Severe Dissociative Experiences beyond Detachment in a Large Clinical Sample of Inpatients with Post-Traumatic Stress Disorder: Diagnostic and Treatment Implications
Leonhard Kratzer, S. Tschöke, Johanna Schröder, M. Shevlin, P. Hyland, Christine Eckenberger, Peter Heinz, T. Karatzias
Psychopathology July 22, 2024 DOI: 10.1159/000539740 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study using latent profile analysis of retrospective clinical routine data Peer reviewed |
|---|---|
| Sample size | 1,360 |
| Population | Severely traumatized inpatients with PTSD |
| Measures | Childhood Trauma Questionnaire, Impact-of-Event Scale-Revised, Dissociative Experiences Scale-Taxon (DES-T) |
| Topics | PTSD |
| Key findings | Latent profile analysis identified three classes: PTSD, a dissociative subtype, and a third class with more complex and severe dissociative symptoms such as auditory-verbal hallucination, amnesia, and identity alteration. This third class was the most prevalent in the inpatient sample, suggesting that dissociative symptoms beyond detachment are common in severe PTSD. |
Abstract
Abstract
Introduction: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a dissociative subtype of post-traumatic stress disorder (PTSD) characterized by depersonalization and derealization. Yet, there is evidence that dissociative symptoms in PTSD go beyond this kind of detachment dissociation and that some patients present with additional compartmentalization dissociation in the form of auditory-verbal hallucination, amnesia, and identity alteration.
Methods: Hence, in this study, we examined latent profiles of childhood trauma (Childhood Trauma Questionnaire), PTSD (Impact-of-Event Scale-Revised), and pathological dissociation (Dissociative Experiences Scale-Taxon; DES-T) in a large sample of severely traumatized inpatients with PTSD (N = 1,360).
Results: Results support a three-class solution of the latent profile analysis with a PTSD class, a dissociative subtype class, and a third class characterized by more complex and more severe dissociative symptoms. Importantly, in our inpatient sample of patients with severe PTSD, the latter class was found to be the most prevalent. Both the exploratory character of our retrospective analysis of clinical routine data and the use of the DES-T limit the generalizability of our findings, which require methodologically more rigorous replication.
Conclusion: In severe PTSD, dissociative symptoms beyond detachment are highly prevalent. Diagnostic and treatment implications are discussed.