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.

  • American Journal of Psychiatry 08/2014; 171(8):811-3. DOI:10.1176/appi.ajp.2014.14050611 · 13.56 Impact Factor
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    ABSTRACT: This paper describes the key findings of an NSPCC study estimating need, in the UK, for therapeutic services for children who have experienced sexual abuse. This is based upon current estimates of the prevalence and impact of sexual abuse towards children and young people against the availability of therapeutic services in the UK. Data were collected on service location, availability, scope and coverage across England, Wales, Northern Ireland and Scotland. Researchers: (1) mapped 508 services; (2) collected data from 195 services via a structured questionnaire; (3) followed up 21 service managers and 11 service commissioners with a semi-structured interview; and (4) carried out two focus groups with young people.‘Data were collected on service location, availability, scope and coverage’The overall level of specialist provision is low, with less than one service available per 10 000 children and young people in the UK. Calculations of need indicate that 57 156 children across the UK in the last year may have been unable to access a service. Findings from services support the view that need outstrips availability; that referral routes are limited, leaving few options for young people who have been raped or seriously sexually assaulted to directly access support; that significant waiting lists mean services must focus on reactive, rather than preventive, work; and that services are less accessible for certain groups, especially sexually abused teenagers, children with disabilities and those from Black, Asian, Minority Ethnic and Refugee backgrounds. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner MessagesRelevant professionals must be adequately trained to talk to children about sexual abuse and to identify those vulnerable in order to identify need.Expert specialist services are well placed to share learning on early help and identification with broader children's service providers.Active steps need to be taken by commissioners in consultation with young people, voluntary sector and adult sexual violence service providers to meet the shortfall at the level of local authorities.
    Child Abuse Review 09/2012; 21(5). DOI:10.1002/car.1205 · 0.56 Impact Factor
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    ABSTRACT: Objective :This study sought to determine the trauma-related psychiatric comorbidity of somatization disorder among women who applied to an outpatient psychiatric unit of a general hospital in eastern Turkey. Methods: Forty women with somatization disorder and 40 non-clinical controls recruited from the same geographic region participated in the study. Somatization Disorder and Posttraumatic Stress Disorder (PTSD) sections of the Structured Clinical Interview for DSM-IV (including its criterion A traumatic events checklist), Dissociative Disorders Interview Schedule, Dissociative Experiences Scale (Taxon), Hamilton Depression Rating Scale, and Childhood Abuse and Neglect Questionnaire were administered to all participants. Results: A significant proportion of the women with somatization disorder had the concurrent diagnoses of major depression, PTSD, dissociative disorder, and borderline personality disorder. Women with somatization disorder reported traumatic experiences of childhood and/or adulthood more frequently than the comparison group. A significant proportion of these patients reported possession and/or paranormal experiences. Binary logistic regression analysis demonstrated that current major depression, being married, total number of traumatic events in adulthood, and reports of possession and/or paranormal experiences were independent risk factors for somatization disorder diagnosis.Conclusions: Among women with endemically high exposition to traumatic stress, multiple somatic complaints were in a significant relationship with major depressive disorder and lifelong cumulative traumatization. While accompanying experiences of possession and paranormal phenomena may lead to seeking help by paramedical healers, the challenge of differential diagnosis may also limit effective service to this group of somatizing women with traumatic antecedents and related psychiatric comorbidities.
    Comprehensive Psychiatry 08/2014; 55(8):1837-1846. DOI:10.1016/j.comppsych.2014.08.052 · 2.26 Impact Factor


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May 28, 2014