Symptom Patterns in Dissociative Identity Disorder Patients and the General Population
The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas 75080, USA.Journal of Trauma & Dissociation (Impact Factor: 1.72). 10/2010; 11(4):458-68. DOI: 10.1080/15299732.2010.495939
The authors used the Dissociative Disorders Interview Schedule to compare structured interview symptom patterns in a general population sample (N= 502) and a sample of patients with clinical diagnoses of dissociative identity disorder (N= 303). Based on the Trauma Model, the authors predicted that the patterns would be similar in the 2 samples and that symptom scores would be higher in participants reporting childhood sexual abuse in both samples. They predicted that symptom scores would be higher among women with dissociative identity disorder reporting sexual abuse than among women in the general population reporting sexual abuse, with the clinical sample reporting more severe abuse. These predictions were supported by the data. The authors conclude that symptom patterns in dissociative identity disorder are typical of the normal human response to severe, chronic childhood trauma and have ecological validity for the human race in general.
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- "A c c e p t e d M a n u s c r i p t 4 4 family chaos and exposure to violence in later childhood (e.g., 7-12 years). Despite the high levels of sexual and physical abuse in DD samples, there is evidence that females report even more sexual abuse than males, but differences are not present for physical abuse (Ross & Ness, 2010; cf., Loewenstein & Putnam, 1990). "
ABSTRACT: Only a select number of studies have examined different forms of child maltreatment in complex dissociative disorders in comparison to other groups. Few of these have used child abuse-related chronic PTSD and mixed psychiatric patients with maltreatment as comparison groups. This study examined child sexual, physical and emotional abuse, as well as physical and emotional neglect in dissociative disorder (DD; n = 39), chronic PTSD (C-PTSD; n = 13) and mixed psychiatric (MP; n = 21) samples, all with abuse and neglect histories. The predictive capacity of these different forms of maltreatment across the 3 groups were assessed for pathological dissociation, shame, guilt, relationship esteem, relationship anxiety, relationship depression and fear of relationships. All forms of maltreatment differentiated the DD from the MP group, while sexual abuse differentiated the DD sample from the C-PTSD group. Childhood sexual abuse was the only predictor of pathological dissociation. Emotional abuse predicted shame, guilt, relationship anxiety and fear of relationships. Emotional neglect predicted relationship anxiety and relationship depression. Physical neglect was associated with less relationship anxiety. Different forms of abuse and neglect are associated with different symptom clusters in psychiatric patients with maltreatment histories.
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- "Severe dissociative symptoms that continue beyond their adaptive capacity may lead to dissociative identity disorder (DID), which involves a compartmentalization of the individual's identity into self-states (distinct and alternate personality states and identities), accompanied by amnesia (American Psychiatric Association, 2013). The etiology of DID and Dissociative Disorder Not Otherwise Specified (DDNOS) in CM is supported through such patients evidencing CM rates from 80 to 95% (e.g., Boon & Draijer, 1993; Brand et al., 2009; Dalenberg et al., 2012; Ellason, Ross, & Fuchs, 1999; Putnam, Guroff, Silberman, Barban, & Post, 1986; Ross & Ness, 2010; Saxe, Chinman, Berkowitz, & Hall, 1994; Saxe, van der Kolk, Berkowitz, & Chinman, 1993; Yargiç, S ¸ ar, Tutkun, & Alyanak, 1998). "
ABSTRACT: Childhood maltreatment (CM) is a risk factor for subsequent intimate partner violence (IPV) in adulthood, with high rates of retrospectively reported CM among IPV victims and perpetrators. A theorized mechanism of the link between CM and IPV is dissociation. Dissociation may allow perpetrators of violence to remain emotionally distant from their behavior and minimize empathy toward those they victimize, enabling them to commit acts of violence similar to their own experiences. Indeed, elevated rates of dissociation and dissociative disorders (DD) have been found among IPV survivors and perpetrators. In addition, in pilot studies, DD clinicians have reported high levels of violent behavior among DD patients.
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- "The aim of the current study was to evaluate the prevalence of a history of sexual abuse among MMT patients and to further characterize this population by expanding our knowledge on OCD to include other psychiatric comorbidities in sexually abused patients compared to their non-sexually abused counterparts. We also evaluated the prevalence of posttraumatic stress disorder (PTSD), complex PTSD (cPTSD) and dissociative symptoms and dissociative identity disorder (DID), which are known to be highly prevalent among sexually abused individuals (Herman, 1992; Roth et al., 1997; van der Kolk et al., 2005; Ross and Ness, 2011). We first studied a random representative sample of patients being treated in our MMT clinic to determine the prevalence of sexual abuse among MMT patients in general, and then extended the study cohort to include all the females attending the MMT clinic during the study period, given that they are well known as comprising a major group at risk for sexual abuse. "
ABSTRACT: The aim of this study was to assess the prevalence of a history of sexual abuse and its relation to psychiatric comorbidity among former opiate addicts currently on methadone maintenance treatment (MMT). We evaluated the history of sexual abuse and current clinical obsessive compulsive disorder (OCD), dissociative identity disorder (DID), and complex posttraumatic distress disorder (cPTSD), and administered the Life Events Inventory Questionnaire among 125 MMT patients (76 females and 49 males). Eighty (64%) patients had experienced sexual abuse, 69 (55.2%) met the criteria for clinical OCD, 20 (16.0%) for cPTSD and 13 (10.4%) for DID. More females had clinical OCD than males (63.2% vs. 42.9%, respectively, p=0.03). Sexually abused patients had higher rates of clinical OCD than their non-abused counterparts (67.5% vs. 33.3%, respectively, p<0.0005) and a higher mean number of negative life events (8.0±2.0 vs. 7.1±1.8, p=0.01). Sexually abused patients showed a trend towards a higher Dissociative Experiences Scale score (17.6±10.1 vs. 14.6±8.1, p=0.08) and rate of DID (13.8% vs. 4.4%, p=0.1), but no significant difference in the rate of cPTSD (17.5% vs. 13.3%, p=0.6) compared to non-abused subjects. The 80 sexually abused patients were mostly female (85%), and 57.5% of them were abused by a family member. In summary, more sexually abused MMT patients were diagnosed with clinical OCD and fewer with cPTSD and DID. Those with cPTSD were characterized by more negative life events, higher dissociation scores, and assaults by a family member. We conclude that sexually abused MMT patients should be screened for clinical OCD.
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