Journal of Trauma & Dissociation最新文献

An increasing number of studies have been investigating the co-occurrence of posttraumatic symptoms and dissociation in trauma-exposed samples. As traumatized refugees are particularly susceptible to developing posttraumatic stress disorder (PTSD), the aim of this study was to investigate the relationship between PTSD and dissociation in a traumatized refugee sample. Cross-sectional data from a clinical refugee sample (N = 526) were collected. Latent class analysis (LCA) examined different classes of PTSD, based on the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) items. Subsequently, it was examined whether cumulative trauma, sexual trauma and general psychopathology predicted class membership. The LCA identified five classes. The classes were summarized as (1) "High PTSD," (2) "Moderate PTSD," (3) "High PTSD with high loss of interest," (4) "High PTSD with moderate loss of interest," and (5) "PTSD-DS." PTSD DS (10% of the sample) was characterized by high PTSD symptoms, as well as high depersonalization and derealization symptoms. The majority (61.4%) of this group has been exposed to sexual trauma. Overall endorsement of PTSD symptoms was extremely high in this clinical sample of refugees. A group evidencing the PTSD dissociative subtype was identified.

Numerous studies have shown the detrimental effects of childhood trauma on individuals' psychological functioning. This study examined the relation from childhood traumatic experiences to dissociation, life satisfaction, and attitude toward seeking psychological help while additionally shedding light on the possible mediating role of emotion regulation and basic psychological needs based on the framework of Self-Determination Theory (SDT). Using a cross-sectional design, data were collected from 489 Italian young adults (Mage = 23.63, SDage = 3.53, 68.7% female) through an online survey. Findings indicated positive associations between childhood trauma and emotion dysregulation, suppression, need frustration, and dissociation. In contrast, negative associations were found with emotion integration, need satisfaction, life satisfaction, and attitude toward seeking psychological help. Structural equation modeling analysis supported the hypothesized indirect associations, suggesting that childhood trauma is indirectly associated with 1) higher levels of dissociation through increased emotion dysregulation, emotion suppression, and need frustration; 2) lower life satisfaction via higher emotion dysregulation and need frustration, as well as diminished need satisfaction and emotion integration; and 3) less positive attitude toward seeking psychological help by elevated emotion suppression and reduced emotion integration. These findings validate SDT as a potent framework for understanding the nuanced pathways from childhood trauma to adult psychological functioning, providing the groundwork for intervention development and a pathway for further exploration with clinical populations.

The abusive and/or neglectful relational mis-attunement disrupts ongoing developmental growth and binds attachments to abusive caregivers. This shame-based relational frame then becomes a template for subsequent relationships and self-definitions. Shame and dissociation combine to provide a paradoxical and powerful self-protective form of self-regulation via a dis-enlivened existence that enables people with DID to live with otherwise potentially dysregulating affects and relationships. Shame-activated defenses and extreme inhibition of feeling couple with dissociative compartmentalization to limit affective awareness and enable the wounded individual to hide from the life around them and within them.

Personality pathology is a common and debilitating problem for many, and among the factors associated with personality pathology is trauma. Recent research on the association between personality pathology and trauma has highlighted the role of trauma perpetrated by a person whom the victim trusts and/or relies upon for support (i.e., betrayal trauma). There is an increasing number of studies on the association between betrayal trauma and a range of different forms of personality pathology, although neither these studies nor the more general bodies of the literature on which they draw (i.e., in both trauma and personality pathology) have been meaningfully integrated. The goals of this paper are threefold. We first review relevant theories and research on trauma (definition, diagnosis, and different typologies, including betrayal trauma) and personality pathology (conceptualization, risk factors). Second, we review and integrate research on the association between betrayal trauma and different forms of personality pathology (e.g. antisocial/psychopathic, borderline, histrionic, narcissistic, obsessive-compulsive, schizoid, and schizotypal). Finally, we use this integration to suggest directions for future research on and clinical application with respect to the intersection of betrayal trauma and personality pathology.

Exposure to multiple adverse childhood experiences (ACEs) is a risk factor for the development and increase in somatization symptoms among adolescents. Defense mechanisms and dissociation may play a key role in the association between these variables. The aim of the study was to analyze the indirect association between direct and indirect exposure to ACEs with somatization symptoms through defense mechanisms and dissociation symptoms in Faroese adolescents. The sample consisted of 687 Faroese adolescents, who completed validated self-report questionnaires that assessed the variables under study. Serial multiple mediation models were tested by conducting a structural equation modeling employing Preacher and Hayes' procedures (2008). Results showed that both direct and indirect exposure to multiple types of ACEs was indirectly related to somatization symptoms through immature defenses and dissociation symptoms. Indirect exposure to multiple types of ACEs was also indirectly related to somatization symptoms through neurotic defenses and dissociation symptoms. It was also observed that indirect exposure to multiple types of ACEs was indirectly related to somatization symptoms through immature and neurotic defense mechanisms. The results suggest the central role of both defense mechanisms and dissociation symptoms in the association between direct and indirect exposure to multiple types of ACEs and somatization symptoms in Faroese adolescents.

Poor sleep quality has been linked to both poor psychological and physical well-being. Mood and anxiety levels are affected by poor quality sleep, and the relationship between these variables appears to be mediated by a tendency to depersonalize or not. This study examines these relationships in 112 Adults (Female = 82, Male = 30), via an online study. The Pittsburgh Sleep Quality Index, Patient Health Questionnaire4, Cambridge Depersonalization Scale-9, and Patient Health Questionnaire-15 were administered using the Gorilla platform. The following variables were analyzed using correlation statistics, and mediation analyses: sleep quality, anxiety, depression, somatic pain, and depersonalization. Poor sleep quality was associated with higher levels of all psychological variables. As predicted, depersonalization mediated the relationship between sleep quality and anxiety, depression and somatic concerns. The findings indicate that sleep quality and the mediating effect of depersonalization have a significant impact on psychological well-being in adults.

This pilot study aimed to understand the moderating role of context processing (i.e. encoding and memorizing) when mothers are confronted with threatening stimuli and undergo physiologic monitoring in order to understand a possible mechanism favoring intergenerational transmission of posttraumatic stress. Thirty-one mothers (M age = 33.87 years, SD = 4.14) and their toddlers (M age = 22.66 months, SD = 7.01) participated in the study. Mothers reported adverse life events (ALE), their current posttraumatic stress symptoms (PTSS), as well as regulatory problems of their toddler. Mothers performed a context-encoding and -memory (CEM) task including emotional facial expressions (especially angry faces considered as threatening stimuli) embedded into photo-backgrounds, after which they were asked to recognize both the faces and contexts. Maternal heart rate variability (HRV) was measured during resting state. Maternal current PTSS, but not ALE, had impact on child dysregulation only for mothers with poor context processing (β = 0.014, p = .017). Baseline HRV was negatively correlated with the recognition of contexts previously associated with angry faces (ρ = -.53, p = .006), and marginally with the recognition of angry faces (ρ = -.37, p = .059). This pilot study identifies psychophysiological markers (i.e. CEM, HRV) that may influence the intergenerational transmission of posttraumatic stress. This may open new avenues in early identification and intervention with traumatized mothers and their toddlers.

Purpose: Trauma disorders are prevalent and confer high rates of psychiatric comorbidity and functional impairment. Women are more likely to be affected by trauma disorders; however, rates and symptom burden in women's inpatient psychiatric units remains understudied. We hypothesized the prevalence of probable posttraumatic stress disorder (PTSD) would be higher among women admitted to a women's inpatient unit compared to women in the general population and mixed gender units. We evaluated demographic and clinical characteristics associated with probable PTSD diagnosis.

Methods: Screening for probable PTSD diagnosis was performed using the PTSD Checklist for DSM-5 (PCL-5) questionnaire. Descriptive statistics were completed to determine demographic and clinical characteristics associated with a probable PTSD diagnosis. Logistic regression was performed to assess the adjusted associations between covariates and probable PTSD.

Results: We identified 262 patients, including 192 (73.3%) with probable PTSD. Individuals with probable PTSD had higher rates of previous suicide attempt (69.8% versus 34.3%; p < .001), previous psychiatric hospitalization (73.4% vs 60.0%; p = .04), and comorbid mood disorder (76.6% versus 54.3%; p < .001). Formally diagnosed PTSD by the time of hospital discharge was observed in 70 (36.5%) of the women with probable PTSD. Logistic regression demonstrated that a previous suicide attempt and mood disorder increased the odds of probable PTSD.

Conclusions: These findings illuminate the high prevalence of probable PTSD on a women's psychiatric unit, supporting the need for increased screening and tailored treatment. Focusing on trauma-related symptoms could help alleviate patient suffering and improve treatment effectiveness.

The startle eyeblink reflex is thought to function as a means of orienting to salient stimuli, and, by proxy, sensitivity to threat cues. The absence or attenuation of this reflex may thus suggest disengagement from one's environment, potentially in circumstances when engagement is called for, and, therefore, may serve as a potential marker for dissociation as it occurs. The present study investigates whether individual differences in startle response magnitude and habituation are attributable to early and multiple trauma exposure, dissociation, and PTSD symptom severity. Fifty-four Black college students with at least one traumatic event completed self-report measures of trauma exposure, PTSD symptoms, and in-task dissociation, and underwent a standard acoustic startle task. Startle data were analyzed for quadratic trauma feature (symptoms/exposure) by time interactions in order to detect nonlinear decreases in reactivity. Participants with earlier trauma (before age 6) and greater in-task dissociation showed significantly decreased startle reactivity, but neither multiple trauma exposures nor PTSD were related to startle reactivity. Contrary to expectations of solely exaggerated startle reactivity, the group with early life trauma exposure and dissociative experiences had attenuated startle reactivity compared to their peers with later-onset exposure and lower dissociation. Data are consistent with the existing literature on DSM-5 Dissociative subtype of PTSD, and supports the notion that some symptomatic individuals may in fact benefit from greater engagement with their environments, which may counter a notion of habituation to stressors as a primary therapeutic goal.