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The association of dissociative symptoms with exposure to trauma

Published online by Cambridge University Press:  21 January 2018

S. Ullah
Affiliation:
Department of Psychology, International Islamic University, Islamabad, Pakistan
M. T. Khalily
Affiliation:
Department of Psychology, International Islamic University, Islamabad, Pakistan
I. Ahmad
Affiliation:
Department of Psychology, International Islamic University, Islamabad, Pakistan
B. Hallahan*
Affiliation:
Department of Psychiatry, National University of Ireland, Galway, Ireland
*
*Address for correspondence: B. Hallahan, Department of Psychiatry, National University of Ireland, Galway, Ireland. (Email: brian.hallahan@nuigalway.ie)

Abstract

Background

The Khyber Pakhtunkhwa province of North-West Pakistan has endured increased levels of violence in recent years. The psychological sequelae of such trauma including the presence of dissociative symptoms has been minimally investigated to date. The study examines psychopathology experienced including the presence of dissociative symptoms, and ascertain what factors are potentially predictive of these symptoms.

Method

Third-level students (n=303) completed psychometric instruments relating to their experience of traumatic events and assessed depression, anxiety and dissociative symptoms.

Results

Symptoms suggestive of post-traumatic stress disorder were evident in 28% of individuals. Symptoms relating to intrusive experiences and alterations in reactivity predicted dissociative, depressive and anxiety symptoms (p<0.01).

Conclusion

Trauma related to violence in this study was associated with significant pathology including dissociative symptoms. Identification and subsequent treatment of dissociative symptoms in individuals who have experienced trauma, may have a significant ameliorating effect on levels of functioning and thus should be included in clinical assessment.

Type
Original Research
Copyright
© College of Psychiatrists of Ireland 2018 

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References

Alper, K, Devinsky, O, Perrine, K, Luciano, D, Vasquez, B, Pacia, S, Rhee, E (1997). Dissociation in epilepsy and conversion non-epileptic seizures. Epilepsia 38, 991997.Google Scholar
American Psychiatric Association (APA) (2014). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. APA: Washington, DC.Google Scholar
Anwar, I (2016). Statistics shows marked drop in terrorist attacks, DAWN News (https://www.dawn.com/news/1282160). Accessed 25 July 2017.Google Scholar
Ashbaugh, AR, Houle-Johnson, S, Herbert, C, El-Hage, W, Brunet, A (2016). Psychometric validation of the English and French versions of the Posttraumatic stress disorder checklist for DSM-5 (PCL-5). PLoS One 11, e0161645, (in press).CrossRefGoogle ScholarPubMed
Bernstein, EM, Putnam, FW (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease 174, 727735.Google Scholar
Brand, BL, Stadnik, R (2013). What contributes to predicting change in the treatment of dissociation: initial levels of dissociation, PTSD, or overall distress? Journal of Trauma and Dissociation 14, 328341.CrossRefGoogle ScholarPubMed
Briere, J (2006). Dissociative symptoms and trauma exposure: specificity, affect dysregulation, and posttraumatic stress. The Journal of Nervous and Mental Disease 194, 7882.CrossRefGoogle ScholarPubMed
Britvić, D, Antičević, V, Kaliterna, M, Lušić, L, Beg, A, Brajević-Gizdić, I, Kudric, M, Stupalob, Z, Krolob, V, Pivac, N (2015). Comorbidities with Posttraumatic Stress Disorder (PTSD) among combat veterans: 15 years postwar analysis. International Journal of Clinical and Health Psychology 15, 8192.Google Scholar
Cloitre, M, Koenen, KC, Cohen, LR, Han, H (2002). Skills training in affective and interpersonal regulation followed by exposure: a phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology 70, 1067.Google Scholar
Cloitre, M, Stovall-McClough, KC, Miranda, R, Chemtob, CM (2004). Therapeutic alliance, negative mood regulation, and treatment outcome in child abuse-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 72, 411415.Google Scholar
Dalenberg, CJ, Brand, BL, Gleaves, DH, Dorahy, MJ, Loewenstein, RJ, Cardeña, E, Frewen, PA, Carlson, EB, Spiegel, D (2012). Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychological Bulletin 138, 550588.CrossRefGoogle ScholarPubMed
Dalenberg, CJ, Paulson, K (2009). The case for the study of “normal” dissociation processes. In Dissociation and the Dissociative Disorders: DSM-V and beyond, (ed. Routledge), pp. 145–154. Routledge: New York, NY.Google Scholar
Filza, H (2015). Trauma: the real cost of unending war and disaster in Pakistan. DAWN News (http://www.dawn.com/news/1219430).Google Scholar
Gershuny, BS, Thayer, JF (1999). Relations among psychological trauma, dissociative phenomena, and trauma-related distress: a review and integration. Clinical Psychology Review 19, 631657.Google Scholar
Gray, MJ, Litz, BT, Hsu, JL, Lombardo, TW (2004). Psychometric properties of the life events checklist. Assessment 11, 330341.Google Scholar
Khalily, MT (2011). Mental health problems in Pakistani society as a consequence of violence and trauma: a case for better integration of care. International Journal of Integrated Care 11, e128.Google Scholar
Khalily, TM, Fooley, S, Hussain, I, Bano, M (2011). Violence, psychological trauma and possible acute post-traumatic interventions in Pakistani society. Australasian Journal of Disaster and Trauma Studies 1, 19.Google Scholar
Khan, AA, Haider, G, Sheikh, MR, Ali, AF, Khalid, Z, Tahir, MM, Malik, TM, Salick, MM, Lakhani, LS, Yousuf, FS, Khan, MB, Saleem, S (2016). Prevalence of post-traumatic stress disorder due to community violence among university students in the world’s most dangerous megacity: a cross-sectional study from Pakistan. Journal of Interpersonal Violence 31, 23022315.Google Scholar
Khan, I (2014). Pakistan most terror-hit nation. DAWN News (https://www.dawn.com/news/1088864). Accessed 23 September 2017.Google Scholar
Levy, BS, Sidel, VW (2013). Adverse health consequences of the Iraq War. The Lancet 381, 949958.CrossRefGoogle ScholarPubMed
Lewis, CA, Musharraf, S, Dorahy, MJ, Lewis, MJ (2013). The dissociative experiences scale: an Urdu translation. Journal of Pakistan Psychiatric Society 10, 4650.Google Scholar
Lovibond, SH, Lovibond, PF (1995). Manual for the Depression Anxiety Stress Scales, 2nd edn. Psychology Foundation: Sydney.Google Scholar
Lynn, SJ, Lilienfeld, SO, Merckelbach, H, Giesbrecht, T, McNally, R, Loftus, EF, Bruck, M, Garry, M, Malaktaris, A (2014). The trauma model of dissociation: inconvenient truths and stubbom fictions. Comment on Dalenberg et al. (2012). Psychological Bulletin 140, 896910.Google Scholar
Merckelbach, H, Muris, P (2001). The causal link between self-reported trauma and dissociation: a critical review. Behaviour Research and Therapy 39, 245254.Google Scholar
Norman, SB, Stein, MB, Davidson, JR (2007). Profiling posttraumatic functional impairment. The Journal of Nervous and Mental Disease 195, 4853.CrossRefGoogle ScholarPubMed
Olsen, SA, Clapp, JD, Parra, GR, Beck, JG (2013). Factor structure of the Dissociative Experiences Scale: an examination across sexual assault status. Journal of Psychopathology and Behavioral Assessment 35, 394403.Google Scholar
Price, M, Kearns, M, Houry, D, Rothbaum, BO (2014). Emergency department predictors of posttraumatic stress reduction for trauma-exposed individuals with and without an early intervention. Journal of Consulting and Clinical Psychology 82, 336.Google Scholar
Razik, S, Ehring, T, Emmelkamp, PM (2013). Psychological consequences of terrorist attacks: prevalence and predictors of mental health problems in Pakistani emergency responders. Psychiatry Research 207, 8085.CrossRefGoogle ScholarPubMed
Ruiz, MA, Poythress, NG, Lilienfeld, SO, Douglas, KS (2008). Factor structure and correlates of the Dissociative Experiences Scale in a large offender sample. Assessment 15, 511521.CrossRefGoogle Scholar
Soffer-Dudek, N, Lassri, D, Soffre Dudek, N, Shahar, G (2015). Dissociative absorption: an empirically unique, clinically relevant, dissociative factor. Consciousness and Cognition 36, 338351.Google Scholar
Spitzer, RL, First, MB, Wakefield, JC (2007). Saving PTSD from itself in DSM-V. Journal of Anxiety Disorders 21, 233241.Google Scholar
Stockdale, GD, Gridley, BE, Balogh, DW, Holtgraves, T (2002). Confirmatory factor analysis of singleand multiple-factor competing models of the dissociative experiences scale in a nonclinical sample. Assessment 9, 94106.Google Scholar
Weathers, FW, Litz, BT, Palmieri, DG, Schnurr, PP, Marx, BP, Keane, TM (2013a). The life events checklist for DSM-5 (LEC-5). Instrument available from the National Center for PTSD (www.ptsd.va.gov). Accessed 25 July 2017.Google Scholar
Weathers, FW, Litz, BT, Palmieri, DG, Schnurr, PP, Marx, BP, Keane, TM (2013b). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD (www.ptsd.va.gov). Accessed 25 July 2017.Google Scholar
Waller, G, Hamilton, K, Elliott, P, Lewendon, J, Stopa, L, Waters, A, Kennedy, F, Lee, G, Pearson, D, Kennerley, H, Hargreaves, I, Bashford, V, Chalkey, J (2001). Somatoform dissociation, psychological dissociation, and specific forms of trauma. Journal of Trauma & Dissociation 1, 8198.Google Scholar
Yazdani, A, Shafi, K (2014). Indirect exposure to violence and prevalence of vicarious trauma in adolescents. Bahria Journal of Professional Psychology 13, 5771.Google Scholar
Zafar, H, Khalily, MT (2005). Urdu translation of the depression anxiety stress scale (DASS-42). Department of Psychology, International Islamic University, Islamabad. (http://www2.psy.unsw.edu.au/groups/dass/Urdu/Zafar%20&%20Khalily).Google Scholar