Journal of Trauma & Dissociation最新文献

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.

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.

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.

Sexual assault has been repeatedly associated with multiple types of psychological distress, including posttraumatic stress. Post-assault outcomes are frequently linked to individual psychological processes (e.g. cognitions, behaviors) that are targeted in common psychotherapies, yet contextual factors (e.g. relationships, institutional factors) also play important roles in distress. Using a socioecological approach, this study examined how contextual factors such as institutional betrayal cross-sectionally predict posttraumatic stress in a sample of campus sexual assault survivors who enrolled at a large, public university in the Pacific Northwest of the United States and who disclosed their assault to another person (N = 245). Results indicated that multiple contextual factors outside of the individual (e.g. relationship with perpetrator, reactions to disclosure, institutional betrayal) were significantly associated with posttraumatic stress (r's = .27-.51) and explained significant unique variance in posttraumatic stress in regression analyses. These associations remained even after controlling for self-blame cognitions and avoidance coping behaviors - two individual-level factors frequently addressed by evidence-based treatments for posttraumatic stress. Such results highlight a need for psychological and public health interventions that target higher levels of the social ecology, such as relational or institutional interventions.

Survivors of abuse, such as intimate partner violence (IPV), may experience a range of mental health difficulties. A new theory introduces a harmful and often overlooked aspect of abuse: doubt regarding abuse-related appraisals (DARA). This concept refers to survivors' uncertainty about their assessments of the abuse, their own experiences during the abuse, and their perpetrator. According to this view, DARA not only deepens survivors' confusion but also hinders the healing process, increasing their vulnerability to trauma-related symptoms. This study aimed to explore these ideas by examining (1) the relationships between DARA and trauma-related symptoms following IPV, and (2) the contribution of DARA in explaining trauma-related symptoms beyond childhood abuse history, degree of IPV exposure, length of the abusive relationship, and IPV status. An online survey was conducted among a convenience sample of female adults. The sample consisted of 378 women aged 19-60 years (M = 35.50, SD = 8.64) who reported experiencing IPV and provided data on the study variables. Trauma-related symptoms, DARA, childhood abuse history, and IPV characteristics (degree of IPV exposure, length of the abusive relationship, and IPV status) were assessed through self-report measures. The results revealed significant associations between DARA and trauma-related symptoms. Furthermore, analyses indicated that DARA uniquely explained trauma-related symptoms beyond childhood abuse history, degree of IPV exposure, length of the abusive relationship, and IPV status. The current findings support the DARA theory and highlight the need for clinical interventions aimed at reducing DARA to alleviate trauma-related distress in survivors.

Dissociative identity disorder (DID) is a childhood-onset posttraumatic biopsychosocial syndrome characterized by identity alteration symptoms in which one loses a sense of agency and ownership over some thoughts, feelings, memories, and behaviors. There is limited investigation of sociodemographic variability related to DID prevalence. Further, there is limited assessment of symptoms in non-clinical samples that may shed light on potential dissociative phenotypes in the general population. We utilized a large citizen science online data collection platform to collect self-report symptoms of dissociative identity disorder among self-selected adults in the general population. Participants (N = 5,589) provided demographic information and completed the Multiscale Dissociation Inventory self-report assessment (MDI). We completed general linear models to investigate associations between race, gender, and geographic location with a provisional self-report DID diagnosis and MDI identity dissociation scores. In general, individuals from marginalized racial groups had higher provisional DID prevalence rates and more severe identity dissociation symptoms compared to White individuals. Genderqueer individuals reported higher rates of provisional DID compared to men and women, and men reported higher rates compared to women. We also observed significant differences in the prevalence of DID symptoms across geographic regions. These novel results suggest that race, gender, and geographic location are linked to variation in rates of provisional DID diagnosis and identity alteration symptom severity. Marginalized groups with potentially the highest rates of DID are underrepresented in current research. Future work should explore contributing factors to these sociodemographic differences to develop effective prevention and treatment strategies for specific groups.

Contemporary approaches to trauma tend to minimize or even overlook a psychodynamic perspective to treatment. The challenge for the clinician is sensing when such interventions might help or hurt. This chapter illustrates this dilemma by drawing upon the author's experience, both personal and professional, in arriving at some basic principles. The synthesis of his experience on an inpatient dissociative disorders unit with his long-term analytic work in the outpatient setting is a treatment model, Psychoactive Psychotherapy. It is a six stage, transference-based approach, addressing the autohypnotic nature of dissociation as a defense. Integration of the compartmentalized self-states (alters) is facilitated through the delineation of the "mosaic transference" and the therapist's capacity for containment.

Sándor Ferenczi's contribution recognizes the relevant interpersonal aspects and intersubjective dialogue as central to psychoanalytic theory and clinical practice. Through his theoretical, clinical and technical studies, he has developed numerous notions in relation to trauma, the effects of its disavowal and its impact exceeding the victim's capacity for understanding and symbolization. After about 50 years of forced oblivion, Ferenczi's thought has regained full recognition since 1990s among the wider psychoanalytic and clinical community in general. Authors analyze Ferenczi's fundamental intuitions on the "confusion of tongues" and trauma, dissociative, and defensive processes, understood as a dysfunctional interpersonal process that undermines the capacity to make sense of experience. Consequently, healing can only occur through new and functional relational experiences within a sincere and affective therapeutic relationship. The latter, moreover, is seen as an exercise in reflective thinking in the form of participatory dialogue that helps the patient to develop, trust, reflective capacity and to integrate his personality.