Journal of Trauma & Dissociation最新文献

Pathological dissociation is characterized by disruptions in consciousness, memory, identity, perception, and affect, often linked to trauma and observed across various psychiatric conditions. Previous reviews do not fully cover key biological correlates used as biomarkers and do not clearly define the trauma-dissociation link. Therefore, this systematic review gives an overview of the studies on biomarkers research of the most relevant findings in associations between dissociative disorders and biological correlates. Additionally, it seeks to explore potential links between specific trauma types and recurrent biomarkers. A total of 123 studies were included, highlighting the role of increased prefrontal cortex activation and reduced hippocampal volume as potential biomarkers for pathological dissociation. Altered connectivity in the limbic system, frequently tied to childhood trauma, further underscores the neurobiological basis of dissociative symptoms. Biochemical and genetic studies, while promising, present inconsistent results and require further validation. This review underscores the importance of identifying reliable biomarkers to improve diagnostic accuracy, inform personalized treatment strategies, and monitor therapeutic responses. Future research should aim to unify methodologies and explore novel approaches to enhance clinical applications.

Dissociative symptoms constitute a transdiagnostic phenomenon not only characterizing dissociative disorders but also occurring across a broad range of other mental disorders such as posttraumatic stress disorder or borderline personality disorder. In the latter disorders, dissociative symptoms such as depersonalization, derealization, or gaps in awareness significantly burden patients' wellbeing and functioning. Many efforts have been undertaken to better understand these debilitating symptoms. However, empirical findings have not yet converged in many areas (e.g., considering neurobiological correlates or effects of dissociative psychopathology on treatment outcome), which might partially be due to the heterogeneity and limitations of employed methodology. Here, we critically review the current state-of-the-art methodology in dissociation research, comparing methods to assess dissociative symptoms, provoke dissociative symptoms in the laboratory, select the participant sample, and consider critical sample characteristics. Discussing the informative value and limits of various standard and novel methodological approaches, we aim to provide information and nuanced guidance for future research. By these means, we aim to raise and harmonize standards in dissociation research and enable researchers of all career stages to enter, navigate, and make a significant and lasting contribution to research on dissociative symptoms in a broad range of mental disorders, ultimately contributing to a better understanding of dissociative psychopathology.

How survivors label a nonconsensual sexual experience (i.e. sexual assault labeling) has been linked to posttraumatic stress symptoms (PTSS), but past cross-sectional research has been unable to determine the direction of this relation. To inform support approaches following sexual assault, we examined how sexual assault labeling and PTSS were related over time. We also examined the contextual factor of pre-assault trust in the perpetrator on these relations. Participants were 609 college student sexual assault survivors (aged 19 to 25) who completed an initial online survey and were invited to a follow-up survey 1 to 2 months later. When controlling for individual and assault-specific covariates, results of a cross-lagged panel model indicated that greater sexual assault labeling was associated with subsequent elevations in PTSS, and heightened PTSS was associated with subsequent increases in sexual assault labeling. Moreover, pre-assault trust in the perpetrator was a significant moderator. Specifically, participants who reported greater (vs. weaker) pre-assault trust demonstrated more stability in labeling between timepoints, stronger associations between labeling and later PTSS, and weaker relations between PTSS and later labeling. Findings supported a prospective, bidirectional relation between sexual assault labeling and PTSS and underscored the importance of pre-assault trust in the perpetrator, which may make such labeling uniquely distressing. Informal and formal support providers should be prepared for the distress that may be associated with using a sexual assault label, particularly when survivors trusted the perpetrator before the assault.

Internal moderation is theorized as a regulatory mental mechanism that mitigates the impact of incongruent stimuli by generating a calibrated internal response. The aim of this study was to develop a standardized self-report instrument designed to measure an individual's current level of internal moderation. An initial version of the Internal Moderation Questionnaire (IMQ), the Dissociative Experiences Scale (DES), the Difficulties in Emotion Regulation Scale (DERS), and the Childhood Trauma Questionnaire (CTQ-33) were applied to 329 college students. A test-retest evaluation was conducted on a separate group of 50 college students with two administrations in a 7-day interval. Reliability and validity analyses yielded a 24-item final version of the questionnaire with excellent internal consistency. The IMQ demonstrated strong to moderate correlations with DES and DERS total scores, while its association with CTQ-33 total scores was rather minimal. In principal components analysis, a three-factor solution yielded the "dual," "on," and "off" modes of internal moderation. Higher scores on these modes, and in particular the dual mode score, which represented the largest proportion of the total variance, and the sum of the on and off scores were associated with higher disturbance overall, while the difference between them was not. This preliminary study supported the validity and reliability of the IMQ in a self-referred non-clinical sample of young adults. Further studies on larger, diverse, and clinical samples should identify its significance in detection of prodromal risk syndromes, assessment of treatment response, forensic evaluations, prediction of self-destruction and impulsivity, and decision-making in uncertain conditions.

Women with posttraumatic stress disorder (PTSD) often report problems with sexuality. Relationship dimensions and psychological dimensions of sexuality seem to be impaired. We examined whether trauma focused therapies improve relationship and psychological dimensions of sexuality. In a randomized controlled trial that took part between 2014 and 2016 in Germany, N = 193 cisgender women with PTSD after child abuse (mean age = 36.3 years) completed the Multidimensional Sexuality Questionnaire, assessing psychological dimensions of sexuality and the Resources in Sexuality and Partnership, assessing relationship dimensions of sexuality. PTSD was assessed via Clinician Administered PTSD Scale for DSM-5. Assessments took part in the beginning and after Dialectical Behavior Therapy for PTSD or Cognitive Processing Therapy. Using hierarchical linear modeling, changes in psychological and relationship dimensions of sexuality from beginning to post treatment were assessed, also the association between PTSD symptom reduction and reduction in psychological and relationship dimensions. From beginning to post treatment, relationship dimensions of sexuality improved (p < .01; Cohen's d = .36). PTSD symptom reduction moderated this effect. The psychological dimension sexual satisfaction increased (p < .05; Cohen's d = .32), sexual anxiety (p < .001; Cohen's d = ‒.51) and sexual depression (p < .001; Cohen's d = ‒.44) decreased. PTSD symptom reduction moderated these effects. Sexual esteem and sexual motivation did not change after therapy. Our results suggest that relationship dimensions and some psychological dimensions of sexuality can improve after trauma focused therapy. Other psychological dimensions like sexual esteem might need specific therapeutic interventions to improve.

The current investigation consists of two studies aimed at validating an Arabic version of the Maternal Disintegrative Responses Scale (A-MDRS), designed to evaluate maternal intrusive thoughts and dissociative experiences during early caregiving. The participants consisted of Arab mothers in Israel within 12 months post-childbirth. Study 1 (n = 243) assessed the factorial structure and reliability of the scale, and its correlation with maternal background variables. Study 2 (n = 195) further explored its factorial structure and reliability, as well as its construct validity, by examining associations with postpartum depression, maternal role satisfaction, and psychological flexibility. Confirmatory factor analyses in both studies supported a two-factor solution, demonstrating good reliability. In addition, Study 2 revealed a positive correlation between the A-MDRS factors and postnatal depression, and a negative association with maternal role satisfaction and psychological flexibility. The findings endorse the A-MDRS's value in identifying maternal disintegrative responses during the postpartum period, affirming its factorial structure and reliability.

Schizoid personality disorder (SPD) is among the most enduring forms of personality pathology. Research suggests that one factor associated with schizoid pathology is childhood maltreatment, although it is unclear which specific experiences of childhood maltreatment may be most impactful. In this study, we examined associations between different experiences of childhood maltreatment (e.g. physical, emotional, and sexual abuse, and physical and emotional neglect) and schizoid pathology in a sample of men and women recruited online (N = 327) using a Bayesian approach to structural equation modeling. Results suggest that emotional neglect had the strongest association with schizoid pathology over and above other forms of maltreatment and other traumatic life events. Findings further indicate that emotional and physical neglect as well as other negative life events are associated with schizoid pathology in men but only emotional abuse is associated with schizoid pathology for women. These findings provide support for the influence of childhood maltreatment on schizoid pathology and have implications for future research and clinical intervention.

Caregivers involved in child maltreatment investigations depend on the child protection system to safeguard their child from harm. Given this dependence, Institutional Betrayal (IB) may be a useful framework to characterize caregivers' experiences with child protection. However, research has yet to examine IB in the child protection system. The current study sought to understand whether caregiver report experiences that are consistent with key characteristics of IB identified in other systems, such as sexual assault investigations. Caregivers of children involved in child maltreatment investigations (n = 32) were asked open-ended questions. Through content analysis, we identified examples and counterexamples of four key characteristics of IB: exclusion, discrimination, invalidation, and inaction. Caregivers described exclusion from the process (e.g. through uncertainty about their role), discrimination (e.g. through perceptions that socioeconomic factors influenced investigation outcomes), invalidation (e.g. through victim-blaming), and inaction on the part of system personnel (e.g. through lack of follow-through on promised steps). Participants also provided counterexamples to each characteristic. All participants highlighted the importance of communication in experiences of IB. Utilizing caregiver feedback to address IB is crucial for enhancing caregiver engagement and supporting the child protection system's goals of promoting child and family well-being.

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.