Dissociative Experiences Scale Research Articles

Loneliness and Problematic Internet Use in Adolescents: The Mediating Role of Dissociation

Background/Objectives. Problematic Internet uUse (PIU) is a multifaceted syndrome characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding Internet use leading to significant impairments in daily life and mental health. Previous research has separately related PIU to loneliness and dissociation, both in adults and adolescents. The aim of the present study is to analyze the mutual relationship between PIU, loneliness, and dissociation in an adolescent sample, in particular evaluating the indirect effect of dissociation on the relationship between loneliness and PIU. Methods. A cross-sectional design was used with 243 Italian high school students (69.1% females), from year 9 to 13 (age: M = 17.1, SD = 1.4 years), who participated in the study from January to June 2020. They completed measures of PIU (Generalized Problematic Internet Use Scale-2), loneliness (UCLA Loneliness Scale), and dissociation (Adolescent Dissociative Experiences Scale). Socio-demographic and contextual variables were also collected (i.e., age, gender, type of school, school year, sport practice, hobby engagement, assessment before/during the COVID-19 pandemic). Data were analyzed using regression, Pearson’s correlation, and mediation analysis. Results. Severe PIU was observed in 8.6% of the sample. None of the socio-demographic and contextual variables had a significant effect on PIU. Positive medium-sized correlations were observed between PIU, loneliness, and dissociation. Mediation analyses showed an indirect effect of loneliness on PIU through dissociation. Conclusions. Feelings of loneliness may significantly exacerbate adolescents’ PIU by increasing their dissociative tendency. Understanding this dynamic is crucial for developing targeted interventions to address both loneliness and dissociation in efforts to mitigate PIU among adolescents.

The Detection of Invalid Responses Using the Dissociative Experiences Scale-V (DES-V)

ABSTRACT The Dissociative Experiences Scale (DES) is the most widely used self-report measure of dissociation but lacks a validity scale. Abu-Rus et al. (2020) created the DES-V by embedding atypical and inconsistency items in the DES, ultimately concluding that atypicality demonstrated the greatest ability to differentiate honest respondents from feigners. Among their study limitations, Abu-Rus et al. noted the homogeneous nature of their clinical group (i.e., largely comprising individuals with PTSD) and the potential need to refine the existing atypicality items for a more heterogenous dissociation population. The current study aimed to refine the DES-V by enlisting dissociation experts to improve the believability of the atypical items (while simultaneously ensuring they did not betoken any actual dissociative symptomology) and by supplementing the online sample with a clinical sample that included a broad range of dissociative disorders. Data cleaning comprised eight different techniques, to better ensure the validity of the online sample. Honest and Feigning groups completed the assessments through Amazon’s Mechanical Turk; the clinical dissociative disorder group completed hard copy versions. The atypicality scale discriminated the three groups well, with the Feigning group scoring significantly higher than both of the honest groups (online and clinical). The mean atypicality scores of the two honest groups did not differ significantly. In addition, the scale incremented over the original DES-V in a logistic regression predicting honest and feigning participants. These robust results suggest that the revised DES-V could provide researchers with a valuable tool for validating online samples with greater precision – an increasingly vital need in light of the growing reliance on online samples.

TRANSLATION AND VALIDATION OF URDU VERSION OF BRIEF DISSOCIATIVE EXPERIENCE SCALE FOR SUBSTANCE USE DISORDER IN PAKISTAN

Objective Dissociation is a ubiquitous construct in psychology and is of high clinical relevance. The objective of this study was to translate and validate the Brief Dissociative Experience Scale (DES-B) in the Urdu language for individuals with substance use disorder (SUD). DesignThis was a cross sectional study. Place and Duration of StudyThe study was conducted with a sample of 200 individuals with SUD aged 18 and above from drug rehabilitation centres across Pakistan between July to November 2023. MethodsThis study utilized a rigorous procedure of Mapi guidelines for translation and validation of DES-B. The validation of DES-B was determined through confirmatory factor analysis. ResultsThe data was analyzed using SPSS and AMOS software and factor structure, internal consistency, composite reliability, and convergent validity of the scale were determined. Of the 200 participants, 79.0% were male. The mean age of the participants was 30.61 years (SD = 8.87) with a range between 18 to 65. The findings indicated a good model fit for a one-factor structure with 8 items (χ²/df = 2.61, p < 0.00, RMSEA = 0.089, CFI = 0.908, GFI = 0.944). Moreover, the composite reliability (CR = .77), convergent validity (AVE = .31), and internal consistency (α =.76) showed favorable results. Overall, the Urdu version of DES-B demonstrated acceptable results in terms of the construct’s validity and reliability. ConclusionThe Urdu version of DES-B can be used as a reliable and valid tool to assess dissociative experiences in individuals with SUD suitable for research and clinical settings.

A Network Analytic Approach to Dissociation: New Insights from Clinical Data

ABSTRACT The transdiagnostic construct of dissociation, characterized by a disintegration of specific psychological functions such as consciousness, memory, identity, perception, body representation, and behavior, remains elusive to a unified conceptualization. Specifically, its dimensionality is a matter of ongoing controversy. Empirical approaches applying factor analyses to the Dissociative Experiences Scale (DES) have yielded inconsistent findings. This study adopts a novel methodological approach, utilizing Exploratory Graph Analysis (EGA) to address this issue. In a sample of 668 day-hospital patients undergoing psychotherapy for a variety of mental disorders, a Gaussian graphical model was estimated for the 28 items of the DES. Additionally, the stability of the results was ensured by bootstrap procedures. While both the original EGA and the bootstrap EGA suggested four dimensions, the structural consistency of this solution was low due to an instability of 12 items. After excluding 10 of these unstable items, re-analyses again revealed a four-factor structure, but boot EGA indicated that one factor had unsatisfactory structural consistency due to the multidimensionality of its two items. Upon removing these, our final network consisted of 16 items mapping onto 3 dimensions. Our study, using data from a diagnostically heterogeneous sample, replicates and extends previous findings on the dimensionality of dissociation as captured by the DES. The three dimensions identified correspond to segregated processes, derealization/depersonalization, and absorption. This solution aligns with a bipartite model of dissociation with two broader categories referring to either altered states of consciousness (often named detachment) or to non-integrated mental modules (labeled as compartmentalization).

Detecting Noncredible Responding in College Student ADHD Assessment: A Comparison of Several Brief Symptom Validity Tests

AbstractA diagnosis of attention-deficit/hyperactivity disorder (ADHD) offers tangible and psychological benefits to college students. These incentives lead some students to exaggerate symptoms on self-report rating scales. Although validity tests can detect noncredible responding, they are seldom used by clinicians who conduct adult ADHD evaluations. Many validity tests require considerable time, are expensive to administer, or are not accessible to many clinicians. We conducted a between-subjects simulation study examining the ability of several brief symptom validity tests to differentiate college students with self-reported ADHD (n = 229) and students without ADHD randomly assigned to honest control (n = 260) or simulator (n = 239) conditions. All participants completed the Conners’ Adult ADHD Rating Scales (CAARS) with several embedded validity indicators (i.e., CAARS Inconsistency Index, CAARS Infrequency Index [CII], Dissociative Experiences Scale, Exaggeration Index [EI]), and the Subtle ADHD Malingering Screener. Results showed that students without ADHD could easily simulate this condition. Simulators earned significantly higher scores than participants in the ADHD and control conditions on all the validity tests that we examined, except the CAARS Inconsistency Index. Elevated scores on the CAARS hyperactive-impulsive scale, the CII, or the EI yielded the best classification statistics with specificity to controls ranging from 98.5 to 100%, sensitivity to simulators ranging from 35.6 to 42.7%, and low positive cases among participants in the ADHD condition. Associations between these validity scales were moderate. Requiring elevated scores on multiple validity scales yielded perfect specificity to controls, sensitivities to simulators between 27.2 and 31.8%, and few positive cases among participants in the ADHD condition (0 to 3.1%). These tests may offer clinicians a time- and cost-effective way to evaluate the validity of students’ self-reports, especially when integrated with objective information from other sources.

Clinical characteristics of 217 Chinese cases with depersonalization/derealization disorder

Depersonalization/derealization disorder (DPD) is a prevalent yet inadequately understood clinical condition characterized by a recurrent or persistent sense of unreality. This study aims to provide insight into DPD through descriptive and comparative analyses involving a large group of Chinese participants. The socio-demographic details (age, gender proportion, education, occupational status, marital status), depersonalized and dissociative symptom characteristics (symptomatic factors or subscales of the Cambridge Depersonalization Scale and the Dissociative Experiences Scale), development trajectory (age of onset, potential precipitating factors, course characteristics), treatment history (duration of delayed healthcare attendance, duration of delayed diagnosis, previous diagnoses), and adverse childhood experiences of the DPD patients are presented. Comparisons of anxiety and depressive symptoms, alongside psychosocial functioning, between DPD participants and those diagnosed with generalized anxiety disorder, bipolar disorders, and major depressive disorder were conducted. The analysis highlights a higher male preponderance and early onset of DPD, symptomatology marked by derealization, notable impairment in psychosocial functioning, and prolonged periods of delayed healthcare attendance and diagnosis associated with symptom severity. Furthermore, noteworthy relationships between adverse childhood experiences and symptom levels were identified. The findings substantiate the view that DPD is a serious but neglected mental disorder, urging initiatives to improve the current condition of DPD patients.

Structure, network analysis, psychometric properties and clinical utility of the self-absorption scale in China

BackgroundSelf-absorption refers an excessive, persistent, and rigid preoccupation with information regarding the self. This study aims to introduce the Self-Absorption Scale (SAS) into China with an assessment of its latent variable structure, network structure, psychometric properties, and clinical utility in a nonclinical Chinese sample.Methods209 participants completed the translated SAS as well as the Short General Health Questionnaire (GHQ-12), rumination subscale of the Rumination-Reflection Questionnaire (RRQ), the Mindful Attention Awareness Scale (MAAS), the Private Self-Consciousness Scale (PrSCS), the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Dissociative Experiences Scale (DES-II). In addition, 30 respondents completed the Chinese version of the SAS and retested it 2 weeks later.ResultsThe Chinese version of the SAS (CH-SAS) had a desirable two-correlated-factor structure with the reverse scored item removed, which was invariant across different genders. The core items in the network structure of the CH-SAS were related to excessive self-immersion, uncontrollability and anxiety aspects of self-absorption. The Cronbach’s alpha coefficient for the CH-SAS was 0.903 while the McDonald’s omega coefficient was 0.916 and the test-retest reliability was 0.908. The CH-SAS and its two subscales had moderate positive correlations with the rumination subscale of the RRQ (ranging from 0.474 to 0.616; p < .001) and the GHQ-12 (ranging from 0.479 to 0.538; p < .001), and moderate negative correlations with the MAAS (ranging from − 0.413 to − 0.360; p < .001). The PrSCS has almost no correlation with the CH-SAS and PrSAS (p > .05), and its correlation with the PubSAS was significant at the 0.05 level, with a remarkably low correlation coefficient (r = .157). The hierarchical regression analysis suggested that the CH-SAS can significantly predict the severity of OCD beyond factors such as depression, anxiety, rumination, dissociation, and mindful attention awareness.ConclusionsThe CH-SAS demonstrates excellent reliability, including internal consistency and test-retest reliability. Additionally, it exhibits favorable structural validity, as well as strong evidence of convergent and divergent validity. Furthermore, the self-absorption measured using the CH-SAS contributed significantly to the prediction of OCD beyond other relevant psychological factors, suggesting its clinical utility.

Course and Prediction of Dissociation in Patients with Borderline Personality Disorder and Personality-Disordered Comparison Subjects: A 24-Year Follow-Up Study

ABSTRACT The first purpose of this study was to determine the course of dissociation among patients with borderline personality disorder (BPD) and personality-disordered comparison subjects (OPD) over 24 years of prospective follow-up. The second purpose was to determine clinically meaningful predictors of dissociation among patients with BPD. The Dissociative Experiences Scale (DES) was administered to 290 patients with BPD and 72 personality-disordered comparison subjects at baseline, and then once every two years over 24 years of prospective follow-up. Baseline predictors were assessed with the Revised Childhood Experiences Questionnaire (CEQ-R), the SCID-I, and the Shipley Institute of Living Scale. Time-varying predictors were assessed at baseline and every subsequent two years by means of the Abuse History Interview (AHI). Patients with BPD had higher baseline dissociation scores than personality-disordered comparison subjects. Whilst dissociation decreased significantly over time for both patient groups, the BPD group showed a steeper decline. Severity of childhood sexual abuse, adult history of rape, adult history of partner violence, and IQ were multivariate predictors of dissociation among patients with BPD. Taken together, the present findings suggest that a combination of interpersonal trauma exposure and cognitive abilities may contribute to the severity of dissociation in adult patients with BPD.

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.

PTSD, dissociative experiences, and depressive symptoms in a clinical sample of women who featured in pornographic productions

IntroductionThe mental health of the people who featured in Pornographic Productions (PP) is underexamined. However, PP frequently involve unsimulated violent acts mostly experienced by women. Furthermore, some women participating in PP also report being coerced into unwanted sexual acts. Therefore, featuring in a PP could be experienced as a traumatic event, and could be associated with negative mental health disorders.ObjectivesOur study examines mental health indicators among Women who have participated in at least one PP (WPP), and who consulted clinical psychologists, after referral by WPP support groups.MethodsThirty-six women were recruited by two clinical psychologists during an individual consultation. Participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES), as well as the 13-item Beck Depression Inventory (BDI-13). Data on socio-demographic characteristics, lifetime experience of sexual violence prior to participating in a PP, as well as the perceived effect of participating in a PP were also measured.ResultsThe mean age of participants was 31.2 (std=7), and the average age at first participation in a PP was 23.4 (std=6). The majority (78%) of participants reported lifetime experience of sexual violence prior to participation in a PP. Thirty women (83%) had a PCL5 score over 33 indicative of probable PTSD, and 28 women (78%) had a DES score of 30 or more indicating high levels of dissociation. Further, 16 participants (44%) reported a BDI-13 score over 16 indicating severe depression.ConclusionsThis study highlights the high prevalence of PTSD, dissociative experiences, and depressive symptoms in a clinical population of women who featured in at least one PP. Further studies are needed to better understand the scale of the problem and optimize care interventions.Disclosure of InterestNone Declared

Diagnosing Trauma-related Dissociative Disorders in Hungary: The Development of the Hungarian Version of MID (MID-HU)

IntroductionThe recognition, diagnostics and treatment of dissociative disorders (DD) in Hungary is currently in its infancy. According to international researches the prevalence of dissociative disorders is similar to that of the major psychiatric disorders (bipolar disorder, schizophrenia, etc.). Due to the lack of valid diagnostic tools no data is available regarding the prevalence of dissociative disorders in Hungary so far.ObjectivesTo fill this gap within our profession; to provide a complex diagnostic tool; developing the hungarian version of the Multidimensional Dissociation Questionnaire (MID-HU)Methods 341 people participated in our study classified into four groups: (1) healthy controls (n=88), (2) patients from private practice diagnosed with DD and all those participants who have DD according to their MID results (n=103), (3) hospitalized psychiatric (mixed sample, n=60) and (4) SUD patients (n=89). The questionnaire package contained the hungarian version of the Multidimensional Inventory of Dissociation (MID-HU), the Dissociative Experience Scale (DES), the Traumatic Antecendents Questionnaire (TAQ), the Self-Report Version of the Dissociative Disorders Interview Schedule (DDIS-SR) and additional questions. Now we present the first results regarding the adaptation process of the hungarian MID (MID-HU).ResultsThe mean age of the participants was 36 years, 61,6% were female and 38,4% male. The MID-HU has strong internal consistency: the alpha coefficients for the 14 facet scales were 0.88 or higher. The alpha coefficients for the 23 dissociation diagnostic scales ranged from 0,74-0,95; 9 were excellent (0,90 or above), 10 were good (0,80 or above), and 4 were fair (0,70 or above). The test-retest correlation of the Mean MID-HU scores is good (0,87). Factor analysis of the MID-HU extracted one main factor: dissociation. The mean MID-HU scores correlated with mean DES scores (0,87), indicating a good convergent validity. We found significant differences between the healthy control group and the dissociatve group in the mean DES (control: 9,5, dissociative: 27,6, Sig:&lt;0,001), mean MID (control: 2,5, dissociative: 27, Sig: &lt;0,001), the 23 dissociative diagnostics scales of the MID, 14 facet scales of the MID, and all diagnostics scales of the DDIS (using Mann-Whitney).ConclusionsThe MID-HU seems to be a valid instrument, that can differentiate between DD patients and healthy people.Disclosure of InterestNone Declared

Dissociative Identity Unveiled: A Case Report of 17 Distinct Identities Emerging in a Clear Timeline Following Trauma Events

Introduction Dissociative Identity Disorder (DID) is a complex and enigmatic mental disorder in which an individual maintains two or more distinct identities or personality states. We present a rare and captivating case report of a 27-year-old female patient who exhibited a remarkable 17 distinct identities, developed in a clear and unprecedented timeline following a series of specific traumatic events. The novelty of this case lies in the comprehensive documentation and analysis of the sequential emergence of these identities, offering valuable insights into the development and progression of DID.ObjectivesOur aim in presenting this case study is to offer a unique presentation to the constantly evolving understanding of DID. This case offers insight and provokes the need for research into the traumagenic nature of DID. This case showcases the influence on the chronological evolution of the patient’s 17 identities following a multitude of traumatic events.MethodsStructured interviews, psychiatric assessments, and psychological measurements, including self-reported measures of the Dissociative Experiences Scale, were employed to assess the identities and their individual experiences of the traumatic events. The patient was diagnosed with DID and received treatment including pharmacotherapy, psychoeducation, and trauma-focused psychotherapy. As a result of the therapeutic process, the patient was able to develop a higher sense of self-awareness and thus was able to integrate their 17 fragmented identities into a single host identity, demonstrating improvement in the functioning of interpersonal relationships.ResultsThe patient’s history reveals that the onset of her DID was linked to a traumatic event that occurred during early childhood, triggering the emergence of her first alternate identity. Over time, additional identities manifested, each appearing to serve as a coping mechanism to contend with the psychological distress stemming from subsequent significant trauma episodes. This case report meticulously outlines the chronological development of these identities and explores the distinct characteristics, behaviors, and roles assumed by each personality.ConclusionsThis case report offers valuable information on the complex development and pathogenesis of DID with a trauma influence. The presentation of this patient may lead to further research and more tailored therapeutic interventions for individuals suffering from DID.Disclosure of InterestNone Declared

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.