Higher Levels Of Dissociation Research Articles

Correlates of risk-taking behaviour and suicidality among humanitarian aid workers

In an era of high need for humanitarian assistance, humanitarian aid workers face increased exposure to potentially traumatic events and, correspondingly, a greater risk of psychological distress (e.g., anxiety, depression, posttraumatic stress disorder [PTSD], and burnout). Less studied among humanitarian workers, however, are other known correlates of trauma-exposure: complex PTSD, risk-taking behaviours, and suicidality. The current study examined levels of trauma exposure and rates of trauma-related mental health disorders, risk-taking behaviour, and levels of suicidality among a sample (N = 232) of humanitarian workers located across 52 countries. Multiple linear regression analysis was used to determine which demographic (i.e., sex, age, cadre, years working as an aid worker), psychological (i.e., social support, personality traits), and trauma-related (trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, and dissociation) variables were uniquely associated with risk-taking behaviours and suicidality. Overall, 12.9 % (95 % CI = 8.5 %, 17.2 %) of humanitarian workers met the diagnostic requirements for PTSD, and 8.6 % (95 % CI = 5.0 %, 12.2 %) met requirements for CPTSD. Higher risk-taking behaviours were significantly associated with being male, an international worker, greater trauma exposure, extraversion, neuroticism, and CPTSD symptoms. Suicidality was significantly associated with being an international staff member and higher levels of dissociation. Results are consistent with previous studies citing a high risk of psychological distress among humanitarian workers. Humanitarian aid agencies have a duty of care to their workers - both professional and volunteer - and greater safeguarding measures are necessary to mitigate the risk to mental health brought on by humanitarian work-related stressors.

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

Dissociation and other trauma symptomatology are linked to imbalance in the competing neurobehavioral decision systems.

Dissociation is a conscious state characterized by alterations in sensation and perception and is thought to arise from traumatic life experiences. Previous research has demonstrated that individuals with high levels of dissociation show impairments in cognitive-emotional processes. Therefore, using the Competing Neurobehavioral Decisions System (CNDS) theory, we used statistical modeling to examine whether dissociative experience and trauma symptoms are independently predicted by impulsivity, risk-seeking, affective state (i.e., anxiety, depression, stress, and negative affect), and trauma history. In this cross-sectional study design, data were collected via Amazon Mechanical Turk from a total of n = 557 English-speaking participants in the United States. Using Qualtrics, participants answered a series of self-reported questionnaires and completed several neurocognitive tasks. Three independent multiple linear regression models were conducted to assess whether impulsivity, risk seeking, affective state, and trauma history predict depersonalization, trauma symptoms, and PTSD symptoms. As hypothesized, we found that depersonalization and other trauma symptoms are associated with heightened impulsivity, increased risk-seeking, impaired affective states, and a history of traumatic experiences. We demonstrate that an imbalanced CNDS (i.e., hyperimpulsive/hypoexecutive), as evidenced by decreased future valuation, increased risk seeking, and impaired affective states, predicts heightened depersonalization and other trauma and PTSD symptomatology. This is the first time that dissociation has been connected to delay discounting (i.e., the tendency to place more value on rewards received immediately compared to farther in the future). Interventions that positively impact areas of the CNDS, such as episodic future thinking or mindfulness meditation, may be a target to help decrease dissociative symptoms.

The mediating role of trait mindfulness and dissociative experiences in the relationship between childhood emotional abuse and problematic internet use in Italian adolescents.

There is clear evidence linking trauma, mindfulness, dissociation and problematic internet use (PIU). Nonetheless, little is known about the role trait mindfulness and dissociative experiences may have in the relationship between childhood emotional abuse (CEA) and PIU, as well as the role that gender may have in such relationships. In the current research, self-report questionnaires on CEA, trait mindfulness, dissociative experiences and PIU were administered to 1074 Italian adolescents (50% females) aged 14-17 years old, to test whether trait mindfulness and dissociative experiences mediated the relationship between CEA and PIU, and whether the proposed mediation was invariant across genders. Furthermore, the main analyses were controlled for background variables. The findings highlighted significant associations between all direct and indirect paths and invariance of the mediation model across boys and girls. The results of this study highlight that emotionally abused boys and girls with high levels of dissociation and inadequate mindful skills may be more exposed to dysfunctional online activities. Hence, developing dissociation-focused and mindfulness-based interventions for emotionally abused adolescents may be clinically effective when building tailored approaches for the prevention and management of PIU. Further implications are discussed.

Borderline personality disorder features and their relationship with trauma and dissociation in a sample of community health service users

BackgroundPrevious studies have indicated that borderline personality disorder (BPD) is closely associated with trauma and dissociation. Nevertheless, BPD is a heterogeneous condition, and not all people with BPD have severe dissociation. This study examined whether the relationship of BPD features with trauma and dissociation would remain significant after controlling for some general non-specific mental health distress. We also made the first attempt to explore which specific BPD features would be particularly associated with dissociation.MethodsWe analyzed survey data from a sample of community health service users in Hong Kong (N = 376). Hierarchical multiple regression and data-driven network analysis were used.ResultsThe lifetime prevalence of DSM-5 BPD was 16.0% in our sample. Of participants who met criteria for BPD, 43.3% scored above cutoff on the dissociation measures, thus possibly having clinically significant dissociative symptoms. BPD features were associated with adulthood trauma and psychoform dissociation even after controlling for age, depression and self-esteem. Network analysis showed that some BPD features – including impulsivity, identity disturbance and suicidal/self-mutilation behaviors – were particularly associated with dissociation; other BPD features such as interpersonal-related problems had relatively weak to no connection with dissociation.ConclusionsOur results suggested that some particular BPD features might be dissociative in nature, although further longitudinal research is required. We argue that a trauma-informed perspective should be employed when working with clients presenting with BPD features despite these features being commonly stigmatized. Further research on the intervention needs of the people with BPD who suffer from high levels of dissociation is required.

Exploring looked-after adolescents’ reports of their dissociative experiences.

ObjectiveIn this study, the relationship between levels of dissociation, several pre-placement factors and other background variables was explored to facilitate understanding of the high prevalence of dissociation in adolescents living in care. MethodsA sample of adolescents (n = 68) between the ages of 11 and 17 in care at Five Rivers Child Care (FRCC) participated in the study. The Adolescent Dissocitive Experiences Scale (ADES), a self-administered dissociation questionnaire was compared with an established carer-report measure of dissociation, the Child Dissociative Checklist (CDC), the Strengths and Difficulties Questionnaire (SDQ) and the Trauma and Adverse Life Experiences Assessment (TALE) to explore the relationship between dissociation and other emotional, behavioural, and trauma-related difficulties in a looked-after population. ResultsThe exploration of demographic variables revealed that dissociation was more likely to be present in females than males, with the age placed in care also influencing levels of dissociation. Measures related to pre-placement risk factors were not shown to be related to dissociative experiences. As expected, regression models were not significant in explaining variance in ADES scores with minimal effects from background, pre-placement risk and psychopathology variables. Finally, a discrepancy was observed between participant self-related dissociation and carer, or residential worker observational scores of the adolescents’ dissociation. ConclusionThe study's findings corroborate previous research confirming high levels of dissociation among adolescents in a specific care population, with the ADES questionnaire demonstrating the ability to measure dissociation. Utilising the ADES can offer an opportunity to understand the presentation of dissociation in looked-after children, and for clinicians, may provide a deeper comprehension when formulating a more sophisticated support or treatment plan.

Psychological trauma, mood and social isolation do not explain elevated dissociation in functional neurological disorder (FND)

Functional Neurological Disorder (FND) results in altered motor, sensory and cognitive function in the absence of evident organic disease. It often co-occurs alongside dissociative disorders and dissociation has been found to be high in patients across FND subtypes (particularly in those with Non-Epileptic Attack Disorder; NEADs). However, the presence of dissociation in FND is varied and there are contradictory definitions and suggestions for elevated levels. Here, three studies show that dissociation is a prominent, defining feature of people with FND compared to those who are healthy or have other, similar long-term health conditions, and that this heightened dissociation is not explained by a history of trauma (study 1, N = 121), mood (study 2, N = 589) and is not associated with social isolation/social exclusion (study 3, N = 542). As dissociation appeared to occur in FND in the absence of the usual contributing factors, and as higher levels of dissociation were associated with increased disability and illness impacts, understanding its role is of fundamental importance to developing our understanding of FND. These findings have further applications, beyond the theoretical, in clinical settings and in research; the implications for further research are discussed.

Dissociative Model in Patients With Resistant Schizophrenia.

BackgroundSchizophrenia is a severe mental illness in which, despite the growing number of antipsychotics from 30 to 50% of patients remain resistant to treatment. Many resistance factors have been identified. Dissociation as a clinical phenomenon is associated with a loss of integrity between memories and perceptions of reality. Dissociative symptoms have also been found in patients with schizophrenia of varying severity. The established dispersion of the degree of dissociation in patients with schizophrenia gave us reason to look for the connection between the degree of dissociation and resistance to therapy.MethodsThe type of study is correlation analysis. 106 patients with schizophrenia were evaluated. Of these, 45 with resistant schizophrenia and 60 with clinical remission. The Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scales were used to assess clinical symptoms. The assessment of dissociative symptoms was made with the scale for dissociative experiences (DES). Statistical methods were used to analyze the differences in results between the two groups of patients.ResultsPatients with resistant schizophrenia have a higher level of dissociation than patients in remission. This difference is significant and demonstrative with more than twice the level of dissociation in patients with resistant schizophrenia.The level of dissociation measured in patients with resistant schizophrenia is as high as the points on the DES in dissociative personality disorder.ConclusionPatients with resistant schizophrenia have a much higher level of dissociation than patients in clinical remission. The established difference between the two groups support to assume that resistance to the administered antipsychotics is associated with the presence of high dissociation in the group of resistant patients. These results give us explanation to think about therapeutic options outside the field of antipsychotic drugs as well as to consider different strategies earlier in the diagnostic process.

The manifestations and correlates of dissociation amongst looked-after children in middle childhood

ObjectiveTo explore the manifestations and correlates of dissociation amongst a sample of primary school-aged children looked-after children (LAC) in the care of their local authority. MethodsIn part one, the Child Dissociative Checklist (CDC), Strengths and Difficulties Questionnaire (SDQ) and Relationship Problems Questionnaire (RPQ) were administered to 91 primary school-aged LAC under the care of Five Rivers (an independent fostering agency). Variables pertaining to participants’ background and placement history were examined in relation to CDC scores. In part two, a subsample of children (n=34) with identified psychosocial difficulties were administered the Story Stems Assessment Procedure (SSAP). Relationships between dissociative symptoms and SSAP constructs were explored using Spearman's correlation and K-means clustering. ResultsPart 1. Forty-one LAC (45%) scored on or above the CDC's clinical threshold suggestive of sustained pathological dissociation. Children who had experienced sexual abuse were more likely than others to display dissociative behaviours, as were children placed alone compared to those placed with a related sibling. Total CDC scores were positively correlated with SDQ total difficulties, and RPQ disinhibited and inhibited subscores. Part 2. Dissociative symptoms were negatively correlated with features of attachment security and positive parent representations in children's narratives. Three clusters were identified in the dataset: two groups showed clinically significant levels of dissociation but differed with respect to their representations. ConclusionsChildren who have suffered maltreatment are at high risk of pathological dissociation, especially those who have experienced sexual abuse. Placing LAC with their siblings may mitigate against dissociative symptoms. Dissociation covaries with psychosocial problems, yet dissociative children are a heterogenous group. High levels of dissociation may be accompanied by the relative absence of positive or negative attachment representations, or by the dominance of negative representations, including features of disorganisation.

ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in treatment seeking veterans: risk factors and comorbidity.

Emerging evidence suggests that ICD-11 CPTSD is a more common condition than PTSD in treatment seeking samples although no study has explored risk factors and comorbidities of PTSD and CPTSD in veteran populations. In this study, risk factors and comorbidity between veterans meeting criteria for PTSD or CPTSD using the ICD-11 International Trauma Questionnaire (ITQ) were explored. A sample of help-seeking veterans who had been diagnosed with a mental health difficulty (n = 177) was recruited. Participants completed a range of mental health and functioning measures. Multinomial logistic regression analysis was conducted to explore differences in the above factors between participants meeting case criteria for PTSD, CPTSD or another mental health disorder. Those with CPTSD appeared to have taken longer to seek help, reported higher rates of childhood adversity and more experiences of emotional or physical bullying during their military careers. Further, participants with CPTSD reported a greater burden of comorbid mental health difficulties including high levels of dissociation, anger, difficulties related to moral injury and common mental health difficulties and greater degree of impairment including social isolation, sleep difficulties and impaired functioning. Considering that CPTSD is a more debilitating condition than PTSD, there is now an urgent need to test the effectiveness of new and existing interventions in veterans with CPTSD.

The Link from Child Abuse to Dissociation: The Roles of Adult Disorganized Attachment, Self-Concept Clarity, and Reflective Functioning

ABSTRACT In this study of 624 adult participants from the general population (i.e., a community sample), we examine adult disorganized attachment, a construct that can now be measured on a self-report scale, and its linkage between child abuse to dissociation. Prior research has demonstrated that child abuse is positively associated with adult disorganized attachment, which in turn is linked to a variety of externalizing and internalizing behaviors (e.g., depression, anxiety) in adulthood. Based on the literature regarding self-concept, we further consider that having an integrated sense of self is crucial in examining how having an adult disorganized attachment could result in dissociative symptoms. We consider two measures representing an unintegrated sense of self – self-concept clarity and reflective functioning – and find that both play a role in moderating the mediating effects of adult disorganized attachment. Specifically, lower levels of clarity were associated with higher levels of dissociation in our sample, and reflective functioning played a more nuanced and complex role in examining moderated mediation in our sample. Overall, using moderated mediation analysis, we found support for our hypotheses.

Psychogenic non-epileptic seizures in children – psychophysiology & dissociative characteristics

The purpose of this study was to determine psychophysiology and dissociative characteristics of psychogenic non-epileptic seizures (PNES) in a clinical pediatric setting. A retrospective chart review was conducted over a 5-year period that included children meeting criteria for probable, clinically established or documented PNES. Of these, 33 patients (81%) underwent psychophysiology assessment as part of standardized care and were selected for study inclusion. Ages ranged from 10 to 17 years inclusive (70% female). The majority of patients were found to have some form of autonomic decompensation at baseline (82%) and lack of autonomic recovery from a cognitive stressor (58%). Inhibition of electrodermal skin response to laboratory stressor was associated with significantly longer duration of PNES illness (t=2.65, p=.013), while elevated heart rate (above 90th percentile) was associated with significantly higher frequency of PNES events in the month preceding diagnosis (t=3.1, p=.004). High levels of dissociation and hyperventilation symptoms were self-reported by adolescent patients (n=19) with a moderate degree of positive association (r=0.35, p=.038). The majority of patients (n= 25, 89%) were taught to correct respiratory CO2 levels during a single biofeedback training session. Conclusions: Child PNES populations appear to be characterized by chronic autonomic hyperarousal reflecting severity of their symptoms, which can feasibly be targeted for behavioral treatment.

Collapsed Structure of Hydrophobically Modified Polyacrylamide Adsorbed at the Air-Water Interface: The Polymer Surface Excess and the Gibbs Equation.

Neutron reflectometry has been used to measure the surface excesses and structures of hydrophobically modified polyacrylamide polymers (HMPAMs) at the air-water (A-W) interface. The HMPAMs were based on a range of commercially available PAM, which were modified by the N-alkylation of the amide group to give an N-CnD2n+1 hydrophobic group with n = 8, 12, and 16 at levels of 0.5, 1, 2, 4, and 6 mol %. A further HMPAM was synthesized in two isotopic forms with either N-CnD2n+1 or N-CnH2n+1 as hydrophobes. For moderate- and high MW species the near surface structure at the A-W interface consists of two layers. All the hydrophobic units are in these two layers as well as a large fraction of backbone units, often amounting to a total volume comparable to that of the hydrophobes. The outer layer next to air contains no water, but the residual volume in the inner layer is filled with water. A further large fraction of the backbone units also form a diffuse third layer extending a substantial distance into the solution. In a low MW HMPAMs there was preferential adsorption of species with higher mol % of hydrophobe and a tendency to form apparently nonequilibrium structures, which in some cases resulted in more complex structures than the simple one characteristic of the large MW polymers. With the exception of this polymer, the variation of the patterns of surface excess and structure with solution concentration suggested that systems containing hydrophobic units at a level of 0.5, 1, and 2 mol % formed equilibrium or near-equilibrium surface layers at bulk concentrations of 0.01-0.35 wt % for C8 to C16 units. However, higher levels of 4 and 6 mol % of the C12 hydrophobe led to much less regular patterns of adsorption, indicating that equilibration is more difficult once the molar fraction of hydrophobe exceeds 2 mol %. The behavior of the surface tension (ST) over the same concentration range as the NR experiments could be accounted for by the Gibbs equation using the directly measured surface excesses and the incorporation of a low charge on the polymers (about 1 charge per 100 backbone units). The presence of such a charge in PAM can arise from hydrolysis of some amide to carboxylate and was known to be present for one of the polymers. The extra structural information obtained by NR on these HMPAMs combined with more recent measurements of the state of ionization in polyacrylates (PAA) allowed us to reinterpret earlier ST and X-ray reflection results on hydrophobically modified HMPAANa containing a similar level of 1 and 2 mol % C12H25 hydrophobes. The Gibbs equation again accounted quantitatively for the ST behavior by using the correct state of ionization of the polymer. Although the adsorption of hydrophobic groups in HMPAANa is about one-tenth of that for the corresponding HMPAM, the ST drops more quickly to lower values for HMPAANa because of its higher level of dissociation, which increases the magnitude of the slope in the Gibbs plot.

Childhood Sexual Abuse and Sexual Motivations – The Role of Dissociation

ABSTRACT The present study sought to examine the relations between a history of childhood sexual abuse (CSA) and sexual motivations and to explore the moderating role of dissociation within these relations. The study was conducted among 889 men and women (ages 18–70). Results indicated a history of CSA was significantly related to higher scores on self-affirmation, coping, partner approval and peer pressure sexual motivations. Interactions between CSA and gender in explaining sexual motivations, were not significant. Among participants with a history of CSA (n = 365), dissociation was significantly related to sexual motivations, so that participants who had dissociation scores above the cutoff (reporting high levels of dissociation) scored higher on intimacy, self-affirmation, coping, and partner approval than did those with a history of CSA who reported low levels of dissociation. Analyzes revealed significant moderating effects for dissociation within the relations between CSA and intimacy, coping, and partner approval sexual motivations. The present study suggests CSA survivors and those who report high levels of dissociation in particular, utilize sex for intimacy, for coping with negative emotions, and for partner approval. Therapists working with CSA survivors should be aware of the potential effects the abuse has on the survivor’s reasons to engage in sex.

Effectiveness of combined use of antibiotics, essential metals and probiotic bacterial strain complexes against multidrug resistant pathogens

Large-scale uncontrolled use of antibiotics in various spheres of human activities (agriculture, veterinary medicine, and food industry) has led to the emergence of multi-resistant pathogen isolates. The aim of this study was to assess the complex potential effects of antibiotics and metals on P. aeruginosa clinical isolate. In this study, clinical isolates of P. aeruginosa were used as test organisms in respect of which combinations based on antibiotics, salts of essential metals with a high level of dissociation in aqueous solutions and the probiotic bacterial strain of B. subtilis 534 were examined. The specific selection criterion for antibiotics and metals was their resistance to specific concentrations of B. subtilis 534 strain and their inhibitory or subinhibitory effect against P. aeruginosa. In the course of the research it was found that the most promising is the use of CuSO4, since it has a more pronounced bactericidal effect on P. aeruginosa at a concentration of 40 mg/ml, in contrast to B. subtilis 534 for which this concentration is not toxic. Of all the studied antibacterial drugs, we selected fosfomycin for further research as it meets the requirements of the studies performed, with more pronounced resistance of B. subtilis 534 (0.25 mg/ml) compared to P. aeruginosa (0.03125 mg/ml). Generalized experimental data indicate that studies of the antibacterial complex based on fosfomycin, CuSO4, and the probiotic strain B. subtilis 534 are the most promising.

Studying the Prevalence of Dissociative Experiences Among Methadone Maintenance Treatment Patients at Different Dosages and its Effect on Addiction Severity Index Subscales

Background: According to “chemical dissociation” hypothesis, is suggested that substance use disorder patients may not experience a high level of dissociation due to substance use, they may experience some level of dissociative-like states. There are few and albeit contradictory reports about prevalence of dissociative experiences among patients with substance use disorder. Objectives: The aim of this study was to consider the dissociative experiences among patients referred to Addiction Treatment Clinic of Baharan Hospital of psychiatry, Zahedan, IR. Methods: In this descriptive cross-sectional study, 231 patients, referred to MMT Clinic of Baharan Psychiatric Hospital in Zahedan, were studied. Sampling was convenient and patients were divided to two groups, including those receiving less than 60 mg of methadone daily (group A) and those receiving equal or more than 60 mg of methadone daily (group B). Dissociative experiences scale (DES) and addiction severity index (ASI) forms were completed. Finally, data were analyzed by using SPSS version 19 and independent t-test. Results: A total of 231 patients participated in this study. Mean age of patients was 33.9 ± 8.0 (P = 0.053). They included 204 males (88.3%) and 27 females (11.7%) (P = 0.328). Total mean DES score was 15.3 ± 11.7. Mean DES scores were 15.6 ± 11.2 in group A and 16.1 ± 11.7% in group B (t (1) = -0.1, P = 0.827). Addiction severity index were 0.74 ± 1.69 in patients with DES scores more than 30 and 0.43 ± 1.51 in patients with DES scores less than 30 (t (1) = 1.1, P value = 0.204). Conclusions: Based on the current study, it can be concluded that different dosages of methadone induce the same chemical dissociation and this has no significant relationship with different areas of ASI.

Schizophrenia and dissociation: Its relation with severity, self-esteem and awareness of illness

This article describes the conclusions of an investigation done with 120 Spanish patients: the finding of a new psychopathological profile within a subgroup of patients suffering from schizophrenia.The patients were evaluated through different questionnaires about sociodemographic data, traumatic events, the severity index (both clinical and psychopathological), self-esteem and consciousness of the illness. From the scores obtained on a scale of dissociative experiences, they were classified into two groups: high dissociative symptomatology or HD, and low dissociative symptomatology or LD.The HD group contained 44 patients (36.7% of the total population). The groups LD and HD show meaningful differences with respect to dissociative symptomatology levels, general psychopathology and level of traumatic events suffered. The percentage of patients with low self-esteem was higher in group HD than in group LD (M=25.52 front 28.76 of group LD; t (118)=2.94, p=.00). In addition, the group HD was more conscious of having a mental disorder, of the beneficial effects of medication and of the social consequences of their illness: F (1)=10.929, p=.001; ƞ2pt=0.083; 1-β=0.907.The results show the existence of a subgroup of schizophrenic patients with higher levels of dissociation and trauma that were related with higher levels of symptomatology, lower self-esteem and higher consciousness of the illness, building a population of higher severity in which it would make sense to implement coadjutant treatments specifically oriented to these variables and, in addition, opening a therapeutic possibility for the patients with refractory schizophrenia.

Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale.

Dissociation is a complex, ubiquitous construct in psychopathology. Symptoms of dissociation are present in a variety of mental disorders and have been connected to higher burden of illness and poorer treatment response, and not only in disorders with high levels of dissociation. This meta-analysis offers a systematic and evidence-based study of the prevalence and distribution of dissociation, as assessed by the Dissociative Experiences Scale, within different categories of mental disorders, and it updates an earlier meta-analysis. More than 1,900 original publications were screened, and 216 were included in the meta-analysis, comprising 15,219 individuals in 19 diagnostic categories. The largest mean dissociation scores were found in dissociative disorders (mean scores >35), followed by posttraumatic stress disorder, borderline personality disorder, and conversion disorder (mean scores >25). Somatic symptom disorder, substance-related and addictive disorders, feeding and eating disorders, schizophrenia, anxiety disorder, OCD, and most affective disorders also showed mean dissociation scores >15. Bipolar disorders yielded the lowest dissociation scores (mean score, 14.8). The findings underline the importance of careful psychopathological assessment of dissociative symptoms in the entire range of mental disorders.

Evaluation of a pilot innovative cognitive-behavioral therapy-based psychoeducation group treatment for functional non-epileptic attacks

A high proportion of patients presenting at epilepsy clinics experience functional non-epileptic attacks (FNEA), and while psychological treatment is generally thought to be the required intervention, evidence regarding psychological treatment of FNEA is limited. A small number of psychoeducation treatments have been evaluated, with promising results. As part of routine care within a neuropsychiatry service, a 3-session cognitive-behavior therapy- (CBT-) informed psychoeducation group was developed. Patients with comorbid epilepsy were included. The group's effectiveness was evaluated in terms of attack frequency, mood, illness perception, dissociative experiences, and patient feedback. Pre- and post-treatment data were obtained for 19 patients. The proportion of patients experiencing attacks significantly decreased, with almost 40% of treatment completers reporting being attack-free at the end of treatment. Significant improvements were also found on level of psychological distress, illness beliefs, and understanding of the condition. No significant changes in mood or general functioning were observed. High satisfaction was reported by almost all patients. Treatment outcome was not significantly affected by the level of dissociative experiences. The results suggest that CBT-based psychoeducation group treatment can be a beneficial part of treatment for those with FNEA, even for those experiencing high levels of dissociation. Further controlled studies with larger sample sizes are required.

Психологические механизмы регуляции социальной идентичности лиц, находящихся в местах лишения свободы

The results of an empirical study of the psychological mechanisms of regulating the social identity of persons in places of confinement are presented. It is established that the regulation of social identity at the level of the structural organization of prisoners, regardless of the gravity of the committed crime, is provided by associative-dissociative mechanisms. In persons who have done harm to life and health of citizens, the discrepancy in the structural organization of identity manifests itself at the level of values of power, achievement, independence, universalism, traditions and security that manifests itself in a premature identity status and is provided with a high level of dissociation. In persons who damaged citizens' property, the discrepancy of the structural organization of identity also manifests itself at the level of the values of power, achievement, independence, security, conformity, and traditions, and manifests itself in the status of premature and diffuse identity and is maintained by a high level of dissociation. The increase in the revealed tendencies is ascertained with increasing gravity of the committed unlawful act.