Magazine article Clinical Psychiatry News

Dissociative Symptoms May Play a Substantial Role in PTSD

Magazine article Clinical Psychiatry News

Dissociative Symptoms May Play a Substantial Role in PTSD

Article excerpt

NEW ORLEANS -- Posttraumatic stress disorder is classified as an anxiety disorder, but data increasingly suggest that it has an important dissociative element, John J. Arnold, Ph.D., said at the annual conference of the International Society for the Study of Dissociation.

"Since its inception as a diagnosis in 1980, PTSD has been classified as an anxiety disorder within the DSM, and dissociative symptoms are not referenced as a defining feature," said Dr. Arnold of Lake Chelan Community Hospital in Chelan, Wash. When dissociative symptoms are studied in association with PTSD, they are subsumed within the context of anxiety and considered to be secondary in nature, he explained.

More recently, with the advent of acute stress disorder as a diagnosis, dissociative symptoms have been recognized as important characteristics of this disorder. They are, however, still classified within the context of an anxiety disorder, he said.

Empirical evidence shows that dissociative symptoms are important in the development and maintenance of PTSD, and some researchers have argued that the reexperiencing and avoidance symptom clusters for PTSD in the DSM represent dissociative processes. Recent theoretical work proposes that PTSD occurs within the context of a trauma-related structural dissociation of personality, with anxiety symptoms occurring within the context of posttraumatic dissociative pathology, he said.

In Dr. Arnold's own study assessing the relationship between dissociation and anxiety in PTSD, dissociative symptoms accounted for significant variance in explaining PTSD severity above and beyond that contributed by anxiety symptoms alone. …

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