Evaluating the Unified Protocol in the Treatment of Dissociative Identify Disorder

Mohajerin, Banafsheh; Lynn, Steven Jay; Bakhtiari, Maryam; Dolatshah, Behrouz

doi:10.1016/j.cbpra.2019.07.012

Cited by 16 publications

(12 citation statements)

References 39 publications

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“…Critics argue that trauma-focused treatment without a preceding stabilization-phase may be more effective. Evidence-based treatments for other psychiatric disorders have also been suggested as potentially effective for CDD (Huntjens et al, 2019a;Mohajerin et al, 2020). Our results highlight that there is much room for improvement in the treatment of patients suffering from CDD and the importance of continued innovation in interventions and treatment delivery.…”

Section: Discussionmentioning

confidence: 75%

Group treatment for Complex Dissociative Disorders: A randomized controlled trial

Bækkelund¹,

Ulvenes²,

Boon³

et al. 2021

Preprint

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Patients with complex dissociative disorders report high levels of childhood- abuse experiences, clinical comorbidity, functional impairment, and treatment utilization. Although a few naturalistic studies indicate that these patients can benefit from psychotherapy, no randomized controlled trials have been reported with this patient-group. In the current study, 59 patients with Dissociative Identity Disorder (DID) or Other Specified Dissociative Disorders (OSDD) were randomized to 20 sessions of stabilizing group – treatment, conjoint with individual therapy, or individual therapy alone, in a delayed-treatment design. The treatment is based on the manual Coping with Trauma-Related Dissociation (Boon, Steele, & Hart, 2011). The primary outcome was Global Assessment of Functioning (GAF), while secondary outcomes were PTSD and dissociative symptoms, general psychopathology, interpersonal difficulties, and self-destructive behavior. Results indicate medium to large effects on psychosocial functioning and small to insignificant effects on reduction of symptoms and self-destructive behavior. Mixed effect models showed no condition x time interaction, indicating no immediate differences in treatment outcome, but some indication of positive effects in the six months follow-up period.

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Section: Discussionmentioning

confidence: 75%

Group treatment for Complex Dissociative Disorders: A randomized controlled trial

Bækkelund¹,

Ulvenes²,

Boon³

et al. 2021

Preprint

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“…In previous studies, SCID-D had good-to-excellent reliability and validity. The Persian version of SCID-D yielded 100% agreement with the diagnosis of dissociative disorders [35]. In the present study, the information and scores obtained from SCID-D were used to identify patients with comorbid dissociative disorders based on DSM-5 criteria.…”

Section: Scid-dmentioning

confidence: 88%

“…In contrast, Positive and Negative Syndrome Scale (PANSS) [33] was only performed to evaluate patients with schizophrenia and other psychotic disorders by an expert psychiatrist. Moreover, the patients with schizophrenia spectrum and other psychotic disorders were assessed via a SCID-5-PD [34] and SCID-D [35] in terms of comorbidity with borderline personality disorder and dissociative disorders. To abide by the declaration of Helsinki [36], the individuals were told that their participation was voluntary and they could leave the study for any reason.…”

Section: Methodsmentioning

confidence: 99%

Dissociation as a causal pathway from sexual abuse to positive symptoms in the spectrum of psychotic disorders

2021

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Background Although numerous studies have supported the role of childhood maltreatment in the etiology of psychosis, underlying mechanisms have not been well understood yet. The present study aimed to investigate the mediating role of particular forms of dissociation in the relationship between five major types of childhood abuse and psychotic symptoms among patients with schizophrenia spectrum and other psychotic disorders. Methods In this cross-sectional correlation study, 70 first-episode psychotic patients and 70 chronic psychotic patients were selected by systematic random sampling (with the sampling interval of 3) from among inpatients and outpatients referring to Baharan Psychiatric hospital, Zahedan, Iran, and were matched based on age, gender, and education level. Moreover, 70 age-, gender-, and education level-matched community controls were recruited from hospital staff and their relatives and friends. All of the participants completed a research interview and questionnaires. Data on experiences of childhood maltreatment, psychosis, dissociation, and demographics were collected and analyzed by SPSS V25 software. Results The obtained results revealed that the mean scores of sexual abuse, emotional abuse, and physical abuse were higher in psychotic patients than community controls (without any significant difference between first-episode psychotic patients and chronic psychotic patients). Furthermore, the highest mean scores of dissociative experiences belonged to chronic psychotic patients. Multiple-mediation also indicated that absorption and dissociative amnesia played a mediating role in the relationship between sexual abuse and positive symptoms. Moreover, this study demonstrated the role of physical abuse in predicting psychotic symptoms even in the absence of sexual abuse. Conclusions This study illustrated specific associations among childhood maltreatment, dissociative experiences, and psychotic symptoms in the clinical population. Thus, to provide appropriate interventions, patients with schizophrenia spectrum and other psychotic disorders were asked about a wide range of possible adverse childhood experiences and dissociative experiences. Nevertheless, further studies using prospective or longitudinal designs need to be carried out to realize the differential contribution of various forms of childhood maltreatment and their potential interactions, more precisely.

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“…Critics argue that processing of trauma without a preceding stabilization-phase may be more effective [ 51 ]. Evidence-based treatments for other psychiatric disorders have also been suggested as potentially effective for CDD [ 51 , 52 ]. Our results highlight that there is much room for improvement in the treatment of patients suffering from CDD, and the importance of continued innovation in interventions and treatment delivery.…”

Section: Discussionmentioning

confidence: 99%

Group treatment for complex dissociative disorders: a randomized clinical trial

et al. 2022

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Background Patients with complex dissociative disorders (CDD) report high levels of childhood- abuse experiences, clinical comorbidity, functional impairment, and treatment utilization. Although a few naturalistic studies indicate that these patients can benefit from psychotherapy, no randomized controlled trials have been reported with this patient-group. The current study evaluates a structured protocolled group treatment delivered in a naturalistic clinical setting to patients with CDD, as an add-on to individual treatment. Methods Fifty nine patients with CDD were randomized to 20 sessions of stabilizing group–treatment, conjoint with individual therapy, or individual therapy alone, in a delayed-treatment design. The treatment was based on the manual Coping with Trauma-Related Dissociation. The primary outcome was Global Assessment of Functioning (GAF), while secondary outcomes were PTSD and dissociative symptoms, general psychopathology, and interpersonal difficulties. Results Mixed effect models showed no condition x time interaction during the delayed treatment period, indicating no immediate differences between conditions in the primary outcome. Similar results were observed for secondary outcomes. Within-group effects were non-significant in both conditions from baseline to end of treatment, but significant improvements in psychosocial function, PTSD symptoms, and general psychopathology were observed over a 6-months follow-up period. Conclusion In the first randomized controlled trial for the treatment of complex dissociative disorders, stabilizing group treatment did not produce immediate superior outcomes. Treatment was shown to be associated with improvements in psychological functioning. Trial registration Clinical Trials (NCT02450617).

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Evaluating the Unified Protocol in the Treatment of Dissociative Identify Disorder

Cited by 16 publications

References 39 publications

Group treatment for Complex Dissociative Disorders: A randomized controlled trial

Group treatment for Complex Dissociative Disorders: A randomized controlled trial

Dissociation as a causal pathway from sexual abuse to positive symptoms in the spectrum of psychotic disorders

Group treatment for complex dissociative disorders: a randomized clinical trial

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