Dissociation in victims of childhood abuse or neglect: a meta-analytic review

Vonderlin, Ruben; Kleindienst, Nikolaus; Alpers, Georg W.; Bohus, Martin; Lyssenko, Lisa; Schmahl, Christian

doi:10.1017/s0033291718000740

Cited by 172 publications

(105 citation statements)

References 104 publications

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“…This is in line with a recent meta-analytic review (Vonderlin et al, 2018) that also found CSA to be especially strongly related to dissociation, when compared to neglect and emotional abuse. CSA has also been identified as a potent risk factor for auditory hallucinations (Bentall et al, 2014), which are conceptualized as a symptom of TRASC in the 4-D model.…”

Section: Discussionsupporting

confidence: 90%

Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders

Bækkelund

Frewen

Lanius

et al. 2018

European Journal of Psychotraumatology

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Background: The four-dimensional (‘4-D’) model has been proposed as a theoretical framework to understand and delineate trauma-related dissociative experiences, categorizing symptoms into trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC), which occur along four dimensions: time, thought, body and emotion.Objective: The main aim of the present study was to evaluate the validity of this model in patients with post-traumatic stress disorder (PTSD), with and without comorbid dissociative disorders.Method: The predictions of the 4-D model were tested in 142 patients with PTSD, with (N = 46) and without (N = 96) comorbid dissociative disorders.Results: As predicted by the 4-D model, experiences of TRASC were less frequent and more specifically related to other measures of dissociation, dissociative disorder comorbidity and a history of childhood sexual abuse compared to experiences of NWC. The predicted lower intercorrelation of TRASC was not supported.Conclusion: The 4-D model represents a promising framework for understanding dissociation across trauma-related disorders.

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Section: Discussionsupporting

confidence: 90%

Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders

Bækkelund

Frewen

Lanius

et al. 2018

European Journal of Psychotraumatology

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“…A review of research on the development of dissociation would be incomplete without clear acknowledgement of maltreatment as an aetiological factor. Compelling evidence supports the relationship between maltreatment and dissociation, as most recently meta-analysed by Vonderlin et al (2018). The authors synthesized the findings of 65 crosssectional studies (n = 7352) that investigated links between maltreatment (abuse and neglect) and dissociation, as measured by self-report.…”

Section: Research On Childhood Maltreatment and Dissociationmentioning

confidence: 99%

Developmental and attachment-based perspectives on dissociation: beyond the effects of maltreatment

Guérin-Marion

Sezlik

Bureau

2020

European Journal of Psychotraumatology

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Background: Numerous years of theory and research have informed our understanding of the caregiving experiences that confer vulnerability for dissociation. This work has resulted in widespread agreement on the role of childhood maltreatment as an aetiological factor. Objective: With clear integration of this perspective, the current paper draws attention to the spectrum of vulnerability that can exist over and above the trauma of maltreatment within early caregiving experiences. Method: An integrative review of the developmental literature on dissociation is presented. Results: We first review and integrate existing developmental theories of dissociation into a more unified perspective, highlighting a combination of defensive and intersubjective pathways towards dissociative outcomes. Next, we present empirical research demonstrating which specific caregiving experiences are associated with dissociation. Lastly, we review recent neurodevelopmental research demonstrating that (non-extreme) caregiving stressors during infancy impact the developing limbic structures in the brain. We conclude by offering directions for future research. Conclusion: Findings make the case for approaching assessments of the caregiver-child relationship with discernment of factors beyond the presence/absence of maltreatment when conceptualizing risk pathways toward dissociation. Perspectivas basadas en apego y desarrollo sobre la disociación: más allá de los efectos del maltrato Antecedentes: Varios años de teoría, investigación y avances clínicos sustentan nuestra comprensión de experiencias particulares en el cuidado temprano que confieren vulnerabilidad para la disociación. Este trabajo ha dado lugar a un acuerdo generalizado sobre el papel del maltrato infantil como un factor etiológico. Objetivo: Con una clara integración de esta perspectiva, el presente artículo enfatiza el espectro de vulnerabilidad que puede existir más allá del trauma que constituye el maltrato dentro de las experiencias de cuidado tempranas. Método: Se presenta una revisión integradora de la literatura del desarrollo sobre la disociación. Resultados: Primero, revisamos e integramos las teorías del desarrollo existentes sobre la disociación en una perspectiva más unificada, resaltando una combinación de vías defensivas e intersubjetivas que resultan en disociación. Luego, presentamos una investigación empírica que demuestra qué experiencias específicas en el cuidado temprano están asociadas con la disociación. Finalmente, revisamos una investigación reciente en neurodesarrollo que demuestra que los estresores (no extremos) durante el cuidado en lainfancia impactan el desarrollo de las estructuras límbicas del cerebro. Conclusión: Los hallazgos justifican abordar las evaluaciones de la relación cuidador-niño con el discernimiento de factores más allá de la presencia/ausencia de maltrato al conceptualizar las vías de riesgo de disociación.

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“…Nevertheless, the link between dissociation and suggestibility remains controversial in part because many researchers conflate elevated suggestibility with proneness to false memories rather than conceptualizing it as a multidimensional cognitive-perceptual function. Furthermore, suggestibility does not reliably correlate with dissociation in the general population (Alganami et al, 2017; P. V. Butler & Bryant, 1997;Dienes et al, 2009), and it has a mixed relationship with trauma exposure (Eisen & Carlson, 1988;Nash & Lynn, 1985;Rhue et al, 1990), which is widely considered to be the principal antecedent of dissociation (Dalenberg et al, 2012;Vonderlin et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Trauma and anxious attachment influence the relationship between suggestibility and dissociation: a moderated-moderation analysis

Wieder

Terhune

2019

Cognitive Neuropsychiatry

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Introduction: Hypnotic suggestibility is elevated in the dissociative disorders but the relationship between dissociative tendencies and suggestibility in the general population seems to be constrained by additional factors. The diathesis-stress (DS) model stipulates that suggestibility interacts with trauma exposure to augment the propensity for dissociative states whereas the dual pathway to suggestibility (DPS) model proposes two developmental routes involving either dissociation preceded by trauma, or a healthy cognitive profile characterized by superior imagination. Methods: This study sought to discriminate between these partially competing accounts and further considered the moderating role of anxious attachment. 209 participants completed psychometric measures of dissociative tendencies, trauma, and attachment, and a behavioural measure of suggestibility. Results: In support of the DS model, trauma moderated the relationship between suggestibility and dissociation and, as predicted by the DPS model, dissociation moderated the relationship between trauma and suggestibility. Anxious attachment additionally moderated both effects. Model comparisons indicated that the DS model consistently provided a superior fit to the data. Further analyses showed that secure attachment independently predicted suggestibility, thereby supporting the non-dissociative pathway in the DPS model. Conclusions: These results suggest that high suggestibility confers vulnerability to dissociative states in individuals exposed to trauma and displaying an anxious attachment style.

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Dissociation in victims of childhood abuse or neglect: a meta-analytic review

Cited by 172 publications

References 104 publications

Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders

Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders

Developmental and attachment-based perspectives on dissociation: beyond the effects of maltreatment

Trauma and anxious attachment influence the relationship between suggestibility and dissociation: a moderated-moderation analysis

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