Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders
Harald Bækkelund, Paul Frewen, Ruth A. Lanius, Akiah Ottesen Berg, E. Arnevik
European Journal of Psychotraumatology 2018 DOI: 10.1080/20008198.2018.1544025 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 142 |
| Population | Patients with post-traumatic stress disorder (PTSD), with and without comorbid dissociative disorders |
| Topics | Altered states of consciousness PTSD |
| Key findings | TRASC experiences were less frequent and more specifically related to dissociation measures, dissociative disorder comorbidity, and childhood sexual abuse compared to NWC experiences, but the predicted lower intercorrelation of TRASC was not supported. |
Abstract
ABSTRACT
Background: The four-dimensional (‘4-D’) model has been proposed as a theoretical framework to understand and delineate trauma-related dissociative experiences, categorizing symptoms into trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC), which occur along four dimensions: time, thought, body and emotion.
Objective: The main aim of the present study was to evaluate the validity of this model in patients with post-traumatic stress disorder (PTSD), with and without comorbid dissociative disorders.
Method: The predictions of the 4-D model were tested in 142 patients with PTSD, with (N = 46) and without (N = 96) comorbid dissociative disorders.
Results: As predicted by the 4-D model, experiences of TRASC were less frequent and more specifically related to other measures of dissociation, dissociative disorder comorbidity and a history of childhood sexual abuse compared to experiences of NWC. The predicted lower intercorrelation of TRASC was not supported.
Conclusion: The 4-D model represents a promising framework for understanding dissociation across trauma-related disorders.
Comparable studies
Other observational and cohort studies on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| MDMA-Assisted Psychotherapy Using Low Doses in a Small Sample of Women with Chronic Posttraumatic Stress Disorder Women with chronic PTSD secondary to sexual assault | 2008 | Observational cohort | n = 6 |
| An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder Treatment-seeking veterans, current serving military members, and emergency service... | 2017 | Observational study using ambulatory polysomnography | n = 35 |
| Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD. Female sexual assault survivors with chronic nightmares | 2004 | Observational cohort | n = 44 |
| Posttraumatic stress symptoms following near-death experiences. Persons who report near-death experiences and those who came close to death without NDEs | 2001 | Observational study | |
| Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Outpatients with treatment-resistant depression and PTSD | 2018 | Retrospective review | n = 37 |
Citations in the library
Cited by 3
- Hitting and missing on consciousness Psychiatry and Clinical Neurosciences September 17, 2026
- Neural tracking at theta predicts drumming-induced altered states of consciousness Scientific Reports March 26, 2026
- Examining the 4-D Model in Persons Enrolled in the Top DD Internet Intervention. Journal of Trauma & Dissociation 2022
Cites 6
- Trauma-related dissociation and altered states of consciousness: a call for clinical, treatment, and neuroscience research European Journal of Psychotraumatology May 19, 2015
- Trauma-Related Altered States of Consciousness: Exploring the 4-D Model Journal of Trauma & Dissociation March 20, 2014
- Trauma-Related Altered States of Consciousness (TRASC) and Functional Impairment II: Perceived Causal Relationships in an Online Sample Journal of Trauma & Dissociation September 17, 2015
- Trauma-Related Altered States of Consciousness (TRASC) and Functional Impairment I: Prospective Study in Acutely Traumatized Persons Journal of Trauma & Dissociation September 17, 2015
- Trauma-related altered states of consciousness in women with BPD with or without co-occurring PTSD European Journal of Psychotraumatology August 18, 2014
and 1 more in the library