Dissociative symptoms can arise from psychological trauma or as a side effect of certain medications, making accurate assessment important. The 23-item Clinician Administered Dissociative States Scale (CADSS) was evaluated in 276 participants: 148 with trauma history and PTSD, 100 with trauma history but no PTSD, and 28 healthy controls without trauma or psychiatric disorder. The scale showed high internal consistency (Cronbach's alpha 0.91) and a single-factor structure. Trauma-exposed participants with PTSD had higher CADSS scores than those without PTSD or without trauma. Veterans with combat-related PTSD showed increased scores after exposure to combat-related stimuli. The CADSS performs reliably for assessing dissociation in psychologically traumatized individuals.
Dissociative symptoms are common in many patients with PTSD and also appear during the first esketamine treatment for treatment-resistant depression. Comparing 134 PTSD patients and 759 TRD patients receiving their first esketamine dose, dissociative symptoms were more prevalent overall in the esketamine group. However, the pattern differed: PTSD patients more often reported dissociative amnesia and identity fragmentation, while esketamine patients most frequently experienced depersonalization and derealization. This distinct pattern suggests that the underlying causes of dissociative symptoms may differ between these conditions.
In veterans with PTSD, mindfulness-based stress reduction (MBSR) and present-centered group therapy both increased morning cortisol levels from baseline to 9 weeks, but the increase was significantly smaller with MBSR (mean difference 1.69 ± 0.8 SE). Changes in interleukin-6 and C-reactive protein did not differ between groups. Greater self-reported mindfulness was linked to higher cortisol and to reduced PTSD and depression severity. Higher IL-6 and CRP were associated with less severe PTSD but not depression. Pooled results confirmed MBSR outperformed the active control for clinical improvement. Increased mindfulness may recalibrate cortisol levels, suggesting a therapeutic response.
Both mindfulness-based stress reduction (MBSR) and present-centered group therapy (PCGT) led to significant improvement in PTSD symptoms among U.S. military veterans, as measured by the clinician-administered CAPS-IV scale, with no statistically significant difference between the two treatments. However, the MBSR group showed a statistically significant improvement in self-reported PTSD symptoms on the PTSD Checklist over the nine-week treatment period, though this difference was not maintained at the 16-week follow-up. The study involved 214 veterans randomly assigned to eight weeks of either 90-minute group MBSR or PCGT. Strengths include a large sample and multisite design; limitations include high attrition and low representation of women.