Dissociative Experiences Scale Scores Research Articles

Dissociative experiences of adolescents with borderline personality disorder: description and prediction

AimsThe first purpose of this study was to assess the severity of dissociative experiences reported by adolescent inpatients with borderline personality disorder (BPD). The second purpose was to compare the severity of their dissociative symptoms to those reported by a sample of adult inpatients with BPD. The third purpose of this study was to assess a range of clinically meaningful predictors of the severity of dissociation in adolescents and adults with BPD.MethodsThe Dissociative Experiences Scale (DES) was administered to a total of 89 hospitalized girls and boys aged 13–17 with BPD and 290 adult inpatients with BPD. Predictors of the severity of dissociation in adolescents and adults with BPD were assessed using the Revised Childhood Experiences Questionnaire (a semi-structured interview), the NEO, and the SCID I.ResultsBorderline adolescents and adults had non-significant differences on their overall DES scores and subscale scores. They also had a non-significant distribution of low, moderate, and high scores. In terms of multivariate predictors, neither temperament nor childhood adversity was a significant predictor of the severity of dissociative symptoms in adolescents. However, co-occurring eating disorders were found in multivariate analyses to be the only bivariate predictor to significantly predict this outcome. In adults with BPD, however, both the severity of childhood sexual abuse and co-occurring PTSD were significantly related to the severity of dissociative symptoms in multivariate analyses.ConclusionsTaken together, the results of this study suggest that the severity of dissociation is not significantly different in adolescents and adults with BPD. However, the etiological factors differ substantially.

The Same Day on Repeat: A Unique Case of Persistent Déjà Vu Phenomenon as a Long COVID Symptom in an Older Adult

IntroductionDéjà vu is a condition characterized by the experience of recognizing a current situation as familiar with the awareness that the recognition is inappropriate (Pasic et al. Psychiatria Danubina; 30, 21–25). This phenomenon has been well described in temporal lobe epilepsy, and is thought to be caused by abnormal synchronization in the corticolimbic network. While the etiology of neuropsychiatric symptoms in long COVID is still not well demarcated, studies have found that the virus attacks the temporal lobe and limbic system; therefore, we suggest that the ongoing symptoms of déjà vu, in this case, may be a manifestation of long COVID.ObjectivesTo illustrate a unique case of persistent déjà vu after severe infection with COVID-19 virus.MethodsThe patient is a 79-year-old female with a pertinent past medical history of generalized anxiety disorder, major depressive disorder, and prior hospitalization for delirium who presented with a chief complaint of being tired of living the same day. The patient was hospitalized eight months prior for a severe COVID-19 infection that now requires continuous oxygen therapy. Since leaving the hospital, the patient began to develop episodic confusion, memory impairment, and tinnitus which gradually improved. However, the patient developed severe distress due to a constant feeling of déjà vu characterized by a sense of familiarity with events in her daily life. There was no history of loss of consciousness, abnormal involuntary movements, or other semiology related to seizures. Due to distress caused by the déjà vu symptoms, the patient also endorsed depression, anxiety, and insomnia, with deterioration of quality of life.ResultsMRI showed mild volume loss and multifocal regions, including bilateral temporal lobes, of subcortical and periventricular high T2/FLAIR signal abnormality consistent with chronic white matter microangiopathy. MOCA score was 24/30, and the dissociative experiences scale score was 15.36/100. The patient continues to be treated for her depression, insomnia and anxiety with escitalopram 10mg daily and mirtazapine 7.5mg at night as a neuropsychological assessment and electroencephalogram are done.ConclusionsThe incidence of neurological symptoms is more than 80% in severe cases of COVID-19 (Douaud et al. Nature; 604,697–707). This patient was likely predisposed to developing these symptoms due to her age and psychiatric history. Déjà vu occurs in temporal lobe epilepsy, schizophrenia, and depersonalization disorders, all of which affect the limbic-temporal lobe networks (Pasic et al. Psychiatria Danubina; 30, 21–25). Signal abnormalities in the medial temporal lobe are one of the findings seen on MRI in patients with neuropsychiatric symptoms after severe COVID-19 infection. We propose that the persistent déjà vu phenomenon along with cognitive impairments described in this case are manifestations of long COVID.Disclosure of InterestNone Declared

Efficacy of traumatic memory reactivation with or without propranolol in PTSD with high dissociative experiences

ABSTRACT Background: Post-traumatic stress disorder (PTSD) with dissociative symptoms is now a full-fledged subtype of this disorder. The dissociative subtype is associated with a greater number of psychiatric comorbidities. To date, the impact of dissociation on the efficacy of PTSD treatment remains unclear. Objective: The aim of this study was to compare the efficacy of a traumatic memory reactivation procedure with the administration of propranolol or a placebo once a week for six consecutive weeks in reducing PTSD and MDE symptoms between PTSD subjects with or without high dissociative symptoms. Method: For that, we conducted a randomized clinical trial in 66 adults diagnosed with longstanding PTSD and measured the SCID PTSD module, the PTSD Checklist (PCL-S), Beck’s Depression Inventory-II (BDI-II), and the Dissociative Experiences Scale (DES). Results: Patients with and without high dissociative experience had significant improvement in their PCL-S scores over the 6 treatment sessions, and PCL-S scores continued to decline in all patients during the post-treatment period. However, there was no correlation between the presence/absence of high dissociative experiences and no specific effect of propranolol treatment. We found exactly the same results for MDE symptoms. Interestingly, patients with high dissociative experiences before treatment exhibited very significant improvement in their DES scores after the 6 treatment sessions, and patients maintained this improvement 3 months post-treatment. Conclusions: The traumatic memory reactivation procedure is an effective way to treat dissociative symptoms in patients with PTSD, and improvement of these dissociative symptoms was associated with a decrease in both PTSD and depression severity.

A case of dissociative identity disorder and attention deficit hyperactivity disorder comorbidity

IntroductionDissociative identity disorder(DID) is characterized by the existence of two or more distinct identities which involve changes in consciousness, emotion, memory, and behavior. It is associated with childhood traumatic experiences and other psychiatric disorders. Comorbidity in DID can lead to complex clinical presentations, poor treatment responses. Thus, it is crucial to identify patients with comorbidity and take them into the treatment plan.ObjectivesWe aim to report a case of DID and Attention-Deficit/Hyperactivity Disorder(ADHD) comorbidity.MethodsA case report is presented alongside a review of the relevant literature regarding “dissociative identity disorder” and “attention deficit hyperactivity disorder”.ResultsWe describe the case of a 39-year-old woman with DID, onsetting at age 25, who had consistently responded poorly to long-term psychotherapy and pharmacological treatment. She presented with anxiety, distinct personality states, alterations in memory, consciousness and behavior problems in functioning, and high Dissociative Experiences Scale(DES) scores. Throughout the interviews, we noticed that she had limited attention, excess movements. After a detailed evaluation, diagnosis of ADHD is established, using the Diagnostic Interview for ADHD(DIVA) and ADHD Self-Reporting Scale(ASRS). Methylphenidate was prescribed in addition to previous medication. İmprovement in the severity of both ADHD and DID symptoms was presented with lower scores in DES and ASRS after the introduction of methylphenidate with progressive dose adjusting till 60mg/day.ConclusionsAlthough previous studies demonstrated ADHD symptoms are related to dissociation, there is no well-established strategy for this. We believe that this case report provides a better approach to the comorbidity of ADHD and DID.DisclosureNo significant relationships.

Dissociative symptoms in generalized anxiety disorder and panic disorder and its relationship with temperament-character features

Introduction: The relationship between anxiety and dissociative symptoms is frequently mentioned, but dissociative symptoms are not seen in all patients with anxiety disorder. The aim of this study is to investigate the relationship between dissociative symptoms and temperament-character features in patients with anxiety disorders. 
 Methods: The study sample consisted of 75 patients diagnosed with generalized anxiety disorder (GAD) and panic disorder (PD) according to DSM-5 and 75 healthy individuals for the control group (HC). The severity of their complaints were assessed using Hamilton Anxiety and Depression Rating Scales (HAM-A, HAM-D). Sociodemographic data form, Dissociative Experiences Scale (DES), Dissociation Scale (DIS-Q) and Temperament-Character Inventory (TCI) were filled for every participant. 
 Results: There was a significant difference between the groups in terms of HAM-A, HAM-D, DES and DIS-Q scores (PD> GAD> HC). The factors affecting DES and DIS-Q scores were high HAM-A scores, diagnosis, low self-directedness(SD) and high self-transcendence(ST) scores, and when the diagnosis was checked, DES and DIS-Q scores continued to be affected by HAM-A, SD and ST scores. 
 Conclusion: The high prevalence of dissociative symptoms was confirmed in patients with anxiety disorder. It was observed that character traits of low SD and high ST may be predisposing for the development of dissociative symptoms, while temperament traits were not influential on dissociative symptoms. These results may suggest that dissociation is not only related to trauma.

Associates of Adult Seperation Anxiety Disorder among University Students: A Case Control Study

Purpose: Separation anxiety is a state of extreme anxiety, felt by an individual in case of separation from attachment figure. It was aimed to investigate attachment styles, temperament traits, childhood trauma and dissociative experiences of university students diagnosed with adult separation anxiety disorder (ASAD). 
 Methods: Sixty five university students, diagnosed to have ASAD by a structured clinical interview were compared with healthy students via˝Adult Attachment Style Questionnaire (AAQ)," "Childhood Trauma Questionnaire (CTQ)," "Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A)," and "Dissociative Experiences Scale (DES)." 
 Results: Twenty two (33.8%) students with ASAD had problems with orientation and getting used to university. According to AAQ, students with ASAD had higher prevalence of insecure attachment styles, and especially high ambivalent attachment styles and to CTQ, students with ASAD had significantly higher scores in all subscales except physical abuse. Overall DES score was higher in students with ASAD compared to the control group. DES score and history of physical disease in the family were independent associates of ASAD. 
 Conclusion: DES score and history of physical disease in the family were independent associates of ASAD among university students. Hence, early awareness of dissociative symptoms and family history might help early identify students with ASAD.

Relationships between childhood trauma and dissociative, psychotic symptoms in patients with schizophrenia: a case–control study

BackgroundChildhood trauma (CT) is an important risk factor in the emergence and clinical course of psychiatric disorders. In the latest literature, an association exists between CT and patients with schizophrenia....

Temporal Stability of Dissociative Symptoms in the General Population.

The most widely used measure to quantify dissociative symptoms is the Dissociative Experiences Scale (DES). However, little information is available concerning its temporal stability. The purpose of this study was to assess the stability of DES scores after 4 years. A total of 316 respondents recruited from a general population in Brazil took part in baseline and follow-up (70.57% were men; mean age = 32.97, SD = 10.95, minimum = 22, maximum = 74). Temporal stability was assessed through test-retest correlations and mean-level stability analyses. We found that the DES total and subscale scores revealed moderate test-retest correlations, with small variations among the DES factors. No significant difference (p > 0.05) was found between average scores for times 1 and 2. Overall, DES scores are significantly stable over time. Future studies would benefit from an investigation of the correlates and predictors of dissociation at different time points.

Childhood maltreatment and suicidal behavior among adults with attention deficit hyperactivity disorder

Childhood maltreatment (CM) is associated both with suicidal behavior and attention deficit hyperactivity disorder (ADHD). Yet not much is known about the relationship of CM and suicidal behavior in adults diagnosed with ADHD. This study aims to further investigate this potential risk. Adult ADHD Self-Report Scale (ASRS-V1.1), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), A self-rating Questionnaire for Suicide Ideation (SIQ) and Suicidal Behavior Scale (SBS) were employed to 104 cases with adult ADHD, whose comorbid psychiatric disorders were examined according to the DSM-5 criteria. It was found that, while age and education level are significantly lower; the fraction of those who are single, as well as the DES, BDI, BAI, SIQ and SBS scores are significantly higher in the ADHD cases with CM history than those with no history of CM. In addition, SIQ and emotional abuse scores were found as significant predictors of SBS scores in adults with ADHD. These results suggest that investigating CM, as well as suicidal behaviors in adults diagnosed with ADHD can be useful in creating a treatment plan to prevent suicide attempts and suicide.

Dissociative Experiences and Stressful Life Events in Dissociative Disorders - A Cross Sectional Study

Background: Unconscious defenses and dissociative experiences have always been related to stressful life events. A stressful life event has a role to play both in normative and pathological dissociation. These events can be desirable and undesirable and both acute and chronic events can lead to dissociative phenomena Aims: To assess the dissociative experiences and type of stressful life events and also to correlate the events with dissociative disorders. Methodology: A detailed history was obtained along with the application of Dissociative Experiences Scale (DES) and Presumptive Stressful Life Event Scale (PSLES) to know the type of dissociative experiences and the type of stressors. Their correlation was studied using SPSS-20 software. The scores of dissociative experiences and stressful life events were also calculated to find any relation between the scores and the type of dissociative presentation. Results: The majority of people diagnosed with dissociative disorders were females, although there is no gender difference in the DES scores. The mean age of presentation is 25.21±9.12 years. We found out that any subtype of patients can have any score on DES scale. The PSLES scores did not determine the type of dissociative presentation (subtype). Conclusion: Dissociative experiences are related to stressful events in last year, and it acts as a precipitating factor for people with poor coping mechanisms. The scores do not predict the subtype of dissociation.

Prevalence of Dissociative Experiences and Dissociative Disorders in Methamphetamine Users in Shahid Beheshti Hospital of Kerman

Background: Dissociative symptoms have been reported to result from issues such as substance use. However, there is limited knowledge on the relationship between methamphetamine use and dissociative symptoms, and only a few studies have been conducted on this issue. Objectives: Given little knowledge on the relationship between methamphetamine use and dissociative symptoms, in particular dissociative disorders, the present study was done to investigate the prevalence of dissociative experiences and dissociative disorders in methamphetamine users in Shahid Beheshti hospital of Kerman City, Kerman Province, Iran. Methods: In this descriptive cross-sectional study, two groups of subjects, including methamphetamine users (N = 50) and controls (N = 51), were randomly selected from the individuals referring to Shahid-Beheshti Hospital, Kerman City, from September 2016 to March 2018. After validating the diagnosis of methamphetamine use via methamphetamine positive-urine test, the Dissociative Experiences Scale (DES) and dissociative disorders interview schedule-DSM5 (DDIS) were employed to assess dissociative experiences and disorders, respectively. Next, the Positive and Negative Syndrome Scale (PANSS) was utilized for the determination of positive and negative symptoms of psychosis in the case group. Finally, the chi-square test and t test were applied for comparing the study groups using SPSS version 20 software. Results: Our findings revealed that the mean score of dissociative symptoms was 15.3 in methamphetamine users. The mean score of depersonalization/derealization subscale of DES, as a dissociative experience, was higher in the case group (P < 0.01). The experience of possession, as a dissociative experience, was recorded in 17 methamphetamine users, while 18 (36%) methamphetamine users were diagnosed with dissociative disorder. Furthermore, a significant correlation was found between the DES score and positive symptoms in methamphetamine users (P < 0.05). Conclusions: According to the findings of the present study, it can be concluded that methamphetamine induces dissociative psychosis in methamphetamine users.

Dissociative Experiences Associated With Internet Gaming Disorder After Controlling For Childhood Trauma And ADHD Diagnosis

ABSTRACT The aim of this study was to investigate the relationships among childhood trauma, dissociative experiences, and internet gaming disorder (IGD) in young adults diagnosed with attention deficit hyperactivity disorder (ADHD) and age- and gender-matched controls. Forty participants diagnosed with ADHD at a university hospital psychiatric outpatient clinic and 40 healthy controls completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale (ASRS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ), and Internet Gaming Disorder Scale – Short Form (IGDS9-SF). The CTQ (t = −4.61, p < .01), DES (t = −4.71, p < .01), SDQ (t = −2.40, p < .01), and IGDS9-SF (t = −4.89, p < .01) scores were significantly higher in the ADHD group than in the control group. A hierarchical regression analysis that explained 50% of unique variance in internet gaming disorder (IGD) indicated that being male (β = 0.41, t = 4.61, p < .001) and having an ADHD diagnosis (β = 0.48, t = 5.49, p < .001) are robust predictors. Additionally, the DES score, which indicates the severity of psychoform dissociation (β = 0.34, t = 2.43, p = .017), was found to be significantly associated with IGD after controlling for ADHD diagnosis and childhood trauma. While excessive gaming may increase dissociative symptoms, the mental state of dissociative experiences may be a predisposing factor for IGD; however, further studies are needed to investigate these claims.

A neurostructural biomarker of dissociative amnesia: a hippocampal study in dissociative identity disorder.

Little is known about the neural correlates of dissociative amnesia, a transdiagnostic symptom mostly present in the dissociative disorders and core characteristic of dissociative identity disorder (DID). Given the vital role of the hippocampus in memory, a prime candidate for investigation is whether total and/or subfield hippocampal volume can serve as biological markers of dissociative amnesia. A total of 75 women, 32 with DID and 43 matched healthy controls (HC), underwent structural magnetic resonance imaging (MRI). Using Freesurfer (version 6.0), volumes were extracted for bilateral global hippocampus, cornu ammonis (CA) 1-4, the granule cell molecular layer of the dentate gyrus (GC-ML-DG), fimbria, hippocampal-amygdaloid transition area (HATA), parasubiculum, presubiculum and subiculum. Analyses of covariance showed volumetric differences between DID and HC. Partial correlations exhibited relationships between the three factors of the dissociative experience scale scores (dissociative amnesia, absorption, depersonalisation/derealisation) and traumatisation measures with hippocampal global and subfield volumes. Hippocampal volumes were found to be smaller in DID as compared with HC in bilateral global hippocampus and bilateral CA1, right CA4, right GC-ML-DG, and left presubiculum. Dissociative amnesia was the only dissociative symptom that correlated uniquely and significantly with reduced bilateral hippocampal CA1 subfield volumes. Regarding traumatisation, only emotional neglect correlated negatively with bilateral global hippocampus, bilateral CA1, CA4 and GC-ML-DG, and right CA3. We propose decreased CA1 volume as a biomarker for dissociative amnesia. We also propose that traumatisation, specifically emotional neglect, is interlinked with dissociative amnesia in having a detrimental effect on hippocampal volume.

Trait dissociation as a predictor of induced dissociation by ketamine or esketamine in treatment-resistant depression: Secondary analysis from a randomized controlled trial

Dissociative symptoms are common, possibly severe, side effects associated with the use of ketamine and esketamine in depression. We investigated the relationship between trait dissociation and dissociation induced by ketamine and esketamine used as augmentation therapy in treatment-resistant depression (TRD). Adults with TRD were randomly assigned to receive a single intravenous infusion, with a duration of 40 min, of either esketamine 0.25 mg/kg or ketamine 0.5 mg/kg. We assessed trait dissociation with the Dissociative Experience Scale (DES) and, to evaluate induced dissociation, the Clinician-Administered Dissociative States Scale (CADSS) was used. Thirty-two subjects received esketamine and 29 received ketamine. The groups had similar median DES scores (p = 0.26). More than 30% of the patients in both groups had DES scores ≥30 points. The median CADSS score in the esketamine group was equivalent to that in the ketamine group (p = 0.40). Every 5 points increment in the DES was associated with a 10.9% (95% CI 4.5–17.8%) increase in the CADSS, in an exponential fashion when the two groups were pooled together. Subjects with high trait dissociation had a higher risk of induced dissociation state (relative risk [RR] 1.41, 95% CI 1.11–1.78) and very high induced dissociation (RR 3.05, 95% CI 1.14–8.15). Induced dissociation was not a serious adverse effect. The findings suggest that trait dissociation is a predictor of induced dissociation by Ketamine or Esketamine in TRD subjects. Screening for trait dissociation and counseling patients with high trait dissociation on the risks of dissociation by these drugs are recommended.

Dissociative experiences and health anxiety in panic disorder.

Background:Dissociative experiences and health anxiety are frequently encountered in anxiety disorders and contribute to the burden of illness.Aim:The aim was to assess and compare dissociative experiences and level of health anxiety in patients with panic disorder and normal individuals.Materials and Methods:We recruited forty eligible patients with panic disorder and forty healthy volunteers without any psychiatric diagnoses. Health anxiety was evaluated by the Short Health Anxiety Inventory and dissociative symptoms were assessed by the Dissociative Experiences Scale (DES).Results:Dissociative experiences were more frequently reported by patients with panic disorder compared to normal controls, but overall mean DES scores were lower in both groups compared to previous literature. A high level of health anxiety was also seen in panic disorder compared to normal individuals.Conclusion:Health anxiety and dissociative experiences, especially depersonalization-derealization, are commonly encountered in panic disorder and should be actively explored to understand how they influence psychopathology and treatment outcome.

The relationship between dissociative symptoms and the medications used in the treatment of opioid use disorder

Opioid use disorder has long been associated with psychiatric symptoms, including dissociative experiences. Medications used to treat opioid use disorder can potentially impact dissociative symptoms, but the existing literature has not explored this. We examined the relationship between dissociative symptoms and opioid use disorder using the Dissociative Experiences Scale (DES). We studied subjects who were taking prescribed methadone, buprenorphine, or naltrexone for opioid use disorder. We gave the DES, the Patient Health Questionairre-9 (PHQ-9), and the PTSD Checklist for DSM-5 (PCL-5) with Criterion A to subjects in three substance use treatment facilities in Ohio. We conducted Analysis of Variance (ANOVA) and Spearman's Rank Correlations to examine associations between the variables and outcomes. We developed three separate multiple linear regression models. We included 116 participants in our exploratory and naturalistic study. The majority of participants were female (51.7%), white (89.5%), ≤ 40 years of age (64.7%), and taking buprenorphine (55%). The average DES score was 16.1 (standard deviation = 14.9) and we considered 80.9% to have low dissociation (score < 30). Approximately 55% (n = 64) of participants were taking prescribed buprenorphine. Approximately 27% (n = 32) were taking prescribed methadone and approximately 18% (n = 21) were taking prescribed naltrexone (oral or extended release). There was a significant association between opioid medication type and log dissociative symptoms (p = .01). Participants taking prescribed buprenorphine had higher mean log dissociation symptom scores (2.7) compared to those taking prescribed methadone (2.2) and prescribed naltrexone (2.1). Log dissociation symptom scores were significantly associated with last use of any opiates (rs = −0.21; p = .02) and time on medication (rs = −0.228; p = .01). Compared to those taking buprenorphine, those taking both methadone (β = −0.26; p = .01) and naltrexone (β = −0.27; p = .006) had significantly lower dissociation scores, controlling for the other variables in the model. Dissociation scores were positively correlated with depression scores (r = 0.45; p < .0001) and with PCL-5 scores (r = 0.51; p < .0001). Our study highlights the importance of diagnosing and monitoring dissociative symptoms in individuals who are taking prescribed medications for opioid use disorder, especially since dissociative symptoms can interfere with substance use treatment.

Dissociation, Stressors, and Coping in Patients of Psychogenic Nonepileptic Seizures.

Background:Psychogenic nonepileptic seizures (PNES) commonly present both to neurologists and psychiatrists and include a wide range of psychopathology. In order to understand the demographics, dissociative experiences, stressful life events, abuse, and coping in these patients, this study was undertaken.Methods:This was a cross-sectional, observational study. A total of 71 patients of PNES, referred from neurology, were assessed on Dissociative Experience Scale (DES), Scale For Trauma and Abuse, Presumptive Stressful Life Events Scale (PSLES), and Ways of Coping Questionnaire to ascertain the dissociative experiences; the prevalence of trauma, abuse, and stressful life events, and the coping mechanisms.Results:Females predominated, with the duration of PNES up to 2 years. The mean ± SD total DES score was 38.14 ± 14.1, indicating high dissociation. On the PSLES, for the stressful life events in the last one year, the mean score was 98.28 ± 87.1. Marital and family conflicts and death were reported more. History of childhood or adult physical and sexual abuse was less reported. History of head trauma was present in 13 patients. Emotion-focused coping was used more than problem-solving strategies.Conclusions:Very few Indian studies have looked into these nuances. This study has helped in improving the understanding of the various risk factors of PNES and the coping strategies, and in sensitizing psychiatrists and neurologists to enquire into trauma and abuse of these patients.

The effect of trauma type on the severity of Post-Traumatic Stress Disorder (PTSD) symptoms

Abstract Objective: The high prevalence of trauma exposure calls for detailed research on how trauma type affects the development of Post-Traumatic Stress Disorder (PTSD). Therefore, the aim of our study was to investigate the effects of the type of trauma on the severity of symptoms, anxiety, depression, and dissociative experiences in the PTSD patient population. Method: The sample of the study consists of 80 volunteer PTSD patients (20 sexual trauma, 20 work accidents, 20 traffic accidents and 20 combat related trauma). Once the severity of symptoms was determined in all subjects by the Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory, Beck Anxiety Inventory and Dissociative Experiences Scale (DES) were applied. Results: A statistically significant difference were found between trauma types with regard to age, time without treatment, and the total and subscale scores obtained in DES and CAPS. It was found that in the group that has PTSD diagnosis related to sexual trauma, the length of the time without treatment, DES and CAPS scores. Conclusion: The study we conducted showed that PTSD continued more severe and resistant after a sexual trauma. Moreover, specific type of trauma was significant in PTSD patients.

A Prospective Study on Dissociative Experiences, Suicidal Ideation, and Predicting Factors During the Isolation Period of Hematopoietic Stem Cell Transplant.

The aim of the present study was to investigate suicidal ideation and dissociative experiences and to predict demographic and clinical risk factors during isolation periods in patients undergoing hematopoietic stem cell transplant. Our study included 61 consecutive stem cell recipients (29 autologous, 32 allogeneic). Patients were evaluated with the Suicidal Ideation Scale, Dissociative Experiences Scale, Hamilton Depression Scale, Hamilton Anxiety Scale, and State Trait Anxiety Inventory. The transplant procedure did not influence the Dissociative Experiences or Suicidal Ideation Scales (P > .05). However, patients had higher anxiety and depression levels at time of discharge (P < .001). Suicidal ideation scores were correlated with higher Hamilton Depression Scale, State Trait Anxiety Inventory, and Dissociative Experiences Scale scores on admission (P < .05), with the latter 2 scores also higher at the time of discharge in patients who received radiotherapy prior to transplant (P < .05). Suicidal ideation and dissociative experiences, which may emerge because of complex and traumatic processes, should be considered by clinicians. Social and psychological support should be provided for patients undergoing hematopoietic stem cell transplant.

The Association between General and Pathological Dissociation and Disaster-Related Psychopathology in Directly Exposed Survivors

Objective: Dissociation and trauma have a well-documented relationship, and dissociation is assumed to result from trauma exposure. If trauma generates dissociative psychopathology, it should be observed after exposure to disaster and be associated with disaster-related psychopathology. Few studies have focused specifically on dissociation as an outcome of disaster trauma. This study examined dissociation and its association with disaster-related psychopathology in survivors of five different disasters. Methods: In the first 6 postdisaster months, directly exposed survivors (N = 216) of mass shootings, floods, or a firestorm completed structured diagnostic interviews providing lifetime predisaster and postdisaster prevalent/incident psychiatric diagnoses and the Dissociative Experiences Scale (DES) 1–3 years after baseline. Results: DES scores were very low; only 1% met the DES Taxon signifying pathological dissociation. In multivariate models including predisaster lifetime major depression, lifetime panic disorder, lifetime generalized anxiety disorder, and lifetime alcohol use disorder; disaster-related PTSD; and number of incident somatoform symptoms as independent covariates, predisaster lifetime major depression and alcohol use disorder were independently associated with both general (DES score) and pathological (DES Taxon) dissociation, and postdisaster incident somatization symptoms were also associated with general dissociation, but postdisaster psychopathology including disaster-related PTSD was not associated with general or pathological dissociation. Conclusions: Neither general nor pathological dissociation was independently associated with disaster-related PTSD or other incident psychopathology. The only psychiatric disorders associated with dissociation were present before the disasters. Coupled with the low dissociation rates, these findings indicate that dissociation does not appear to be a mental health outcome of disaster trauma.