Prevalence and clinical correlates of dissociative subtype of posttraumatic stress disorder at an outpatient trauma clinic in South Korea

Abstract

Background: Previous studies on of the dissociative subtype of posttraumatic stress disorder (d-PTSD) have relied on specialized statistical methods (i.e. profile or class analyses) for diagnosis than clinical rating available to clinicians. Objective: This study investigated the prevalence and covariates of d-PTSD diagnosed by a semi-structured interview in a cohort of outpatients with DSM-IV PTSD in a specialized trauma clinic in South Korea. Method: Data from 249 patients with civilian PTSD were examined, including demographics, clinical variables, Clinical Global Impression (CGI) Scale, and Clinician-Administered PTSD Scale (CAPS-IV). We defined d-PTSD as the presence of either depersonalization or derealization according to additional dissociative items of the CAPS. About one third (n = 82, 32.9%) of patients were designated as having d-PTSD. Results: Compared to the other patients with PTSD, those with d-PTSD were younger, had more severe PTSD symptoms, frequent interpersonal trauma, and a higher number of comorbid disorders. When these variables and their interactions were entered into a logistic regression model, younger age, severe PTSD symptoms and two or more comorbid conditions remained for the final model. We did not find a significant difference in improvement over the course of treatment between two groups. Conclusions: This study highlights the high prevalence of d-PTSD in a clinical population. Associated features of d-PTSD were similar to those reported in the Euro-American literature. Further studies are needed to better understand mechanisms and treatment options for d-PTSD.

Factor structure and symptom classes of ICD-11 complex posttraumatic stress disorder in a South Korean general population sample with adverse childhood experiences

“…Our PTSD class may represent the dissociative subtype PTSD (APA, 2013), which was also found in a previous LCA study on interpersonal trauma (Palic et al, 2016). Also, a previous Korean sample study found that interpersonal trauma was more associated with dissociative PTSD rather than non-dissociative PTSD (Kim et al, 2019), which supports that our sample is more likely to have a dissociative PTSD.…”

Global Psychotrauma Screen (GPS): psychometric properties in two Internet-based studies

“…However, it is widely recognized that the immediate and long-term mental health consequences of exposure to potentially traumatic life events often extend beyond the symptoms of any single psychological disorder, be it PTSD or otherwise (e.g., Clemens et al, 2018 ; Gribble, Goodwin, & Fear, 2019 ; Hoppen & Morina, 2019 ; Kim et al, 2019 ; McLaughlin, Colich, Rodman, & Weissman, 2020 ; Nordin & Perrin, 2019 ; Pietrzak et al, 2015 ; Sambuco, Bradley, Herring, Hillbrandt, & Lang, 2020 ; Zoellner, Pruitt, Farach, & Jun, 2014 ). Rather, response to traumatic stressors tends to follow the principle of multifinality (Cicchetti & Rogosch, 1996 ) from myriad forms of resilience to psychopathology where similar stressors can lead to various transdiagnostic outcomes across different persons and cultures.…”

A systematic scoping review of dissociation in borderline personality disorder and implications for research and clinical practice: Exploring the fog

“…Despite these challenges, the current literature signals that dissociation is a potential marker for both BPD severity and poor treatment response, indicating a need to better understand the mechanisms involved and develop strategies to address them. In the PTSD literature, dissociative symptoms are linked to clinical severity and lower response to psychotherapy ( Kim et al, 2019 ; Lanius et al, 2012 ). This reduced response has been explained by data demonstrating prefrontal inhibition of limbic regions, leading to emotional overmodulation in response to emotional or traumatic cues ( Lanius et al, 2010 ; Lyssenko et al, 2018 ).…”