Article

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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    • "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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    • "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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    • "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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