Dissociative Phenomena Research Articles

The Relationship Between Dissociation and Symptoms of Psychosis: A Meta-analysis.

Evidence suggests that dissociation is associated with psychotic experiences, particularly hallucinations, but also other symptoms. However, until now, symptom-specific relationships with dissociation have not been comprehensively synthesized. This is the first prospectively registered (CRD42017058214) meta-analysis to quantify the magnitude of association between dissociative experiences and all symptoms of psychosis. MEDLINE, PsycINFO, PubMed, and Scopus databases were searched using exhaustive terms denoting dissociation and psychotic symptoms. We included both nonclinical (58 studies; 16 557 participants) and clinical (46 studies; 3879 patient participants) samples and evaluated study quality. Ninety-three eligible articles considering 20 436 participants were retained for analysis. There was a robust association between dissociation and clinical and nonclinical positive psychotic symptoms (r = .437; 95%CI: .386 -.486), with the observed effect larger in nonclinical studies. Symptom-specific associations were also evident across clinical and nonclinical studies, and included significant summary effects for hallucinations (r = .461; 95%CI: .386 -.531), delusions (r = .418; 95%CI: .370 -.464), paranoia (r = .447; 95%CI: .393 -.499), and disorganization (r = .346; 95%CI: .249 -.436). Associations with negative symptoms were small and, in some cases, not significant. Overall, these findings confirm that dissociative phenomena are not only robustly related to hallucinations but also to multiple positive symptoms, and less robustly related to negative symptoms. Our findings are consistent with proposals that suggest certain psychotic symptoms might be better conceptualized as dissociative in nature and support the development of interventions targeting dissociation in formulating and treating psychotic experiences.

D.W. Winnicott and Religion: The Intermediate Area of Experiencing as a Dissociative Phenomenon

Winnicott's concept of an ‘area of intermediate experiencing’ is a very important component of his understanding of religious and cultural practices. It is nonetheless a term that seems to have created considerable confusion and uncertainty among analysts and others. In this paper, I suggest, through a discussion of Winnicott's own work, a review of dissociative phenomena and a selection of illustrations, that the intermediate area of experiencing can be understood best when considered within the framework of a normal, voluntary dissociative or near‐dissociative process that is characteristic of many religious experiences generally. This approach suggests that religious practices and expressions need not be understood primarily on the basis of factual truth as Freud would have done. They also need to be considered on the basis of their meaning or value for the individual or society, as Winnicott suggests. Religious practices and expressions often can be understood as dissociative or near‐dissociative processes that have their own unique properties and characteristics that are separate from but related to the more usual expressions of logical, goal‐directed mental activity that are so valued in modern societies.

Répression des pleurs comme traumatismes relationnels précoces

What to make of very young children's crying remains largely misunderstood and this topic is often neglected during the training of early childhood professionals. Linking this omission to a form of infantile amnesia, we start with the hypothesis that for the very young, dissociation is a primitive adaptation strategy related to attunement with a dissociative state in the parent. These early dissociative states appear in infants’ maturing brains when the adult care-giver does not respond to the infants’ emotional needs during repeated critical periods of crying while the child's attachment system is activated. Thusly, when the adult's reaction to the very young child's crying is to repress it, a chronic traumatic prototypic situation occurs in which we can witness in the infant, a repeated absence of the ability to regulate the intensity and duration of distress. We shall see how the genesis of these early traumas can, from a phenomenological point of view, put the notion of dissociation into question. While no longer considering it as only a defensive action system, an alternative hypothesis would be to consider the dissociative phenomena as an expression of repetition of early experiences in pathological relationships. This phenomenological reflection invites an epistemological debate in order to put into dialectical perspective different theoretical fields referring to dissociative phenomena. In closing, we shall discuss the importance of exploring infantile crying with adults who suffer from dissociative disorders.

Anomalous and dissociative experiences in a religious context: an autoethnographic approach

The present study explored the phenomenological characteristics of anomalous experiences (AEs) reported during Umbanda rituals, a mediumistic Brazilian religion, with the aim of comparing AEs reported during rituals involving the use of Ayahuasca (an entheogen frequently used in some Umbanda contexts) and rituals without the use of this substance. In order to do so, we compared individuals with different levels of involvement with the mediumistic practices. The study was based on an auto-ethnographic approach. This methodological perspective allowed us to confront subjective data with the available knowledge in the scientific literature about AEs, dissociative phenomena and altered states of consciousness and was of fundamental importance for a more sensitive understanding of the nuances and characteristics of these experiences. The results attest to a significant similarity between the experiences reported with and without the use of Ayahuasca in mediumistic contexts. In both groups, the experiencers were able to identify certain similarities in their experiences regarding a reduction of voluntary motor control, changes in memory and perception, communicability and accessibility of experiences, anomalous information reception and increases in interpersonal sensitivity. The results support the methodological feasibility of autoethnography as a research tool and point to its relevance to a deeper understanding of AEs and other subjective experiences usually of difficult investigation by other research methods.

Differential executive functioning in the topology of Spirit possession or dissociative disorders: an explorative cultural study

BackgroundIn Oman, anecdotal and impressionistic observation have helped parse and categorize various manifestations of spirit possession into two broad and distinct categories: intermittent dissociative phenomenon and transitory dissociative phenomenon. The primary aim of the present study was to compare the performance of participants on neuropsychological tests among different grades of possession. Other correlates were also sought.MethodsAssessment criteria for the two groups included measures examining executive functioning: controlled oral word association test Verbal Fluency, Wisconsin Card Sorting Test (Perseverative error and the number of categories achieved), Trail Making Test and the Tower of London Test (number of correctly solved problems). Sociodemographic variables and the history of trauma were also sought.ResultAmong 84 participants, one third of them presented the intermittent possession type and two thirds, the transitory possession type. Their mean age was 34.17 ± 11.82 and 56% of them were female. Nearly 35% of them endorsed a history of a traumatic experience. Both the multivariate models showed statistical significance (F (5, 78) = 5.57, p < 0.001, R2 = 0.22), F (5, 78) = 11.38, p < 0.001, R2 = 0.39) with an independent predictor of intermittent dissociative phenomenon (β = − 3.408, p < 0.001), (β = 63.88, p < 0.001) for Verbal Fluency and Trail Making Test, respectively. The history of the traumatic event was also statistically significant with the results of the Trail Making Test (β = − 26.01, p < 0.041. Furthermore, the subtype of Pathogenic Possession turned out to be an independent predictor across all models: Wisconsin Card Sorting Test perseverative error, Wisconsin card sorting test categories achieved and the number of problems solved in the Tower of London Test (OR = 3.70, 95% C.I. 2.97–4.61; p < 0.001), (OR = 0.57, 95% C.I.0.39–0.84; p = 0.004) and (OR = 0.80, 95% C.I. 0.65–0.99; p < 0.037) respectively.ConclusionsThis study suggests that typology of spirit possession found in Oman tends to differ on indices of executive function. Those with ‘diagnosis’ of intermittent possession showed impairment in many indices of executive functioning. Despite its wide prevalence, spirit possession has not been examined in terms of its neuropsychological functioning. We believe that this study will be instrumental in laying the groundwork for a more robust methodology.

Cognitive and neural facets of dissociation in a traumatized population.

Dissociative phenomena are frequently experienced by psychologically traumatized people. However, little is known about the cognitive profiles of highly dissociative traumatized individuals, and corresponding patterns of neural connectivity when attentional networks are engaged in the context of emotion. One hundred seventeen traumatized women completed the multiscale dissociation inventory (MDI) and neuropsychological testing; MDI scores were used to classify high- and low-dissociative participants. Forty-six participants also underwent fMRI during performance of an attentional control task that incorporates emotionally distracting images (Affective Number Stroop; ANS). Compared to low-dissociative participants, high-dissociative participants demonstrated better performance on an executive functioning task (F1,111 = 4.64, p = .03), worse performance on a task of visual memory (F1,111 = 9.52, p = .003), and similar performance on all other neuropsychological measures. In addition, dissociative symptoms were negatively correlated with functional connectivity between the amygdala and right anterior insula in response to trauma-related ANS trials. These findings indicate that highly dissociative traumatized people experience difficulties with attentional control in the context of emotionally evocative stimuli, but in a neutral context, their overall cognitive profiles are similar to low-dissociative people. Highly dissociative participants also demonstrated weaker connectivity between the amygdala and insula in response to trauma-relevant images. Evocative, trauma-relevant stimuli appear to disrupt neutral networks involved with attention to salient cues and interoception in highly dissociative traumatized individuals. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A study of dissociation in survivors of 5 disasters

This study examined dissociation as an outcome to disaster in dissociative data collected from 423 highly-exposed survivors of 5 different disasters using consistent methodology. Ten items selected for conceptual relevance to disaster experience were administered from the Dissociative Disorders Interview Schedule, a structured interview for lifetime dissociative disorders. Structured psychiatric interviews provided data on incident somatization symptoms, disaster-related PTSD, and lifetime predisaster psychopathology. The Temperament and Character Inventory assessed personality. Observed levels of dissociation were low and not usually postdisaster. Dissociation level was associated with female sex, number of incident somatization symptoms, personality (underdeveloped executive functioning), PTSD, and predisaster psychopathology in bivariate analyses. In multiple linear regression models, dissociation was associated with the low number of incident somatoform symptoms observed independent of the effects of PTSD, hyperarousal specifically (but not intrusion or avoidance/numbing), personality, predisaster psychopathology, and demographic variables which were not independently associated with dissociation. The low levels of dissociation found in this study and the lack of association between dissociation and indicators of psychopathology point to a largely nonpathological nature of the dissociative phenomena measured. These findings do not indicate the development of dissociative psychopathology as a prevalent mental health outcome of disasters.

Evidence for subjective emotional numbing following induced acute dissociation

The aim of the study was to examine the effects of acute dissociation on emotional responsivity in healthy individuals. We used a previously validated technique (mirror-gazing, Caputo, 2010) to experimentally induce acute dissociation in non-clinical participants and assessed post-induction subjective responsivity (ratings of valence and arousal) to standardized emotional images. Fifty non-clinical participants were randomised to either the dissociation induction (n = 25) or control conditions (n = 25). The dissociation manipulation effect was corroborated by a significant post-induction elevation in state dissociation in the dissociation-induction group relative to controls (p = .004). The dissociation-induction group rated negative (p = .028) and neutral (p = .025) stimuli as significantly less unpleasant than controls. There was also a non-significant trend for positive stimuli to be rated as less pleasant by the dissociation-induction group compared to controls (p = .060). These findings provide experimental evidence for the short-term alleviation (i.e., emotional numbing) of negative affect during dissociative states, which may serve as a coping mechanism for some individuals. However, this tendency of emotional numbing also reduced positive affective responses to pleasant stimuli to some extent. Further investigation of dissociative phenomena and their impact on emotional processing appears warranted.

Strange-face illusions during eye-to-eye gazing in dyads: specific effects on derealization, depersonalization and dissociative identity

ABSTRACTExperimentally induced strange-face illusions can be perceived when two individuals look at each other in the eyes under low illumination for about 10 minutes. This task of subject-other eye-to-eye gazing produces the following perceptions by the subject: (i) mild to huge deformations and color/shape changes of face and facial features; (ii) lifeless, unmoving faces and immaterial presences akin to out-of-body experiences; (iii) pseudo-hallucinations, enlightened ‘idealized’ faces and personalities – rather than the other’s actual face. Dissociative phenomena seem to be involved, whereas the effects of non-pathological dissociation on strange-face illusions have not yet been directly investigated. In the present study, dissociative perceptions and strange-face illusions were measured through self-report questionnaires on a large sample (N = 90) of healthy young individuals. Results of correlation and factor analyses suggest that strange-face illusions can involve, respectively: (i) strange-face illusions correlated to derealization; (ii) strange-face illusionscorrelated to depersonalization; and (iii) strange-face illusions of identity, which are supposedly correlated to identity dissociation. The findings support the separation between detachment and compartmentalization in dissociative processes. Effects of gender show that strange-face illusions are more frequent in men with respect to women if dyads are composed of individuals of different-gender. Furthermore, drawings of strange-faces, which were perceived by portrait artists in place the others’ faces, allowed a direct illustration of examples of dissociative identities. Findings are discussed in relation to the three-level model of self-referential processing.

Dissociation in Problematic Gaming: a Systematic Review

The present article consists of a systematic review of recent (2007–2018) empirical studies addressing the relationship between problematic gaming and dissociation. Nineteen peer-reviewed empirical studies that examined the relationship between problematic gaming and dissociation were identified. The findings suggest that excessive video game use is linked to a variety of dissociative phenomena (e.g. depersonalisation experiences, escapism, psychotic-like experiences, game transfer phenomena). Dissociative experiences are associated with problematic gaming. The findings support the hypothesis that problematic video game use can represent a maladaptive coping strategy on which people can rely to escape from disturbing mental states, adverse emotions or real-life problems. In these circumstances, dissociative symptoms might represent the side effects of an alteration in consciousness that is generated by excessive video game use. However, further research (especially experimental and longitudinal) is required in order to establish a potential causal link between problematic gaming patterns and dissociation.

Defense style and dissociative phenomena in patients with borderline personality disorder

Introduction Patients with borderline personality disorder (BPD) are unique and diverse in their pathology, defense style, and clinical presentations. Many of these patients have other personality disorders as well. They tend to display a wide range of other psychiatric disorders, including dissociative phenomena and experiences. Patients and methods A total of 60 female patients were diagnosed with BPD using the Diagnostic and Statistical Manual of Mental Disorders, IV ed. Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Severity of illness and emotional and behavioral aspects of patients were assessed using Borderline Evaluation of Severity over Time. Defense style of patients was assessed using the Defense Style Questionnaire. Dissociative phenomena were studied using the Dissociative Experience Scale (DES). Results The most commonly used defenses by the study patients were undoing, idealization, somatization, and splitting. Patients with absent criteria 4 (impulsivity) and 7 (feeling of emptiness) of BPD significantly displayed more mature defenses, whereas patients having criterion 9 (paranoid ideation and severe dissociation) of BPD significantly displayed neurotic type of defenses. Mature defenses were significantly negatively correlated with the absorption and depersonalization factors of DES. Neurotic defenses were significantly correlated with the total score of DES, absorption, and depersonalization factors. Immature defenses were significantly correlated only with the depersonalization factor of DES. Conclusion Patients with BPD have a specific pattern of defense style that might be linked to their specific illness criteria. Displaying certain phenomena of dissociation might be related to the particular pattern of the dominant defense mechanisms in these patients.

"I feel like I do not exist:" A study of dissociative experiences among war-traumatized refugee youth.

War-traumatized refugee children and adolescents have been overlooked in research on trauma-related dissociation, and whatever research has been conducted has relied almost exclusively on questionnaires. The present study was an exploration of dissociative experiences in multitraumatized war-refugee youth. In this study, we used a mixed-method approach by grouping participants according to a Western-based dissociation measure (the Adolescent Dissociative Experiences Scale; Armstrong, Putnam, Carlson, Libero, & Smith, 1997), and conducting qualitative and quantitative analyses of their verbal descriptions of mental experiences related to dissociation in the aftermath of war and resettlement. The sample included 40 refugee youth, ages 13 to 21, 19 girls and 21 boys resettled in Sweden because of war and persecution. Severe trauma-related dissociation was a problem for a considerable subgroup of the sample. Some dissociative experiences were present in all the sample; others were restricted to the most dissociative group. The correlates of severe dissociation included high frequency and severity of emotional dysregulation and intensity, negative self- and body-perception, depressive mood, and experiences of detachment. Clinicians are urged to be aware of and assess trauma-related dissociation in war-refugee youth, and consider not only dissociative phenomena, but also other important processes such as emotional dysregulation. (PsycINFO Database Record

Differential Diagnosis between Anomalous Experiences and Dissociation Disorder Using the Dissociative Disorders Interview Schedule (DDIS)

ABSTRACTBackground. It is important to understand the most diverse cultural aspects related to religiosity. Scientifically, it is important to understand religious manifestations and their relation to health, and to differentiate them from psychopathological manifestations. Objective. To evaluate the mental health of a group of mediums and compare it with that of a control group from the same religious context who do not manifest mediumship, using the Dissociative Disorders Interview Schedule (DDIS). Methods. This was a cross-sectional study, evaluating 47 mediums (Group 1) and comparing them with 22 non-medium volunteers from the same religious context (Group 2) using the DDIS questionnaire. All results were matched with historical data from patients with dissociative identity disorder (DID) who answered the DDIS. Results. Scores obtained from the DDIS were similar in both groups. The number of positive symptoms was comparable in a wide range of analyzed areas, involving but not being restricted to somatization disorder, major depressive episode, borderline personality disorder, extrasensory/paranormal experiences, physical/sexual abuse and five dissociative disorders. There were considerable differences when we compared these results with historical data from patients with DID. Conclusion. In agreement with the extant literature, these results showed that mediumship can be considered a non-pathological form of dissociative phenomena.

Relationship of Internet gaming disorder with dissociative experience in Italian university students

The purpose of this study was twofold: (a) to investigate the prevalence of Internet gaming disorder (IGD) among Italian university students and (b) to explore the associations between the former and dissociative phenomena. The sample included 221 college students, 93 males and 128 females, aged between 18 and 25 (M = 21.56; SD = 1.42). They were asked to state their favourite games choice and were administered a demographic questionnaire, the APA symptom checklist based on the diagnostic criteria of IGD in the DSM-5, the Internet Gaming Disorder Scale Short Form (IGD9-SF) and the Italian version of dissociative experience scale for adolescents and young adults. The different game types used are distributed as follows: Massively Multiplayer Online Role-Playing Game (30%), flash games (26%), multiplayer games (24%), and online gambling (23%). The results of the study showed a high incidence of Internet gaming disorder risk in college students (84.61%). Specifically, our data confirmed the literature on the incidence of the male gender bias among online players (M = 28.034; SD = 2.213). Thirty-three subjects (31 male and 2 female) on 221 (14.9%) matched five or more criteria for clinical diagnosis of IGD. The data showed a positive correlation between Internet gaming disorder risk and some dissociative experiences: depersonalisation and derealisation (AbII/item6 r = .311; DD/item6 r = .322); absorption and imaginative involvement (AbII/item2 r = .319; AbII/item8 r = .403) and passive influence (PI/item3 r = .304; PI/item4 r = .366; PI/item9 r = .386). This study shedded light on psychopathological aspects that preceded the spread of IGD and encourages the implementation of a programmatic plan of preventative interventions by Italian public institutions, to prevent and tame the spreading of such addictive behaviours.

Ketamine and Its Pharmacologic Profile in Psychiatric Disorders

Ketamine is used to treat psychiatric conditions at low doses to minimize risks associated with anesthetic sedation. Dissociative phenomena and minimally increased heart rate and blood pressure are among the most common but transient side effects during intravenous ketamine infusion. When used in common medical practice as an anesthetic, analgesic, and antidepressant, there is little evidence to support nonreversible adverse events. Several retrospective studies have demonstrated that daily, illicit use of ketamine at high doses over a period of years is associated with neurocognitive dysfunction and ketamine-induced cystitis. Although ketamine may have use in special populations, screening for active psychosis, illicit ketamine use, a history of cystitis, and severe or uncontrolled cardiovascular disease is critical when determining the appropriateness of ketamine treatment. [ Psychiatr Ann. 2018;48(4):170–174.]

Four-Phased Dynamic Therapy Model in Treating Trauma-Induced Dissociation

Traumatic memories are highly emotional, life-altering events that would appear to have the best chance of persisting into the entire life. In complex trauma syndrome, they are usually endless causing often dissociative phenomena—the alterations in one’s consciousness. Thus, traumatic memories may cause a constant feeling of intense fears, helplessness, loss of control, affliction of the powerlessness, and threat of annihilation. Traumatised person usually reports loss of the basic sense of self and bodily integrity. The principle of healing is empowerment of the patient’s ability to re-create the basic capacities for trust, autonomy, competence, identity, and intimacy. The dissociative PTSD subtype is characterised by overmodulation of the affects—predominance of reexperiencing and hyperarousal symptoms with “hidden” and deeply unconscious traumatic memories. Although there are many ways to conceptualise dissociation, in this article we have emphasised the trauma-induced dissociation that involves detachment from the overwhelming emotional content of the experience during and in the aftermath of trauma experience. It has been hypothesised that such experiences elicit dissociation, promoting discontinuity of one’s conscious experience and narrative memory. Four-phased patient oriented Dynamic Therapy model in treating trauma-induced dissociation targets three main goals: 1) restoration of a form of the relatedness (Interconnectivity), 2) restoration of a sense of the aliveness/vitality (Dynamism), and 3) restoration of an awareness of the self and inner events (Insight).

Dissociative phenomenon among sexually abused egyptian female participants with substance dependence

Objective The purpose of this article is to study dissociative symptoms in female addicts exposed to sexual abuse in their childhood. Participants and methods This study included 44 Egyptian females who were recruited from a private psychiatric hospital and from a halfway center receiving treatment for substance abuse. Overall, 22 cases were sexually abused during their childhood (before age of 18 years), whereas 22 controls were not exposed to sexual abuse. Addiction severity index was used to assess history of addiction, age of starting smoking, and age of starting substance abuse. Addiction severity index was used to measure emotional abuse and physical abuse. Sexual abuse questionnaire was used to measure sexual abuse. Questionnaire of experience of dissociation was used to measure dissociative phenomena. Results There was a statistically significant difference regarding the age of starting smoking (P=0.03) and age of starting substance abuse (P=0.04). Moreover, there was a highly statistically significant difference between both groups regarding questionnaire of experience of dissociation scores (P=0.00). Conclusion Female participants with substance dependence who are sexually abused showed more pathological dissociative symptoms than those who were not. Female participants who are sexually abused during their childhood are more prone to start smoking and substance abuse at younger age than their peers. Physical abuse was higher in sexually abused female participants than those who were not.

What was once essential, may become detrimental: The mediating role of depersonalization in the relationship between childhood emotional maltreatment and psychological distress in adults

ABSTRACTDepersonalization (DP) is a dissociative phenomenon, characterized by feeling “unreal” or detached from one’s own emotions, thoughts, and behavior (APA, 2013). It is considered to be a defense mechanism, employed in response to overwhelming events, whereby thoughts and emotions are suppressed in order to enhance the individual’s capacity to function in traumatic environments. DP has been found to co-occur with anxiety and depressive disorders, and childhood emotional maltreatment (EM) has been identified as an important predisposing factor. The study’s primary aim was to investigate the mediating role of DP in the relationship between childhood EM and psychological distress in young adults. Additionally, it aimed to confirm that a history of childhood EM (emotional abuse and emotional neglect) predicted current levels of DP and to explore how both a person’s attitude towards experiencing and expressing emotions (with an emphasis on the affect phobia model) and their current attachment security are related to current DP. A cross-sectional design was employed, which included young adults (N = 761) aged between 18 and 25 years. Participants completed an online survey that comprised of several self-report measures. Regression and mediation analyses were conducted. The results indicated that: (1) DP significantly mediated the relationship between childhood EM and current psychological distress; (2) that a history of EM, but no other forms of childhood abuse, significantly predicted current DP experiences; and (3) EM, attachment-related anxiety, and negative attitudes toward emotions predicted clinical cutoff levels of DP. The results are discussed in detail, including clinical implications and direction for future research.

Brain functional integration: an epidemiologic study on stress-producing dissociative phenomena.

Dissociative phenomena are common among psychiatric patients; the presence of these symptoms can worsen the prognosis, increasing the severity of their clinical conditions and exposing them to increased risk of suicidal behavior. Personality disorders as long duration stressful experiences may support the development of dissociative phenomena. In 933 psychiatric outpatients consecutively recruited, presence of dissociative phenomena was identified with the Dissociative Experience Scale (DES). Dissociative phenomena were significantly more severe in the group of people with mental disorders and/or personality disorders. All psychopathologic traits detected with the symptom checklist-90-revised had a significant correlation with the total score on the DES. Using total DES score as the dependent variable, a linear regression model was constructed. Mental and personality disorders which were associated with greater severity of dissociative phenomena on analysis of variance were included as predictors; scores from the nine scales of symptom checklist-90-revised, significantly correlated to total DES score, were used as covariates. The model consisted of seven explanatory variables (four factors and three covariates) explaining 82% of variance. The four significant factors were the presence of borderline and narcissistic personality disorder, substance abuse disorders and psychotic disorders. Significant covariates were psychopathologic traits of anger, psychoticism and obsessiveness. This study, confirming Janet’s theory, explains that, mental disorders and psychopathologic experiences of patients can configure the chronic stress condition that produces functional damage to the adaptive executive system. The symptoms of dissociative depersonalization/derealization and dissociative amnesia can be explained, in large part, through their current and previous psychopathologic experiences.

Childhood Traumatic Experiences and Dissociative Phenomena in Eating Disorders: Level and Association with the Severity of Binge Eating Symptoms

ABSTRACTThe aim of the current study is to evaluate the presence of childhood trauma, psychoform, and somatoform dissociation in eating disorders (ED). Eighty-six ED outpatients participated in this study, 20 of them were diagnosed with restrictive anorexia (AN-R), 10 of them with anorexia nervosa binge-purging subtypes (AN-B), 25 with bulimia nervosa (BN), and 31 with binge eating disorder (BED). They were matched by sex and age with a control group consisting of 86 healthy subjects (HC). Traumatic experiences were assessed by means of the Childhood Trauma Questionnaire (CTQ), psychological, and somatoform dissociation, respectively, by means of the Dissociative Experience Scale (DES-II) and Somatoform Dissociation Questionnaire (SDQ-20), and binge eating symptoms by means of Binge Eating Scale (BES). ED subjects showed higher levels of childhood trauma, and both psychoform and somatoform dissociation compared to HC subjects. ED patients showed higher levels of childhood trauma compared to the HC group. No significant differences were shown between ED subgroups with respect to all forms of childhood trauma. BN and AN-B subgroups showed higher levels of both psychological and somatoform dissociation. Dissociation and childhood trauma predicted the severity of binge eating symptoms. Our results confirm previous studies in the same field.