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Objectives: Extensive research has shown voice hearing to be associated with symptoms of Post‐Traumatic Stress Disorder (PTSD) and dissociation. However, most studies have adopted a quantitative design, using cross‐sectional data sampling methods, precluding temporal relationships between variables from being defined. Design: Using a qualitative design, this study sought to identify potential symptom relationships by addressing the research question: what is the nature of the temporal relationship between voices, dissociation and PTSD symptoms? Methods: Seven voice hearers (aged 27 to 68 years) participated in a semi‐structured interview exploring voice hearing, PTSD symptoms, and dissociation. The interviews were analysed using Interpretative Phenomenological Analysis. Results: One superordinate theme was identified in the data. Voices were observed to occur in dynamic interrelationship with PTSD symptoms and dissociation, and were frequently experienced before and after PTSD symptoms and dissociative episodes. Conclusions: Implications for theoretical understandings of voice hearing and future research are discussed. [ABSTRACT FROM AUTHOR]

Background: A range of traumas have been linked to voices (auditory verbal hallucinations) and unusual perceptual experiences (UPEs) in other perceptual‐sensory domains. Models of PTSD and positive symptoms of psychosis are insufficient in explaining the relationship between trauma and voices. The trauma‐related voices (TRV) model was developed to generate novel research in this area. Aims: This study aimed to investigate pathways from trauma to the frequency of UPEs based on a subset of hypothesised relationships in the TRV model. Materials: The PTSD Diagnostic Scale for DSM‐5, State Adult Attachment Measure, Depression Anxiety and Stress Scales‐21, Perth Emotion and Regulation Competency Inventory, Dissociative Experiences Measure Oxford, and Multi‐modality Unusual Perceptual Experiences Questionnaire. Methods: We used path analysis in a non‐clinical sample (N = 528) to model indirect effects from diverse trauma experiences to the frequency of multi‐sensory UPEs via a subset of mediators within the TRV model: insecure attachment, emotion regulation deficits, negative affect and dissociation. Results: Our model was an excellent fit to the data and accounted for 37.1% of variance in UPE frequency, and all direct (βs =.14–.61) and indirect pathways (βs =.01–.08) were significant (ps <.001). Discussion: Our findings suggest that insecure attachment may link diverse trauma experiences to emotion regulation deficits and negative affect, which are linked to UPE frequency via dissociation. Conclusion: Our findings provide preliminary evidence for a subset of relationships within the TRV model. Future studies are needed to gather stronger evidence of temporality and causation between these factors, and to test broader pathways within the TRV model. [ABSTRACT FROM AUTHOR]

Objectives: Auditory hallucinations (such as hearing voices) are common in clinical and non‐clinical populations. Many people who hear voices also report early adversity and have an insecure attachment style. Current cognitive models suggest that dissociation mediates an association between disorganised attachment and auditory hallucinations, but this has not been tested experimentally. Design: We recruited a non‐clinical analogue sample highly predisposed to auditory hallucinations and utilised an experimental design to examine the impact of disorganised attachment imagery on hallucinatory experiences, and whether dissociation mediates an expected association. Methods: Participants completed self‐report measures of state auditory hallucinations and dissociation before and after random allocation to secure or disorganised attachment conditions. Results: Attachment imagery did not affect auditory hallucinations. Both secure and disorganised attachment conditions increased state dissociation. Secure attachment imagery reduced paranoia, but state dissociation did not mediate this effect. An exploratory analysis found that trait dissociation fully accounted for the association between trait‐disorganised attachment and hallucinatory experience while controlling for paranoia. Conclusions: Secure attachment imagery reduces paranoia but not auditory hallucinations and the impact on paranoia is not mediated by dissociation. Secure attachment imagery may be useful in reducing fears and distress associated with voices, rather than the frequency or severity of hallucinations. Disorganised attachment may increase hallucinatory experiences for people vulnerable to dissociation. Trait dissociation should be assessed in clinical settings and addressed where indicated as a means of targeting vulnerability to distressing voices. [ABSTRACT FROM AUTHOR]

Complex post-traumatic stress disorder (CPTSD) has recently been recognized as an official psychiatric diagnosis in ICD-11, after years of research and advocacy in the field. It has been suggested that dissociative symptoms are a major feature of CPTSD. This scoping review aimed to summarize the existing knowledge base on the relationship between dissociation and CPTSD, and to identify relevant research gaps. We searched the two largest and most widely used academic databases (i.e., the Web of Science and Scopus databases) and the ProQuest database and identified original studies published in English relevant to our research questions, namely: (1) Would CPTSD be associated with dissociative symptoms? 2) How common are dissociative symptoms among people with CPTSD? (3) What are the correlates of dissociative symptoms among people with CPTSD? In all, 26 studies were included. We found 10 studies which reported that people with CPTSD scored significantly higher on a dissociation measure than those without CPTSD, and 11 studies reported a positive correlation between CPTSD symptoms and psychoform/somatoform dissociation scores. While very few studies reported the prevalence and correlates of dissociative symptoms among people with CPTSD, there may be a considerable subgroup of people with CPTSD who have clinically significant levels of dissociative symptoms (e.g., 28.6–76.9%). Dissociation may also be associated with other comorbidities (e.g., DSM-IV Axis II features, shame, somatic symptoms) in people with CPTSD. We recommend that more studies are needed to investigate the prevalence of dissociative symptoms among people with CPTSD and examine how these symptoms are associated with other comorbid conditions and clinical needs in this vulnerable group. [ABSTRACT FROM AUTHOR]

Dissociative disorders (DD) are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity. Transient dissociative episodes are a common phenomenon during childhood that generally decrease during adolescence to relatively low levels in adults. There is strong evidence that traumatic events play a key role in the development of dissociation, but non-abusive and genetic factors are also considered. In the article, we discuss a few complementary theoretical models of the origin of DD that view them from attachment theory, affect theory, or developmental perspectives. Diagnosing DD among children is especially hard because of their frequent co-occurrence with other disorders, their broad differential diagnosis spectrum, and the fact that symptoms may be unnoticed for a long time. Treatment guidelines are mainly based on experts’ opinions, so appropriate studies on children are necessary.

BackgroundAlthough numerous studies have supported the role of childhood maltreatment in the etiology of psychosis, underlying mechanisms have not been well understood yet. The present study aimed to investigate the mediating role of particular forms of dissociation in the relationship between five major types of childhood abuse and psychotic symptoms among patients with schizophrenia spectrum and other psychotic disorders.MethodsIn this cross-sectional correlation study, 70 first-episode psychotic patients and 70 chronic psychotic patients were selected by systematic random sampling (with the sampling interval of 3) from among inpatients and outpatients referring to Baharan Psychiatric hospital, Zahedan, Iran, and were matched based on age, gender, and education level. Moreover, 70 age-, gender-, and education level-matched community controls were recruited from hospital staff and their relatives and friends. All of the participants completed a research interview and questionnaires. Data on experiences of childhood maltreatment, psychosis, dissociation, and demographics were collected and analyzed by SPSS V25 software.ResultsThe obtained results revealed that the mean scores of sexual abuse, emotional abuse, and physical abuse were higher in psychotic patients than community controls (without any significant difference between first-episode psychotic patients and chronic psychotic patients). Furthermore, the highest mean scores of dissociative experiences belonged to chronic psychotic patients. Multiple-mediation also indicated that absorption and dissociative amnesia played a mediating role in the relationship between sexual abuse and positive symptoms. Moreover, this study demonstrated the role of physical abuse in predicting psychotic symptoms even in the absence of sexual abuse.ConclusionsThis study illustrated specific associations among childhood maltreatment, dissociative experiences, and psychotic symptoms in the clinical population. Thus, to provide appropriate interventions, patients with schizophrenia spectrum and other psychotic disorders were asked about a wide range of possible adverse childhood experiences and dissociative experiences. Nevertheless, further studies using prospective or longitudinal designs need to be carried out to realize the differential contribution of various forms of childhood maltreatment and their potential interactions, more precisely.

This article provides a commentary on a case report about schema therapy for Dissociative Identity Disorder (DID). The authors acknowledge the importance of studying this diagnosis but express concerns about the treatment approach and the accuracy of the case report. They emphasize the need for more detailed information and further research on the treatment of DID. Additionally, the article discusses cannabis-induced depersonalization-derealization disorder, a condition where individuals feel detached from themselves and their surroundings after using cannabis. The authors explore the symptoms, prevalence, and potential causes of this disorder, emphasizing the need for more research in this area. This article offers valuable insights for library patrons interested in understanding the psychological effects of cannabis use. [Extracted from the article]

Introduction When warfighters are unable to fight, they are formally removed from battle through temporary or permanent duty limitation profiles. This study uses a population-based data repository to characterize permanent behavioral health (BH)–related profiles across the army for an identified 2-year period. The absolute risk of a permanent duty limitation for specific BH categories was also examined. Materials and Methods This study utilized a retrospective population-based design to identify all new BH diagnoses across the U.S. Army. Service members identified as having a new BH diagnosis were tracked for 12 months following the diagnosis to determine the recommendation of a permanent duty limitation profile. Results From 2017 to 2018, 16% (n  = 102,440) of service members received a "new" BH diagnosis. Less than 10% (9.5%; n  = 9,752) of soldiers diagnosed with a BH disorder were issued a permanent BH-related duty profile within 12 months of the initial diagnosis. The absolute risk of a permanent profile was highest for soldiers diagnosed with a psychotic or delusional disorder (42%; n  = 324) followed by dissociative or somatoform disorders (26%; n  = 178) and eating disorders (23%; n  = 108). Conclusions Military regulations dictating medical readiness and retention standards reflect both the standards required for mission readiness and a layer of medical protection for the service member. This study provides important information on the relationship between a new BH diagnosis and the likelihood that a service member will be referred for a retirement evaluation. [ABSTRACT FROM AUTHOR]

Recent diagnostic developments suggest that paranoia is a transdiagnostic characteristic common to several personality disorders rather than a personality disorder per se. Nonetheless, empirical literature fails to provide comprehensive and univocal findings on whether and how paranoid presentations relate to different personality disorders. In the present scoping review, we map the empirical literature on paranoid presentations in personality disorders, considering the entire spectrum of paranoid manifestations (i.e., the paranoia hierarchy). In selecting original quantitative studies on paranoid presentations in personality‐disordered patients, we screened 4,433 records in PsycArticles, PsycInfo and PUBMED. We eventually included 47 eligible studies in the review. Our synthesis indicates consistent empirical evidence of a wide range of paranoid presentations in Paranoid, Schizotypal and Borderline personality disorders. Conversely, little empirical literature exists on paranoid presentations in other personality disorders. Preliminary findings suggest broad‐severity paranoid presentations, ranging from milder to severe forms, in Paranoid, Schizotypal and Borderline personality disorders. There is also some evidence of milder forms of paranoia in Avoidant, Antisocial and Narcissistic personality disorders. Conversely, there is poor evidence of paranoid presentations in Schizoid, Histrionic, Dependent or Obsessive‐compulsive personality disorders. Research gaps and recommendations for improving empirical research on paranoid presentations in personality disorders are discussed. [ABSTRACT FROM AUTHOR]

Objective: The schema mode model offers a new conceptualisation of complex dissociative disorders (CDD) as it explains shifts between identities as shifts between schema modes. Furthermore, in this model CDD is conceived as personality pathology, incorporating core features of personality disorders. This study tested the assumptions of this schema mode model of CDD. Method: Questionnaires measuring personality disorder traits, schemas, schema modes and coping styles were filled out by patients with CDD, borderline personality disorder and avoidant personality disorder (N = 210), and their scores on the various constructs were compared. Results: Participants with CDD were characterised by specific schizoid, schizotypal, borderline and avoidant personality traits and early maladaptive schemas in the domains of disconnection and rejection and over‐vigilance and inhibition. The most pronounced schema modes were the dysfunctional parent modes, avoidant coping modes and the vulnerable child mode. For coping styles, no differences were found between the diagnostic groups. Conclusion and discussion: On all outcome measures participants with CDD scored at the level of personality disorders and showed a unique pattern different from participants with borderline and avoidant personality disorder. This suggests that CDD shows features akin to a personality disorder. A clinical implication is that an adapted form of schema therapy might present a viable treatment option for CDD. [ABSTRACT FROM AUTHOR]

Dissociative amnesia is controversial. We tested other factors that could contribute to an inability to remember an important aspect of a traumatic event: how traumatic the event was, organic amnesia, dissociative state, childhood amnesia, expression suppression, sleep disturbance, repeated experiences, and ordinary forgetting. Trauma survivors who reported an inability to remember an important aspect of a traumatic event rated the event as traumatic as trauma survivors who reported no such inability to remember. Moreover, all cases of an inability to remember an important aspect of the traumatic event could be explained by at least one factor other than dissociative amnesia. These findings are contrary to dissociative amnesia. Compared to participants who reported no inability to remember an important aspect of the traumatic event, participants who did report an inability to remember were more likely to (1) have felt disconnected from their body during the traumatic event, which may have altered memory encoding, (2) have experienced sleep problems in the year after the traumatic event, which may have reduced memory consolidation, and (3) have experienced the traumatic event repeatedly, which may have led to less detailed memories. These findings have implications for the inclusion of dissociative amnesia in the DSM. [ABSTRACT FROM AUTHOR]

Recent studies found that post-traumatic and dissociative symptoms are common in people with depressive symptoms. Although a trauma-related subtype of depression has been proposed, little is known about the persistence and clinical consequences of these symptoms. This one-year follow-up study investigated the persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms. We analyzed longitudinal data from an international sample of people self-reporting depressive emotions (N = 152) (mean Patient Health Questionnaire-9 score = 17.27; SD = 6.31). More than half (58.4%) of participants with baseline post-traumatic stress disorder (PTSD) still met the criteria for PTSD after one year. Participants with dissociative symptoms at baseline were significantly more likely to report lifetime psychiatric hospitalization (31.2% vs 14.7%), past-year use of psychiatric hospitalization (10.4% vs 0%) and emergency services (16.9% vs 4%) than those without dissociative symptoms. All post-traumatic and dissociative symptom clusters were cross-sectionally (r =.286 to.528, p <.001) and longitudinally (r =.181 to.462, p <.001) correlated with depressive symptoms. A sense of current threat (β =.146, p <.05) and negative self-concept (β =.173, p <.05) at baseline significantly predicted depressive symptoms after one year. These findings contribute to the increasing body of knowledge regarding the PTSD/dissociation-depression comorbidity. Given their persistence and clinical consequences, we recommend that post-traumatic and dissociative symptoms be regularly screened for in clinical settings. The existence of a possible trauma-related subtype of depression should receive more attention in both research and clinical practice. Post-traumatic and dissociative symptoms are common in people with depressive symptoms. These symptoms generally persist over one year and predict more depressive symptoms at follow-up. Trauma-related symptoms should be regularly screened for in clinical settings. [ABSTRACT FROM AUTHOR]

The clinical guidelines for the treatment of dissociation focus primarily on psychotherapy. However, different psychoactive drugs are used in clinical practice. The use of opioid antagonists has been proposed as a therapeutic option based on the theory that dissociation might be a phenomenon mediated by dysregulation of the endogenous opioid system. To review and meta-analyse the available evidence on the efficacy of the opioid antagonists naltrexone, naloxone, and nalmefene as treatments for dissociative symptoms and disorders. The PRISMA guidelines were followed, and this review was registered in Prospero with reference number CRD42021280976. The search was performed in the PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and PubPsych databases. 1,798 citations were obtained. After removing duplicates and applying inclusion and exclusion criteria, we included 5 comparative studies with 9 dissociation measures that had included a total of 154 participants, of whom 134 had been treated with an opioid antagonist. The results of the meta-analysis showed a treatment effect for dissociation when using opioid antagonists [pooled d = 1.46 (95% CI: 0.62–2.31)]. However, the studies we included were very heterogeneous [Q = 66.89 (p <.001)] and there may have been publication bias. Although more research is needed and the results must be interpreted with caution because of the limited amount of data and heterogeneity in the studies and their methodological qualities, opioid antagonists (particularly naltrexone) are promising candidates for the treatment of dissociative symptoms and showed a moderate – large effect size in reducing these symptoms. The results of the meta-analysis showed a treatment effect for dissociation when using opioid antagonists [pooled d = 1.46 (95% CI: 0.62–2.31)]. The results must be interpreted with caution because of the limited amount of data and heterogeneity in the studies and their methodological qualities. Opioid antagonists (particularly naltrexone) are promising candidates for the treatment of dissociative symptoms and showed a moderate – large effect size in reducing these symptoms. [ABSTRACT FROM AUTHOR]

Background: The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced the dissociative subtype of posttraumatic stress disorder (D-PTSD). To assess this subtype, the Dissociative Subtype of PTSD Scale (DSPS), a 15-item self-report measure to identify lifetime and current dissociative symptoms of D-PTSD, was developed. However, so far, the scale has only been validated in war veterans. Moreover, criterion validity and diagnostic utility have not been examined yet. Objective: We aimed to validate the DSPS in two samples of civilian trauma-exposed German-speaking participants. Methods: In Study 1, a pre-registered online study, participants with and without PTSD symptoms (N = 558) answered questionnaires about traumatic experiences, dissociation, PTSD, depression, generalized anxiety disorder, somatic symptom disorder, alcohol use disorder, absorption, and dissociative responding to trauma-related questionnaires. In Study 2, which used secondary data of a pre-registered clinical study, participants with a PTSD diagnosis (N = 71) answered questionnaires about traumatic experiences, dissociation, PTSD, depression, generalized anxiety disorder, somatic symptom disorder, and dissociative responding to standardized trauma exposure. Moreover, PTSD, D-PTSD, and other diagnoses were assessed with structured clinical interviews. Results: Analyses confirmed a three-factor structure as well as high internal consistency, and high convergent, discriminant, and criterion validity of the DSPS. Moreover, the scale was able to identify a latent D-PTSD group and individuals with D-PTSD diagnosis. Conclusions: The DSPS constitutes a reliable and valid tool to assess D-PTSD symptoms in clinical practice and research and thereby may contribute to a better understanding of these debilitating symptoms. Many individuals with posttraumatic stress disorder (PTSD) suffer from dissociative symptoms which can be assessed with the Dissociative Subtype of PTSD Scale (DSPS; Wolf et al., 2017). The DSPS demonstrated good psychometric properties in two German-speaking trauma-exposed samples and hence might be used to assess D-PTSD symptoms in research and clinical practice. Complementing the original English version, a German version of the DSPS is provided in the Supplements. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a serious health concern, occurring worldwide in various forms and settings. Over the past years, multiple sources reported an increase of IPV globally, partly related to COVID-19 restrictions. Childhood maltreatment enhances the risk of IPV, possibly via alterations in emotion regulation, attachment, maladaptive core beliefs, dissociation, and psychopathological symptoms. However, studies investigating these associations simultaneously are still needed. This study aimed to investigate association between IPV, childhood maltreatment severity, maladaptive schemata (mistrust, alienation, enmeshment), attachment anxiety, social support, emotion regulation, dissociation, posttraumatic stress disorder (PTSD), and borderline personality disorder (BPD) symptoms. We further explored the complex interplay of all factors, accounting for their shared associations. An anonymous online survey was posted on international online platforms for people experiencing domestic violence and on research platforms. Regression analyses and graph-theoretical network analysis were used to explore associations between all variables. N = 434 participants (40% in treatment) completed the survey. IPV perpetration and victimization were highly correlated. Both were significantly associated with childhood maltreatment severity, early maladaptive schemata, dissociation, BPD features, and PTSD symptoms. When including all variables in one model, IPV was associated with dissociation, which indirectly linked it to childhood maltreatment experiences, PTSD symptoms, withdrawal, and self-blame. Our findings suggest that IPV perpetration and victimization often co-occur. Dissociation may be an important bridge symptom, linking IPV to childhood maltreatment experiences, PTSD symptoms, and maladaptive coping. Prospective studies are needed to corroborate these findings and to establish psychological mechanisms underlying IPV. [ABSTRACT FROM AUTHOR]

Objectives: Compassion‐focused therapy (CFT) is an evolution‐informed biopsychosocial approach that seeks to cultivate attachment and care motivational systems and their psychophysiological regulators. These can counteract some of the harmful effects of social threat, inferiority, shame, self‐criticism and depression, which are common in people with psychosis and undermine their well‐being, social trust and ability to feel safe. This study aimed to test the acceptability of a novel manualized individual CFT intervention for psychosis (CFTp). Design: A non‐concurrent, multiple‐baseline, case series design, with three phases: baseline, intervention and follow‐up. Methods: The 26‐session CFTp intervention was provided for a sample of eight people with distressing psychotic experiences and a psychosis‐related diagnosis. The study aimed to assess acceptability of CFTp and to test clinically reliable improvements while receiving the intervention, compared to a baseline period. Results: Seven of eight participants completed the therapy, and clinically reliable improvements were found at both the single‐case and group level of analysis. At the single‐case level, over half the participants showed improvements in depression (5/7), stress (5/7), distress (5/7), anxiety (4/7) and voices (3/5). One participant showed a deterioration in anxiety (1/7) and dissociation (1/7). At the group level (n = 7), there were significant improvements in depression, stress, distress, voices and delusions. The improvements in voices, delusions and distress were sustained at 6‐ to 8‐week follow‐up, but depression and stress dropped slightly to trend‐level improvements. Conclusions: CFTp is a feasible and acceptable intervention for psychosis, and further investigation is warranted with a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Background: Severe self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited. Objectives: To investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors. Method: A cross sectional study (period 2019-2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report. Results: The target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset <18 years. The target sample reported increasing severity of self-harm acts and suicidal intention over time. Both samples had high levels of childhood trauma, impaired personality functioning, and a majority fulfilled criteria for PD. In the target sample, comorbid depression, PTSD, anxiety disorders, and substance use occurred more frequently and in 50%, psychosis/dissociative disorder/autism spectrum disorder/ADHD was reported (outpatient comparison sample: 9%). 35% in the target sample screened over cut-off for possible intellectual disability. The target sample reported poor psychosocial functioning and health-related quality of life - greater impairment than the outpatient comparison sample. Conclusion: The study reveals that severe self-harm inpatients have complex psychopathology and highlights the importance of individualized and thorough assessment among patients with severe and/or repetitive self-harm. [ABSTRACT FROM AUTHOR]

Background: Mood instability and risk-taking are hallmarks of borderline personality disorder (BPD). Schema modes are combinations of self-reflective evaluations, negative emotional states, and destructive coping strategies common in BPD. When activated, they can push patients with BPD into emotional turmoil and a dissociative state of mind. Our knowledge of the underlying neurocognitive mechanisms driving these changes is incomplete. We hypothesized that in patients with BPD, affective instability is more influenced by reward expectation, outcomes, and reward prediction errors (RPEs) during risky decision-making than in healthy controls. Additionally, we expected that these alterations would be related to schema modes. Methods: Thirty-two patients with BPD and thirty-one healthy controls were recruited. We used an established behavioral paradigm to measure mood fluctuations during risky decision-making. The impact of expectations and RPEs on momentary mood was quantified by a computational model, and its parameters were estimated with hierarchical Bayesian analysis. Model parameters were compared using High-Density Intervals. Results: We found that model parameters capturing the influence of RPE and Certain Rewards on mood were significantly higher in patients with BPD than in controls. These model parameters correlated significantly with schema modes, but not with depression severity. Conclusions: BPD is coupled with altered associations between mood fluctuation and reward processing under uncertainty. Our findings seem to be BPD-specific, as they stand in contrast with the correlates of depressive symptoms. Future studies should establish the clinical utility of these alterations, such as predicting or assessing therapeutic response in BPD. [ABSTRACT FROM AUTHOR]

Introduction: Spinal cord infarction secondary to ankylosing spondylitis is a rare but severe disorder. Case presentation: Here we present a case of acute spinal cord infarction in a 54 years-old man with a medical history of ankylosing spondylitis, scoliosis, and hypotension. The patient complained of a sudden onset of lower limb weakness. A physical examination showed that he suffered from a dissociative sensory disorder, paralysis, and concomitant sphincter disturbances. After undergoing a whole-spine MRI, he was diagnosed with an acute ischemic injury from T2 to T5. As he did not treat his ankylosing spondylitis, it later caused a spinal deformity, making the lumbar puncture technically challenging. However, using Taylor's approach, a CSF sample was successfully obtained. A CSF biochemical test ruled out myelitis, NMOSD, and MS. After receiving treatment with low-molecularweight heparin, atorvastatin calcium, and methylprednisolone, his sphincter function gradually recovered, but his strength was only partially restored. Conclusion: Although this is a rare entity, it is necessary for physicians to consider it when evaluating patients with a sudden loss of sensation and strength in their lower limbs. [ABSTRACT FROM AUTHOR]

The Dissociative Symptoms Scale (DSS) was developed to assess moderately severe types of dissociation (depersonalization, derealization, gaps in awareness and memory, and dissociative reexperiencing) that would be relevant to a range of clinical populations, including those experiencing trauma-related dissociation. The current study used data from 10 ethnically and racially diverse clinical and community samples (N = 3,879) to develop a brief version of the DSS (DSS-B). Item information curves were examined to identify items with the most precision in measuring above average levels of the latent trait within each subscale. Analyses revealed that the DSS-B preserved the factor structure and content domains of the full scale, and its scores had strong reliability and validity that were comparable to those of scores on the full measure. DSS-B scores showed high levels of measurement invariance across ethnoracial groups. Results indicate that DSS-B scores are reliable and valid in the populations studied. [ABSTRACT FROM AUTHOR]

The article announces selected additional 2022 articles published in the journal for honorable mention in the Richard P. Kluft Award, as well as publication of special issues on topics including the intersection between trauma and reproductive rights after the U.S. Supreme Court's overturn of the constitutional right to abortion ruling in the case Roe v. Wade.

Appraisal of trauma is a critical factor in the development of impairing post-traumatic stress symptoms, such as dissociation. Individuals may appraise trauma as morally injurious (i.e., moral injury exposure [MIE]) and experience subsequent moral distress related to this exposure (i.e., moral injury distress [MID]). To date, however, investigation into the relations between moral injury appraisals and dissociation has been limited, particularly within community populations. This study investigated MIE and MID in relation to six facets of dissociation (disengagement, depersonalization, derealization, memory disturbances, emotional constriction, identity dissociation) in a sample of trauma-exposed community members (n = 177, 58.2% Black, 89.3% female) recruited from a public hospital and/or community advertisements. Participants completed measures assessing trauma exposure, MIE, MID, dissociation, and posttraumatic stress disorder (PTSD) symptoms. Partial correlation analyses revealed that after controlling for PTSD symptoms, MIE was correlated with disengagement, r =.23, p ≤.025, and depersonalization, r =.25, p ≤.001, and MID was correlated with depersonalization, r =.19, p ≤.025. Sex moderated each association, with stronger associations observed for female participants. Findings suggest that moral injury appraisals are linked to more severe dissociative symptoms among female civilians, and as such, may need to be specifically targeted in empirically supported treatments. [ABSTRACT FROM AUTHOR]

Some evidence in non-clinical groups suggests that the relationship context in which dissociation is experienced might moderate its association with shame. The current study used vignettes detailing either dissociative symptoms or the expression of sadness occurring in three different relationship contexts: with a friend, an acquaintance, or when alone. Ratings of emotional (e.g. shame, anxiety) and behavioral (e.g. leave, talk) reactions were made on single-item measures, and shame feelings were further assessed with the State Shame Scale. Participants were in treatment for either dissociative identity disorder (n = 31) or other specified dissociative disorder (n = 3; N = 34). Feelings of shame were elevated in the acquaintance condition compared to when with a close friend or alone regardless of whether dissociation or sadness was experienced. In the acquaintance context, participants exposed to dissociation or sadness reported feeling annoyed at themselves, having a greater desire to leave, and a lesser desire to talk compared to when these experiences happened with a close friend or alone. Results suggest those with a dissociative disorder appraise themselves as more vulnerable to shame if experiencing dissociation or sadness when with an acquaintance, potentially because the risk of not being understood and rejected is heightened. [ABSTRACT FROM AUTHOR]

The relationship between dissociation and cognitive abilities remains controversial. Empirical studies have reported positive, negative and non-existent associations between dissociation and cognition. These inconsistent results may be due to the fact that the studies focused mainly on trait dissociation, while dissociation is not stable but transient. After validating the French version of the Clinician Administered Dissociative States Scale (CADSS), the aim of the present study was to evaluate the relationship between state dissociation and cognitive abilities. We recruited 83 patients suffering from post-traumatic stress disorder (PTSD) and assessed them twice. At T1, they performed a neutral Stroop task and a neutral binding task. At T2 (one to three weeks later), after a script-driven dissociative induction, they performed an emotional Stroop task and an emotional binding task. Between the two sessions, they completed questionnaires at home evaluating PTSD severity, trait dissociation and cognitive difficulties. State dissociation was assessed at T1 and T2 using the Clinician-Administered Dissociative States Scale (CADSS). We found good psychometric properties of the French version of the CADSS. After inducing dissociation, significantly lower attentional performance was found among patients with than without dissociative reactions. We found a significant positive correlation between state dissociation and increased attention and memory difficulties after induction. The French version of the CADSS is a reliable and valid tool to assess state dissociation, which is correlated with attentional difficulties. Attentional training is recommended to help patients control dissociative symptoms. [ABSTRACT FROM AUTHOR]

Based on previous findings in a U.S. sample, the present study validated the relationship between childhood trauma and dissociation, as well as the mediating role of disorganized attachment and the moderating role of mentalizing (i.e. self-concept clarity and reflective functioning) in a group of 569 Chinese adults (i.e. a community sample). Results demonstrated a mediating role for disorganized attachment relationships in linking childhood maltreatment and dissociative symptoms. Moreover, self-concept clarity moderated this mediating relationship. An interesting finding that differs from the U.S. sample is that reflective functioning did not play a moderating role between insecure attachment and dissociation in Chinese adults. Chinese culture places greater emphasis on collectivism, altruism, and other-oriented, and thus the protective effect of the reflective function may not be as effective as in an individualistic culture. This study provides evidence for a better understanding of the relationship between childhood trauma, attachment, dissociation, and the moderating role of mentalizing in an Eastern culture, and it opens the door to further research examining whether more Western (such as the U.S.) and Eastern (particularly Chinese) relationships are similar in both social and clinical psychology. [ABSTRACT FROM AUTHOR]

Revictimization research, to date, has primarily focused on sexual revictimization (i.e., child sexual abuse and adult sexual assault), which has resulted in a lack of understanding of trauma revictimization more generally. Specifically, it is unclear what factors are placing individuals with a history of child maltreatment (i.e., sexual abuse, physical abuse, and witnessing intimate partner violence [IPV]) at greater risk for subsequent adult victimization (i.e., sexual assault and IPV). Existing theoretical and empirical work on revictimization suggest that multiple risk factors are likely present within this framework (e.g., posttraumatic stress symptoms [PTSS], emotion dysregulation, and risk-taking behaviors). Prior research has suggested that PTSS are often linked with these other risk factors, and it is possible that the development of PTSS following child maltreatment may be related to the development or maintenance of additional factors that increase the likelihood of revictimization. The purpose of this review was to synthesize findings regarding risk factors that place maltreated individuals at greater risk for adult revictimization. Approximately 228 studies were identified following a thorough search of the peer-reviewed literature using multiple databases (PsycINFO, PILOTS, and Google Scholar). Each study was critically analyzed for relevance. The included studies were used in our review of prevalence, specific risk factors that have been identified, and unanswered questions in this literature. PTSS were noted to be particularly important in the revictimization framework, and thus, a novel model of revictimization was also proposed where PTSS are illustrated as being associated with the development and maintenance of other factors within the revictimization framework. [ABSTRACT FROM AUTHOR]

The objective: to analyze the features of the course of depersonalization-derealization disorder (DDD) in men on the example of a clinical case. Materials and methods. The pilot study included 51 individuals, namely: 8 (15.7%) men and 43 (84.3%) women, with average age 21 years (SD=3.66) and 23.86 years (SD=6.88), respectively. Study participants had criteria for DDD according to the International Classification of Diseases for Mortality and Morbidity Statistics 10th revision (ICD-10). The following tests were used in the research, such as the Hamilton Anxiety Rating Scale (HAM-A), the Beck Hopelessness Questionnaire (BHI), the Sheehan Patient Rated Anxiety Scale (SPRAS), the Cambridge Depersonalization Scale (CDS), and the Dissociative Experiences Scale (DES). Statistical data analysis was carried out using the IBM SPSS Statistics program. Results. Depending on comorbid pathology, three groups of participants were formed: 1) without comorbid pathology; 2) with comorbid depressive disorders; 3) with anxiety disorders. Two men were found to have cannabis-induced DDD. The article presents one typical case of cannabis-induced DDD. A statistically significant difference was determined between men and women who have higher scores on the Dissociative Experiences Scale DES (p=0.032). Several correlations between the CDS and Beck tests, as well as the Beck and Hamilton tests (men Tb=0.571; p=0.01) were found only in men. Conclusions. These cases have a high comorbidity, especially with anxiety disorders. Further research is needed to confirm this correlation. The specific weight of depersonalization-derealization symptoms according to the DES scale is significantly higher in men. Cannabis-induced DDD is more common in men than women. At the same time, no sociodemographic differences between the sexes were found. [ABSTRACT FROM AUTHOR]

Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming frompandemic- related events, such as sickness, isolation, losing loved ones, and fear for one's life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID- 19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Therapies based on an exposure model have been shown to be effective in the treatment of uncomplicated Post-Traumatic Stress Disorder (PTSD), but less effective when used to treat Complex Post-Traumatic Stress Disorder (CPTSD), because an essential first step in the exposure model is a patient's emotional engagement with traumatic material. This engagement is prevented by a suppressive/dissociative reaction typical of CPTSD. Several methods of overcoming this suppressive/dissociative reaction have been investigated, but have proved impractical. Familiar psychodynamic techniques appear to circumvent the suppressive/dissociative response and elicit the required emotional engagement in standard clinical settings. [ABSTRACT FROM AUTHOR]

Between 1983 and 1989, the number of women in U.S. jails more than doubled and continues to increase. Most women behind bars have been victims of violence including childhood sexual abuse. This may lead to psychiatric dissociative disorders such as Complex Post‐Traumatic Stress Disorder and Dissociative Identity Disorder (Multiple Personality Disorder.). It is difficult for clinicians to study these women. This article describes several severe dissociative disorders in the women in the Washington, D.C. Detention Center ("D.C. jail") from September 1987 to September 1989. The author was able to live with them for more than 2 years. The author, a surgeon, kept a diary and frequently intervened in the episodes described here. Conditions in the co‐ed jail were hostile and dangerous to the women inmates. The women's observed dissociative behaviors included Dissociative Identity Disorder ("DID"), prolonged screaming, and prolonged sexual self‐abuse. Dissociative episodes could trigger ones in other women inmates or even in female jail "Officers." The author suggests (i) that dissociation is likely to be common and severe among incarcerated women (ii) that at least one of its antecedents here is severe childhood sexual abuse and that (iii) judicial and correctional biases exacerbate these symptoms. [ABSTRACT FROM AUTHOR]