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An Update on the Dissociative Experiences Scale

Authors:
  • National Center for PTSD and Stanford University School of Medicine

Abstract

Reviews studies that relate to the norms, reliability, and validity of the Dissociative Experiences Scale (DES). Appropriate clinical and research use of the scale are discussed together with factor analytic studies and fruitful statistical analysis methods. Research reported for 1989–1992 with the DES is described, and promising new research questions are highlighted. Suggestions are made for translating and using the DES in other cultures. A 2nd version of the DES, which is easier to score, is included as an appendix. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Dissociative Experiences Scale -II (PES: Carlson & Putnam. 1993). This is a 28-item self-report questionnaire, measuring the extent of dissociative experiences (Appendix H). The questionnaire measures three types of dissociative experience: amnesic dissociation, absorption / imaginative involvement, and depersonalisation / derealisation. The DBS has been reported as having good reliability and valid ...
... The questionnaire measures three types of dissociative experience: amnesic dissociation, absorption / imaginative involvement, and depersonalisation / derealisation. The DBS has been reported as having good reliability and validity in both clinical and non-clinical populations (Carlson & Putnam, 1993). It was included to investigate whether cognitive avoidance is Schema avoidance in bulimia 11 associated with other forms of schema avoidance. ...
Thesis
p>Treatments based on traditional cognitive behavioural models of bulimia are effective only in approximately 50% of cases. This suggests that alternative models of bulimia and its treatment need to be considered. Recent models highlight the role of negative emotions in bulimia and suggest that bulimic behaviours may serve to 'block' such emotions. The literature review focuses on how bulimic women process threatening information. A recent information processing model (Beck and Clark, 1997) highlights the role of attentional bias and schema avoidance in pathology. These processes are discussed in relation to bulimia. The literature review highlights the similarities between bulimia and other impulsive behaviours, and suggests that they might serve a similar function. The present study examined whether bulimia and impulsivity are associated with avoidance of threats to self-esteem. The results indicated that there were no significant differences between the bulimic group and a non-clinical group in levels of cognitive avoidance, and there were no significant associations between cognitive avoidance and impulsivity. However, differences were found in levels of dissociation for certain types of impulsive behaviours.</p
... Adolescents experiencing Type II trauma have been found to experience higher levels of dissociation . It has been hypothesized that dissociation helps individuals to cope with stress by enabling them to cut themselves off from the intolerable affect (through absorption, depersonalisation, derealisation and amnesia) associated with the traumatic event (Carlson & Putnam, 1993;. As bullying could be defined as a Type II trauma, one might hypothesize that bullied adolescents use dissociation as a means to cope with the bullying. ...
Thesis
p>The dissertation explores post-traumatic stress (PTS) symptoms in bullied adolescents. The initial part of the literature review discusses prevalence, gender differences and developmental aspects of bullying. The risk factors of being bullied are explored as well as the subsequent sequelae. The second part of the review discusses the adolescent trauma literature, particularly focusing on the developmental issues and sequelae. Because only a small proportion of individuals experience PTS symptoms, the moderating and mediating factors of developing PTS symptoms are discussed. The final section of the review brings the two bodies of literature together and argues that some bullied adolescents may actually be experiencing PTS reactions. The empirical study tests the argument proposed in the literature review that bullied adolescents experience symptoms associated with PTS symptoms, exploring the moderating role of social support and mediating role of dissociation. The participants were members of a secondary school (n = 689) who filled in four questionnaires exploring bullying experiences, levels of dissociation and support, and PTS symptoms. The results indicated that those who reported being bullied experienced significantly more PTS and dissociation symptoms that those who reported not being bullied. Over half of those bullied more than once or twice had scores for the Impact of Events Scale which fell in the clinically significant range for PTS symptoms. Dissociation was found to be a mediator between bullying and PTS symptoms but social support was not identified as a moderator. The implications for clinical practice and future research are discussed.</p
... Proneness to dissociation might play a role in this regard. In the first publication on maladaptive daydreaming, Somer (2002) (Janet, 1920;Putnam, 1999;Van der Kolk & Van der Hart, 1989), that is, the tendency to become engaged in an internal or external stimulus to the point of obliviousness to one's surroundings (Carlson & Putnam, 1993 symptoms in daydreamers (Soffer-Dudek, 2014). This proposition is based on the concept that dissociation is no continuous event and the daydreamer's attention periodically returns to be externally-directed (Butler, 2004). ...
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Aim: Daydreaming is a cognitive phenomenon characterized by the redirection of attention from the external world to inner representations. Although serving several adaptive functions, excessive daydreaming has been related to emotional problems and poor psychosocial adjustment. During adolescence, this phenomenon has been scarcely explored as potential psychopathological correlate. This study aims to explore daydreaming frequency and association with psychopathological symptoms in a non‐referred population. Methods: Participants were adolescents from a community sample (N = 251). Daydreaming was assessed through the Daydreaming Frequency Scale (DDFS). Youth Self‐Report (YSR) and Strength and Difficulties Questionnaire (SDQ) were used as self‐reports to evaluate psychopathological problems and adaptive functioning. Results: Excessive daydreaming was present in 12.7% of participants. DDFS scores were significantly elevated in respondents with clinical scores for internalizing, depressive, obsessive–compulsive, and post‐traumatic stress problems. Symptom severity correlated positively with the DDFS. Higher daydreaming was also associated with emotional symptoms, conduct problems and total difficulties on the SDQ. Conclusions: Adolescents who daydream show increased depressive, obsessive–compulsive, and post‐traumatic stress symptoms. Possible cognitive processes at play in the relationship between daydreaming and psychopathology are discussed. Daydreaming may represent a silent psychopathological index that deserves better recognition in the clinical practice and in mental health initiatives for adolescents.
... The higher prevalence rate of 9.7% in Israel (Somer et al., 2015) could be due to some unique social causes in the Middle East, such as wars and conflicts (Pocock, 2017), which will cause traumatic experiences and stress that may increase the risk of DDD. Our findings show that DDD is more prevalent in the younger population, with a prevalence of around 11%, consistent with existing evidence that dissociative symptoms are more prevalent in adolescents (Carlson & Putnam, 1993). High levels of anxiety in the mid-teens (Abe & Suzuki, 1986) could be a potential factor when explaining the higher prevalence of DDD in the younger population, as existing literature suggests that depersonalization is associated with anxiety in the general population (Trueman, 1984). ...
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Depersonalization-Derealization disorder (DDD) is a psychiatric condition characterized by persistent feelings of detachment from one's self and of unreality about the outside world. This review aims to examine the prevalence of DDD amongst different populations. A systematic review protocol was developed before literature searching. Original articles were drawn from three electronic databases and included only studies where prevalence rates of DDD were assessed by standardized diagnostic tools. A narrative synthesis was conducted. Twenty-three papers were identified and categorized into three groups of participants: general population, mixed in/outpatient samples, and patients with specific disorders. The prevalence rates ranged from 0% to 1.9% amongst the general population, 5-20% in outpatients and 17.5-41.9% in inpatients. In studies of patients with specific disorders, prevalence rates varied: 1.8-5.9% (substance abuse), 3.3-20.2% (anxiety), 3.7-20.4% (other dissociative disorders), 16.3% (schizophrenia), 17% (borderline personality disorder), ~50% (depression). The highest rates were found in people who experienced interpersonal abuse (25-53.8%). The prevalence rate of DDD is around 1% in the general population, consistent with previous findings. DDD is more prevalent amongst adolescents and young adults as well as in patients with mental disorders. There is also a possible relationship between interpersonal abuse and DDD, which merits further research.
... First, we will describe the treatment process. We will then present scores of the process measures ratings and the progress of the patient as repeatedly measured during treatment by the Dissociative Experiences Scale -II (DES-II) 31 , a self-report measure of EMS, and the Posttraumatic Stress Disorder Checklist (PCL-5) 32 . The rationale for applying ST to this specific case was that this is an evidence-based therapy 33 covering a wide array of consequences following adulthood and childhood trauma, including BPD 34,35 and PTSD 36 . ...
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Complex dissociative disorders (CDD) include dissociative identity disorder (DID) and the most common other specified dissociative disorder (OSDD, type 1). While consensus-based treatments for CDD are lacking in several international guidelines, patients suffering from CDD show high levels of impairment, treatment utilization and costs. Migrants and refugees often present risk factors for trauma-related and dissociative disorders and need effective and culturally adapted treatments. Schema Therapy (ST) is an integrative psychotherapy that has been recently proposed as a treatment for CDD. This case study examined the process of individual ST, in a three phases-based approach, with a 38-year-old male Yemeni refugee with OSDD, type 1, posttraumatic stress disorder and borderline personality disorder. The treatment was provided in a Western country and the setting included two Western therapists (co-therapy) and an Arabic interpreter/cultural mediator. We assessed the patient’s change by using self-report assessments of dissociative and PTSD symptoms, cognitive schemas over 2-year and 4-months treatment periods and a 6-months follow-up. Posttreatment and follow-up reliable change analyses showed significant improvements in dissociative and PTSD symptoms as well as in some cognitive schemas. Despite any firm conclusion cannot be drawn due to the limitations of this study (i.e., single case study), the findings suggest that ST integrated in a phase-oriented approach may be an effective treatment for CDD. Additionally, our study provides some preliminary elements about cross-cultural validity of the schema modes construct as well as cross-cultural effectiveness of ST. More research based on larger samples and specific cross-cultural focused design is needed to confirm these assumptions.
Article
Game Transfer Phenomena (GTP) refers to a cluster of involuntary phenomena related to playing videogames, including sensory and cognitive intrusions, transient changes in perception and self-agency. The Game Transfer Phenomena Scale (GTPS) has been used to measure the frequency of GTP with respect to five factors. The present study aimed to validate an instrument for assessing the multiple dimensions of GTP (GTP-MDS) that helps clarify the distinction between GTP experiences. GTP were contextualized onto the spectrum of intrusive cognitions, perceptual distortions, and dissociations. The relationship between GTP, involuntary phenomena without game content (INVWG) in terms of, e.g., hallucinations and perceptual distortions, and game-biased perceptions (GBPA), as well as the positive and negative impact of GTP and level of distress were also examined. The data were collected using a survey ( N = 1,301, male 83.4%, mean age = 28.14). Separate confirmatory factor analyses of the dimensions of “inner intrusions/misperceptions,” “outer intrusions/distortions,” and “dissociations/mix-ups” produced acceptable fit indices. The findings show that phenomena manifesting as internal experiences are more common, while those manifesting as externalized intrusions are less common. Correlations between the GTP dimensions, INVWG, and GBPA, such as the insertion of game elements in thoughts, perceptions, and dreams, supported convergent validity. The correlations between the GTP dimensions and hours played supported criterion validity. Distress was correlated with outer intrusions and dissociations/mix-ups, but not with inner intrusions. Taken together, these results support the validity and reliability of the proposed assessment of GTP constructs.
Article
The dissociative disorders and germane conditions are reliably characterized by elevated responsiveness to direct verbal suggestions. However, it remains unclear whether atypical responsiveness to suggestion is similarly present in depersonalization-derealization disorder (DDD). 55 DDD patients and 36 healthy controls completed a standardised behavioural measure of direct verbal suggestibility that includes a correction for compliant responding (BSS-C), and psychometric measures of depersonalization-derealization (CDS), mindfulness (FFMQ), imagery vividness (VVIQ), and anxiety (GAD-7). Relative to controls, patients did not exhibit elevated suggestibility (g = 0.26, BF10 = .11) but displayed significantly lower mindfulness (g = 1.38), and imagery vividness (g = 0.63), and significantly greater anxiety (g = 1.39). Although suggestibility did not correlate with severity of depersonalization-derealization symptoms in controls, r=-.03 [95% CI: -.36, .30], there was a weak tendency for a positive association in patients, r=.25, [95% CI: -.03, .48]. Exploratory analyses revealed that patients with more severe anomalous bodily experiences were also more responsive to suggestion, an effect not seen in controls. This study demonstrates that DDD is not characterized by elevated responsiveness to direct verbal suggestions. These results have implications for the aetiology and treatment of this condition, as well as its classification as a dissociative disorder in psychiatric nosology.
Thesis
p>The majority of research on dissociation focuses on adulthood, although adolescence is thought to be a transitional time in the development of dissociation. This dissertation consists of two papers, both of which emphasize the importance of investigating dissociation during adolescence. A literature review of dissociation in adolescence was carried out. Recent conceptualizations of dissociation were firstly evaluated, followed by a review of studies investigating the developmental course of dissociation. The relationship between normal adolescent processes and dissociation was explored and the evidence for a relationship between dissociation and adolescent psychopathology was examined. Subsequently, the empirical evidence and theoretical basis for childhood trauma and disorganized attachment leading to dissociation were evaluated. It was argued that the developmental tasks of adolescence may provoke pathological dissociation in vulnerable young people. Finally, the clinical and research implications of a greater understanding of dissociation in adolescence were outlined. The research paper investigated the psychometric properties of the Adolescent Dissociative Experiences Scale and changes in the frequency of dissociative experiences during adolescence, as well as exploring the relationship between dissociation and psychological symptomatology in adolescence, particularly in females with anorexia. Dissociation was highly correlated with psychological symptomatology in non-clinical, mixed clinical and anorexic adolescent females and appeared to relate in a specific way to symptomatology in anorexia. The clinical and research implications of these findings were discussed.</p
Article
Personality traits of young adults play an important role in their stress tolerance, which may encounter their daily functioning. The present study investigated the relationship between personality traits, stress, dissociation, and sleep-related experiences. It was intended to find out the mediating role of stress between neuroticism personality trait and sleep-related experiences and the predicting role of dissociation on sleep-related experiences. A purposive and convenient sampling technique was used to collect as sample of 657 young adults including 312 male and 345 female within the age range of18-26. The Big Five Inventory (John et al.,1991), Perceived Stress Scale (Cohen et al., 1983), The Dissociative Experiences Scale–II (Carlson & Putnam, 1993), and Iowa Sleep Experiences Survey (Watson, 2001) were used to measure the study variables. Inter-Scale correlation showed significantly positive relationship between neuroticism stress whereas, significantly negative relationship between extraversion, agreeableness, conscientiousness, and openness personality traits. Regression analysis for mediation indicated that stress mediates the relationship between neuroticism personality trait and dissociation. While linear regression showed that dissociation significantly predicts sleep-related experiences among young adults. Thus, the present study helped in extending the research on the dimension of dissociation and sleep-related experiences among young adults.
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The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.
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