Dissociation in bipolar disorder: Relationships between clinical variables and childhood trauma

Hariri, Aytül Gürsu; Güleç, Medine Yazıcı; Orengul, Fatma; Sumbul, Esra Aydin; Elbay, Rümeysa Yeni; Güleç, Hüseyin

doi:10.1016/j.jad.2015.05.023

Cited by 29 publications

(19 citation statements)

References 59 publications

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“…Growing empirical evidence has indicated that dissociative experiences are pervasive within clients with SMIs; heightened dissociation is commonly reported by individuals who received diagnoses of psychosis , bipolar disorder and personality disorders . In line with evidence suggesting that dissociation is a common sequela of adverse and/or traumatic life experiences, many empirical studies have demonstrated that individuals with SMIs exposed to childhood adversity (e.g. sexual abuse, physical abuse, emotional abuse, neglect, bullying), experience greater dissociation compared to individuals exposed to little or no trauma .…”

Section: Introductionmentioning

confidence: 96%

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Rafiq

Campodonico

Varese

2018

Acta Psychiatr Scand

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The relationship between childhood adversities and dissociation in severe mental illness: a meta-analytic review Rafiq S, Campodonico C, Varese F. The relationship between childhood adversities and dissociation in severe mental illness: a metaanalytic review Objective: Several studies have observed that dissociative experiences are frequently reported by individuals with severe mental illness (SMI), especially amongst patients that report a history of adverse/traumatic life experiences. This review examined the magnitude and consistency of the relationship between childhood adversity (sexual abuse, physical abuse, emotional abuse, neglect, bullying, natural disasters and mass violence) and dissociation across three SMI diagnostic groups: schizophrenia, bipolar disorder and personality disorders. Method: A database search (EMBASE, PubMed and PsycINFO) identified 30 eligible empirical studies, comprising of 2199 clinical participants. Effect sizes representing the relationship between exposure to childhood adversity and dissociation were examined and integrated using a random-effects meta-analysis. Results: The results indicated that exposure to childhood trauma was associated with heightened dissociation across SMIs. Positive significant associations were also found between specific childhood adversities and dissociation, with aggregated effect sizes in the small-to-moderate range. Conclusion: These findings support calls for the routine assessment of traumatic experiences in clients with SMIs presenting with dissociative symptoms and the provision of adequate therapeutic support (e.g. trauma-focused therapies) to manage and resolve these difficulties. Summations• Small-to-moderate relationship between childhood trauma and dissociation across SMIs. • Medium relationship between childhood trauma and dissociation in schizophrenia-spectrum disorders.• All forms of childhood traumatic experiences (e.g. sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect) were found to be associated with dissociation in people diagnosed with SMI. Considerations• Only three studies were found eligible for the bipolar sample (i.e. low power); therefore, no strong conclusions can be drawn regarding the association between childhood trauma and dissociative experiences in bipolar disorder.• The relationship between childhood trauma and dissociation in SMI requires further corroboration using longitudinal designs to determine causality and directionality.• No firm conclusions can be drawn regarding which specific traumatic experience is most strongly associated with dissociation, as the studies included in the analysis were not independent (i.e. effects for sexual abuse and physical abuse estimated from the same sample of participants). 509Acta Psychiatr Scand 2018: 138: 509-525

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Section: Introductionmentioning

confidence: 96%

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Rafiq

Campodonico

Varese

2018

Acta Psychiatr Scand

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“…It seems that the comorbidity of dissociative disorder is related with poor prognostic features in other psychiatric disorders [9,10]. However, it is notable that the dissociative disorders in bipolar disorders have been less evaluated in literature [11,12].…”

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confidence: 99%

Investigation of the comorbidity of dissociative disorders in patients with bipolar disorder

Tekin

Demiryürek

Güleken

et al. 2019

The European Research Journal

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Objectives: The aim of this study was to investigate the comorbidity of dissociative disorders in patients with bipolar disorder. Methods: Fifty-one patients who are diagnosed with bipolar disorder in euthymic state and forty-nine healty controls were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Dissociative Experiences Scale (DES) and Childhood Trauma Questionnaire (CTQ-28) were administered to all participants with a sociodemographic form. Results: Mean DES and CTQ-28 total scores were statistically higher in patients group than control group (p < 0.001 and p < 0.001, respectively). Emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse subscale scores of CTQ-28 were higher in patients group than healthy controls group (p = 0.002, p < 0.001, p = 0.005, p < 0.001 and p < 0.021, respectively). The rate of any dissociative disorder comorbidity was 35.4% in patients with bipolar disorder. The most frequent dissociative disorder in patient with bipolar disorder was depersonalization disorder (17.6%). There was a positive correlation between DES score and number of suicidal attempts (r = 0.284). Negative correlations were found between DES score and age of disease onset, and CTQ-28 total score and age of disease onset (r =-0.332 and r =-0.291). Conclusion: Our results have shown that dissociative disorders may be frequently accompanied in patients with bipolar disorder. Dissociation and childhood traumatic events can be related with clinical features in patients with bipolar disorder.

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“…In at least two prospective studies, BPD symptoms (such as anger and dissociation) were some of the strongest predictors of suicide over 1 (Glenn & Klonsky, 2011) and 10 (May, Klonsky, & Klein, 2012) years. More specifically, research has consistently found that anger/hostility (Nyer et al, 2013; Wedig, Frankenburg, Bradford Reich, Fitzmaurice, & Zanarini, 2013) and trauma-related dissociation (Briere, Hodges, & Godbout, 2010; Hariri et al, 2015) are consistently predictive of suicidal ideation and attempts (Sadeh & McNiel, 2013).…”

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confidence: 99%

The Mediating Roles of Hostility and Dissociation in the Relationship Between Sexual Assault and Suicidal Thinking in College Students

Keefe

Hetzel-Riggin

Sunami

2017

J Interpers Violence

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Sexual assault and suicide are two serious public health concerns. Research has documented the relationship between sexual assault and suicidal thinking and attempts; however, limited research explores the more multifaceted relationships between posttraumatic stress reactions and suicidal ideation in college students through unsuccessful modulation of emotion. The authors hypothesized a mediation model where the relationship between sexual assault and suicidal ideation is mediated by dissociation and hostility. In total, 1,677 undergraduate students were administered modified versions of the Traumatic Life Events Questionnaire (TLEQ), Symptom Checklist-90-Revised (SCL-90-R), and Peritraumatic Dissociative Experiences Questionnaire (PDEQ). The results revealed both significant partial but equal mediators of hostility and dissociation. However, a portion of the direct effect between sexual assault and suicidal ideation remained unaccounted for by indirect effects. The current model supports previous work on dialectical behavior therapy that says either side of the dialectic between extreme expression and suppression of hostility increases the likelihood of suicidal thinking after sexual assault. With sexual assault survivors, practitioners should use strategies that emphasize both anger expression and healthy avoidance as a way to modulate emotion to potentially reduce suicidal thoughts. Future research should focus on different gender models, additional possible mediators such as alcohol use and guilt, and different forms of sexual assault. Limitations of the correlational, cross-sectional methodology are discussed.

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Dissociation in bipolar disorder: Relationships between clinical variables and childhood trauma

Cited by 29 publications

References 59 publications

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Investigation of the comorbidity of dissociative disorders in patients with bipolar disorder

The Mediating Roles of Hostility and Dissociation in the Relationship Between Sexual Assault and Suicidal Thinking in College Students

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