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Strouza AΙ, Vissia EM, Schlumpf YR, Del Marmol E, Nijenhuis ERS, Draijer N, Veltman DJ, Reinders AATS. Clinical, cognitive, creativity and cultural measures in dissociative identity disorder: A controlled study. Psychiatry Res 2025; 348:116407. [PMID: 40056876 DOI: 10.1016/j.psychres.2025.116407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Revised: 01/28/2025] [Accepted: 02/16/2025] [Indexed: 03/10/2025]
Abstract
BACKGROUND Dissociative identity disorder (DID) is associated with severe clinical and cognitive debilitating psychopathology. Additionally, it is often thought that creativity and cultural differences contribute to DID's symptomatology. Thus, the present study aimed to expand previous empirical data by investigating differences in clinical, cognitive, creativity and cultural measures between two distinct samples in order to gain a better insight into this disorder. METHODS Clinical, cognitive and creativity self-reported measures of 97 participants from The Netherlands and Switzerland were compared between two groups: 32 participants with DID and a control group of 65 controls. RESULTS Participants with DID scored significantly higher than the control group on the majority of clinical and creativity scales, but not on the cognitive measures. CONCLUSION Outcomes indicate heightened dissociative, depressive and anxiety symptomatology, as well as increased traumatic experiences, parental affectionate control and sleep disturbances in individuals with DID as compared to controls. These findings replicate and corroborate previous empirical findings and support the Trauma Model of DID. No cultural differences were observed between Dutch and Swiss individuals with DID.
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Affiliation(s)
- Aikaterini Ι Strouza
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, The Netherlands
| | - Yolanda R Schlumpf
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Switzerland
| | - Eugenie Del Marmol
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Nel Draijer
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - D J Veltman
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Lee DW, Kim K, Hyun J, Jung SJ. Depressive symptoms and neuroticism mediate the association between traumatic events and suicidality - A latent class mediation analysis of UK Biobank Database. J Affect Disord 2024; 356:13-21. [PMID: 38588726 DOI: 10.1016/j.jad.2024.03.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/21/2024] [Accepted: 03/29/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Mental disorders that follow traumatic experience may increase risk of suicidality, but a comprehensive approach to understand how these mental disorders mediate the association between psychological traumatic experience and suicidality should be elucidated. In this study, we attempted to provide comprehensive evidence on how depressive symptoms and neuroticism can mediate the association between psychological traumatic experiences and suicidal behaviours including suicidal ideation, suicidal planning, and suicide attempts. METHODS We analyzed 111,931 participants from UK Biobank who had completed mental health web-based questionnaire from 2016 to 2017. "Self-harm and suicidal behaviour and ideation (SSBI) score" was calculated by the response from suicidal behaviours and self-harm questionnaires. Conducting multivariate linear regression, depressive symptoms, anxiety symptoms, and neuroticism were selected as potential mediators. We constructed a latent class mediation model estimated direct effect of psychological traumatic events on suicidality and indirect effect of psychological traumatic events mediated by depressive symptoms and neuroticism. RESULTS Psychological traumatic events were positively associated with suicidal behaviours. Depressive symptoms and neuroticism significantly mediated the effect of psychological traumatic events on suicidality. Anxiety symptoms did not mediate the association between psychological traumatic events and suicidality. CONCLUSION Psychological traumatic events, irrespective of life stage of occurrence, are associated with suicidality. The association between psychological traumatic events and suicidality can be partially explained by depressive symptoms and neuroticism of those who were exposed to psychological trauma.
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Affiliation(s)
- Doo Woong Lee
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Kwanghyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jinhee Hyun
- Department of Social Welfare, College of Social Sciences, Daegu University, Gyeongsan, Republic of Korea
| | - Sun Jae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
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3
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Ricci V, Maina G, Martinotti G. Dissociation and Temporality in Substance Abuse: A Clinical Phenomenological Overview. Psychopathology 2023; 57:219-228. [PMID: 37903485 DOI: 10.1159/000533862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/26/2023] [Indexed: 11/01/2023]
Abstract
The term "dissociation" encompasses a wide array of symptoms and phenomena, all sharing the common characteristic of involving altered states of consciousness where an individual temporarily loses the sense of continuity of their own identity. In the context of addiction pathology, however, the dissociative paradigm remains a topic of ongoing debate. It fluctuates between the description of individual dissociative symptoms and the notion of post-traumatic dissociation as a structural process. This process involves fragmentation that extends beyond the confines of perception and experience within a singular moment, instead ensuring a persistent discontinuity of the self throughout one's existence. Pathological addiction stresses the question of the donation of sense in this deep and dramatic experience; it situates individuals within a compressed and constricted realm of vital space, alongside a frozen perception of time. Within this context, every emotion, sensation, and comprehension becomes impaired. Consequently, we have embarked on a journey starting with a historical analysis: the aim was to construct an elucidative framework for the dissociative paradigm in the context of addiction. This involves an in-depth exploration of the fundamental constructs of trauma and temporality, examined through the lens of phenomenological perspective.
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Affiliation(s)
- Valerio Ricci
- Department of Psychiatry, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Giuseppe Maina
- Department of Psychiatry, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università Degli Studi G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Gori A, Topino E, Cacioppo M, Craparo G, Schimmenti A, Caretti V. An Integrated Approach to Addictive Behaviors: A Study on Vulnerability and Maintenance Factors. Eur J Investig Health Psychol Educ 2023; 13:512-524. [PMID: 36975391 PMCID: PMC10047755 DOI: 10.3390/ejihpe13030039] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial–parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Firenze, Italy
- Integrated Psychodynamic Psychotherapy Institute (IPPI), Via Ricasoli 32, 50122 Florence, Italy
- Correspondence:
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193 Rome, Italy
| | - Marco Cacioppo
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193 Rome, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, UKE—Kore University of Enna, Cittadella Universitaria, 94100 Enna, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE—Kore University of Enna, Cittadella Universitaria, 94100 Enna, Italy
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193 Rome, Italy
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Impulsivity as a mediator between childhood maltreatment and suicidal behavior: A systematic review and meta-analysis. J Psychiatr Res 2022; 151:95-107. [PMID: 35477079 DOI: 10.1016/j.jpsychires.2022.04.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 04/18/2022] [Indexed: 01/15/2023]
Abstract
Childhood maltreatment is a known risk factor for the development of suicidal behavior. Possible mediators of the association between childhood maltreatment and suicide have been analyzed. Some studies have considered impulsivity as one of these mediators, but there are no previous reviews on this topic. We, therefore, present a systematic review and mediation meta-analysis of the literature summarizing the evidence on impulsivity as a mediator of the relationship between childhood maltreatment and lifetime suicidal behavior. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The review was registered in the PROSPERO database. We searched PubMed, PsycINFO, WebOfScience, and EMBASE databases up to February 2021 to identify studies exploring the association between childhood maltreatment and suicide through impulsivity. Fourteen articles met the selection criteria and were included in the review. Seven articles could be included in the mediation meta-analysis. Impulsivity was a significant mediator of the relationship between childhood maltreatment and suicidal behavior in ten of the fourteen included studies. This result was confirmed using mediation meta-analysis (β = .06, 95% CI 0.03-0.10). Studies suggest that exposure to traumatic situations in childhood affects the proper neurobiological, cognitive, and affective development of individuals. This may increase impulsivity, which in turn would be related to an increased risk of suicide. The effects of childhood maltreatment and impulsivity may be both therapeutic targets of interest to reduce suicide rates.
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Gori A, Topino E, Craparo G, Bagnoli I, Caretti V, Schimmenti A. A Comprehensive Model for Gambling Behaviors: Assessment of the Factors that can Contribute to the Vulnerability and Maintenance of Gambling Disorder. J Gambl Stud 2022; 38:235-251. [PMID: 33844125 PMCID: PMC8866302 DOI: 10.1007/s10899-021-10024-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 12/21/2022]
Abstract
Gambling Disorder is a complex and multifaceted phenomenon which requires a careful understanding by analysing both the life experiences and the psychopathological components linked to this type of behaviour. This study aimed to apply a Comprehensive Model of Addiction and to delve deeper the dimensions involved in the vulnerability and maintenance of the disease. Therefore, the effect of alexithymia and traumatic experiences in mediating the relationship between insecure attachment and dissociation, as well as the roles of impulsiveness and compulsiveness in influencing obsessiveness were explored in pathological gamblers. A sample composed of 253 individuals with a mean age of 47.8 years (SD = 12.4) with a diagnosis of Gambling Disorder (82.6% males, 17.4% females) completed the battery of measures. Results showed that alexithymia significantly mediates the relationship between insecure attachment and dissociation, while no significance was found in the effect of complex trauma. Furthermore, a significant impact role of impulsiveness and compulsiveness in determining obsessiveness was found. Therefore, the data suggested that alexithymia may increase the risk of developing a gambling disorder, mediating the association between insecure attachment and dissociation. The model of craving which could have a core role in disease maintenance processes was also confirmed, highlighting a significant influence of impulsiveness and compulsiveness on obsessiveness. Such findings might have relevant implications to increase the effectiveness of both preventive interventions and therapeutic works, favouring positive results for a better mental health of the subjects.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Piazza S. Marco 4, 50121, Firenze, Italy.
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193, Rome, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, Cittadella Universitaria, 94100, Enna, Italy
| | - Ilaria Bagnoli
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193, Rome, Italy
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193, Rome, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, Cittadella Universitaria, 94100, Enna, Italy
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Lynn SJ, Polizzi C, Merckelbach H, Chiu CD, Maxwell R, van Heugten D, Lilienfeld SO. Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework. Annu Rev Clin Psychol 2022; 18:259-289. [PMID: 35226824 DOI: 10.1146/annurev-clinpsy-081219-102424] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identify empirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Steven Jay Lynn
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Craig Polizzi
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Harald Merckelbach
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Chui-De Chiu
- Department of Psychology, Chinese University of Hong Kong, Hong Kong, China
| | - Reed Maxwell
- Department of Psychiatry, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dalena van Heugten
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Gambaro E, Mastrangelo M, Sarchiapone M, Marangon D, Gramaglia C, Vecchi C, Airoldi C, Mirisola C, Costanzo G, Bartollino S, Baralla F, Zeppegno P. Resilience, trauma, and hopelessness: protective or triggering factor for the development of psychopathology among migrants? BMC Psychiatry 2020; 20:358. [PMID: 32641011 PMCID: PMC7346618 DOI: 10.1186/s12888-020-02729-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 06/12/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Recently, many studies have investigated the role of migration on mental health. Nonetheless, only few focused on the consequences of childhood trauma, hopelessness, and resilience on migrants' psychopathology, including psychiatric disorders and symptoms. METHOD 119 migrants were recruited between May 2017 and April 2018, among those applying for assessment to the Mental Health Operational Unit of the National Institute for Health, Migration and Poverty (NIHMP) in Rome, Italy. Assessment included the following: Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), Connor-Davidson Resilience Scale (CD-RISC), Childhood Trauma Questionnaire (CTQ), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Beck Hopelessness Scale (BHS), Beck's Suicide Intent Scale (SIS), Brief Aggression Questionnaire (BAQ), Deliberate Self-Harm Inventory (DSHI). RESULTS 53.39% of migrants scored above the PCL-5 cut-off score (mean score was 39.45). SDS scores below the cutoff suggested the presence of depression in 42.37%, while According to SAS scores anxiety levels were low in 38.98% of migrants. During childhood, physical abuse and neglect were reported respectively by 56.78 and 69.49% of migrants. CONCLUSION We found that Post Traumatic Stress Disorders play the role of mediators for the relation between the childhood traumatic experiences and aggressiveness, anxious and depressive symptomatology, while hopelessness is a mediator between the childhood traumatic experiences and the development of depression in adulthood. Hopelessness seems to influence the strength of the relation between childhood traumatic experiences and the individual's current intensity of suicidal attitudes, plans, and behaviors. Further developments and future perspectives of the research project are to address key gaps in the field of resilience by means of a longitudinal evaluation study in migrants, including a native population control group, acceding to NIHMP.
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Affiliation(s)
- Eleonora Gambaro
- Department of Translational Medicine, Institute of Psychiatry, University of Western Piedmont, via Solaroli, 17, 28100, Novara, Italy.
- Psychiatric Ward, Maggiore della Carità University Hospital, Corso Mazzini 18, 28100, Novara, Italy.
| | - Martina Mastrangelo
- Department of Medicine and Health Science, University of Molise, Via De Santis, 86100, Campobasso, Italy
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Via De Santis, 86100, Campobasso, Italy
- National Institute of Migration and Poverty, Via San Gallicano 25, Rome, Italy
- National Medical University, Almaty, Kazakhstan
| | - Debora Marangon
- Psychiatric Ward, Maggiore della Carità University Hospital, Corso Mazzini 18, 28100, Novara, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Institute of Psychiatry, University of Western Piedmont, via Solaroli, 17, 28100, Novara, Italy
- Psychiatric Ward, Maggiore della Carità University Hospital, Corso Mazzini 18, 28100, Novara, Italy
| | - Camilla Vecchi
- Department of Translational Medicine, Institute of Psychiatry, University of Western Piedmont, via Solaroli, 17, 28100, Novara, Italy
| | - Chiara Airoldi
- Department of Translational Medicine, Institute of Psychiatry, University of Western Piedmont, via Solaroli, 17, 28100, Novara, Italy
| | - Concetta Mirisola
- National Institute of Migration and Poverty, Via San Gallicano 25, Rome, Italy
| | - Gianfranco Costanzo
- National Institute of Migration and Poverty, Via San Gallicano 25, Rome, Italy
| | - Silvia Bartollino
- Department of Medicine and Health Science, University of Molise, Via De Santis, 86100, Campobasso, Italy
| | - Francesca Baralla
- Department of Medicine and Health Science, University of Molise, Via De Santis, 86100, Campobasso, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Institute of Psychiatry, University of Western Piedmont, via Solaroli, 17, 28100, Novara, Italy
- Psychiatric Ward, Maggiore della Carità University Hospital, Corso Mazzini 18, 28100, Novara, Italy
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Çoban A, Tan O. Attention Deficit Hyperactivity Disorder, Impulsivity, Anxiety, and Depression Symptoms Mediating the Relationship Between Childhood Trauma and Symptoms Severity of Obsessive-Compulsive Disorder. ACTA ACUST UNITED AC 2019; 57:37-43. [PMID: 32110149 DOI: 10.29399/npa.23654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/11/2019] [Indexed: 12/21/2022]
Abstract
Introduction A growing body of research associates childhood trauma with obsessive-compulsive disorder (OCD). The aim of this study was to investigate the relationships between childhood trauma and OCD, including both its severity and OCD patients' comorbid impulsivity, ADHD, anxiety, and depressive symptoms. Methods A convenient sample consisting of 106 patients with OCD was given the Childhood Trauma Questionnaire (CTQ), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Wender Utah Rating Scale (WURS), Hamilton Rating Scale for Depression (HAM-D), Beck Anxiety Inventory (BAI), and Barratt Impulsivity Scale-11 (BIS-11). Results The results showed that childhood trauma indirectly predicts the severity of OCD and directly predicts comorbidities in OCD patients, including anxiety, ADHD, WURS, and impulsivity. Patients with childhood trauma had higher WURS, BAI, and BIS-11 scores and fewer years of education. Ongoing adult ADHD was more common in individuals with childhood trauma. Conclusion A history of childhood trauma in OCD patients has indirect effects on the severity of OCD and depressive symptoms and is associated with more severe anxiety, higher levels of impulsivity, higher prevalence of ADHD, and lower levels of education. More research is needed to clarify the effects of childhood trauma on OCD severity and comorbidity.
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Affiliation(s)
- Adnan Çoban
- HTA Neuropsychiatry Center, İstanbul, Turkey
| | - Oğuz Tan
- NP Feneryolu Medical Center, Üsküdar University, İstanbul, Turkey
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Mahoney CT, Benight CC. The Temporal Relationship Between Coping Self-Efficacy and Dissociation in Undergraduate Students. J Trauma Dissociation 2019; 20:471-487. [PMID: 30924408 DOI: 10.1080/15299732.2019.1597805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Dissociation is a lack of information integration resulting from a process that ranges on a continuum from normative experiences (e.g., daydreaming) to a pervasive traumatic response involving alterations and/or fragmentation in mental processes such as memory, emotion, and perception. Perceived coping self-efficacy (CSE) is a cognitive appraisal ability utilized to regulate internal and external stressors that arise from traumatic events, and is crucial for effective adaptation after extreme stress or trauma. Thus, CSE may be a critical component in decreasing dissociative experiences following a traumatic event. In the present study, 136 undergraduate students (M age = 22.36 years, SD = 6.27; 81% female, 69.1% Caucasian, 77.2% attended some college) completed self-report measures of trauma, dissociation, and coping self-efficacy. All measures were completed by the same participants at two different time points (Time 1 and Time 2) two months apart; all participants reported a history of exposure to at least one Criterion A traumatic event (according to the DSM-5) at Time 1. We hypothesized that CSE for posttraumatic coping demands at Time 2 would mediate the relationship between dissociation at Time 1 and dissociation at Time 2, and subsequently found evidence of significant mediation, 95% CI [.02, .18]. These findings suggest that initial levels of persistent dissociation negatively predict CSE, which in turn directly and negatively influence persistent dissociation at a later time point. This highlights how CSE may serve as a protective factor against persistent dissociation.
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Affiliation(s)
- Colin T Mahoney
- a Department of Psychology , Idaho State University , Pocatello , ID , USA
| | - Charles C Benight
- b Department of Psychology , University of Colorado at Colorado Springs , Colorado Springs , CO , USA
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11
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Bteich G, Berbiche D, Khazaal Y. Validation of the short Arabic UPPS-P Impulsive Behavior Scale. BMC Psychiatry 2017; 17:244. [PMID: 28683772 PMCID: PMC5499064 DOI: 10.1186/s12888-017-1407-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/27/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Impulsivity is involved in numerous psychiatric and addictive disorders, as well as in risky behaviors. The UPPS-P scale highlights five complementary impulsivity constructs (i.e., positive urgency, negative urgency, lack of perseverance, lack of premeditation, and sensation seeking) that possibly work as different pathways linking impulsivity to other disorders. In this study, we aimed to evaluate the psychometric properties of the Arab language short 20-item UPPS-P scale and to eventually validate it. METHODS Participants were recruited online through e-mail invitations. After online informed consent was obtained, the questionnaires (the UPPS-P and the Compulsive Internet Use Scale [CIUS]) were completed anonymously. The five dimensions of the Arab UPPS-P model were assessed in a sample of 743 participants. RESULTS As in other linguistic assessments of the UPPS-P, confirmatory factor analysis showed the validity of a model with five different, but nonetheless interrelated, facets of impulsivity. A three-factor model with two higher order factors-urgency (negative and positive) and lack of conscientiousness (lack of premeditation and lack of perseverance)-and a third sensation seeking factor fit the data well, but to a lesser extent. The results suggested good internal consistency, with external validity shown from correlations between some of the UPPS-P components and a measure of addictive Internet use (the CIUS). CONCLUSION The Arab short UPPS-P is a valid assessment tool with good psychometric properties and is suitable for online use.
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Affiliation(s)
- Ghada Bteich
- Lebanese University Faculty of Public Health, Lebanon University, Tripoli, Lebanon
| | - Djamal Berbiche
- 0000 0000 9064 6198grid.86715.3dCharles-LeMoyne Hospital Research Centre, Sherbrooke University, Sherbrooke, Canada
| | - Yasser Khazaal
- Geneva University Hospitals, Grand-Pré 70C, 1206, Geneva, Switzerland. .,University of Geneva, Geneva, Switzerland. .,University Institute of Mental Health at Montreal, Montreal, Canada.
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12
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Berkol TD, Balcioglu YH, Kirlioglu SS, Erensoy H, Vural M. Dissociative features of fibromyalgia syndrome. ACTA ACUST UNITED AC 2017; 22:198-204. [PMID: 28678214 PMCID: PMC5946364 DOI: 10.17712/nsj.2017.3.20160538] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: To assess the relationships between the dissociative features of FMS and the pain, psychological status, and functional status. Methods: Twenty-seven women with fibromyalgia syndrome (FMS) and 24 controls from the Istanbul Physical Medicine and Rehabilitation Hospital (2013-2015) were included in this cross-sectional study. The Diagnostic and Statistical Manual of Mental Disorders Structured Clinical Interview for Axis I Disorders was used to evaluate the participants. A visual analogous scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were used to assess the levels of pain, quality of sleep and functional and psychological statuses. The Dissociative Experiences Scale (DES) was used to evaluate the dissociative features. Results: The BDI, BAI and DES scores were statistically significantly higher in the cases of FMS. There were remarkable associations between all but 2 of the DES and FIQ scores, while positive correlations were found between the DES and, VAS pain and sleep quality scores. The prevalences of current and lifelong dysthymia, and major depressive disorder; not otherwise specified, common anxiety and somatoform disorders were higher in the cases of FMS. Conclusion: Pain, physical function and emotional status appear to be associated with dissociative features in FMS. Further studies are required to define these relationships and improve treatment.
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Affiliation(s)
- Tonguc D Berkol
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Dr. Tevfik Saglam St. No. 52/2, Zuhuratbaba, Bakirkoy, Istanbul,Turkey. E-mail:
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13
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Evren C, Umut G, Bozkurt M, Can Y, Evren B, Agachanli R. Partial mediator role of physical abuse on the relationship between attention-deficit/hyperactivity disorder symptoms and severity of dissociative experiences in a sample of inpatients with alcohol use disorder. Indian J Psychiatry 2017; 59:306-312. [PMID: 29085089 PMCID: PMC5659080 DOI: 10.4103/psychiatry.indianjpsychiatry_366_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM This study aimed to evaluate the relationship of attention-deficit/hyperactivity disorder (ADHD) symptoms with dissociative experiences, and the mediator role of childhood traumas on this relationship, while controlling the effect of depression in alcohol use disorder (AUD). SETTINGS AND DESIGN It was a hospital-based, cross-sectional study. MATERIALS AND METHODS One hundred and ninety inpatients with AUD were evaluated with the Beck Depression Inventory, the Adult ADHD Self-Report Scale (ASRS), Childhood Trauma Qestionnaire, and Dissociative Experiences Scale (DES). STATISTICAL ANALYSIS One-way ANOVA, Chi-squared test, and hierarchical linear regression model were performed. RESULTS The ratio of those who receive 10 points or less from DES was 26.8%, those who receive points between 11 and 30 was 45.3%, and those who receive more than 30 points was 27.9%. The latter group that was considered as a group with high risk of dissociative disorder had higher scores from depression, childhood trauma, and ADHD scores than the other groups. Rate of those with high probability of ADHD was higher among this group. ASRS total score and inattentive subscale scores were moderately (r = 0.552 and r = 0.547, respectively) and hyperactive/impulsive subscale was mildly (r = 0.430) correlated with DES score. Severity of ADHD was related with the severity of dissociative symptoms, and physical abuse had partial mediator effect on this relationship, even after controlling the depressive symptoms. CONCLUSIONS These findings demonstrate that the presence of severe IN symptoms is an important factor related with dissociative tendency in AUD population with a history of physical abuse.
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Affiliation(s)
- Cuneyt Evren
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Gokhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Muge Bozkurt
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Yesim Can
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Bilge Evren
- Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey
| | - Ruken Agachanli
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
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14
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Zavattini GC, Garofalo C, Velotti P, Tommasi M, Romanelli R, Santo HE, Costa M, Saggino A. Dissociative Experiences and Psychopathology Among Inmates in Italian and Portuguese Prisons. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2017; 61:975-992. [PMID: 26585993 DOI: 10.1177/0306624x15617256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The association between dissociation and psychopathological symptoms is well established, yet studies with inmates are lacking. If higher rates of dissociation and psychiatric symptoms are reported in inmate samples, it is not clear whether they represent two separate, albeit related, characteristics. We examined the association between dissociation and psychopathological symptoms among 320 Italian subjects (122 inmates and 198 community participants) and a Portuguese inmate sample ( n = 67). Then, we tested whether dissociation and psychopathology levels were higher among inmates. Both hypotheses were supported, confirming the relevance of dissociative, paranoid, and psychotic symptoms among inmates, as well as their interrelations. Notably, the group difference in dissociation remained significant after partialing out the variance associated with other psychopathological symptoms. Conversely, only the difference in paranoid symptoms remained-marginally-significant when controlling for the influence of dissociation. This finding suggests that dissociation may have unique relevance for the psychological functioning of inmates.
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Affiliation(s)
| | - Carlo Garofalo
- 1 Sapienza University of Rome, Italy
- 2 Tilburg University, The Netherlands
| | | | | | | | | | - Mara Costa
- 5 Miguel Torga Institute, Coimbra, Portugal
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15
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Odell A, Reynolds GL, Fisher DG, Huckabay LM, Pedersen WC, Xandre P, Miočević M. Attention Deficit Hyperactivity Disorder, Aggression, and Illicit Stimulant Use: Is This Self-Medication? J Nerv Ment Dis 2017; 205:372-379. [PMID: 28230564 PMCID: PMC5439354 DOI: 10.1097/nmd.0000000000000668] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study compares adults with and without attention deficit hyperactivity disorder (ADHD) on measures of direct and displaced aggression and illicit drug use. Three hundred ninety-six adults were administered the Wender Utah Rating Scale, the Risk Behavior Assessment, the Aggression Questionnaire (AQ), and the Displaced Aggression Questionnaire (DAQ). Those with ADHD were higher on all scales of the AQ and DAQ, were younger at first use of amphetamines, and were more likely to have ever used crack and amphetamines. A Structural Equation Model found a significant interaction in that for those with medium and high levels of verbal aggression, ADHD predicts crack and amphetamine. Follow-up logistic regression models suggest that blacks self-medicate with crack and whites and Hispanics self-medicate with amphetamine when they have ADHD and verbal aggression.
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Affiliation(s)
- Annie Odell
- School of Nursing, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, California 90840, USA
| | - Grace L. Reynolds
- Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, California 90840, USA
| | - Dennis G. Fisher
- Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, California 90840, USA
- Department of Psychology, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, California 90840, USA
| | - Loucine M. Huckabay
- School of Nursing, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, California 90840, USA
| | - William C. Pedersen
- Department of Psychology, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, California 90840, USA
| | - Pamela Xandre
- School of Nursing, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, California 90840, USA
| | - Milica Miočević
- Department of Psychology, Arizona State University, 950 S. McAllister Ave, Tempe, AZ 85287, USA
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16
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Calati R, Bensassi I, Courtet P. The link between dissociation and both suicide attempts and non-suicidal self-injury: Meta-analyses. Psychiatry Res 2017; 251:103-114. [PMID: 28196773 DOI: 10.1016/j.psychres.2017.01.035] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 01/09/2017] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
Abstract
Dissociative disorders (DD) are frequently associated with suicidal behaviors. We performed the first meta-analysis of studies comparing rates of suicide attempts (SA) and non-suicidal self-injury (NSSI) in psychiatric individuals with and without DD. We included: 1) studies comparing SA and NSSI rates in psychiatric individuals with and without DD; 2) studies comparing Dissociative Experiences Scale (DES) scores in both SA and NSSI psychiatric patients versus non SA and non NSSI ones. Cochrane Collaboration Review Manager Software and STROBE statement were used. Nineteen studies were included in the analyses. DD patients were more likely to report both previous SA and NSSI in comparison to non DD patients. Importantly, results remained highly significant in both outcomes but with no more heterogeneity when including studies using a DSM-based method to diagnose DD. Both SA and NSSI patients reported higher DES scores in comparison to non SA and non NSSI patients. The presence of DD diagnosis or higher DES scores seems to be related to both SA and NSSI in psychiatric patients. Hence, it may be reasonable to hypothesize the presence of a dissociative subtype in a subset of these patients, which should be considered as a transdiagnostic factor and should be carefully assessed.
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Affiliation(s)
- Raffaella Calati
- INSERM U1061, La Colombière Hospital, University of Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France; Department of Emergency Psychiatry & Post Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.
| | - Ismaïl Bensassi
- INSERM U1061, La Colombière Hospital, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry & Post Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Philippe Courtet
- INSERM U1061, La Colombière Hospital, University of Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France; Department of Emergency Psychiatry & Post Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
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17
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Mergler M, Driessen M, Lüdecke C, Ohlmeier M, Chodzinski C, Weirich S, Schläfke D, Wedekind D, Havemann-Reinecke U, Renner W, Schäfer I. Relationships between a Dissociative Subtype of PTSD and Clinical Characteristics in Patients with Substance Use Disorders. J Psychoactive Drugs 2017; 49:225-232. [DOI: 10.1080/02791072.2017.1296209] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michaela Mergler
- Psychologist, Alpen-Adria-Universitat Klagenfurt, Clinical Psychology, Klagenfurt, Austria
| | - Martin Driessen
- Professor, Clinic of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany
| | - Christel Lüdecke
- Clinician, Klinikum Region Hannover Psychiatrie Wunstorf, Wunstorf, Germany
| | | | - Claudia Chodzinski
- Social Worker, Medizinische Hochschule Hannover Klinik fur Psychiatrie Sozialpsychiatrie und Psychotherapie, Hannover, Germany
| | - Steffen Weirich
- Clinician, Universitatsmedizin Rostock Klinik und Poliklinik fur Psychiatrie und Psychotherapie, Rostock, Germany
| | - Detlef Schläfke
- Professor, Department of Forensic Psychiatry, University of Rostock, Rostock, Germany
| | - Dirk Wedekind
- Professor, Universitatsklinikum Göttingen, Göttingen, Germany
| | | | - Walter Renner
- Professor, Pan European University Bratislava, Bratislava, Slovakia
| | - Ingo Schäfer
- Clinician, Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Psychiatrie und Psychotherapie, Hamburg, Germany
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18
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Traumatic experiences, alexithymia, and Internet addiction symptoms among late adolescents: A moderated mediation analysis. Addict Behav 2017; 64:314-320. [PMID: 26586032 DOI: 10.1016/j.addbeh.2015.11.002] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 12/22/2022]
Abstract
The association between traumatic experiences, alexithymia, and substance abuse is well established. Less is known about the role of traumatic experiences and alexithymia in the onset and maintenance of Internet-related disorders. In the present study, self-report measures on traumatic experiences, alexithymia, and problematic Internet use were administered to 358 high school students (57% females) aged 18-19years old, to test whether alexithymic traits mediated the relationship between traumatic experiences and Internet addiction symptoms, and whether gender moderated the proposed mediation in the sample. While partial mediation occurred in the entire sample, gender directly affected the relationship between the investigated constructs: Internet addiction symptoms were independently related to traumatic experiences among males, and to alexithymic traits among females. Therefore, the results of this study suggest that trauma memories among males, and problems with affect regulation among females, may increase the risk of problematic Internet use during late adolescence. Such findings might have relevant implications to inform any treatment plan for late adolescent students who are overinvolved with online activities, pointing out that tailored approaches to their problems and difficulties are particularly needed in clinical practice.
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Rasche K, Dudeck M, Otte S, Klingner S, Vasic N, Streb J. Factors influencing the pathway from trauma to aggression: A current review of behavioral studies. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.npbr.2016.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Bulai I, Enea V. Dissociation and alexithymia in a Romanian sample of substance abuse patients. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.3109/14659891.2015.1130183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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21
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Terock J, Van der Auwera S, Janowitz D, Spitzer C, Barnow S, Miertsch M, Freyberger HJ, Grabe HJ. From Childhood Trauma to Adult Dissociation: The Role of PTSD and Alexithymia. Psychopathology 2016; 49:374-382. [PMID: 27623153 DOI: 10.1159/000449004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 07/29/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The mechanism of how childhood trauma leads to increased risk for adult dissociation is not sufficiently understood. We sought to investigate the predicting effects and the putatively mediating roles of PTSD and alexithymia on the path from childhood trauma to adult dissociation. METHODS A total of 666 day-clinic outpatients were administered the Childhood Trauma Questionnaire (CTQ), the Toronto Alexithymia Scale (TAS-20), the Posttraumatic Diagnostic Scale (PDS), and the Dissociative Experiences Scale (DES) and controlled for sex, age, and the Global Symptom Index (GSI). Linear regression analyses and mediation analyses were applied. RESULTS Independent predictive effects on dissociation were found for childhood trauma, alexithymia and PDS, even after adjusting for GSI. Effects of childhood neglect on dissociation were slightly stronger than of abuse. Alexithymia did not mediate the path from childhood trauma to dissociation. Mediation by PDS was specific for childhood abuse, with all PTSD symptom clusters being significantly involved. CONCLUSIONS Childhood abuse and neglect are important predictors of dissociation. While the effects of abuse are mediated by PTSD, the mechanism of how neglect leads to dissociation remains unclear. The results further support the predictive value of alexithymia for adult dissociation above and beyond the effects of childhood trauma, PTSD, and GSI scores.
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Affiliation(s)
- Jan Terock
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Klinikum Stralsund, Stralsund, Germany
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22
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Lemieux A, al'Absi M. Stress psychobiology in the context of addiction medicine: from drugs of abuse to behavioral addictions. PROGRESS IN BRAIN RESEARCH 2015; 223:43-62. [PMID: 26806770 DOI: 10.1016/bs.pbr.2015.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In this chapter, we briefly review the basic biology of psychological stress and the stress response. We propose that psychological stress and the neurobiology of the stress response play in substance use initiation, maintenance, and relapse. The proposed mechanisms for this include, on the one hand, the complex interactions between biological mediators of the stress response and the dopaminergic reward system and, on the other hand, mediators of the stress response and other systems crucial in moderating key addiction-related behaviors such as endogenous opioids, the sympathetic-adrenal-medullary system, and endocannabinoids. Exciting new avenues of study including genomics, sex as a moderator of the stress response, and behavioral addictions (gambling, hypersexuality, dysfunctional internet use, and food as an addictive substance) are also briefly presented within the context of stress as a moderator of the addictive process.
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Affiliation(s)
| | - Mustafa al'Absi
- University of Minnesota School of Medicine, Duluth, MN, USA.
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23
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Armour C, Elklit A, Lauterbach D, Elhai JD. The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims? J Anxiety Disord 2014; 28:418-26. [PMID: 24568742 DOI: 10.1016/j.janxdis.2013.12.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 11/01/2013] [Accepted: 12/27/2013] [Indexed: 11/18/2022]
Abstract
The DSM-5 currently includes a dissociative-PTSD subtype within its nomenclature. Several studies have confirmed the dissociative-PTSD subtype in both American Veteran and American civilian samples. Studies have begun to assess specific factors which differentiate between dissociative vs. non-dissociative PTSD. The current study takes a novel approach to investigating the presence of a dissociative-PTSD subtype in its use of European victims of sexual assault and rape (N=351). Utilizing Latent Profile Analyses, we hypothesized that a discrete group of individuals would represent a dissociative-PTSD subtype. We additionally hypothesized that levels of depression, anger, hostility, and sleeping difficulties would differentiate dissociative-PTSD from a similarly severe form of PTSD in the absence of dissociation. Results concluded that there were four discrete groups termed baseline, moderate PTSD, high PTSD, and dissociative-PTSD. The dissociative-PTSD group encompassed 13.1% of the sample and evidenced significantly higher mean scores on measures of depression, anxiety, hostility, and sleeping difficulties. Implications are discussed in relation to both treatment planning and the newly published DSM-5.
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Affiliation(s)
- Cherie Armour
- School of Psychology, University of Ulster at Coleraine Campus, Coleraine, Northern Ireland, UK.
| | - Ask Elklit
- The National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark.
| | - Dean Lauterbach
- Department of Psychology, Eastern Michigan University, MI, USA.
| | - Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, OH, USA; Department of Psychiatry, University of Toledo, Toledo, OH, USA.
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