Dissociative Depression Among Women with Fibromyalgia or Rheumatoid Arthritis

Abstract

The aim of this study was to inquire about the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (n = 30) or rheumatoid arthritis (n = 20) participated in the study. The Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire (SDQ), Dissociation Questionnaire (DIS-Q), Beck Depression Inventory (BDI), Spielberger State-Trait Anger Expression Inventory, and Dissociative Disorders Interview Schedule were administered to all participants. Women with a lifetime diagnosis of depressive disorder had higher scores for somatoform and psychoform dissociation than the nondepressive patients. However, childhood trauma scores did not differ between the 2 groups. In regression analysis, current severity of depression (BDI) was predicted by psychoform dissociation (DIS-Q) and lower education, and lifetime diagnosis of major depression was predicted by somatoform dissociation (SDQ). Whereas childhood emotional neglect predicted somatoform dissociation, psychoform dissociation was predicted by childhood sexual abuse. Mental processing of anger seems to be 1 of the dimensions of psychodynamics in trauma-related depressive conditions. In the context of the perceived threat of loss of control due to expressed anger and mental disintegration, somatoform dissociation seems to contribute to overmodulation of emotions in dissociative depression. Among patients suffering from physical illness with possible psychosomatic dimensions, assessment of somatoform dissociation in addition to psychoform dissociation may be helpful to understand diverse psychopathological trajectories emerging in the aftermath of childhood adversities. The recently proposed category of "dissociative depression" (Sar, 2011) seems to be a promising concept for future research on psychosomatic aspects of traumatic stress.

The relationship of childhood trauma, dissociative experiences and depression with pain in female patients with fibromyalgia: a cross-sectional study

“…Our findings are similar to other studies and support the claim that CTs may predispose to FM disease. Because of the variety of literature on trauma subtype, it is difficult to define a specific subscale score related with FM (12,15,(33)(34)(35). Similar to the study of Taylor et al (36), there was no difference in sexual abuse subscale of trauma between study and control groups in our study.…”

Trauma-related psychiatric comorbidity of somatization disorder among women in eastern Turkey

“…An epidemiological study conducted in a town of central-eastern Turkey reported that this type of depressive disorder constituted 40% of the depression cases among women in the community [57]. A recent study on women with fibromyalgia or rheumatoid arthritis revealed that there was a relationship between childhood trauma, posttraumatic anger, dissociation and major depression [58]. Interestingly, in the present study, both depression and dissociation were associated with cumulative trauma of adulthood rather than those of childhood.…”

Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation

“…A different appearance was obtained in a study (Kiliç et al, 2014) of women with a physical illness which explored the relationship of post-traumatic anger and cognitive-emotional and sensori-motor dissociation to unipolar depression. The diagnosis of lifetime depressive disorder (a trait measure) was predicted by sensori-motor dissociation whereas cognitive-emotional dissociation was related to current severity of depression (a state measure).…”