Academic journal article European Journal of Psychotraumatology

The Expectancy of Threat and Peritraumatic Dissociation

Academic journal article European Journal of Psychotraumatology

The Expectancy of Threat and Peritraumatic Dissociation

Article excerpt

SHORT COMMUNICATION

The expectancy of threat and peritraumatic dissociation

Pamela McDonald1, Richard A. Bryant1*, Derrick Silove1, Mark Creamer2, Meaghan O'Donnell2 and Alexander C. McFarlane3

1School of Psychology, University of New South Wales, Kensington, New South Wales, Australia; 2Australian Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, Victoria, Australia; 3Department of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia

Abstract

Background : Peritraumatic dissociation is one of the most critical acute responses to a traumatic experience, partly because it predicts subsequent posttraumatic stress disorder. Despite this, there is little understanding about the factors that influence peritraumatic dissociation. This study investigated the extent to which peritraumatic dissociation is predicted by the amount of perceived warning that participants had of the impact of the trauma.

Method : Randomized eligible admissions to four major trauma hospitals (N =243) were assessed during hospital admission with the Peritraumatic Dissociation Experiences Questionnaire (PDEQ) and the perceived warning that participants had before the trauma impact occurred.

Results : Whereas female gender predicted both Awareness and Derealization subscale scores on the PDEQ, perceived warning also predicted scores on the Derealization subscale.

Conclusions : This finding suggests that the degree of anticipated threat may contribute to peritraumatic dissociation.

Keywords: dissociation; peritraumatic; Derealization; trauma

*Correspondence to: Richard A. Bryant, School of Psychology, University of New South Wales, NSW, 2052, Australia, Tel: +61 2 9385 3640, Fax: +61 2 9385 3641, Email: r.bryant@unsw.edu.au

For the abstract or full text in other languages, please see Supplementary files under Article Tools online

Received: 12 May 2013; Revised: 9 July 2013; Accepted: 5 September 2013; Published: 13 December 2013

European Journal of Psychotraumatology 2013. © 2013 Pamela McDonald et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Citation: European Journal of Psychotraumatology 2013, 4: 21426 - http://dx.doi.org/10.3402/ejpt.v4i0.21426

Peritraumatic dissociation potentially involves disturbed awareness, impaired memory, or altered perceptions during and immediately after a traumatic experience (Cardeña & Spiegel, 1993). These responses are very common in the immediate aftermath of trauma, with common reports of emotional numbing, reduction in awareness of one's surroundings, depersonalization, and amnesia (Cardeña & Spiegel, 1993; Feinstein, 1989). One of the major reasons much attention has focused on peritraumatic dissociation has been the strong relationship it has with subsequent posttraumatic stress disorder (PTSD). Numerous studies have reported that peritraumatic dissociation is a strong predictor of PTSD (Ehlers, Mayou, & Bryant, 1998; Koopman, Classen, & Spiegel, 1994; Murray, Ehlers, & Mayou, 2002; Shalev, Freedman, Peri, Brandes, & Sahar, 1997), although the relationship appears to be complex (Breh & Seidler, 2007; Velden et al., 2006). It was largely on the basis of this evidence that DSM-IV defined the diagnosis of acute stress disorder, which placed considerable emphasis on dissociative symptoms (Harvey & Bryant, 2002).

There is limited understanding about the factors that lead to peritraumatic dissociation (Bryant, 2007). Most models of peritraumatic dissociation build on the historical notion derived from the work of Janet (1907) that dissociation allows traumatic memories to be split from awareness and thereby to minimize distress. …

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