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Objective: To the extent that dissociation is a multidimensional phenomenon, and given a growing literature on complex posttraumatic outcomes, we hypothesized a new construct: dissociative complexity (DC). DC is defined as the tendency to simultaneously endorse multiple, relatively independent dissociative dimensions into their clinical ranges, and therefore represents the overall breadth or complexity of an individual's dissociative response., Method: DC was evaluated in general population and prison participants using the Multiscale Dissociation Inventory (MDI; Briere, 2002)., Results: DC was higher among prisoners and women, and, as hypothesized, was associated with cumulative trauma and serious comorbidities (suicidality and substance abuse), even when controlling for generally elevated dissociation., Conclusions: DC appears to be a meaningful clinical construct that is phenomenologically and empirically different from a unidimensional index of dissociative severity. DC may serve as a clinical marker for multiple trauma exposures, complex dissociative outcomes, and risk of problematic comorbidities. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Objective: Despite a number of studies, the reasons for self-injurious behavior (SIB) have yet to be clearly specified. Using path analysis, we sought to test the hypothesis that exposure to adverse events produces depression and posttraumatic stress, which in turn motivate dissociation that, when at high levels, supports the use of SIB., Method: A sample of 679 adults (54% female, mean age = 53 years) were recruited from the general population by a national survey company, and administered measures evaluating posttraumatic stress, depression, dissociation, and SIB., Results: A total of 4.3% of participants reported some level of SIB within the prior 6 months. Younger age, exposure to adverse events, posttraumatic stress, depression, and dissociation were all related to SIB by univariate analyses. Path analyses revealed that although adverse events predicted posttraumatic stress and depression, which were then associated with SIB, these paths to SIB were no longer significant once dissociation was entered into the model, indicating full mediation., Conclusion: Rather than arising directly from posttraumatic stress or depression, SIB may occur most proximally in response to dissociation, with the pain associated with SIB potentially serving to interrupt or titrate unwanted hypoarousal and numbing. Clinicians should consider specifically targeting dissociation and its adversity-related antecedents when treating SIB. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Complex trauma involves multiple exposures to adverse events over the lifespan. Such experiences are associated with a variety of psychological outcomes, including a decreased threshold for the development of posttraumatic stress disorder as well as self-capacity problems and dysfunctional behaviors. Psychological interventions that increase affect regulation, support titrated processing of memories and cognitions, and emphasize the therapeutic relationship seem to be most helpful for complex trauma effects. Pharmacologic treatments have some efficacy in the treatment of the posttraumatic stress components of complex posttraumatic outcomes but are generally less successful in reducing self-related problems and symptoms., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A number of studies suggest that dissociation is reliably related to trauma exposure, and that inadequate regulation of posttraumatic distress may be a significant factor. We examined whether affect dysregulation predicts dissociation in those denying any lifetime exposure to trauma. These relationships were evaluated in a general population sample and a second sample of nontraumatized university students. In the first study, multivariate analyses indicated that, along with gender, affect dysregulation was a relatively strong predictor, accounting for 27% of the variance in dissociation. In the replication study, dissociation was associated with affect dysregulation, but not gender. Affect dysregulation seems to predict dissociative symptomatology in nontraumatized individuals. It is hypothesized that emotional distress, whether from trauma or other etiologies, motivates dissociation to the extent that it challenges the individual's compromised capacity for affect regulation. Treatment implications may include the potential helpfulness of interventions that increase emotion regulation skills.

Although dissociation is often described as a posttraumatic response, the actual statistical association between trauma exposure and dissociative symptoms is surprisingly small. This suggests that that some dissociative phenomena may be unrelated to trauma, or may be related in more complex ways. Analysis of the normative data for the Multiscale Dissociation Inventory revealed significant dissociative symptoms in only 8% of trauma-exposed individuals from the general population. However, 90% of those with at least one clinically significant dissociation scale on the Multiscale Dissociation Inventory reported a trauma history, and significant dissociation was found in only 2% of nontraumatized individuals. A history of interpersonal violence, number of different types of trauma exposure, posttraumatic stress, and affect dysregulation were univariate predictors of dissociative symptomatology in trauma-exposed participants, but only posttraumatic stress and affect dysregulation were multivariate predictors. Trauma is probably an important, but insufficient, condition for the development of dissociative symptomatology. Additional risk factors, such as high posttraumatic stress and/or reduced affect regulation capacities, may determine whether trauma exposure results in clinically significant dissociation.

Objective: Dissociative responses that occur at the time of a trauma (peritraumatic dissociation) have been described as a major risk factor for subsequent posttraumatic stress disorder (PTSD). The current study evaluated peritraumatic dissociation and PTSD from a multivariate perspective, along with a less-investigated phenomenon: trauma-specific dissociation that begins during or after an event and continues until the time of assessment (persistent dissociation)., Method: In two studies, 52 local community participants and 386 participants from the general population with histories of exposure to at least one traumatic event were assessed for the presence of PTSD and were administered measures of dissociation and peritraumatic distress., Results: In both studies, peritraumatic dissociation, persistent dissociation, peritraumatic distress, and generalized dissociative symptoms were associated with PTSD by univariate analyses. However, multivariate analyses in both studies indicated that PTSD status was no longer related to peritraumatic dissociation once other variables (especially persistent and generalized dissociation) were taken into account. In contrast, persistent dissociation was a strong predictor at univariate and multivariate levels., Conclusions: Trauma-related persistent dissociation is a substantial predictor of PTSD, whereas peritraumatic dissociation ceases to predict PTSD at the multivariate level. These findings suggest that it is less what happens at the time of a trauma (e.g., disrupted encoding) that predicts PTSD than what occurs thereafter (i.e., persistent avoidance).

The dimensionality of dissociation was examined in a combined sample of 1,326 general population, clinical, and university participants who completed the Multiscale Dissociation Inventory (MDI). Principal components analysis identified five moderately intercorrelated factors (mean r = .39): Disengagement, Identity Dissociation, Emotional Constriction, Memory Disturbance, and Depersonalization/Derealization. Differential relationships were found between individual MDI factors and demographics, trauma history, clinical status, posttraumatic stress, and scores on other dissociation measures. Surprisingly, after controlling for sex and age, trauma exposure accounted for only 3 to 7% of the variance in MDI factors. The notion of dissociation as a general trait was not supported. Instead, dissociation may represent a variety of phenomenologically distinct and only moderately related symptom clusters whose ultimate commonality is more theoretical than empirical.

M. R. Nash, T. L. Hulsey, M. C. Sexton, T. L. Harralson, and W. Lambert (1993) reported on the effects of controlling for family environment when studying sexual abuse sequelae. Sexual abuse history was associated with elevated Minnesota Multiphasic Personality Inventory and Rorschach scores in a sample of 105 women, but many of the reported differences disappeared when a Family Functioning Scale score was used as a covariate. The present article considers the findings of Nash et al. in terms of the theoretical and statistical constraints placed on analysis of covariance and other partializing procedures. Because family dysfunction is not always causally antecedent to sexual abuse, and given the quasi-experimental quality of most abuse research, the use of covariate techniques to test hypotheses about the causal role of family environment in the impacts of sexual abuse may be ill advised. Analyses of a 2,964-subject data set illustrate these concerns.

A 13-item Dissociation scale is introduced, and preliminary data regarding its reliability are presented. Designed to complement the Symptom Checklist (SCL-90; Derogatis, Lipman, & Covi, 1973) and the Hopkins Symptom Checklist (HSCL; Derogatis, Lipman, Rickels, Ulenhuth, & Covi, 1974), this scale may be especially useful in research on the effects of psychological trauma.

Self-mutilation, examined in samples of the general population, clinical groups, and self-identified self-mutilators, was reported by 4% of the general and 21% of the clinical sample, and was equally prevalent among males and females. Results suggest that such behavior is used to decrease dissociation, emotional distress, and posttraumatic symptoms. Childhood sexual abuse was associated with self-mutilation in both clinical and nonclinical samples. [ABSTRACT FROM AUTHOR]