Academic journal article European Journal of Psychotraumatology

The Shutdown Dissociation Scale (Shut-D)

Academic journal article European Journal of Psychotraumatology

The Shutdown Dissociation Scale (Shut-D)

Article excerpt

Responsible Editor: Julian D. Ford, University of Connecticut Health Center, US.

Copyright: © 2015 Inga Schalinski et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

Received: 7 August 2014; Revised: 16 April 2015; Accepted: 18 April 2015; Published: 13 May 2015

Competing interests and funding: There is no conflict of interest in the present study for any of the authors. The Deutsche Forschungsgemeinschaft (DFG) and the European Refugee Fund as well as the University of Konstanz funded the studies.

*Correspondence to: Inga Schalinski, Department of Psychology, University of Konstanz, P.O. Box 905, DE-78457 Konstanz, Germany, Email: inga.schalinski@uni-konstanz.de

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Based on the defense cascade model, we developed the Shutdown Dissociation Scale (Shut-D; Schauer & Elbert, 2010), which is able to meet the new requirements for assessing the expression of derealization and depersonalization as a consequence of shutting down emotions, sensations, cognitions, and as a result behavior that would be suboptimal for surviving certain threats. The DSM-5 defines a dissociative subtype of posttraumatic stress disorder (PTSD) recognizing that those patients exhibit additional symptoms of primarily depersonalization and derealization (Friedman, Resick, Bryant, & Brewin, 2011; Lanius, Brand, Vermetten, Frewen, & Spiegel, 2012). To support the subtype hypothesis, it is necessary to describe the symptom profiles and differentiating factors. More research is needed to clarify whether dissociative symptoms occur in a distinct PTSD subgroup with a high symptom severity and distinct neurobiological profile or whether there is a dissociative continuum within the PTSD (Dalenberg & Carlon, 2012). Similar to the concept of shutdown dissociation, the DSM-5 committee links the dissociation to an overwhelming experience that may arise when the individual is confronted with an overwhelming threat with perceived inescapability, such as childhood sexual abuse, torture, or war trauma (American Psychiatric Association, 2013). Being confronted with an imminent life-threat, for which flight-or-fight is no longer a viable option to counter danger, the organism may shift to immobility and dissociative responding. To escape the threatening situation as well as the internal distress and arousal, dissociative responding may be adaptive. The defense cascade model by Schauer and Elbert (2010) considers the corresponding shutdown dissociation as a progression on the defense cascade that enhances survival (Bracha, 2004; Bradley, Codispoti, Cuthbert, & Lang, 2001; Lang, Bradley, & Cuthbert, 1998; Table 1).

Table 1 . Assumed survival advantage of the shutdown continuum according to Schauer and Elbert (2010) in order to inhibit non-adaptive action disposition and enable survival

[Table omitted; see PDF]

The defense cascade model

In life-threatening situations, the ongoing perceptual and behavioral processes would initially be interrupted, followed by enhanced sensory perception towards the threatening stimulus (Graham & Clifton, 1966; Sokolov, 1963). If the stimulus is threatening, then the sympathetic branch of the autonomous nervous system becomes dominant and the release of sympathetic mediated adrenalin is initiated. …

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