Severe dissociative experiences beyond detachment in a large clinical sample of inpatients with PTSD: Diagnostic and treatment implications

Kratzer, Leonhard; Tschöke, Stefan; Schröder, Johanna; Shevlin, Mark; Hyland, Philip; Eckenberger, Christine; Heinz, Peter; Karatzias, Thanos

Abstract

Introduction: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) 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 = 1360). 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.

• Journal Article Type: Article
• Acceptance Date: Jan 30, 2024
• Deposit Date: Jan 31, 2024
• Print ISSN: 0254-4962
• Electronic ISSN: 1423-033X
• Publisher: Karger Publishers
• Peer Reviewed: Peer Reviewed
• Keywords: post-traumatic stress disorder, dissociation, auditory verbal hallucination, childhood abuse, amnesia, compartmentalization, identity alteration
• Public URL: http://researchrepository.napier.ac.uk/Output/3497295
• Publisher URL: https://karger.com/psp