Journal of Trauma & Dissociation最新文献

Therapeutic play is a foundational discovery from psychoanalysis and is now a major contribution to child treatment in all its forms. Underacknowledged derivatives from child's play in adult treatments include: the attention to principles of development; the application of nonverbal relational process; utilization of somatic movement; and above all, the therapeutic engagement with child self-states in the full spectrum of dissociative disorders. This case report describes psychoanalytic play with a therapist/analyst who is schooled in principles of trauma treatment and its dissociative manifestations as well as principles of dyadic, countertransferential attentiveness. The treatment mode - child psychoanalysis - allows for a natural integration of other forms of trauma work while still following the child, in all the twists and turns that her treatment illustrates and which both adult and child psychoanalysis privilege so uniquely.

This paper examines the relationship between psychoanalysis and trauma, focusing specifically on dissociation-and, more narrowly, on dissociative multiplicity, the most challenging form for psychoanalysis to address. Dissociative multiplicity involves the presence of more than one center of consciousness, more than one "I," a feature of multiple personality, now called Dissociative Identity Disorder or DID, and OSDD-1, or subthreshold DID. The central question is whether classic psychoanalytic constructs, such as splitting, repression, various triadic views (oedipal, topographic, structural, Fairbairnian, Kohutian), object relations, and attachment theory, can adequately account for dissociative multiplicity. I explain how they cannot, but also how they remain applicable to multiplicity. I conclude with a summary view and reflection on what still needs to occur to reintegrate dissociation into mainstream psychoanalytic theory and practice.

Sandor Ferenczi contributed some of the best formulations of complex trauma and dissociation that exist. No one has described more passionately than Ferenczi the traumatic induction of dissociative trance with its resulting fragmentation of the personality. His concept of identification with the aggressor (which differed significantly from Anna Freud's later concept using the same term) describes how the traumatized child splits/dissociates the perpetrating aspects from the nurturing aspects of the aggressor and internalizes these in separate self-states, enabling the traumatically overwhelmed child to maintain a bond of tenderness with the aggressor. This article applies Ferenczi's concept of identification with the aggressor, along with some of Freud's and Bion's concepts of group dynamics, to the bond with and appeal of authoritarian leaders to their followers. Here, we find both dissociated parts that Ferenczi described operating in tandem, involving an idealization of the aggressor simultaneous with the enactment of aggressor-identified parts.

Despite decades of primary research investigating the nature of dissociation through its relationship with broad personality constructs, the nature of these relationships has remained unclear. Sampling errors, variations in sample size, the measures used, and methodological design have precluded the possibility of obtaining precise estimates of these relationships and, consequently, drawing accurate conclusions. To bring clarity to the dissociation-personality literature, we conducted the first (to our knowledge) systematic review and meta-analyses of relationships between dissociation (including dissociation factors) and personality domains contained within the five-factor model. We included 23 primary studies that provided between 11 and 25 independent effect sizes, depending on the analysis. We coded effect size data, extraneous information for moderator analyses and methodological quality for the included studies. We conducted 20 meta-analyses and found 19 statistically significant dissociation-personality relationships. The five higher-level meta-analyses of dissociation total scores and personality domains contained within the five-factor model indicated the following statistically significant relationships: neuroticism-dissociation total (r = .24), extraversion-dissociation total (r = -.07), openness-dissociation total (r = .10), agreeableness-dissociation total (r = -.15), and conscientiousness-dissociation total (r = -.21). For some variables, participants' clinical status and gender and the dissociation and personality measure used were significant moderators of the dissociation-personality relationship. Findings indicate that dissociation is relatively independent of trait-model personality.

This study explores the relationship between maladaptive daydreaming (MD) and identity shame among individuals with MD. Participants described how MD originated or intensified during periods of distress related to aspects of their identity they felt shame toward, such as sexuality, culture, or disability. They constructed idealized versions of themselves in fantasies and imaginary communities, which provided them with belonging and acceptance. These fantasies seemed to allow participants to process shame without external support. The obsessive nature of MD narratives suggests participants were trapped in an incomplete emotional processing loop. Identity shame may be a core driver in some cases of MD, with fantasies serving as maladaptive coping when authentic identity expression is impeded. We utilized psychoanalytic concepts of projection and dissociation to provide a framework for understanding MD rooted in identity issues.

While recent meta-analyses documented positive correlations between childhood maltreatment severity, on the one hand, and early maladaptive schemas as well as dissociation severity, on the other hand, it is currently unknown whether early maladaptive schemas (partially) explain the association with dissociative reactions. We aimed to explore to which degree dissociative symptoms after prolonged interpersonal eye gazing can be predicted by childhood trauma severity and whether this association is mediated by attachment as well as moderated by emotional reactivity. A sample of n = 243 healthy young adults was assessed for their childhood maltreatment history, early maladaptive schemas and emotional reactivity as well as their dissociative symptoms following the eye gazing task via self-report. Regression analyses indicated that childhood maltreatment severity significantly predicted dissociative symptoms, but that this association was fully mediated by early maladaptive schemas. Moderation analyses indicated that the interaction between early maladaptive schemas and emotional reactivity was statistically significant, but had a small effect size: Subjects with high emotional reactivity and early maladaptive schemas experienced more dissociative symptoms following the interpersonal eye gazing task. In conjunction, the data indicate that the severity of childhood maltreatment is associated with the level of dissociative symptoms following an interpersonal dissociation induction task and that this association is explained by the level of early maladaptive schemas as well as emotional reactivity.

Transgender and nonbinary (i.e. trans) people commonly report dissociation as a survival strategy in hostile sociopolitical contexts, and initial studies have identified childhood trauma, transphobic marginalization, and gender incongruence as potential predictors of trans dissociation. However, more research is needed to establish transtheoretical explanatory factors using an intersectional lens. We thus sought to use an intracategorical complexity intersectional approach to assess whether social categories, general factors (i.e. childhood trauma, fantasy proneness, cognitive failures, sleep disturbance), and trans-specific factors (i.e. transphobic marginalization, gender congruence, gender dysphoria) would be related to dissociation. A cross-sectional online survey was administered to N = 203 trans adults who were diverse in gender, sexuality, SES, disability status, age, and state of residence, but were mostly White (73.4%). More frequent dissociation among trans men, nonbinary, gender non-conforming, younger, lower-SES, and disabled participants suggests important intersections of cissexism with classism and ableism. All general and trans-specific factors were significantly correlated with dissociation at the bivariate level, except for a non-significant trend with gender congruence; general factors explained additional variance in dissociation above social categories, but trans-specific factors did not. More research is needed to explore interactions of general and trans-specific factors, intersectional marginalization, temporal distinctions, and direct assessment of the unique gender dissociation identified in prior qualitative studies. The current findings may inform decolonized, affirming, intersectional marginalization trauma-informed mental health care, as well as social justice advocacy to reduce exposure to childhood trauma and transphobic marginalization in the current sociopolitical climate.

DARVO (Deny, Attack, Reverse Victim and Offender) is a common tactic used by perpetrators of interpersonal violence to deflect blame and responsibility. Individuals' exposure to perpetrator DARVO has previously been measured using the 72-item DARVO Questionnaire (DARVO-LF;). We aimed to identify and validate a short-form version of the original 72-item DARVO Questionnaire. We also sought to expand on DARVO-related knowledge by testing DARVO's associations with trauma symptoms, confrontation type, gender, and marginalized identities. Participants were recruited from online research participation platform Prolific (N = 319) and from a large public university in the American West (N = 261). An exploratory factor analysis identified an 18-item version of the DARVO Questionnaire (DARVO-SF). The DARVO-SF had high internal reliability and was highly correlated with the DARVO-LF. In support of our predictions, analyses revealed the DARVO-SF predicted trauma symptoms after controlling for trauma history. DARVO exposure varied by confrontation type and was higher in confrontations about emotional and psychological mistreatment. Contrary to expectations, we did not find any associations between DARVO exposure and gender or marginalized identities. Overall, the current study identifies a substantially improved DARVO measure and provides novel insight into individuals' experience of this tactic.

Objective: Experiencing trauma is associated with several forms of emotional distress. Although emotional distress has long been expressed in terms of categorical diagnoses, recent research has emphasized the utility of dimensional models of distress. An example of this is the tripartite model, which posits three dimensions of emotional distress: general distress (GD), anxious arousal (AA), and anhedonic depression (AD). One factor associated with problems captured in the tripartite model is mindfulness, which has five facets (observe, describe, acting with awareness, non-judging, and non-reactivity). Research suggests that mindfulness in general is associated with lower levels of emotional distress after experiencing trauma. However, there is less research on how specific facets of mindfulness are associated with specific dimensions of emotional distress or how these facets may affect the association between traumatic experiences and emotional distress.

Methods: In this study, we examined the main and moderating effects of mindfulness on the association between traumatic experiences and GD, AA, and AD in a crowdsourced sample of women and men (N = 317) using a Bayesian approach to multiple regression. Results Results show that traumatic experiences had a positive association and mindfulness had a negative association with each dimension of emotional distress. Results further suggest the observe and describe facets moderated the association between traumatic experiences and AA such that observe exacerbated and describe attenuated trauma's effect on AA.

Conclusion: These findings suggest that labeling anxiety in the context of trauma may be more effective in reducing anxiety than simply noticing it.

This study explores the mental health impact of potentially traumatic events (PTEs) during wartime, focusing on the prevalence and severity of post-traumatic stress disorder (PTSD) and dissociative symptoms among a sample of 1,511 Israeli adults exposed to the recent war. Data were collected during the third month of the Israel-Hamas war. Our findings reveal elevated clinical PTSD symptoms (36.8%) and dissociation (16.3%) across the population, including 17.8% of individuals not directly exposed to trauma who nonetheless reported PTSD symptoms above the clinical threshold. These results challenge the adequacy of DSM-5 Criterion A in ongoing conflict contexts, where indirect exposure can contribute significantly to psychological distress. Furthermore, participants exposed to three or more PTEs demonstrated markedly higher PTSD and dissociative symptoms, emphasizing the cumulative burden of repeated trauma. These findings suggest that clinicians must consider both the number and nature of PTEs when developing treatment plans. Additionally, mental health policies should account for the psychological effects of indirect trauma, particularly in settings of ongoing conflict, where the entire population is at risk. The study highlights the urgent need for tailored interventions that address the complex and enduring mental health challenges associated with both direct and by-proxy trauma exposure.