Skip to main content
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 8/2016

11.05.2016 | Original Paper

Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?

verfasst von: Maj Hansen, Jana Műllerová, Ask Elklit, Cherie Armour

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Abstract

Introduction

For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victims with PTSD.

Purpose and method

This study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared with a non-dissociative PTSD class.

Results

The results of LCA revealed a two-class solution with two highly symptomatic classes: a dissociative class and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVAs) suffering from whiplash.

Conclusions

The results are discussed in light of their clinical implications and suggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.
Literatur
1.
6.
Zurück zum Zitat American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th edn. American Psychiatric Association, Washington DC American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th edn. American Psychiatric Association, Washington DC
7.
Zurück zum Zitat American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington DC American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington DC
8.
Zurück zum Zitat Armour C, Elklit A, Lauterbach D, Elhai JD (2014) The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims? J Anxiety Disord 28:418–426. doi:10.1016/j.janxdis.2013.12.008 CrossRefPubMed Armour C, Elklit A, Lauterbach D, Elhai JD (2014) The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims? J Anxiety Disord 28:418–426. doi:10.​1016/​j.​janxdis.​2013.​12.​008 CrossRefPubMed
9.
11.
Zurück zum Zitat Frewen PA, Brown MFD, Steuwe C, Lanius RA (2015) Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype. Eur J Psychotraumatol 6:26406. doi:10.3402/ejpt.v6.26406 PubMed Frewen PA, Brown MFD, Steuwe C, Lanius RA (2015) Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype. Eur J Psychotraumatol 6:26406. doi:10.​3402/​ejpt.​v6.​26406 PubMed
12.
Zurück zum Zitat Steuwe C, Lanius RA, Frewen PA (2012) Evidence for a dissociative subtype of PTSD by latent profile and confirmatory factor analyses in a civilian sample. Depress Anxiety 29:689–700. doi:10.1002/da.21944 CrossRefPubMed Steuwe C, Lanius RA, Frewen PA (2012) Evidence for a dissociative subtype of PTSD by latent profile and confirmatory factor analyses in a civilian sample. Depress Anxiety 29:689–700. doi:10.​1002/​da.​21944 CrossRefPubMed
13.
14.
Zurück zum Zitat Wolf EJ, Miller MW, Reardon AF, Ryabchenko KA, Castillo D, Freund R (2012) A latent class analysis of dissociation and posttraumatic stress disorder evidence for a dissociative subtype. Arch Gen Psychiatr 69:698–705CrossRefPubMedPubMedCentral Wolf EJ, Miller MW, Reardon AF, Ryabchenko KA, Castillo D, Freund R (2012) A latent class analysis of dissociation and posttraumatic stress disorder evidence for a dissociative subtype. Arch Gen Psychiatr 69:698–705CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP (2013) The PTSD checklist for DSM-5 (PCL-5). Scale available from the national center for PTSD. http://www.ptsd.va.gov. Accessed May 25 2015 Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP (2013) The PTSD checklist for DSM-5 (PCL-5). Scale available from the national center for PTSD. http://​www.​ptsd.​va.​gov. Accessed May 25 2015
19.
23.
Zurück zum Zitat Fraley RC, Fazzari DA, Bonanno GA, Dekel S (2006) Attachment and psychological adaptation in high exposure survivors of the September 11th attack on the World Trade Center. Pers Soc Psychol B 32:538–551. doi:10.1177/0146167205282741 CrossRef Fraley RC, Fazzari DA, Bonanno GA, Dekel S (2006) Attachment and psychological adaptation in high exposure survivors of the September 11th attack on the World Trade Center. Pers Soc Psychol B 32:538–551. doi:10.​1177/​0146167205282741​ CrossRef
24.
Zurück zum Zitat Hansen M, Elklit A (2014) Who develops posttraumatic stress symptoms following bank robbery? In: Simmons JP (ed) Banking: performance, challenges and prospects for development. Nova Science Publishers Inc, Hauppauge Hansen M, Elklit A (2014) Who develops posttraumatic stress symptoms following bank robbery? In: Simmons JP (ed) Banking: performance, challenges and prospects for development. Nova Science Publishers Inc, Hauppauge
25.
Zurück zum Zitat Simeon D, Greenberg J, Nelson D, Schmeidler J, Hollander E (2005) Dissociation and posttraumatic stress 1 year after the world trade center disaster: follow-up of a longitudinal survey. J Clin Psychiatr 66:231–237. doi:10.4088/JCP.v66n0212 CrossRef Simeon D, Greenberg J, Nelson D, Schmeidler J, Hollander E (2005) Dissociation and posttraumatic stress 1 year after the world trade center disaster: follow-up of a longitudinal survey. J Clin Psychiatr 66:231–237. doi:10.​4088/​JCP.​v66n0212 CrossRef
28.
Zurück zum Zitat Elklit A, Christiansen DM, Palic S, Karsberg S, Eriksen SB (2014) Impact of traumatic events on posttraumatic stress disorder among Danish survivors of sexual abuse in childhood. J Child Sex Abuse 23:918–934. doi:10.1080/10538712.2014.964440 CrossRef Elklit A, Christiansen DM, Palic S, Karsberg S, Eriksen SB (2014) Impact of traumatic events on posttraumatic stress disorder among Danish survivors of sexual abuse in childhood. J Child Sex Abuse 23:918–934. doi:10.​1080/​10538712.​2014.​964440 CrossRef
29.
30.
Zurück zum Zitat Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J (1992) Harvard Trauma Questionnaire. J Nerv Ment Dis 180:111–116CrossRefPubMed Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J (1992) Harvard Trauma Questionnaire. J Nerv Ment Dis 180:111–116CrossRefPubMed
32.
Zurück zum Zitat Elklit A (1990) Måling af belastninger efter voldeligt overfald med TSC-33 traume symptom checkliste [Measuring distress after violent assault with TSC-33]. Nordisk Psykologi 42:281–289CrossRef Elklit A (1990) Måling af belastninger efter voldeligt overfald med TSC-33 traume symptom checkliste [Measuring distress after violent assault with TSC-33]. Nordisk Psykologi 42:281–289CrossRef
33.
Zurück zum Zitat Bach M (2003) En empirisk belysning og analyse af “Emotionel Numbing” som eventuel selvstændig faktor i PTSD [An empirical illumination and analysis of emotional numbing as an independent factor in PTSD]. Psykologisk studieskriftserie 6:1–199 Bach M (2003) En empirisk belysning og analyse af “Emotionel Numbing” som eventuel selvstændig faktor i PTSD [An empirical illumination and analysis of emotional numbing as an independent factor in PTSD]. Psykologisk studieskriftserie 6:1–199
40.
Zurück zum Zitat Nylund K, Asparouhov T, Muthén BO (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: a monte-carlo simulation study. Struct Equ Model 14:535–569CrossRef Nylund K, Asparouhov T, Muthén BO (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: a monte-carlo simulation study. Struct Equ Model 14:535–569CrossRef
41.
Zurück zum Zitat Nylund K, Bellmore A, Nishina A, Graham S (2007) Subtypes, severity, and structural stability of peer victimization: what does latent class analysis say? Child Dev 78:1706–1722CrossRefPubMed Nylund K, Bellmore A, Nishina A, Graham S (2007) Subtypes, severity, and structural stability of peer victimization: what does latent class analysis say? Child Dev 78:1706–1722CrossRefPubMed
43.
Zurück zum Zitat Raftery AE (1995) Bayesian model selection in social research. Sociol Methodol 25:111–163CrossRef Raftery AE (1995) Bayesian model selection in social research. Sociol Methodol 25:111–163CrossRef
44.
45.
Zurück zum Zitat Muthén LK, Muthén BO (2013) Mplus user’s guide, 7th ed. Muthén & Muthén, Los Angeles Muthén LK, Muthén BO (2013) Mplus user’s guide, 7th ed. Muthén & Muthén, Los Angeles
46.
Zurück zum Zitat Miller MW, Wolf EJ, Kilpatrick D, Resnick H, Marx B, Friedman MJ (2013) The prevalence and latent structure of proposed DSM–5 posttraumatic stress disorder symptoms in US national and veteran samples. Psychol Trauma Theory Res Pract and Policy 5:501–512. doi:10.1037/a0029730 CrossRef Miller MW, Wolf EJ, Kilpatrick D, Resnick H, Marx B, Friedman MJ (2013) The prevalence and latent structure of proposed DSM–5 posttraumatic stress disorder symptoms in US national and veteran samples. Psychol Trauma Theory Res Pract and Policy 5:501–512. doi:10.​1037/​a0029730 CrossRef
49.
Zurück zum Zitat Christiansen D, Elklit A (2012) Sex differences in PTSD. In: Ovuga E (ed) Posttraumatic stress disorder in a global context. In Tech: open access book, pp 113–142 Christiansen D, Elklit A (2012) Sex differences in PTSD. In: Ovuga E (ed) Posttraumatic stress disorder in a global context. In Tech: open access book, pp 113–142
50.
Zurück zum Zitat Wolf EJ, Lunney C, Schnurr PP (2016) The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members. J Consult Clin Psychol 84:95–100. doi:10.1037/ccp0000036 CrossRefPubMed Wolf EJ, Lunney C, Schnurr PP (2016) The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members. J Consult Clin Psychol 84:95–100. doi:10.​1037/​ccp0000036 CrossRefPubMed
52.
Zurück zum Zitat Elklit A, Hyland P, Shevlin M (2014) Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. Eur J Psychotraumatol. doi:10.3402/ejpt.v5.24221 Elklit A, Hyland P, Shevlin M (2014) Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. Eur J Psychotraumatol. doi:10.​3402/​ejpt.​v5.​24221
53.
Zurück zum Zitat Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A (2013) Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol. doi:10.3402/ejpt.v4i0.20706 Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A (2013) Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol. doi:10.​3402/​ejpt.​v4i0.​20706
Metadaten
Titel
Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?
verfasst von
Maj Hansen
Jana Műllerová
Ask Elklit
Cherie Armour
Publikationsdatum
11.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 8/2016
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-016-1235-2

Weitere Artikel der Ausgabe 8/2016

Social Psychiatry and Psychiatric Epidemiology 8/2016 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.