Journal of Trauma & Dissociation最新文献

This study aims to assess the mediating effect of childhood trauma and dissociative experiences on the relationship between self-reported ADHD symptoms during childhood and adulthood in two separate cross-sectional studies. In Study 1, undergraduate students completed an online survey including a sociodemographic form, the Adult ADHD Self-Report Scale (ASRS), the Wender Utah Rating Scale (WURS), the Childhood Trauma Questionnaire (CTQ), and the Dissociative Experiences Scale (DES). Data from 1,148 participants were analyzed using descriptive statistics and mediation analysis. In Study 2, sociodemographic, clinical, and diagnostic data from 202 adults with ADHD, followed at the Adult Neurodevelopmental Disorders Clinic at Selçuk University, were analyzed. Diagnostic evaluations were conducted using the Structured Clinical Interview for DSM-5 Clinician Version. Clinical data included age, gender, years of education, comorbid conditions, and current ADHD medication use. The same self-report scales (ASRS, WURS, CTQ, and DES) were administered in both studies. The two samples differed significantly in terms of clinical characteristics and self-reported symptoms. Current ADHD symptoms were not only directly associated with childhood ADHD symptoms but also indirectly associated with them through increased childhood trauma and dissociative experiences, independent of demographic and clinical confounding factors in both studies. The pathway involving childhood trauma and dissociation may partially mediate the persistence of ADHD symptoms from childhood to adulthood in both undergraduate and adult ADHD samples. Longitudinal clinical studies are needed to better understand how the childhood trauma and dissociation pathway may influence the persistence of ADHD symptoms as individuals age, potentially extending into adulthood.

Introduction: Dissociation is a prevalent phenomenon. Existing psychometric tools for measuring dissociation have faced several criticisms. The Dissociation Questionnaire (DIS-Q) is a noteworthy tool but suffers from being lengthy (63 items) and including non-pathological components of dissociation. This study aims to develop a shorter version of the DIS-Q (sDIS-Q) that focuses on the core pathological manifestations of dissociation.

Method: We recruited 511 participants from the non-clinical sample and used archival data from 86 patients with posttraumatic stress disorder (PTSD). They completed the DIS-Q along with other questionnaires assessing related psychological mechanisms (e.g. PTSD, emotion regulation, beliefs about dissociation). Drawing on the expertise of clinicians, we selected items that were more indicative of pathological forms of dissociation.

Results: We identified a two-factor structure of the sDIS-Q. The first factor was associated with perceived detachment, while the second was related to amnesia. The fit indices were satisfactory in both the non-clinical and the clinical sample. We also observed good internal consistency (α=[.89-.91]) and concurrent validity.

Conclusion: The sDIS-Q is a reliable tool that can be used in both clinical and research settings. Its shorter length is beneficial for patients, researchers, and clinicians.

Background: Disaffiliating from an ultra-Orthodox society is a risk factor for psychological distress, depression, and suicide ideation because the process involves encountering culture shock, education gaps, and disconnection from familiar surroundings. Traumatic experiences such as sexual abuse may augment distress among ex-ultra-Orthodox individuals (ex-ULTOIs).

Objective: This study examined the prevalence of past sexual trauma among ex-ULTOIs, and assessed the contribution of experiences of sexual trauma to psychopathology among this population.

Methods: In an online cross-sectional survey among ex-ULTOIs (N = 724, aged 19-54, 47.9% women), anonymously completed questionnaires concerning prior sexual trauma, psychopathology, depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms, and suicide ideation and behavior.

Results: Sexual trauma was reported by 252 (34.8%) of the respondents, of whom 150 (20.7%) reported being sexually assaulted by a family member. Sexual trauma was associated with increased levels of emotional distress, including a higher probability of depression, anxiety, PTSD, and suicide risk.

Conclusions: Sexually traumatic experiences are prevalent among ex-ULTOIs. Sexual trauma was found to be associated with an increased risk of emotional distress and psychopathology. Bearing in mind that this population is, by definition, vulnerable to high levels of emotional distress, the study results highlight the importance of screening for sexual trauma in order to identify and treat ex-ULTOIs who have experienced sexual abuse. Moreover, therapeutic programs specifically focusing on this vulnerable population are warranted.

Childhood traumas such as childhood abuse and neglect are prevalent in Hispanic populations. They have long-term consequences including posttraumatic stress symptoms (PTSS) in adulthood. Treatment options suitable for Hispanic survivors of childhood traumas and neglect are needed. Expressive writing (EW) can be a short, self-administered intervention and may address instrumental barriers (e.g. time, transportation) and stigma toward psychological disorders and interventions Hispanic trauma survivors may experience. Online EW has successfully reduced PTSS when targeting mixed traumas but has not been tested for PTSS from childhood traumas. The current study administered an online EW protocol to symptomatic Hispanic young adults with either childhood trauma or adult trauma. A longitudinal multilevel modeling approach was used to examine the effects of online EW on PTSS at 1-week, 1-month, and 3-month follow-ups. EW reduced PTSS in both groups at 1-week follow-up and therapeutic gains were maintained up to the 3-month follow-up. The current study provides evidence supporting EW as a short-term, self-administered intervention strategy suitable for Hispanic individuals with PTSS due to childhood trauma or adult trauma.

This study examined autobiographical reasoning and three aspects of global coherence (i.e. temporal, causal-motivational, thematic) of life narratives in individuals with dissociative identity disorder (DID) assessed in both adult and child identity states (n = 13), a psychotic disorder (n = 18), general population adults (n = 49) and children (n = 26), and adults simulating being a child (n = 23). DID participants did not significantly differ between identity states in narrative coherence or autobiographical reasoning if additional predictors were included, although differences in causal-motivational coherence were found if total number of memories in the life-narrative was low. Both DID and psychosis groups displayed less temporal and causal-motivational coherence than non-psychiatric adults, with DID adults also showing less thematic coherence. Individuals with DID in child states demonstrated less temporal coherence than non-clinical child-simulators. Individuals with DID may have reduced coherence of narrative identity that does not differ between identities.

Currently, the diagnosis of posttraumatic stress disorder necessitates exposure to a traumatic event as defined by DSM-5-TR Criterion A. Nevertheless, evidence suggests that experiences not meeting Criterion A stressor definitions, specifically related to intimate relationships (e.g., psychological abuse) can also elicit clinically significant posttraumatic stress symptoms (PTSS). However, the literature examining the unique role of non-Criterion A intimate relationship stressors on PTSS is sparse. This systematic review synthesized the literature examining the influence of non-Criterion A intimate relationship stressors on PTSS. Electronic searches of three databases (i.e., PsychInfo, Scopus, and PubMed) identified 3257 articles which underwent title and abstract screening and, if potentially eligible, full-text review. Nine articles met inclusion criteria; four of which examined PTSS after a conflict in a relationship and/or divorce, two studies focused on infidelity, and three studies focused on partner psychological abuse in an intimate relationship. Results revealed that relationship conflict and divorce, infidelity, and psychological abuse can lead to clinically significant PTSS, however, these findings were not consistent across all studies. Findings reveal considerable variability in the frequency and severity of PTSS following non-Criterion A intimate relationship stressors that is in line with the variability found in Criterion A-exposed samples. Nevertheless, given the limited number of studies identified, further research is needed. Understanding the impact of these stressors may have important implications for diagnostic and treatment considerations and will provide valuable insights for our understanding of the PTSD construct in its entirety.

Posttraumatic Stress Disorder (PTSD) is often comorbid with depression in both the general population and among veterans who have experienced combat trauma. However, there is a lack of studies inquiring into the comorbidity of prolonged PTSD and depression. The network paradigm offers a novel approach to studying this comorbidity via bridge symptom analysis. This study explores the bridge symptoms between depression and prolonged/chronic PTSD in patients diagnosed with both conditions, 10 years after trauma exposure, using network analysis. The sample consisted of 60 male, treatment-seeking veterans (aged 31 to 59) with diagnoses of both depression and PTSD. Bridge nodes detected in the present bridge symptom analysis include reduced sleep, inner tension, poor concentration/concentration difficulties, pessimistic and suicidal thoughts, distressing dreams, restricted range of affects, and agitation. The detected bridge nodes could partially be attributed to the characteristics of the sample, which consisted of patients diagnosed with PTSD comorbid with depression.

Importance: Military Sexual Trauma (MST) affects a large number of female veterans and is associated with various adverse physical and mental health conditions. Sexual trauma can lead to pelvic floor dysfunction, contributing to lower urinary tract symptoms (LUTS), a common urological concern, and fecal incontinence (FI). LUTS and FI may have a higher prevalence among female veterans with MST.

Objectives: This study aimed to evaluate the prevalence and treatment of LUTS/FI among female veterans with a history of MST compared to those without.

Study design: A retrospective cohort analysis was conducted using data from the Veterans Health Administration's (VHA) Corporate Data Warehouse. Baseline demographic data, International Classification of Diseases (ICD-9) codes, and medication use were analyzed, with logistic regression models controlling for confounders.

Results: Of the 416,137 female veterans analyzed, 103,877 (25%) reported a history of MST. Veterans with MST were more likely to be diagnosed with LUTS and FI, including a 22% (aOR 1.215; 95% CI 1.133, 1.302) increase in voiding issues and 17% (aOR 1.163; 95% CI 1.132, 1.194) increase in storage difficulties; 26% (aOR 1.260; 95% CI 1.136, 1.397) increase in interstitial cystitis/bladder pain syndrome (IC/BPS), and 34% (aOR 1.338; 95% CI 1.224,1.462) increase in FI. MST was associated with increased odds of undergoing diagnostic procedures for LUTS, such as cystoscopy (aOR 1.221; 95% CI 1.159, 1.287) and urodynamics (aOR 1.241; 95% CI 1.158,1.331). Veterans with MST were 15% more likely to receive pharmacological treatment for overactive bladder (aOR 1.152; 95% CI 1.122, 1.182).

Conclusions: Female veterans with MST have a higher prevalence of LUTS and FI and are more likely to undergo diagnostic and therapeutic interventions.

In this clinical contribution, we describe the application of Dialectical Behavior Therapy (DBT) for managing dissociative symptoms in individuals with posttraumatic stress disorder (PTSD). We examine how DBT, a treatment originally designed for life-threatening behaviors, can be tailored to address the complex needs of PTSD patients with dissociative symptoms. Through clinical vignettes, we illustrate the application of DBT modifications that enhance emotional stabilization, integrate mindfulness, and build distress tolerance to manage dissociative episodes. The vignettes demonstrate both the challenges encountered and the therapeutic breakthroughs achieved. We discuss how integrating DBT into trauma-informed care frameworks can improve emotional regulation and resilience, highlighting the therapy's effectiveness in fostering recovery and emphasizing the importance of personalized treatment strategies for trauma-related dissociation.