Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark.
Sabina Palić, Jessica Carlsson, Cherie Armour, Ask Elklit
Nordic Journal of Psychiatry May 2015 DOI: 10.3109/08039488.2014.977344 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional clinical assessment study (part of a larger study) Peer reviewed |
|---|---|
| Sample size | 86 |
| Population | Bosnian treatment-seeking refugees in Denmark |
| Measures | Structured Interview for Disorders of Extreme Stress-dissociation subscale (SIDES-D), Dissociative Experiences Scale (DES) |
| Keywords | Assessment Dissociation Refugees Sides |
| Key findings | The SIDES-D interview indicated twice the prevalence of pathological dissociation as the DES self-report; by the DES, 30% had pathological dissociation 15 years after resettlement. Depersonalization and derealization were the most common symptoms on the SIDES-D, and some participants spontaneously described a "split" pre- and post-war identity, which the authors say needs further examination as a possible dissociative phenomenon. |
Abstract
Dissociative experiences are common in traumatized individuals, and can sometimes be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures perform in this clinical group. To describe the phenomenology of dissociative symptoms in Bosnian treatment-seeking refugees in Denmark. As a part of a larger study, dissociation was assessed systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). The SIDES-D indicated twice as high prevalence of pathological dissociation as the DES. According to the DES, 30% of the refugees had pathological dissociation 15 years after their resettlement. On the SIDES-D, depersonalization and derealization experiences were the most common. Also, questions about depersonalization and derealization at times elicited reporting of visual and perceptual hallucinations, which were unrelated to traumatic re-experiencing. Questions about personality alteration elicited spontaneous reports of a phenomenon of "split" pre- and post-war identity in the refugee group. Whether this in fact is a dissociative phenomenon, characteristic of severe traumatization in adulthood, needs further examination. Knowledge of dissociative symptoms in traumatized refugees is important in clinical settings to prevent misclassification and to better target psychotherapeutic interventions. Much development in the measurement of dissociation in refugees is needed.