Academic journal article European Journal of Psychotraumatology

Differences in Trauma History and Psychopathology between PTSD Patients with and without Co-Occurring Dissociative Disorders

Academic journal article European Journal of Psychotraumatology

Differences in Trauma History and Psychopathology between PTSD Patients with and without Co-Occurring Dissociative Disorders

Article excerpt

CLINICAL RESEARCH ARTICLE

Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

Pascal Wabnitz1*, Ursula Gast2 and Claudia Catani1

1Department of Psychology, University of Bielefeld, Bielefeld, Germany; 2Private Praxis, Dammholm, Germany

Abstract

Background : The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD) has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms.

Methods : Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D) to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status.

Results : Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups.

Conclusion : Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

Keywords: Dissociation; dissociative disorders; DDNOS; PTSD; structural dissociation

*Correspondence to: Pascal Wabnitz, Department of Psychology, University of Bielefeld, D-33602 Bielefeld, Germany, Tel: +49 521 106-4491, Fax: +49 521 106-89012, Email: pascal.wabnitz@uni-bielefeld.de

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

Received: 16 May 2013; Revised: 20 October 2013; Accepted: 21 October 2013; Published: 26 November 2013

European Journal of Psychotraumatology 2013. © 2013 Pascal Wabnitz et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported 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 : 21452 - http://dx.doi.org/10.3402/ejpt.v4i0.21452

Since Pierre Janet described the phenomenon of dissociation at the beginning of the 20th century (Janet, 1889), research on dissociation has led to the formulation of comprehensive theories addressing the development of pathological and normal forms of dissociation (for an overview see Dell & O'Neil, 2009). While it has been proposed that the actual link between traumatic stress and dissociation is weak (e.g., Giesbrecht, Lynn, Lilienfeld, & Merckelbach, 2008, 2010), others refute this claim pointing to a clear and persistent association between traumatic stress and dissociation (Bremner, 2010). Until now, the relationship between traumatic stress and dissociation that has been supported by a vast body of literature (e.g., Carlson, Dalenberg, & McDade-Montez, 2012; Nijenhuis & Van der Hart, 2011) remains controversial.

In general, the link between dissociative symptoms and PTSD has been studied in various populations (e.g., Briere, Scott, & Weathers, 2005; Koopman, Classen, & Spiegel, 1994) whereby dissociation has been shown to be a strong predictive factor for PTSD. …

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