Evidence for a dissociative subtype of post-traumatic stress disorder among help-seeking childhood sexual abuse survivors.

Bob Shappel School of Social Work, Tel-Aviv, 69978, Israel.
Journal of Trauma & Dissociation (Impact Factor: 1.72). 02/2006; 7(2):7-27. DOI: 10.1300/J229v07n02_02
Source: PubMed

ABSTRACT This study examined evidence for a dissociative subtype of post-traumatic stress disorder (PTSD) among women seeking psychotherapy for childhood sexual abuse (CSA). One hundred and twenty-two women seeking treatment for CSA completed a battery of questionnaires assessing PTSD, dissociative symptoms, and child maltreatment. Using signal detection analysis, we identified high and low dissociation PTSD subgroups. A constellation of three PTSD symptoms-hypervigilance, sense of foreshortened future, and sleep difficulties-discriminated between these two subgroups (OR = 8.15). Further evidence was provided by the finding of a nonlinear relationship between severity of childhood maltreatment and dissociation in the women with PTSD. These results provide support for a dissociative subtype of PTSD that may stem from more severe childhood experiences of neglect and abuse.

Download full-text


Available from: Lisa Butler, Jun 17, 2015
  • American Journal of Psychiatry 08/2014; 171(8):811-3. DOI:10.1176/appi.ajp.2014.14050611 · 13.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A number of researchers have argued for the existence of different subtypes of posttraumatic stress disorder (PTSD). In the current paper we present criteria by which to assess these putative subtypes, clarify potential pitfalls of the statistical methods employed to determine them, and propose alternative methods for such determinations. Specifically, three PTSD subtypes are examined: (1) complex PTSD, (2) externalizing/internalizing PTSD, and (3) dissociative/nondissociative PTSD. In addition, three criteria are proposed for subtype evaluation, these are the need for (1) reliability and clarity of definition, (2) distinctions between subtypes either structurally or by mechanism, and (3) clinical meaningfulness. Common statistical evidence for subtyping, such as statistical mean difference and cluster analysis, are presented and evaluated. Finally, more robust statistical methods are suggested for future research on PTSD subtyping.
    Depression and Anxiety 08/2012; 29(8). DOI:10.1002/da.21926 · 4.29 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Needs assessment in the wake of disasters is most significant yet highly complex and challenging. Kessler et al. propose a comprehensive disaster mental health research model. This model has several significant advantages: (1) Pre-prepared plans and resources allow rapid deployment of skilled professionals; (2) Continuity will ensure that lessons learned from one disaster will be retained and used in subsequent disasters; (3) Standardization will provide a solid basis for evaluation and comparison across events; (4) Continuous monitoring of needs over time will enable the capture of a full range of responses including delayed effects; and (5) Will provide a valuable resource for researchers in the field. At the same time, there are a number of challenges that must be considered before the establishment and implementation of the proposed center and use of standardized measures. These challenges are associated with the observation that different disasters give rise to different problems and needs; there is considerable cultural variability; and differential power and agenda of stakeholders may result in a limiting 'tunnel vision' approach that may undermine new developments, creativity, and progress. Ways to overcome these challenges and difficulties that are involved in the implementation of such a model are suggested.
    International Journal of Methods in Psychiatric Research 01/2008; 17 Suppl 2(S2):S36-41. DOI:10.1002/mpr.268 · 3.42 Impact Factor