A new instrument, the Clinician Administered Dissociative States Scale (CADSS), was developed to measure present-state dissociative symptoms. Initial analyses showed good interrater reliability and construct validity. CADSS scores successfully discriminated patients with dissociative disorders from patients with other psychiatric disorders and from healthy subjects.
Dissociative symptoms during trauma and afterward in PTSD may be linked to stress-induced glutamate release in the brain. Animal studies show stress stimulates cortico-limbic glutamate release, affecting behavior and neural plasticity, and contributing to neural toxicity. NMDA receptor antagonists also trigger transient glutamate release and produce dissociative-like symptoms in animals and humans. A drug that reduces glutamate release lessens the perceptual effects of the NMDA antagonist ketamine in humans. Because hyperglutamatergic states may contribute to acute and long-term trauma effects, drugs that attenuate glutamate release warrant exploration for treating traumatized individuals with dissociative symptoms.
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.