The relationship between peritraumatic distress and peritraumatic dissociation: an examination of two competing models.

McGill University, Douglas Hospital Research Center, Montreal, Quebec, Canada.
Journal of Nervous & Mental Disease (Impact Factor: 1.81). 12/2006; 194(11):853-8. DOI: 10.1097/01.nmd.0000244563.22864.f1
Source: PubMed

ABSTRACT This study examined whether peritraumatic dissociation serves to protect trauma-exposed individuals from experiencing high levels of peritraumatic distress or is an epiphenomenon of high levels of peritraumatic distress. The sample was comprised of 709 police officers and 317 peer-nominated civilians exposed to a variety of critical incidents. Participants filled out measures of trauma exposure, traumatic stress, peritraumatic distress, and peritraumatic dissociation. There was an overall moderate-to-strong linear relationship between peritraumatic distress and dissociation. Among those with high levels of dissociation, very few reported low levels of distress. Among those with high levels of distress, a significant number--but not all--reported high levels of dissociation. Our results do not provide support for the idea that dissociation protects individuals from experiencing high levels of distress at the time of the trauma but rather suggest that dissociation is an epiphenomenon of high levels of distress observed in a subset of individuals.

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Available from: Alain Brunet, Apr 01, 2015
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    • "DOI: 10.1002/jts.21716 peritraumatic dissociation usually occurs in the context of high distress, recent notions state that peritraumatic dissociation may be a by-product of high arousal (Fikretoglu et al., 2006). "
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    ABSTRACT: Empirical data have challenged the unidimensionality of the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), a widely used measure for peritraumatic dissociation. The aim of this study was to assess the factor structure of the PDEQ in 3 trauma-exposed samples: (a) trauma-exposed police officers (N = 219); (b) trauma-exposed civilians (N = 158); and (c) treatment-seeking trauma-exposed civilians (N = 185). Confirmatory factor analyses using measurement invariance testing supported a 2-factor structure (CFIs .96-.98; RMSEAs .07-.09), but excluded 2 of the original items. Factor 1 was termed Altered Awareness; Factor 2 was termed Derealization. Altered Awareness reflected disturbances in information processing during the traumatic event, whereas Derealization reflected distortions in perception. Hierarchical linear regression analysis showed that Derealization predicted posttraumatic stress severity at 26.5 weeks follow-up only in the sample of police officers (R(2) = .45). Future longitudinal research shortly following trauma is required to elucidate causality and underlying mechanisms of peritraumatic dissociation, which may contribute to the development of more accurate screening strategies, as well as more effective strategies for prevention and early intervention.
    Journal of Traumatic Stress 08/2012; 25(4):475-9. DOI:10.1002/jts.21716 · 2.72 Impact Factor
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    • "To elaborate, dissociation during a trauma may help protect against encoding threatening, aversive memories (e.g., Horowitz, 1986) and may reduce distress and physiological arousal, although support for this hypothesis is inconsistent (Bryant, Harvey, Guthrie, & Moulds, 2000; Fikretoglu et al., 2006; Griffin, Resick, & Mechanic, 1997; Kaufman et al., 2002; Nixon & Bryant, 2005). Distress or arousal during memory encoding has been posited to affect memory fragmentation (e.g., Shobe & Kihlstrom, 1997). "
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    ABSTRACT: Several prominent theories of post-traumatic stress disorder (PTSD) posit that peritraumatic dissociation results in insufficient encoding of the trauma memory and that persistent dissociation prevents memory elaboration, resulting in memory fragmentation and PTSD. In this review we summarise the empirical literature on peritraumatic and trait dissociation and trauma narrative fragmentation as measured by meta-memory and rater/objective coding. Across 16 studies to date, the association between dissociation and fragmentation was most prominent when examining peritraumatic dissociation and patient's own ratings of memory fragmentation. This relationship did not hold when examining trait dissociation or rater-coded or computer-generated measures of fragmentation. Thus initial evidence points more towards a strong self-reported association between constructs that is not supported on more objective fragmentation coding. Measurement overlap, construct ambiguity, and exclusion of potential confounds may underlie lack of a strong association between dissociation and objective-rated fragmentation.
    Memory 02/2012; 20(3):277-99. DOI:10.1080/09658211.2012.655747 · 2.09 Impact Factor
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    • "Consequently, trauma representations are poorly integrated into autobiographical memory and are likely to result in intrusions and flashbacks characteristic of PTSD (e.g., Brewin, Dalgleish, & Joseph, 1996; Ehlers & Clark, 2000). Others have posited that peritraumatic dissociation is an epiphenomenon of peritraumatic distress that occurs in a subset of trauma victims who experienced extreme levels of peritraumatic distress during trauma exposure (e.g., Bernat, Ronfeldt, Calhoun, & Arias, 1998; Fikretoglu et al., 2006; Friedman, 2000). Tonic immobility, on the other hand, has been suggested to represent a behavioral or somatoform manifestation of peritraumatic dissociation (Abrams, Hons, Carleton, Taylor, & Asmundson, 2009; Hagenaars, Van Minnen, & Hoogduin, 2007). "
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    ABSTRACT: The present study explores the associations between three types of peritraumatic reactions (dissociation, distress, and tonic immobility) and posttraumatic stress disorder (PTSD) symptoms in a sample of 125 victims of interpersonal violence who had applied for compensation with the Dutch Victim Compensation Fund (DCVF). In addition, the confounding roles of malingering and fantasy proneness are examined. Results indicate that tonic immobility did not predict PTSD symptom levels when adjusting for other forms of peritraumatic reactions, whereas peritraumatic dissociation and distress did. However, after the effects of malingering and fantasy proneness had been controlled for, malingering is the only factor associated with increased PTSD symptomatology. Implications for policy practice as well as study strengths and limitations are discussed.
    Journal of Interpersonal Violence 04/2011; 26(11):2186-210. DOI:10.1177/0886260510383032 · 1.64 Impact Factor
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