic experiences need to be pondered in practice and research. The study aimed to collect validity evidence of a new measure of exposure to a broad range of potentially traumatic experiences, the Childhood Interpersonal Trauma Inventory (CITI), by evaluating whether the CITI provides important additional information compared to a gold standard measure of childhood trauma. The sample consisted of 2,518 adults who completed the CITI and self-reported measures of trauma (Childhood Trauma Questionnaire; CTQ) and psychiatric symptoms (PTSD Checklist for DSM-5; Kessler Psychological Distress Scale; Dissociative Experiences Scale). First, the sensitivity to properly detect participants having been exposed to childhood maltreatment, as measured by the CTQ (here used as the gold standard), ranged between 64.81% and 88.71%, and the specificity ranged between 68.55% and 89.54%. Second, hierarchical regressions showed that the CITI predicted between 5.6 and 14.0% of the variance in psychiatric symptoms while the CTQ only captured a very small additional part of variance (0.3 to 0.7%). Finally, 25% (n = 407) of CTQ-negative participants screened positive at the CITI. The latter reported higher severity of psychiatric symptoms than participants without trauma, suggesting that the CITI permits the identification of adults exposed to significant traumas that remain undetected using other well-validated measures. The findings underscore the utility of the CITI for research purposes and the latter's equivalence to a gold standard self-reported questionnaire to predict negative outcomes.

Psychopathological symptoms in fibromyalgia and their associations with resistance to pharmacotherapy with SNRI.

Fibromyalgia (FM) is often comorbid with psychiatric disorders. Moreover, several studies show that psychiatric disorders may be linked to the severity and impact of FM. Therefore, the study described in the article had two main goals: (1) to explore various psychopathological symptom dimensions in patients with fibromyalgia and secondly, (2) to examine the links between psychopathology and response to treatment with serotonin and norepinephrine reuptake inhibitors (SNRI). This cross-sectional study was performed between December 2020 and November 2022. The definition of resistance to SNRI was <30% reduction of pain after ≥8 weeks of treatment. 30 FM subjects responsive to SNRI (FM T[+]), 32 patients non-responsive to SNRI (FM T[-]) and 30 healthy controls were enrolled. Participants were examined by physicians and completed self-report tools to evaluate levels of depression (Quick Inventory of Depressive Symptomatology, Hospital Anxiety and Depression Scale), anxiety (State and Trait Anxiety Inventory), anhedonia (Snaith-Hamilton Pleasure Scale), bipolar symptoms (Mood Disorder Questionnaire, Hypomania Checklist), and dissociation (Dissociative Experiences Scale - Revised). ANOVA analysis and a series of simple logistic regressions were used to examine the associations between psychopathological variables and response to SNRI. FM T[-] vs. FM T[+] showed higher levels of: depression, state and trait anxiety and anhedonia as well as higher proportion of scores indicating the presence of anxiety disorder. Increased severity of depression, anxiety and anhedonia were predictors of resistance to SNRI. Modifiable psychopathological symptoms vary in FM T[+] vs. FM T[-] and are predictors of resistance to SNRI. Psychological assessment should be integrated into standard care for FM patients.

An explorative study of the Chinese Pictorial Version of Children's Dissociative Experiences Scale and Posttraumatic Symptom Inventory

IntroductionPsychometric tools for assessing or screening young children with complex trauma and dissociation based on their own subjective experience are very limited. The present study aimed to explore the applicability of the Chinese translated pictorial version of Children's Dissociative Experiences Scale and Posttraumatic Symptom Inventory (CDES/PTSI) for children aged 5 to 11. ObjectiveTo examine the psychometric properties of the newly developed Chinese Pictorial Version of Children's Dissociative Experiences Scale and Posttraumatic Symptom Inventory (CP-CDES/PTSI) in a group of Chinese young children. MethodThe CP-CDES/PTSI was administered to (N = 85) children aged from 5 to 11 for trial use. The Child Trauma Screen (CTS) and Child Dissociative Checklist (CDC) were selected as criterion scales to measure children's dissociative and post-traumatic stress symptoms, as reported by their caregivers. The scale reliability was measured by Cronbach's alpha, the Guttman split-half reliability and index of coefficient Omega. The validity was assessed by correlation, hierarchical regression and multimodal analyses. ANOVA was used to conduct subgroup analysis to investigate the applicability of the instrument on younger children. ResultsThe CP-CDES/PTSI presented with good internal reliability as well as established convergent and predictive validity to dissociative symptoms. The total score was significantly associated with dissociative symptoms in children as reported by their caregivers. A majority (78 %) of children aged between 60 and 71 months could comprehend and finish the test satisfactorily, while all children aged 72 months or above in the group could comprehend the test competently. ConclusionThe findings suggested that the CP-CDES/PTSI can be used with children with age as young as 5 in a Chinese population.

Exploring the Complex Relationship Between Childhood Trauma and Self-Harm

ABSTRACT Previous research has linked self-harm to adverse childhood experiences (i.e. abuse and neglect). Despite the extensive literature on self-harm, it remains of high importance to examine psychological predictors of repetitive self-harming behaviors in those who report childhood trauma. This study explored the role of maladaptive emotion regulation strategies, dissociation proneness, and borderline personality (BP) features. An international sample with n = 374 participants (N = 287, 77%, reporting intentional use of self-harm), was recruited online via relevant mental health platforms and research sites. Within an anonymous survey, participants completed the Self-harm Inventory, Childhood Trauma Questionnaire, Dissociative Experience Scale, Cognitive Emotion Regulation Questionnaire, and Personality Assessment Inventory-Borderline Personality Features Scale. Structural equation modeling (SEM) was used to explore direct and indirect effects. Self-harm was positively correlated to severity of childhood trauma, maladaptive emotion regulation strategies, dissociation, and BP features. In the path-analytical model, independent indirect effects of childhood trauma severity via self-blame, catastrophizing, dissociation, as well as BP features on self-harm were found. Maladaptive emotion regulation, dissociation proneness, and BP features all seem to be important intermediary agents in the close association between childhood trauma and self-harm.

Aberrant salience in cannabis-induced psychosis: a comparative study.

Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk and exacerbate the course of psychotic disorders. These could be influenced by the Aberrant Salience (AS) construct. It refers to an excess of attribution of meaning to stimuli that are otherwise regarded as neutral, thereby transform them into adverse, dangerous, or mysterious entities. This leads the patient to engage in aberrant and consequently incorrect interpretative efforts concerning the normal perception of reality and its relationship with our analytical abilities. AS appears to play a significant role in the onset and perpetuation of psychotic disorders. The internal conflict arising from aberrant attributions of significance leads to delusional thoughts, ultimately culminating in the establishment of a self-sustaining psychosis. To examine the differences between psychoses course not associated with cannabis use and those associated with NC-use and SCs-use, in terms of psychotic and dissociative symptoms, AS, global functioning and suicidal ideation. A sample of 62 patients with First Episode Psychosis (FEP) was divided into 3 groups: non cannabis users (non-users, N = 20); NC-users or rather Delta-9-tetrahydrocannabinol (THC) users (THC-users, N = 21); SCs-users, commonly referred to as SPICE-users (SPICE-users, N = 20). Each group underwent assessments at the onset of psychotic symptoms, as well as at the 3 months and 6 months marks, utilizing a range of psychopathological scales. These included the Positive and Negative Syndrome Scale (PANSS) for investigating psychotic symptoms, the Global Assessment of Functioning (GAF) scale for assessing overall functioning, the Dissociative Experiences Scale (DES-II) for measuring dissociative symptoms, the Scale for Suicide Ideation (SSI) for evaluating suicidal ideation and the Aberrant Salience Inventory (ASI) scale for gauging AS. SPICE-users showed more severe and persistent positive symptoms, while negative symptoms were mostly represented among non-users. Non-users showed better recovery than SPICE-users in global functioning. All groups showed a decrease in both ASI scores and subscale scores. SPICE-users exhibited higher global AS scores and less improvement in this aspect compared to other groups. This study may help understanding the role of AS in both non-substance-related and substance-induced psychosis. This knowledge may lead clinician to a better diagnosis and identify patient-tailored psychopharmacological treatment.

The role of oxidative stress levels and S100B levels in children with functional neurological disorder

Background/Aim: Although stressors and traumatic life events are known to be predisposing factors for developing functional neurological disorder (FND), the etiology of the disorder has not been fully elucidated. In this study, oxidative stress parameters and serum levels of S100B protein were investigated in pediatric patients with functional neurological disorder. The association of these parameters with stress factors and traumatic life events was investigated. Methods: This case-control study included a control group of 35 patients aged 8-18 years and 32 healthy subjects diagnosed with functional neurological disorder. The Childhood Trauma Scale and Dissociative Experiences Scale were applied to both groups. Serum levels of the patient and control groups were compared by blood sampling: total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and S100B. Results: It was found that the Childhood Trauma Scale total score, emotional neglect, emotional abuse, physical neglect and the Dissociative Experiences Scale were statistically significantly higher in the FND group than in the control group (P˂0.001, P˂0.001, P=0.013, P=0.017, P˂0.001). Stressors were found to be statistically significantly higher in the FND group than in the control group (P=0.020). There was no statistical difference between the FND group and control groups regarding the TAS, TOS, OSI, and S100B levels (P=0.965, P=0.228, P=0.268, P=0.517, respectively). Conclusion: Our study is the first to investigate TOS, TAS, OSI and S100B in children with FND. In our study, although stressors and traumatic experiences were significantly higher in the functional neurological disorder group compared to the control group according to the stress susceptibility model, contrary to expectations, there was no significant difference in oxidative stress parameters and serum S100B levels. It was thought that the interaction between FND, which is characterized by biopsychosocial interaction and can manifest itself with various clinical symptoms, and stress may not be linear as initially thought, and the interaction between genetic predisposition and environmental factors may play a more complex role. The absence of significant differences observed in oxidative stress parameters and serum S100B levels may suggest that we should focus on different pathways and different potential biomarkers that need to be investigated in the future to understand the etiology and diagnosis of FND. However, the limitations noted above may affect the generalizability of the study findings.

The symptom criteria for the dissociative subtype of posttraumatic stress disorder.

The dissociative subtype of posttraumatic stress disorder (PTSD) was incorporated into the diagnostic criteria for PTSD in Diagnostic and Statisical Manual of Mental Disorders, Fifth Edition (DSM-5). The subtype requires the presence of persistent or recurrent depersonalization or derealization; however, several authors have suggested that a broader array of dissociative symptoms could be included in the criteria. The objective of the present study was to gather data on a wide range of dissociative symptoms in a sample of highly traumatized individuals. The authors administered a set of measures to 62 inpatients in a private psychiatric inpatient program specializing in PTSD and dissociative disorders. Almost every participant met International Classification of Diseases, 11th Edition criteria for complex PTSD, DSM-5 criteria for the dissociative subtype of PTSD, and DSM-5 criteria for dissociative identity disorder or other specified dissociative disorder; these four diagnoses seem to identify largely the same patients and may not be separate disorders. A broad range of dissociative symptoms was endorsed on the Dissociative Experiences Scale and the Dissociative Disorders Interview Schedule. The results support a recommendation that a broad array of symptoms be included in the criteria for the dissociative subtype of PTSD in future editions of the Diagnostic and Statistical Manual of Mental Disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dissociative Experiences Scale: Psychometric Analysis in Puerto Rico and Contributions to the Discussion of the Factor Structure

Introduction: The Dissociative Experiences Scale (DES-II) is a widely used psychometric tool to assess dissociative symptoms. Over the years, it has been the subject of numerous studies and research in various fields of psychology and psychiatry. Numerous studies have supported the validity and reliability of the DES-II as a reliable measure of dissociative experiences. The most problematic aspect of the DES-II is the inconsistency in its factor structure. Objective: This research aimed to examine the psychometric properties of the DES-II in a clinical and non-clinical sample from Puerto Rico. Method: This research had an instrumental design. An availability sampling of 341 adult participants was used. Several competing models of the DES-II were analyzed, including a bifactor model. Result: Psychometric analyses concluded that the scale has a unidimensional structure, strong reliability, and construct validity. All 28 items met adequate discrimination values. Participants with dissociative disorders obtained higher means on the DES-II than the other diagnostic groups. Furthermore, the more adverse experiences in childhood, the more dissociative experiences in adulthood. Conclusion: The DES-II should be treated and interpreted as a unidimensional dissociation index rather than a multidimensional instrument. This study will advance further research on dissociation and dissociative disorders in Puerto Rico and Latin America.

Reflective functioning and dissociative experiences: A comparison study between adolescents at "high-risk" of psychosis and healthy controls.

Despite the established contribution to psychological well-being in young subjects, the investigation of reflective functioning and dissociative experiences in help-seekers adolescents still appears an unmet need. The study aimed to assess reflective functioning and dissociative symptoms in help-seekers adolescents, and compare them to gender-matched healthy controls. The Reflecting Functioning Questionnaire (RFQ) was used to investigate mentalizing; the Adolescent Dissociative Experience Scale (A-DES) was used to explore dissociative symptoms. The study involved 102 adolescents (mean age 18.06 ± 1.78 years), split into "help-seekers" (N= 51; mean age 19 ± 1.98 years) and healthy controls (N= 51; mean age 17.12 ± 0.84). "Help-seekers" adolescents showed lower RFQ-certainty scores (mean 3.39 ± 2.47), compared to healthy controls (mean 6.73 ± 5.01). Furthermore, "help-seekers" adolescents reported higher scores on RFQ-uncertainty (mean 7.73 ± 4.38), compared to healthy controls (mean 5.14 ± 4.17), which indicates a greater lack of knowledge about mental states (hypomentalizing). Eventually, "help-seekers" adolescents showed significantly worse dissociative symptoms (A-DES total mean score 3.49 ± 2.04), compared to healthy controls (A-DES total mean score 2.06 ± 1.43). The importance of an assessment in early adolescence denotes a topic of increasing concern, in order to identify failures in reflective functioning and the onset of dissociative experiences among help-seekers adolescents, toward the implementation of tailored psychological interventions.

The Psychological Impact ofExposure to Battle onMedics: A Cross-Sectional Study ofEx-Soldiers Who Sought Help From the IDF Combat Reaction Unit.

The present study's central aim was to examine two questions: (1) Will there be differences in mental health outcomes between medics and non-medics who sought help at the Israeli Combat Reaction Unit (CRU)? (2) Will there be differences in mental health outcomes between combatants and non-combatants? This cross-sectional study included files of 1,474 Israeli Defense Forces ex-service members (89% combatants, of whom 13% were medics; 11% non-combatants, of whom 6% were medics), who filled out questionnaires on admission for evaluation at the CRU.Dependent variables were mental health measures and included two PTSD measures (Clinician-Administered PTSD Scale and PTSD Checklist for DSM-5), Beck Depression Inventory, Dissociative Experience Scale, and Brief Symptom Inventory. Military profession (medics vs. non-medics) and status (combatant vs. non-combatant) were the independent variables. Background variables were also examined. We found no substantial differences between medics and non-medics in the mental health measures. When looking at combat and non-combat separately, the non-combat medics (CMs), in general, were in better mental health conditions than the other three groups- CMs, non-medic combatants, and non-medic non-combatants-all of whom had similar scores in the mental health measures. However, compared to the rest, non-CMs took considerably longer years before approaching the CRU. The elapsed time to seek help for non-MCs was explained by their reluctance to seek help, not being combatants, and being medics who are portrayed as resilient. Recommendations for encouraging this subgroup to seek help were given.