Trauma-intrusive hallucinations and the dissociative state.
Deborah Wearne, Guy Curtis, Winston Choy, Richard Magtengaard, Mathew Samuel, Peter Melvill-Smith
BJPsych Open August 30, 2018 DOI: 10.1192/bjo.2018.52 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 69 |
| Population | Participants assessed across four hospitals, including people who heard voices and people who did not |
| Measures | Psychotic Symptoms Rating scale, PTSD Symptoms Scale Interview, Dissociative Subtype of PTSD Score |
| Topics | PTSD |
| Keywords | Dissociation Pseudohallucinations Dissociative state |
| Key findings | The authors argue that trauma-intrusive voices are mediated by general dissociative symptoms rather than trauma-specific ones. Two dissociation scales, derealisation/depersonalisation and loss of awareness, predicted the extent of hearing voices equally well, while PTSD symptom severity did not predict hearing voices. They propose "anchoring" as a potential treatment strategy for clinical management of hearing voices. |
Abstract
Background: Research has supported a model of dissociation mediating the experience of hearing voices in traumatised individuals.
Aims: To further understand this model by examining subtypes of the dissociative experience involved in trauma-intrusive hallucinations.
Method: The study involved four hospitals, 11 psychiatrists and 69 participants assessed using the Psychotic Symptoms Rating scale, the PTSD Symptoms Scale Interview and the Dissociative Subtype of PTSD Score.
Results: In total, 59% (n = 41) of the participants heard voices and they were compared with the 41% (n = 28) who did not. The severity of PTSD symptoms did not predict experience of hearing voices. Regression analysis indicated that two scales of dissociation (derealisation/depersonalisation and loss of awareness) were equally good predictors of the extent of hearing voices. Adding other possible predictors (age of trauma <18, sexual violence) was relevant but did not enhance the prediction.
Conclusions: This research supports the proposal that trauma-intrusive voices are mediated by symptoms of dissociation. The supported model describes general, rather than trauma specific, symptoms of dissociation mediating the experience of hearing voices. The concept of anchoring is discussed and suggests a potential treatment strategy, which could be useful in the clinical management of hearing voices. Declaration of interest: None.
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 |