Dissociative Experiences Scale-II Research Articles

Differential constellations of dissociative symptoms and their association with childhood trauma – a latent profile analysis

ABSTRACT Background: While several studies documented a positive correlation between childhood maltreatment severity and dissociation severity, it is currently unknown whether specific dissociative symptoms cluster together among individuals with childhood trauma histories ranging from none to severe. Objective: We aimed to explore symptom constellations across the whole spectrum of dissociative processing from patients with severe dissociative disorders to healthy controls and relate these to maltreatment severity and sociodemographic characteristics. Methods: We employed latent profile analysis to explore symptom profiles based on five subscales, measuring absorption, depersonalization, derealization, somatoform and identity alteration, based on the 20 items of the German short version of the Dissociative Experiences Scale-II (Fragebogen zu Dissoziativen Symptomen-20) in a large aggregate sample (n = 3,128) overrepresenting patients with trauma-related disorders. We then related these profiles to maltreatment severity as measured by the five subscales of the Childhood Trauma Questionnaire as well as sociodemographic characteristics. Results: Based on the five FDS subscales, six clusters differentiated by symptom severity, but not symptom constellations, were identified. Somatoform dissociation varied in accordance with the remaining symptom clusters. The cluster with the highest overall symptom severity entailed nearly all subjects diagnosed with Dissociative Identity Disorder and was characterized by extreme levels of childhood maltreatment. Both abuse and neglect were predictive of cluster membership throughout. Conclusions: The higher the severity of dissociative processing in a cluster, the more subjects reported high severity and multiplicity of childhood maltreatment. However, some subjects remain resilient to the development of dissociative processing although they experience extreme childhood maltreatment.

Validation of the Korean Version of the Community Assessment of Psychic Experiences in General Population.

The Community Assessment of Psychic Experiences has been widely translated and commonly used as a measure for psychotic experiences and psychosis proneness in clinical and research environments worldwide. This study aimed to establish the psychometric properties (reliability and validity) and factor structure of a Korean version of the Community Assessment of Psychic Experiences (K-CAPE) in the general population. A total of 1,467 healthy participants completed K-CAPE and other psychiatric symptom-related scales (Paranoia scale, Patient Health Questionnaire-9, Dissociative Experiences Scale-II, and Oxford-Liverpool Inventory of Feelings and Experiences) via online survey. K-CAPE's internal reliability was analyzed using Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was performed to investigate whether the original three-factor model (positive, negative, and depressive) and other hypothesized multidimensional models (including positive and negative subfactors) were suitable for our data. Exploratory factor analysis (EFA) was conducted to explore better alternative factor solutions with a follow-up CFA. To assess convergent and discriminant validity, we examined correlations between K-CAPE subscales with other established measures of psychiatric symptoms. K-CAPE showed good internal consistency in all original three subscales (all greater than α=0.827). The CFA demonstrated that the multidimensional models exhibited relatively better quality than the original three-dimensional model. Although the model fit indices did not reach their respective optimal thresholds, they were within an acceptable range. Results from the EFA indicated 3-5 factor solutions. In 3-factor solution, "negative-avolition" items were founded to be loaded more consistently with depressive items than with the negative dimension. In 4-factor solution, positive items were divided into two subfactors: "positive-bizarre experiences" and "positive-delusional thoughts," while negative symptoms were separated into two distinct subfactors in 5-factor solution: "negative-avolition (expressive)," and "negative-social (experiential)." The correlation coefficients between K-CAPE subscales and corresponding measurements were significant (p<0.001), confirming the convergent and discriminant validity. Our study provides evidence to support the reliability and validity of the K-CAPE and its use as a measure of psychotic symptoms in the Korean population. Although alternative factor structures did not improve the model fit, our EFA findings implicate the use of subfactors to investigate more specific domains of positive and negative symptoms. Given the heterogeneous nature of psychotic symptoms, this may be useful in capturing their different underlying mechanisms.

Psychometrics of Three Dissociation Scales: Reliability and Validity Data on the DESR, DES-II, and DESC

ABSTRACT The current study assessed the reliability and validity of three measures of dissociation. Three hundred students completed the Dissociative Experiences Scale Revised (DESR), the Dissociative Experiences Scale-II (DES-II), and the Dissociative Experiences Scale Comparison (DESC); an additional 252 community adults evaluated clarity of instructions. Findings revealed that the three dissociation measures showed acceptable test–retest reliability and Cronbach’s alphas. The DESR and DES-II strongly intercorrelated, but the DESC correlated only moderately with the two remaining dissociation measures, sharing less than 10% of the variance with the original scale. Additionally, the DESR and DES-II showed stronger convergent validity (correlation with measures of alexithymia and post-traumatic stress disorder) than did the DESC. The DESC was the only measure unrelated to trauma history. Participants reported substantially greater difficulty in understanding and utilizing the metric offered by the DESC. In conclusion, evidence supports the DES-II and DESR as alternate measures, but the DESC requires more investigation.

Dissociation as a Mediator of Traumatic Childhood Experiences and Ideas of Reference

ABSTRACT Ideas of reference (IR) – self-attributions about what happens in the social environment are a frequent phenomenon present in a wide variety of people with mental health disorders as well as in the nonclinical population. The purpose of this study was to find out the relationship between traumatic childhood experiences, IR and dissociative states in the nonclinical population, emphasizing the potential mediating role of dissociation between traumatic experiences and IR. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.20 years (SD = 14.08). They filled in the Juvenile Victimization Questionnaire (JVQ), the Dissociative Experiences Scale-II (DES-II) and the Referential thinking Scale (REF). The results supported the original hypotheses and showed that the participants with higher frequency of IR reported more childhood traumatic (χ2 (2) = 64.33, p < .001, f = .39, 1- β = .99) and dissociative experiences (χ 2 (2) = 50,414, p < .001, f = .38, 1- β = .99), and that dissociative states (β = .12, p < .05; 95%CI [.07, .19]; c´ = .26, p < .001), specifically absorption (β = .09, p < .05; 95% CI [.03, .15]; c´ = .26, p < .001), mediated between traumatic childhood experiences and referential thinking. It was concluded that the relationship between traumatic experiences and IR is complex and may be mediated by variables such as dissociation.

Theory of Mind in migraine and medication-overuse headache: A cross-sectional study.

BackgroundTheory of Mind (ToM) is the ability to predict and anticipate others' behaviors through the mental state attribution process. This study aims to investigate the ToM in patients with medication-overuse headache (MOH) and episodic migraine (EM) and to compare it with healthy controls (HC).MethodsThis study enrolled patients with MOH, patients with EM, and HC. ToM was assessed through the Theory of Mind Assessment Scale (ThOMAS), which includes four subscales: Scale A, I-Me, Scale B, Other-Self, Scale C, I-Other, and Scale D, Other-Me, through the Reading the Mind in the Eyes test (RMET), which measures complex emotion recognition, and through the Toronto Alexithymia Scale (TAS-20), which measures alexithymia. Concomitant psychiatric disturbances were evaluated through the Hamilton Anxiety Rating Scale, the Hamilton Depression Rating Scale, and the Dissociative Experiences Scale-II.ResultsThe study involved 21 patients with EM, 22 patients with MOH, and 18 HC. In all the four subscales of the ThOMAS, there was a significant difference between HC, EM, and MOH patients: Scale A (p = 0.009), Scale B (p = 0.004), Scale C (p = 0.039), and Scale D (p = 0.008). In the RMET, MOH patients had worse performances than EM patients and HC (p = 0.039). MOH group exhibited higher levels of alexithymia when compared to the HC (p = 0.033) and higher levels of anxiety than HC (p = 0.001).ConclusionMOH patients showed a subtle psychopathological pattern characterized by impaired social adaptation.

Escaping the Reality of the Pandemic: The Role of Hopelessness and Dissociation in COVID-19 Denialism.

Background: Denialism of coronavirus disease 2019 (COVID-19) severely affected governments’ attempts to contain the spread of the virus. Indeed, groups of deniers showed scepticism and misinformation toward the causes of the virus, leading to less adherence to official guidelines and vaccination campaigns. The present study aimed to investigate the sociodemographic and psychological factors associated with COVID-19 denialism, expressed in the forms of scepticism, nonadherence to guidelines, and negative attitudes toward vaccination. Methods: Four hundred and sixty-one volunteers completed an online survey composed of the Beck Hopelessness Scale, the Dissociative Experiences Scale-II, the Sense of Community Index, and a questionnaire about COVID-19 denialism. Results: The multiple regression analyses showed that higher age and a lower level of education were positive predictors of COVID-19 denialism. Furthermore, the structural equation model showed that hopelessness positively predicted dissociation and negatively predicted the sense of community. In turn, only dissociation was found to positively predict COVID-19 denialism. Conclusions: The findings of the present study suggested that hopelessness could exacerbate a defensive dissociative response that could be associated with greater COVID-19 denialism. Moreover, older and less educated people showed a greater propensity to engage in COVID-19 denialism.

Internalized-stigma and dissociative experiences in bipolar disorder.

IntroductionDissociative symptoms have been recently related to bipolar disorder (BD) symptomatology. Moreover, the disease burden carries on a share of perceived self-stigma that amplifies the BD impairment. Internalized stigma and dissociative symptoms often seem overlapping, leading toward common outcomes, with reduced treatment seeking and poor adherence. We hypothesize a potential relationship between dissociation and self-stigma in patients suffering from BD.Materials and methodsIn this cross-sectional study we enrolled a total of 120 adult clinically stable BD outpatients. All participants completed the Internalized Stigma of Mental Illness (ISMI), Dissociative Experiences Scale-II (DES-II), and Manchester Short Assessment of Quality of Life (MANSA).ResultsAverage age and age at BD (BD-I n = 66, 55%; BD-II n = 54, 45%) onset were 46.14 (±4.23), and 27.45 (±10.35) years, with mean disease duration of 18.56 (±13.08) years. Most participants were female (n = 71; 59.2%) and 40 (33%) of them experienced lifetime abuse, with an average of 1.05 (±0.78) suicide attempts. DES scores (mean 31.8, ±21.6) correlated with ISMI total-score, with significant association with spikes in Alienation (13.1, SD±3.1) (p < 0.001) and Stereotype (13.8, SD±3.9) (p < 0.001). Linear regression analysis has shown a significant association between DES total score and alienation (p < 0.001), stereotype (p < 0.001) and MANSA total-score (p < 0.001).DiscussionFor the first time, our data suggests that self-stigma is associated to dissociative symptoms, reducing overall quality of life in BD. The early identification of at-risk patients with previous lifetime abuse and high perceived stigma could lead the way for an ever more precise tailoring of treatment management.

Effects of vulnerable personality traits of PTSD, working memory abilities and peritraumatic cognitive processing on analogue traumatic flashbacks

<p id=p00010>Trauma-related flashback (also called intrusive imagery) is one of the most typical re-experience symptoms of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) and has important impacts on the development of PTSD. The cognitive model of PTSD and the dual representation theory of PTSD both emphasize the effects of abnormal peritraumatic cognitive processing (i.e., data-driven processing or sensational representation being strengthened while conceptual processing or contextual representation being weakened). Some vulnerable personality traits of PTSD and working memory abilities are also focused in studies of analogue and real trauma, and are considered as risk factors and protective factors respectively. This study aimed to examine the effects of vulnerable personality traits of PTSD, working memory abilities and peritraumatic cognitive processing on flashbacks in different periods after analogue trauma. <break/>A total of 159 healthy college students (38 males; age = 17~26 ys, <italic>M</italic> = 20.44 ± 1.80) participated in the study, who were screened by a self-designed health status questionnaire (e.g., “Did you receive psychotherapy or psychopharmaceutical treatment in recent two years?”), Beck Depression Inventory-II (BDI-II), and Self-report Anxiety Scale (SAS). In the laboratory, they were asked to watch a 14’34’’ long Road Traffic Accidents (RTAs) film alone. Trait anxiety, trait dissociation, neuroticism and attentional control were measured before watching the film respectively by State-trait Anxiety Inventory-Trait version (STAI-T), Dissociative Experiences Scale-II (DES-II), the revised Eysenck Personality Questionnaire Short Scale for Chinese (EPQ-RSC), and Attentional Control Scale (ACS), while working memory capacity was tested by a revised Operation Span Task (OSPAN) seven days later. Immediately after the film, data-driven processing and conceptual processing were measured by Thoughts and Feelings Questionnaire-Chinese Revised (TFQ-CR). Five minutes after the film, participants firstly read a standardized description about the film-related flashback until they fully understood it with the help of the experimenter, and then reported immediate flashback (number, vividness and distress level). In the following week after the laboratory portion, participants independently reported flashback at three regular time points every day through WeChat or QQ. Upon coming back to the laboratory, they reported the frequency of posttraumatic symptoms through the Impact of Event Scale-Revised (IES-R) and triggered flashback after finishing a single-blind fake task assessing the degree in which they liked (10 relevant to the film). <break/>Structural equation model (SEM) and Bootstrap method were mainly adopted in the statistical analyses. Results showed that data-driven processing positively predicted the number, vividness and distress level of all three kinds of flashbacks (i.e., immediate, one-week and triggered) and one-week frequency of intrusion; higher neuroticism predicted higher distress level of triggered flashback; attentional control and working memory capacity both negatively predicted one-week frequency of intrusion. Conceptual processing played a mediating role between attentional control and distress level of immediate flashback. Furthermore, attentional control was positively associated with conceptual processing, whereas conceptual processing negatively predicted distress level of immediate flashback. <break/>These findings suggest that data-driven processing is the main factor influencing flashbacks in different periods after trauma; conceptual processing mainly affects the early acute stress response, while attentional control functions as a protective factor; neuroticism and working memory ability have long-term effects on flashback, and working memory ability serves as a protective factor.

Different dissociation and alexithymia domains specifically relate to patients with psychogenic non-epileptic seizures (PNES) and with PNES and comorbid epilepsy (PNES+EP)

• We investigated dissociation and alexithymia in psychogenic non-epileptic seizures (PNES). • We compared four samples: patients with PNES, PNES with epilepsy (EP), EP and healthy controls. • Dissociative experiences Scale-II (DES-II) and Toronto alexithymia Scale-20 (TAS-20) totals did not predict TAS-20 and DES-II totals, respectively. • In PNES sample, depersonalization/derealization (Dep/Der) was fully mediated by difficulty identifying feelings (DIF) and absorption (Abs) in predicting difficulty describing feelings (DDF). • In PNES with EP sample, DEP/DER was partially mediated by ABS in predicting DDF. Several studies previously examined the role of dissociation and alexithymia in patients with psychogenic non-epileptic seizures (PNES). However, their relationship remains unclear. We administered questionnaires for dissociation (DES-II), alexithymia (TAS-20), anxiety and depression to 57 subjects: 14 patients with PNES, 13 patients with comorbid PNES and epilepsy (PNES+EP), 14 patients with EP and 16 healthy controls. For between-group comparisons we applied Chi-square test, ANOVA and Kruskal-Wallis. The Spearman correlations, hierarchical regression analyses and path models, goodness-of-fit indices and maximum-likelihood estimates of model parameters were obtained through SPSS 27 and AMOS 27. Hierarchical regression analyses showed that nor DES-II neither TAS-20 total scores were able to predict TAS-20 and DES-II total scores, respectively, possibly due to subscale score pooling. Following modification indexes of AMOS 27, in PNES sample, we found that only Depersonalization/Derealization (Dep/Der) was fully mediated by Difficulty Identifying Feelings (DIF) and Absorption (Abs) in predicting Difficulty Describing Feelings (DDF), and a partial effect of DIF and Dep/Der implement DDF, while both DIF and DDF implement Abs. In PNES+EP group, Dep/Der was able to predict DDF, with a partial mediation of Abs that predicted Externally Oriented Thinking, while DDF was able to promote Abs, and DIF effect on Abs was fully mediated by Amnesia (Amn). Our study is cross-sectional, participants were self-selected and the data were derived from self-report measures. Conclusions: In PNES, Dep/Der and DIF may play a prominent role, while in PNES+EP, Dep/Der, Abs, DIF and Amn may be involved. Clinical implications are discussed.

Dissociative Symptoms in Bipolar Disorder: Impact on Clinical Course and Treatment Response.

Background: Dissociative symptoms are under recognized and scarcely studied by clinicians and researchers in patients with bipolar disorder (BD). We examined the relationship between dissociative symptoms and the psychotic features in patients with BD and assessed clinical and socio-demographic characteristics more frequently associated with dissociative symptoms and treatment response.Methods: Participants were 100 adult outpatients with BD. They were screened with semi-structured interview to collect socio-demographic and clinical characteristics; the Dissociative Experiences Scale-II (DES-II) and the ALDA scale were used to assess dissociative psychopathologies and response to treatment with mood stabilizers, respectively.Results: DES score (mean 31.7 ± 21.7) correlated with clinical variables, BD features, and course of illness. Psychotic symptoms, mixed features, and previous suicide attempts significantly predicted DES score [F(3, 47) = 39.880, p < 0.001, R2 corrected = 0.713]. Dissociative symptoms were inversely correlated with poor response to treatment (r = −0.593; p < 0.001).Limitations: Cross-sectional design with a small sample and backward clinical assessment of psychotic symptoms.Conclusions: Dissociative phenomena are closely related to the presence of psychotic symptoms, mixed features, and previous suicide attempts in BD, especially in BD-I. Given the close association between dissociative and psychotic symptoms, this association could represent a diagnostic indicator of BD-I that may guide the clinician to plan the most appropriate treatment.

Cannabis use disorder and dissociation: A report from a prospective first-episode psychosis study

BackgroundCannabis is the most used recreational drug worldwide. Its use can increase the risk of developing psychotic disorders and exacerbate their course. However, the relationship between cannabis use and dissociative symptoms has been scarcely investigated. AimsTo examine differences in psychotic and dissociative symptoms, and in functioning in first-episode psychotic patients (FEPp) using cannabis compared with those not using cannabis. MethodsBetween January 2014 and December 2019, seventy FEPp with cannabis use disorder (N = 35) and without it (N = 35) were recruited in psychiatric inpatient facilities in the Italian regions of Lazio and Piemonte. All subjects were assessed at FEP, after 4 and 8 months, using the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Dissociative Experiences Scale – II (DES-II). Detailed information on the pattern of cannabis and other substance use were collected. ResultsFEP using cannabis showed higher levels of positive symptomatology, dissociative experiences and worse functioning than their non-user counterpart, despite a comparable antipsychotic treatment. At an eight-month prospective evaluation, FEP using cannabis still showed higher levels of positive symptomatology and dissociation. Moreover, global functioning worsened over time in FEPp using cannabis, whereas it improved those not using it. DiscussionOur findings suggest that a greater degree of dissociation and positive symptoms at FEPp and their persistence over time may characterise cannabis-associated psychosis. Both these factors might explain the overall functioning worsening over time that we observed in the cannabis-user group compared to the functioning improvement in the non-user group.

Eating for numbing: a community-based study of trauma exposure, emotion dysregulation, dissociation, body dissatisfaction and eating disorder symptoms.

ObjectiveThe current study tests the relationship between eating disorder (ED) symptoms and trauma exposure. The mechanisms via which trauma is related to ED symptoms have not been sufficiently examined. This study examines the complex role of dissociation and emotional dysregulation in the context of trauma, BMI, ED symptoms and body dissatisfaction (BD). We hypothesized that dissociation and emotional dysregulation would mediate the relationship between trauma exposure and ED symptoms/BD. We further hypothesized that BMI would play a moderating role in this association.MethodA community sample of 229 (16.2% male) participants, with a mean age of 29.08 ± 10.68 reported online on traumatic events (Life Events Checklist), dissociation (Dissociative Experiences Scale-II), emotional dysregulation (Difficulties in Emotional Regulation Scale), ED symptoms (Eating Disorders Examination-Questionnaire) and BD (Figure Rating Scale).ResultsParticipants reported experiencing a mean of 2.87 ± 2.27 traumatic events, with a relatively high percentage (~86%) reporting at least one. The most commonly reported traumatic events were transportation accidents and physical assault. Although frequency of traumatic events did not directly predict ED symptoms, BMI, dissociation, emotional dysregulation and BD did. An SEM model showed that traumatic events predicted ED symptoms indirectly through dissociation, emotional dysregulation and BMI. Dissociation and emotional dysregulation predicted ED symptoms directly. BMI also moderated the association between traumatic events and both ED symptoms and BD.ConclusionsTherapists treating patients with high BMI or obesity should be aware of these relationships and investigate the possibility that trauma and/or PTSD may underlie the presenting disordered eating or eating disorder.

Improving the psychometric properties of the dissociative experiences scale (DES-II): a Rasch validation study

BackgroundThe Dissociative Experiences Scale-II (DES-II) is a self-report questionnaire that measures dissociative experiences such as derealization, depersonalization, absorption and amnesia. The DES-II has been prevalently used as a screening tool in patients suffering from psychotic disorders or schizophrenia. However, dissociative experiences can also be part of normal psychological life. Despite its popularity, the most problematic aspect of the DES-II is the inconsistency in its factor structure, which is probably due to the tendency to treat ordinal responses as responses on an interval scale, as it is assumed in the Classical Test Theory approach. In order to address issues related to the inconsistency of previous results, the aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis, i.e. analyzing the functioning of the response scale.MethodsData were obtained on a sample composed by 320 Italian participants (122 inmates and 198 community-dwelling individuals) and were analyzed with the Rasch model. This model allows the estimation of participants’ level of dissociation, the degree of misfit of each item, the reliability of each item, and their measurement invariance. Moreover, Rasch estimation allows to determine the best response scale, in terms of response modalities number and their discriminant power.ResultsThree items of the scale had strong misfit. After their deletion, the resulting scale was composed by 25 items, which had low levels of misfit and high reliability, and showed measurement invariance. Participants tended to select more often lower categories of the response scale.ConclusionsResults provided new knowledge on the DES-II structure and its psychometric properties, contributing to the understanding and measurement of the dissociation construct.

Validity and reliability of a Persian version of the Dissociative Experiences Scale II (DES-II) on Iranian patients diagnosed with schizophrenia and mood disorders

ABSTRACT Dissociative Experiences Scale (DES) is a valid self-reported tool to evaluate both non-pathological and pathological dissociative experiences. This study aims at evaluating the psychometric properties of a Persian version of the DES-II on both non-clinical samples and patients with schizophrenia and mood disorders. The back-translated DES-II was administered to 370 individuals being divided into three groups (270 healthy subjects, 50 patients with mood disorders, and 50 patients with schizophrenia) recruited from Shahid Beheshti Hospital of Kerman Medical University. The results showed a good reliability (Cronbach’s alpha = 0.95), a very high item-total correlation, and a good internal consistency of 0.892 measured by split half. Moreover, the Persian version of the DES-II questionnaire demonstrated convergent validity of the scale. Analyses of the DES-II subscales revealed significant differences for amnesic experiences, absorption/imaginative involvement, and depersonalization/derealization among healthy individuals, and patients with mood disorders as well as schizophrenia. We also found significant differences among only schizophrenia group but not mood disorders group in comparison with healthy individuals (p value = .0001, and 0.70, respectively), and between patients with schizophrenia and patients with mood disorders (p value = .03) using DES-T. As a conclusion, the Persian version of the DES-II is an appropriate, reliable, and valid tool to screen dissociative experiences and discriminate subcomponents of dissociative disorders in the Iranian population.

The Desire to Dissociate Scale: factor analysis, cross-cultural findings, and links to substance-induced dissociation

ABSTRACT Background Past research identified that a desire for dissociative experiences, rather than dissociative tendencies, mediate the relationship between early sexual abuse and problem drinking in college students. Desire to dissociate was conceptualized as a mechanism facilitating substance-induced dissociation or the use of substances to achieve dissociative-like experiences and was measured using a modified version of the Dissociative Experiences Scale-II. The validity and cross-cultural generalizability of the modified scale are not yet known. Objectives The current study examined the psychometric properties of the modified scale, exploring findings across U.S. and Filipino college samples, and explored how the desire to dissociate construct related to other variables linked to substance-induced dissociation. Methods: Participants were recruited across two U.S. samples and one Filipino sample (N = 2404; 72% female). Instead of asking “how often do you experience” dissociative items, 14-items from the original scale were selected and individuals were asked “how often would you like to experience” items. Results Results supported the validity of the Desire to Dissociate Scale (DDS) with a bifactor model best fitting the data in U.S. and Filipino samples. The bifactor model identified that the DDS primarily measured a general ‘desire to dissociate’ factor and two specific factors comprised smaller portions of the variance. DDS scores were positively correlated with trauma-related and alcohol use variables including drinking to cope, variables conceptually consistent with theories of substance-induced dissociation. Conclusion Clinical implications address avoidant coping patterns and differences in specific factor findings between U.S. and Filipino samples.

Becoming a Character: Dissociation in Conservatory Acting Students

ABSTRACTActors must realistically portray imagined characters in imaginary circumstances by “becoming” their characters. What is it that allows them to do this? We suggest that acting is related to dissociation, a trait typically related to psychopathology. We measured dissociation in 53 conservatory acting students before and after six months of training, using the Dissociative Experiences Scale-II (DES-II). Although no significant changes occurred over time, acting students scored significantly higher than the general population on the DES-II. These scores were driven by just one of the subscales – absorption and imaginative involvement. We argue here that this subscale measures a trait central to the creative process. Furthermore, although the DES-II was designed to measure psychopathology, we found that it is also related to flow (a positive experience). Certain flow dimensions were predictive of dissociation and of its absorption and imaginative involvement subscale. We conclude that total DES-II scores may not necessarily indicate psychopathology in actors. At the very least, these results suggest that clinicians should take extra precaution when diagnosing dissociation in actors using the DES-II.

"Was it real or did I imagine it?" Perfectionistic beliefs are associated with dissociative absorption and imaginative involvement in obsessive-compulsive disorder.

Background and objectivesIn the literature there are inconsistent data regarding the role of dissociation in OCD. No study explored the association between obsessive beliefs and dissociative symptoms in OCD. It is important to understand which clinical factors are related to dissociation in OCD as more severe dissociative symptoms, particularly absorption, have been found to be predictors of treatment non-response. In the present short report we describe the results of an exploratory study aimed to investigate the role of the obsessive beliefs as predictors of the different dissociative symptoms controlling for anxiety and OCD severity in a group of OCD patients.MethodsSixty treatment-seeking patients consecutively referred to psychiatric services were included (mean age=31.17 years, 53.30% females). The Dissociative Experiences Scale-II, the Obsessive Beliefs Questionnaire-46, the Yale-Brown Obsessive-Compulsive Scale, and the Beck Anxiety Inventory were administered.ResultsHigher anxious symptoms predicted higher Dissociative Amnesia, Depersonalization/Derealization, and Absorption/Imaginative Involvement. Higher OCD severity predicted higher Dissociative Amnesia. More severe Perfectionism predicted higher Absorption/Imaginative Involvement.ConclusionPerfectionism in OCD patients may be associated with a higher tendency to absorption and imaginative involvement. Future research should explore whether a psychotherapeutic intervention on perfectionism might improve the outcomes of the OCD patients with higher absorption tendencies.

A correlation network analysis of dissociative experiences

ABSTRACTThe interrelationships between the symptom domains of dissociation, such as the loss of continuity in subjective experience, the inability to access personal information, and the distortions about the perception of self and the environment, need to be better understood. In the current study, 2274 adults from Italy completed the Dissociative Experiences Scale-II (DES-II), and their responses were examined within a correlation network analysis framework. Fifteen dissociative experiences showed the strongest associations with the other dissociative experiences included in the measure, and they were selected for further analysis. A partial correlation network was calculated to reveal the associations between such experiences, and a community detection analysis was used to explore whether they formed distinct clusters in the network. Subsequently, a Bayesian network was estimated to examine the direction of the associations among the dissociative experiences, and a directed acyclic graph (DAG) was generated to estimate a potentially causal model of their relationships. The community detection analysis revealed three clusters of experiences that were conceptualized in terms of trance, experiential disconnectedness, and segregated behaviors. Dissociative amnesia was a common denominator of all the three clusters. The analysis of the DAG further suggested that dissociation can be conceptualized as a network in which dissociative experiences are layered into groups of symptoms that interact among them. Cognizance of the configuration and interactions among the dissociative domains and their related symptoms may be critical for better understanding the internal logic behind the dissociative processes and for addressing them effectively in clinical practice.

Reliability and validity of the Chinese version of the Childhood Trauma Questionnaire-Short Form for inpatients with schizophrenia.

BackgroundThe evaluation of childhood trauma is essential for the treatment of schizophrenia. The short form of Childhood Trauma Questionnaire (CTQ-SF) is a widely used measure of the experience of childhood trauma in the general population. Nevertheless, data regarding the psychometric property of CTQ-SF for assessing childhood trauma of patients with schizophrenia are very limited.MethodsTwo hundred Chinese inpatients with schizophrenia completed the Chinese CTQ-SF, the Child Psychological Maltreatment Scale (CPMS), the Impact of Events Scale-Revised (IES-R), and the Dissociative Experiences Scale-II (DES-II). To assess test-retest reliability of the CTQ-SF, all patients completed the CTQ-SF again two weeks later. Concurrent and convergent validity was assessed by analyzing Pearson bivariate correlation coefficients between CTQ-SF and CPMS, IES-R, and DES-II.ResultsThe Cronbach’s α coefficient of the Chinese CTQ-SF was 0.81, and the two-week re-test reliability was 0.81 (P<0.01). The criterion-related validity coefficients of CTQ-SF with the CMPS, IES-R and DES-II were 0.61, 0.41, and 0.51, respectively.ConclusionThe Chinese CTQ-SF has satisfactory psychometric properties to measure childhood abuse or neglect in Chinese inpatients with schizophrenia.

Does dissociation mediate the relationship between childhood trauma and hallucinations, delusions in first episode psychosis?

BackgroundChildhood trauma has been linked to the presence of delusions and hallucinations in psychosis, although the mechanisms underlying this relationship require elucidation. Dissociation, characterized by disruptions to the integrative functioning of several core mental domains, has emerged as a potential mechanism. There is a paucity of research using a clinician-rated measure of dissociation to test the indirect effect of dissociation on the relationship between childhood trauma and psychotic symptoms. This study aimed to investigate whether dissociation mediated both the relationships between childhood trauma and hallucinations, and childhood trauma and delusions utilizing a clinician-administered measure of dissociation, namely the Structured Clinical Interview for DSM-IV Dissociative Disorders - Revised (SCID-D-R). MethodSixty-six first-episode psychosis (FEP) participants completed a research interview and questionnaires. Information about experiences of childhood trauma, psychosis, dissociation, general psychopathology and demographics were collected. ResultsWhen using the SCID-D-R, childhood trauma positively correlated with dissociation. Further, dissociation mediated the relationship between childhood trauma and delusions. Contrary to previous findings, we found no relationship between dissociation and hallucinations and no mediating effect of dissociation on the association between childhood trauma and hallucinations. The results of the SCID-D-R differed significantly from those of the Dissociative Experiences Scale-II (DES-II) which were consistent with previous research. ConclusionsOur findings are the first to use a clinician-rated measure to test the mediating effect of dissociation on the relationship between childhood trauma and positive symptoms (i.e., hallucinations and delusions). Given the discrepancies in results between the SCID-D-R and DES-II, how dissociation is measured in future research is an important consideration. The results add to a body of work that increasingly recognizes the importance of dissociative symptoms on the relationship between childhood trauma and psychosis. The results suggest that dissociative symptoms should be part of routine assessment in those with a history of trauma and present to FEP services.