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A suvey of board-certified psychiatrists concerning attitudes toward the dissociative disorders diagnoses in the DSM-IV is discussed.

Objective: This study investigated the relationship between self-reported childhood abuse and dissociative symptoms and amnesia. The presence or absence of corroboration of recovered memories of childhood abuse was also studied. Method: Participants were 90 female patients admitted to a unit specializing in the treatment of trauma-related disorders. Participants completed instruments that measured dissociative symptoms and elicited details concerning childhood physical abuse, sexual abuse, and witnessing abuse. Participants also underwent a structured interview that asked about amnesia for traumatic experiences, the circumstances of recovered memory, the role of suggestion in recovered memories, and independent corroboration of the memories. Results: Participants reporting any type of childhood abuse demonstrated elevated levels of dissociative symptoms that were significantly higher than those in subjects not reporting abuse. Higher dissociative symptoms were correlated with early age at onset of physical and sexual abuse and more frequent sexual abuse. A substantial proportion of participants with all types of abuse reported partial or complete amnesia for abuse memories. For physical and sexual abuse, early age at onset was correlated with greater levels of amnesia. Participants who reported recovering memories of abuse generally recalled these experiences while at home, alone, or with family or friends. Although some participants were in treatment at the time, very few were in therapy sessions during their first memory recovery. Suggestion was generally denied as a factor in memory recovery. A majority of participants were able to find strong corroboration of their recovered memories. Conclusions: Childhood abuse, particularly chronic abuse beginning at early ages, is related to the development of high levels of dissociative symptoms including amnesia for abuse memories. This study strongly suggests that psychotherapy usually is not associated with memory recovery and that independent corroboration of recovered memories of abuse is often present.

There is a clearly demonstrated relationship between psychiatric disorders and early trauma, specifically, physical and sexual abuse in childhood. Furthermore, the development of dissociative disorders has been associated with prior trauma. The dissociative defense develops as a psychological escape and later often gives rise to a constellation of other symptoms. It is proposed that there is a greater prevalence of dissociative symptoms among adult female psychiatric inpatients who were abused in childhood than among similar patients who were not abused. Ninety-eight women between the ages of 18 and 60 years old who were admitted to a psychiatric unit were evaluated. The women were predominantly middle-class and white. Self-report instruments were used which focused on history of trauma, dissociative symptoms, and other previous psychiatric problems. A majority of the group, 63 percent, reported either physical and/or sexual abuse in childhood. Twenty-three patients reported both physical and sexual abuse; 27 reported physical abuse only; and 12 reported sexual abuse only. Dissociative symptom scores which exceeded the average for normal adults were found in 83 percent of the subjects. Twenty-four percent of the subjects also had scores which exceeded the average score of patients with post-traumatic stress disorder. These results confirm previous studies that have associated childhood physical and sexual abuse with the development of psychiatric disorders, which constitutes a major public health problem. It is concluded that the prevalence of dissociative symptoms has been underestimated, and more attention should be focused upon screening for these symptoms. As many times these episodes of childhood abuse are denied or concealed, the therapist must explore the possibility of this type of history in patients with appropriate symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)