Correlates of dissociative symptomatology in patients with physical and sexual abuse histories

doi:10.1016/0010-440X(93)90008-R

Comprehensive Psychiatry

Volume 34, Issue 4, July–August 1993, Pages 258-263

https://doi.org/10.1016/0010-440X(93)90008-R Get rights and content

Abstract

Recent studies have demonstrated a high prevalence of sexual and physical abuse histories and high levels of dissociative symptoms in psychiatric inpatients. We examined whether severity, frequency, and age of onset of abuse correlated with subjects' levels of dissociative symptoms. Sixty-four women reporting a lifetime history of physical and/or sexual abuse were recruited from consecutive admissions to three wards of a psychiatric hospital. Subjects completed the Life Experiences Questionnaire (LEQ) and the Dissociative Experiences Scale (DES). Subjects' self-reports of severity, frequency, and age of onset of abuse were analyzed for correlations with DES score. More invasive sexual abuse was associated with more dissociation. Higher-frequency physical abuse was associated with more dissociation, but no conclusion could be drawn about the impact of frequent sexual abuse due to missing data. An inverse correlation was found between age of onset of abuse and degree of dissociative symptomatology. These preliminary findings are consistent with hypotheses linking more severe, more chronic, and earlier abuse to the greater development of dissociative symptoms. The findings further emphasize the importance of recognizing dissociative symptoms in the clinical setting, and of continued study into the effects of childhood trauma.

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Turkish adaptation of the scale of dissociative activities
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Citation Excerpt :
In particular, dissociation is often related to physical or sexual abuse, usually experienced during childhood (Mulder et al., 1998). Accordingly, clinical studies indicate that the tendency to develop high levels of dissociative symptoms is related to more chronic childhood abuses (Chu & Dill, 1990; Kirby et al., 1993); as such, it follows that childhood traumas are positively related to dissociative activities. Furthermore, interpersonal and institutional abuse are both related to dissociation and physical health (Smith & Freyd, 2017).
Dissociation refers to detachment, absorption, amnesia, and compartmentalization. It may work as a defense mechanism against stress and traumatic experiences. It can even take the form of forgetting or daydreaming to shift the focus away from daily experiences. A metric to quantify dissociative behaviors greatly aids in determining when these transition into pathological.
Therefore, this study aims to translate and adapt a scale of dissociative activities (Mayer & Farmer, 2003) into Turkish.
Toward this end, a sample of university students and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used.
According to EFA, subcategories of dissociation loaded to both factors, so one dimensional structure of the scale was deemed to solve cross-loading of subcategories. CFA provided valid evidence to one dimensional structure of the scale, Chi² (527) = 1398.39, p < 0.05, comparative fit index (CFI) = 0.96, standardized root mean square residual (SRMR) = 0.067, the root mean square error of approximation (RMSEA) = 0.10, 90% CI for RMSEA [0.097, 0.11]). The Cronbach alpha for the scale was 0.96 for the first (N = 178) and second (N = 216) data sets. Convergent validity was also determined for the translated version of this scale.
The findings from these analyses indicated that the Turkish version of the scale of dissociative activities had a one-factor structure and seemed to be reliable and valid among Turkish university students. This newly adapted scale should facilitate the diagnosis and comparative studies concerning the tendency or symptoms of dissociation.
The Manifestations and Correlates of Dissociation amongst Looked-After Children in Middle Childhood
2022, European Journal of Trauma and Dissociation
Citation Excerpt :
Though they may be moderating variables, previous research suggests that neither age, gender, intelligence, nor genetic factors significantly influence the development of dissociative symptoms (Putnam, 1997; Waller & Ross, 1997). Environmental factors are therefore thought to be critical and, since the late 19th century, trauma has been regarded as playing a decisive role in the etiology of dissociation (Brand et al., 2018; Breuer & Freud, 1893; Janet, 1889, 1907/1910). Trauma may be defined as a psychological injury incurred through terrifying or otherwise overwhelming experiences.
To explore the manifestations and correlates of dissociation amongst a sample of primary school-aged children looked-after children (LAC) in the care of their local authority.
In part one, the Child Dissociative Checklist (CDC), Strengths and Difficulties Questionnaire (SDQ) and Relationship Problems Questionnaire (RPQ) were administered to 91 primary school-aged LAC under the care of Five Rivers (an independent fostering agency). Variables pertaining to participants’ background and placement history were examined in relation to CDC scores. In part two, a subsample of children (n=34) with identified psychosocial difficulties were administered the Story Stems Assessment Procedure (SSAP). Relationships between dissociative symptoms and SSAP constructs were explored using Spearman's correlation and K-means clustering.
Part 1. Forty-one LAC (45%) scored on or above the CDC's clinical threshold suggestive of sustained pathological dissociation. Children who had experienced sexual abuse were more likely than others to display dissociative behaviours, as were children placed alone compared to those placed with a related sibling. Total CDC scores were positively correlated with SDQ total difficulties, and RPQ disinhibited and inhibited subscores. Part 2. Dissociative symptoms were negatively correlated with features of attachment security and positive parent representations in children's narratives. Three clusters were identified in the dataset: two groups showed clinically significant levels of dissociation but differed with respect to their representations.
Children who have suffered maltreatment are at high risk of pathological dissociation, especially those who have experienced sexual abuse. Placing LAC with their siblings may mitigate against dissociative symptoms. Dissociation covaries with psychosocial problems, yet dissociative children are a heterogenous group. High levels of dissociation may be accompanied by the relative absence of positive or negative attachment representations, or by the dominance of negative representations, including features of disorganisation.
Why are there lasting effects from exposure to stress during development? An analysis of current models of early stress
2016, Physiology and Behavior
Citation Excerpt :
Dissociation is posited to allow children to bond with abusive caregivers and mentally escape trauma when physical escape is not possible [83]. Data on the prevalence of dissociation in response to trauma in childhood are scarce, but Kirby et al. [129] showed that 85% of adult female psychiatric patients abused before age 14 exhibited high levels of dissociation and Zlotnick et al. [271] found dissociation to be the primary coping method for females exposed to multiple sexual abusers as children. The relationship between dissociation and attention is complex and dependent upon developmental stage, but in children dissociation is negatively correlated with attention (in relation to cognitive inhibition) and dissociation may actually bias attention away from threats [14,49,62,84,124].
The potential for stressful experiences in early life to cause lasting changes in phenotype is well documented, but the functional and evolutionary context of these changes is not well understood. Many hypotheses have been proposed to explain the role of lasting effects of stress exposure during gestation and early development; the purpose of this review is to discuss these hypotheses in the context of human and non-human animal research in the last three decades in order to (i) further dialogues between those approaching early stress from biomedical and evolutionary/ecological perspectives, (ii) outline strengths and limitations of current hypotheses, with respect to species and context-specific effects of exposure to stress in early development, and (iii) address recent evidence suggesting that stress in early development can have beneficial effects in adulthood. It is suggested that the hypotheses discussed are not mutually exclusive, but the applicability of each hypothesis will depend upon the environmental conditions and stability a species, or perhaps even an individual, experiences in their lifetime. Potential investigations to clarify applications of the current hypotheses are discussed, including longitudinal studies that span multiple developmental stages and investigations of species where measures of fitness are possible.
Dissociation in victims of childhood abuse or neglect: A meta-Analytic review
2018, Psychological Medicine
Unraveling the Complexity: Exploring the Intersection of Panic Disorder, Dissociation, and Complex Post-Traumatic Stress Disorder
2024, Behavioral Sciences
Using Quantitative and Qualitative Rorschach Data within a Multi-Method, Forensic Assessment of Dissociative Posttraumatic Stress Disorder
2023, Psychological Injury and Law

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: Presented in part at the 145th Annual Meeting of the American Psychiatric Association, May 2–7, 1992, Washington, DC, and at the Ninth International Conference on Multiple Personality and Dissociative States, November 11–15, 1992, Chicago, IL.

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Correlates of dissociative symptomatology in patients with physical and sexual abuse histories

Abstract

Psychosomatics

Compr Psychiatry

Childhood sexual and physical abuse as factors in adult psychiatric illness

Am J Psychiatry

Dissociative symptoms in relation to childhood physical and sexual abuse

Am J Psychiatry

Childhood trauma in borderline personality disorder

Am J Psychiatry

The incest experience and its aftermath

Victimology

Father-Daughter Incest

The persisting negative effects of incest

Psychiatry

Long-term effects of incestuous abuse in childhood

Am J Psychiatry

Frequency and correlates of childhood sexual and physical abuse histories in adult female borderline inpatients

Am J Psychiatry

The clinical phenomenology of multiple personality disorder: review of 100 recent cases

J Clin Psychiatry

Dissociation as a response to extreme trauma

An update on multiple personality disorder

Hosp Community Psychiatry

The psychological consequences of overwhelming life experiences