Evaluating the Impact of Dissociation in Psychiatric Disorders
DOI:
https://doi.org/10.18662/brain/11.3Sup1/132Keywords:
Dissociation, Dissociative Experiences Scale (DES), Psychiatric DisordersAbstract
Introduction: Dissociative symptoms are present in a various number of psychiatric disorders and are viewed as a major risk factor for suicidal and self-destructive behavior. Dissociation is defined in DSM-5 as a “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”. Assessing dissociation within different categories of mental disorders can be used to predict symptom severity and nonresponse to psychotherapeutic treatments. The most important tool in this process is the Dissociative Experiences Scale (DES). The purpose of the current study is to extend the understanding of dissociation in Psychiatric Disorders.
Material and methods: The current study used PubMed and Cochrane databases to identify relevant articles that refer to the subject of dissociation in Psychiatric Disorders.
Results and Discussions: Dissociation and dissociative disorders have been at the root of continuous controversy in psychiatric and psychology communities. The general confusion comes from the reduced conceptual distinction between dissociation as a symptom, process, deficit and psychological defense. At the high end of the DES score we find dissociative disorders, but closely followed by posttraumatic stress disorder, borderline personality disorder and conversion disorder with eating disorders, schizophrenia and anxiety disorders at midrange and the lowest scoring DES psychiatric disorder is found in bipolar disorders. Early intervention, based on these scores, show major improvement in maladaptive functionality, suicidal and self-destructive behavior, coupled with a reduction in total treatment cost.
Conclusions: There is a significant benefit in careful assessment of dissociative symptoms for the entire spectrum of mental disorders. There is a major need to raise awareness in all mental health facilities, of the value that this has in the current clinical setting.
References
Bob, P., Mashour, G. A. (2011). Schizophrenia, dissociation, and consciousness. Consciousness and Cognition., 20(4), 1042-1049. https://doi.org/10.1016/j.concog.2011.04.013
Burlea, G., Burlea, A. M., & Milici, R. C. (2010). Prevention and intervention in speech and language therapy for the success of lexicographical acquisitions. Revista de Cercetare si Interventie Sociala, 30, 86-100. https://www.rcis.ro/en/section1/40-volumul-302010septembrie/315-prevention-and-intervention-in-speech-and-language-therapy-for-the-success-of-lexicographical-acquisitions.html
Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardena, E., & Spiegel D. (2012). Evaluation of the evidence for the trauma and fantasy models of dissection. Psychological Bull., 138,550-588. https://doi.org/10.1037/a0027447
Damasio, A. (1999). The Feeling of What Happens. Body and Emotions in the Making of Conciousness. Harcourt Brace
Evren, C., Sar, V., Karadag, F., Gurol, D. T., & Karagoz, M. (2007) Dissociative disorders among alcohol-dependent inpatients. Psychiatry Res., 152(2-3), 233–241. https://doi.org/10.1016/j.psychres.2005.08.004
Feeny, N. C., Zoellner, L. A., & Fitzgibbons, L. A., Foa, E. B. (2000) Exploring the roles of emotional numbing, depression, and dissociation in PTSD. Journal of Traumatic Stress., 13(3), 489-498. https://doi.org/10.1023/A:1007789409330
Foote, B., & Park, J. (2008). Dissociative identity disorder and schizophrenia: Differential diagnosis and theoretical issues. Current Psychiatry Reports, 10, 217–222. https://doi.org/10.1007/s11920-008-0036-z
Forner, C. (2019). What mindfulness can learn about dissociation and what dissociation can learn from mindfulness. Journal of Trauma & Dissociation, 20(1), 1–5. https://doi.org/10.1080/15299732.2018.1502568
Guardia, D., Conversy, L., Jardri, R., Lafargue, G., Thomas, P., Dodin, V., Cottencin, O., Luyat, M. (2012) Imagining one’s own and someone else’s body actions: Dissociation in anorexia nervosa. PLoS ONE, 7(8), e43241. https://doi.org/10.1371/journal.pone.0043241
Jureidini, J., & Taylor, D. C. (2002). Hysteria. European Child & Adolescent Psychiatry, 11, 123–128. https://doi.org/10.1007/s00787-002-0267-1
Jureidini, J. (2004). Does dissociation offer a useful explanation for psychopathology? Psychopathology, 37(6), 259–265. https://doi.org/10.1159/000081981
Kihlstrom, J.F. (1984). Conscious, subconscious, unconscious: A cognitive view. In K. S., Bowers, & D. Meichenbaum (Eds.), The Unconscious Reconsidered (pp. 149–211). Wiley.
Loewenstein, R. J. (2018). Dissociation debates: Everything you know is wrong. Dialogues in Clinical Neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein
Lyssenko, L., Schmahl, C., Bockhacker, L., Vonderlin, R., Bohus, M., Kleindienst, N. (2017). Dissociation in psychiatric disorders: a meta-analysis of studies using the dissociative experiences scale. American Journal of Psychiatr, 175, 37–46. https://doi.org/10.1176/appi.ajp.2017.17010025
Lupu, V. V., Ignat, A., Paduraru, G., Mihaila, D., Burlea, M., & Ciubara, A. (2015). Heterotopic Gastric Mucosa in the Distal Part of Esophagus in a Teenager Case Report. Medicine, 94(42). https://doi.org/10.1097/MD.0000000000001722
Nijenhuis, E. R. S., & Van der Hart, O. (2011). Dissociation in trauma: a new definition and comparison with previous formulations. Journal of Trauma & Dissociation, 12, 416–445. https://doi.org/10.1080/15299732.2011.570592
Paris, J. (2012). The rise and fall of dissociative identity disorder. The Journal of Nervous and Mental Disease, 200(12), 1076-1079. https://doi.org/10.1097/NMD.0b013e318275d285
Rufer, M., Fricke, S., Held. D., Cremer, J., & Hand, I. (2006) Dissociation and symptom dimensions of obsessive-compulsive disorder: a replication study. European Archives of Psychiatry and Clinical Neuroscience, 256, 146–150. https://doi.org/10.1007/s00406-005-0620-8
Sar, V., Taycan, O., Bolat, N., Özmen, M., Duran, A., Öztürk, E., & Ertem-Vehid, H. (2010). Childhood trauma and dissociation in schizophrenia. Psychopathology, 43, 33–40. https://doi.org/10.1159/000255961
Spiegel, D., Loewenstein, R J., Lewis-Fernandez, R., Sar, V. Simeon, D., Vermetten, E., Cardeña. E., & Dell, P. F. (2011). Dissociative disorders in DSM-5. Depression & Anxiety, 28(9), 824–852. https://doi.org/10.1002/da.20874
Soffer-Dudek, N. (2014). Dissociation and dissociative mechanisms in panic disorder, obsessive-compulsive disorder, and depression: a review and heuristic framework. Psychology of Consciousness: Theory, Research, and Practice, 1(3), 243–270. https://doi.org/10.1037/cns0000023
Spiegel, D. (2003). Hypnosis and traumatic dissociation: Therapeutic opportunities. Journal of Trauma and Dissociation, 4 (3), 73 – 90. https://doi.org/10.1300/J229v04n03_05
Terhune, D. B., Cardena, E., & Lindgren, M. (2011). Dissociative tendencies and individual differences in high hypnotic suggestibility. Cognitive Neuropsychiatry, 16(2), 113–135. https://doi.org/10.1080/13546805.2010.503048
Van Ijzendoorn, M. H, & Schüngel, C. (1996). The measurement of dissociation in normal and clinical populations: meta-analytic validation of the Dissociative Experiences Scale (DES). Clinical Psychology Review, 16, 365–382. https://core.ac.uk/download/pdf/15589623.pdf
Weissenborn, R, & Duka, T. (2000). State-dependent effects of alcohol on explicit memory: The role of semantic associations. Psychopharmacology, 149, 98–106. https://doi.org/10.1007/s002139900349
Wieder, L., & Terhune, D. B. (2019). Trauma and anxious attachment influence the relationship between suggestibility and dissociation: A moderated-moderation analysis. Cognitive Neuropsychiatry, 24(3), 191–207. https://doi.org/10.1080/13546805.2019.1606705
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