Dissociative symptoms are associated with reduced neuropsychological performance in patients with recurrent depression and a history of trauma exposure

Parlar, Melissa; Frewen, Paul A.; Oremus, Carolina; Lanius, Ruth A.; McKinnon, Margaret C.

doi:10.3402/ejpt.v7.29061

Cited by 45 publications

(34 citation statements)

References 65 publications

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“…These symptoms may be associated with neurocognitive dysfunction, particularly with memory and attention (Parlar et al, 2016). These researchers did not consider any association of PD and prior trauma with PTSD.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, future longitudinal research is needed to clarify these relationships. Furthermore, because it is not standard to assess PD with depression, and because impaired neurological function may negatively impact treatment, assessing PD in officers who report depression may facilitate treatment (Parlar et al, 2016). …”

Section: Discussionmentioning

confidence: 99%

“…It has been described as an alteration in time or place and individuals often report feelings of depersonalization, altered perceptions of pain, feeling disconnected, or tunnel vision. It is thought to protect individuals from overwhelming distress during trauma (Dalenberg & Carlson, 2012; Marmar, Weiss, & Metzler, 1997; Parlar, Frewen, Oremus, Lanius, & McKinnon, 2016) and is associated with increased hypothalamic–pituitary–adrenal axis reactivity as well as impaired performance on measures of executive functioning, memory, and verbal recollection (Parlar et al, 2016). Similar responses have been noted in individuals with PTSD and depression as well as individuals who have reported childhood trauma (Molina-Serrano, Linotte, Amat, Souery, & Barreto, 2008).…”

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confidence: 99%

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Association of peritraumatic dissociation with symptoms of depression and posttraumatic stress disorder.

McCanlies¹,

Sarkisian²,

Andrew³

et al. 2017

Psychological Trauma: Theory, Research, Practice, and Policy

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Aim In this study, we evaluated whether peritraumatic dissociation (PD) was associated with symptoms of depression and posttraumatic stress disorder (PTSD), and whether this association was modified by trauma prior to police work. Method Symptoms of depression, PTSD, peritraumatic dissociative experience (PDE), and trauma prior to police work were measured using the Center for Epidemiologic Studies Depression scale, PTSD Checklist–Civilian, PDE questionnaire, and the Brief Trauma questionnaire, respectively, in 328 police officers. Separate regression models were used to assess if either symptoms of depression or PTSD were associated with PD stratified by prior trauma. Means were adjusted for race, number of drinks per week, and smoking. Results PD was associated with symptoms of PTSD and depression (β = 0.65, p < .001 and β = 0.27, p < .001, respectively). PD was positively associated with symptoms of PTSD regardless of prior trauma (β = 0.61, p < .001(without prior trauma), 0.75, p < .001 (with prior trauma). In contrast to PTSD, depression symptoms were significantly associated with PD scores in individuals with prior trauma (β = 0.47, p < .001), but not in individuals without prior trauma (β = 0.13, p = .165). Limitations This is a cross-sectional study. Outcomes were obtained via self-report and were not clinically diagnosed. Aspects of both the trauma event as well as the symptoms and severity of PD may have introduced recall bias. Conclusion These results add to the literature indicating that PD plays a role in symptoms of PTSD and depression and how prior trauma may modify this relationship.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Association of peritraumatic dissociation with symptoms of depression and posttraumatic stress disorder.

McCanlies¹,

Sarkisian²,

Andrew³

et al. 2017

Psychological Trauma: Theory, Research, Practice, and Policy

View full text Add to dashboard Cite

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“…CAPS de-realization and de-personalization items were the only dissociative features captured in this work). Dissociation’s effects on neuropsychological dysfunction is a recurrent finding (McKinnon et al, 2016; Parlar, Frewen, Oremus, Lanius, & McKinnon, 2016), most often linked to PTSD stemming from childhood trauma (De Bellis, Woolley, & Hooper, 2013; Rivera-Vélez, González-Viruet, Martínez-Taboas, & Pérez-Mojica, 2014), but also documented in veterans with PTSD (Roca, Hart, Kimbrell, & Freeman, 2006). Dissociative types of PTSD might have a different underlying neural mechanism and specific deficits in emotional learning (Ebner-Priemer et al, 2009; Lanius et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Evaluating web-based cognitive-affective remediation in recent trauma survivors: study rationale and protocol

Fine

Achituv

Etkin

et al. 2018

European Journal of Psychotraumatology

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Background: The immediate aftermath of traumatic events is a period of enhanced neural plasticity, following which some survivors remain with post-traumatic stress disorder (PTSD) whereas others recover. Evidence points to impairments in emotional reactivity, emotion regulation, and broader executive functions as critically contributing to PTSD. Emerging evidence further suggests that the neural mechanisms underlying these functions remain plastic in adulthood and that targeted retraining of these systems may enhance their efficiency and could reduce the likelihood of developing PTSD. Administering targeted neurocognitive training shortly after trauma exposure is a daunting challenge. This work describes a study design addressing that challenge. The study evaluated the direct effects of cognitive remediation training on neurocognitive mechanisms that hypothetically underlay PTSD, and the indirect effect of this intervention on emerging PTSD symptoms. Method: We describe a study rationale, design, and methodological choices involving: (a) participants’ enrolment; (b) implementation and management of a daily self-administered, web-based intervention; (c) reliable, timely screening and assessment of treatment of eligible survivors; and (d) defining control conditions and outcome measures. We outline the rationale of choices made regarding study sample, timing of intervention, measurements, monitoring participants’ adherence, and ways to harmonize and retain interviewers’ fidelity and mitigate eventual burnout by repeated contacts with recently traumatized survivors. Conclusion: Early web-based interventions targeting causative mechanisms of PTSD can be informed by the model presented in this paper.

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“…In fact, a recent study in adults with depression showed that processing speed worsens with increasing early-life trauma scores (Saleh et al, 2016). Additionally, compared to healthy controls, adults with depression and trauma history exhibited worse executive functioning, delayed recall, and recognition memory (Parlar et al, 2016). In considering these similarities, however, one must also consider that the literature investigating how depression and trauma individually contribute to neurocognition do not control for the presence of the other, i.e., depression studies do not control for trauma or vice versa.…”

Section: Introductionmentioning

confidence: 99%

Investigating the separate and interactive associations of trauma and depression on neurocognition in urban dwelling adults

Karstens

Rubin

Shankman

et al. 2017

Journal of Psychiatric Research

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Background Trauma and depression have each been associated with neurocognitive alterations, but their combined effect on neurocognition is unclear. We investigated the separate and interactive associations of trauma and depression on neurocognition in a sample of ethnically diverse urban dwellers, and explored the impact of age on these effects. Methods 284 adults aged 30–89 were divided into groups based on their current depression and trauma history. Individuals meeting DSM-IV criteria for depression were considered Depressed (D+) and individuals rated through diagnostic interview as having trauma history were considered positive for Trauma (T+). Resulting Ns were 73 D+T+, 56 D+T−, 68 D−T+, and 87 D−T−. A principal component analysis of neuropsychological scores resulted in a 3-factor solution representing verbal learning/memory/recognition (VERBAL-LMR), visual learning/memory/recognition, and speeded attention/cognitive flexibility accounting for 70.21% of the variance. Results Multivariable linear regressions adjusting for age revealed that Trauma, regardless of Depression, is associated with worse VERBAL-LMR performance. This Trauma association was driven by verbal list and prose passages learning and memory, but not recognition memory. Age-stratified (<60 versus ≥60 years) regressions revealed the Trauma association was only significant for older adults. No main or interactive effects for Depression were observed. Conclusions Trauma, regardless of Depression, is associated with worse verbal learning and memory, but not recognition performance. These results suggest that trauma exposure may negatively impact neurocognition. Clinicians working with adults in urban settings should query for trauma in addition to depression when considering subjective and objective measures of neurocognitive functioning, particularly in older adults.

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Dissociative symptoms are associated with reduced neuropsychological performance in patients with recurrent depression and a history of trauma exposure

Cited by 45 publications

References 65 publications

Association of peritraumatic dissociation with symptoms of depression and posttraumatic stress disorder.

Association of peritraumatic dissociation with symptoms of depression and posttraumatic stress disorder.

Evaluating web-based cognitive-affective remediation in recent trauma survivors: study rationale and protocol

Investigating the separate and interactive associations of trauma and depression on neurocognition in urban dwelling adults

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