Pathways to Dissociation: Intrafamilial Versus Extrafamilial Trauma in Juvenile Delinquents

Division of Child and Adolescent Psychiatry , Stanford University, Palo Alto, California, United States
Journal of Nervous & Mental Disease (Impact Factor: 1.81). 01/2004; 191(12):781-8. DOI: 10.1097/01.nmd.0000105372.88982.54
Source: PubMed

ABSTRACT Dissociation is postulated to occur as a function of particular types of child abuse or chronic abuse. Additionally, there is an ongoing controversy examining the perpetrator's relationship to the victim in the development of dissociation. In this study, reports of traumatic events experienced both in the family environment and in the community were used to examine the relationship between dissociative disorder as defined by DSM-IV (pathological dissociation), and dissociation as a defense mechanism. The first objective was to identify whether the site of the trauma or the quantity of trauma correlated more significantly with symptoms of dissociation. The second objective was to explore a potential correlation between topics that participants choose to disclose during a standardized Stress Inducing Speech Task (SIST), and symptoms of dissociation. The third objective was to examine the relationship between the age of occurrence, the duration of trauma, and symptoms of dissociation. Fifty-two delinquent juveniles completed measures (including the SCID-D, REM-71, CTQ, CTI, SIST) assessing traumatic experiences, psychopathological dissociation, and dissociation as defense mechanism. Blind raters scored the SIST for intrafamilial and extrafamilial trauma. The perpetrator's relationship to the victim, site of the trauma, quantity of the trauma, age of occurrence, and duration of the trauma were analyzed by descriptive statistics and Pearson partial correlations. Significant correlations were found between symptoms of pathological dissociation and intrafamilial trauma. Significant correlations were not found between extrafamilial trauma and pathological dissociation and dissociation as defense mechanism. All these correlations held constant the chronicity of traumas reported. The results obtained in this study through blind and independent assessment suggest that special trauma characteristics (i.e., childhood trauma perpetrated by a family member) rather than sheer cumulative effects of trauma may have greater implications for the development of pathological dissociation. The relationships to dissociation as a defense were much weaker.

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Available from: Allison D Redlich, Aug 29, 2015
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    • "Recent research has focused on the specific posttraumatic symptom of dissociation, which is prevalent among traumatized youth in the JJ system (Carrion & Steiner, 2000; Plattner et al., 2003). Studies consistently show that in comparison to other types of trauma, SA is differentially associated with dissociative symptoms among youth and adults (Bernier et al., 2013; Plattner et al., 2003; Trickett, Noll, & Putnam, 2011). Furthermore, rates of dissociation are high among individuals who self-injure, and dissociation has been found to mediate the relation between childhood trauma and NSSI (Shenk, Noll, & Cassarly, 2010; Swannell et al., 2012; Weierich & Nock, 2008). "
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    ABSTRACT: To date, scholars have established associations among non-suicidal self-injury and sexual abuse, posttraumatic stress symptoms, and dissociation. However, leading theoretical models of the mechanisms underlying the association between trauma and negative outcomes suggest a more parsimonious explanation in that deficits in emotion regulation may underlie these various risk factors for self-injury. This study examined whether sexual abuse was differentially associated with non-suicidal self-injury over and above other forms of traumatic experiences and whether the association between sexual abuse and self-injury was statistically mediated by emotion dysregulation and dissociation. Participants included 525 youth (392 boys, 133 girls) recruited from the US juvenile justice system who completed measures of self-reported trauma exposure, posttraumatic stress symptoms, dissociation, and emotion dysregulation. Results of a hierarchical regression demonstrated that sexual abuse predicted posttraumatic stress symptoms and self-injury over and above other forms of traumatic experiences. Results of bootstrapped mediation analyses indicated that emotion dysregulation and dissociation in combination were implicated in self-injury among youth. The results suggests that youth in the juvenile justice system who experience sexual abuse may be at risk for higher rates of posttraumatic stress symptoms, and that self-injury may be particularly salient for youth who experience sexual abuse. Furthermore, the results shed light on the role that dissociation and emotion dysregulation play in the relation between sexual abuse and self-injury, suggesting that a larger framework of self-regulation may have both empirical and clinical utility in helping to understand the underlying processes at play in these associations.
    Journal of Trauma & Dissociation 03/2015; DOI:10.1080/15299732.2015.989647 · 1.72 Impact Factor
    • "In addition to the internalizing disorders commonly identified in studies of childhood peritraumatic dissociation and PTSD, externalizing disorders (Ford & Connor, 2009; Ford et al., 2000) and severe psychiatric disorders (e.g., bipolar disorder , psychosis; Mueser & Taub, 2008) are also either highly comorbid with PTSD or associated with PTSD severity in children. Childhood sexual abuse is the trauma exposure most consistently associated both with child psychopathology (Mueser & Taub, 2008) and with trait dissociation in adults (Briere & Elliott, 2003), adolescents (Plattner et al., 2003), and children (Putnam, Helmers, & Trickett, 1993). Retrospectively recalled childhood peritraumatic dissociation was associated with risk of adult sexual and physical victimization and PTSD severity, and peritraumatic dissociation was the unique correlate of PTSD severity, depression , and dissociative symptoms among women survivors of childhood sexual abuse (Johnson, Pike, & Chard, 2001). "
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    ABSTRACT: Although peritraumatic dissociation and other subjective peritraumatic reactions, such as emotional distress and arousal, have been shown to affect the relationship between a traumatic event and the development of posttraumatic stress disorder (PTSD) in adults, systematic studies with youth have not been done. In a mixed ethnic and racial sample of 90 psychiatrically impaired youth (ages 10-18, 56% boys), we investigated the contributions of peritraumatic dissociation, emotional distress, and arousal to current PTSD severity after accounting for the effects of gender, trauma history, trait dissociation, and psychopathology (attention-deficit/hyperactivity disorder and depression). Peritraumatic dissociation emerged as the only peritraumatic variable associated with current PTSD severity assessed both by questionnaire and interview methods (β = .30 and .47 p < .01). Peritraumatic dissociation can be rapidly assessed in clinical practice and warrants further testing in prospective studies as a potential mediator of the trauma-PTSD relationship in youth.
    Journal of Traumatic Stress 02/2012; 25(1):41-9. DOI:10.1002/jts.21668 · 2.72 Impact Factor
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    • "We also examined traumatic stress symptoms (including anxiety, depression and dissociation) and alexithymia as mediators between HB trauma and health problems. Previous studies that have contrasted the effects of HB trauma with those of other forms of trauma have investigated samples of inpatients (Atlas & Ingram, 1998), abuse survivors (Leahy et al., 2004; Lucenko, Gold, & Cott, 2000), juvenile delinquents (Plattner et al., 2003), or individuals with chronic pain or health problems (Freyd, Klest & Allard, 2005). Others have limited the sample to survivors of sexual trauma (Darves-Bornoz, Berger, Degiovanni, Gaillard, & Lépine, 1999; Ullman, 2007). "
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    ABSTRACT: Betrayal trauma, or trauma perpetrated by someone with whom a victim is close, is strongly associated with a range of negative psychological and physical health outcomes. However, few studies have examined associations between different forms of trauma and emotional and physical symptoms. The present study compared betrayal trauma to other forms of trauma as predictors of young adults' psychological and physical symptoms, and explored potential mediators. A total of 185 university undergraduate students completed the Brief Betrayal Trauma Survey, the Trauma Symptom Checklist, the Toronto Alexithymia Scale, and the Pennebaker Inventory of Limbic Languidness. For each set of symptoms, simultaneous multiple regressions assessed the relative contributions of low versus high betrayal trauma to psychological and physical health reports. Structural equation models examined traumatic stress symptoms and alexithymia as mediators of the relationship between betrayal trauma and physical health symptoms. A total of 151 participants (82%) reported exposure to at least 1 of 11 forms of trauma queried (M = 2.08, SD = 1.94); 96 participants (51.9%) reported at least 1 betrayal trauma. Traumas characterized by high betrayal predicted alexithymia, anxiety, depression, dissociation, physical health complaints, and the number of days students reported being sick during the past month, whereas other traumas did not. Structural equation modeling revealed that traumatic stress symptoms and alexithymia mediated the association between betrayal trauma and physical health complaints. These results indicate that betrayal trauma is associated with young adults' physical and mental health difficulties to a greater extent than are other forms of trauma. Results may inform assessment, intervention, and prevention efforts.
    Journal of Interpersonal Violence 02/2012; 27(3):547-67. DOI:10.1177/0886260511421672 · 1.64 Impact Factor
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