Somatoform Dissociation Discriminates Among Diagnostic Categories Over and Above General Psychopathology

Nijenhuis, Ellert R. S.; Dyck, Richard van; Spinhoven, Philip; Hart, Onno van der; Chatrou, Marlène; Vanderlinden, Johan; Moene, Franny

doi:10.1080/j.1440-1614.1999.00601.x

Cited by 68 publications

(37 citation statements)

References 42 publications

(80 reference statements)

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“…These associations suggest a direct link of physical abuse with somatoform aspects of dissociation independent of level of general psychopathology in two of the three groups in which somatoform aspects of dissociation were measured. These results are consistent with the results of a previous study that found that the SDQ-20 measures a unique construct-somatoform dissociation-which is strongly associated with but not identical to psychological dissociation and general psychopathology [43].…”

Section: Discussionsupporting

confidence: 82%

“…However, mean scores for psychological dissociation on the DES in patients with non-epileptic seizures and conversion disorder were quite comparable to the average DES score as found in the general population (M = 12 (SD = 11)) in 1458 subjects from seven separate studies) [29]. Finally, mean scores for somatoform dissociation in all patient groups were elevated compared to patients with mixed psychiatric disorders (mainly anxiety disorder, depression and adjustment disorder) (M = 23 (SD = 4)) [43].…”

Section: Subject Characteristicssupporting

confidence: 50%

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Trauma and Dissociation in Conversion Disorder and Chronic Pelvic Pain

Spinhoven

Roelofs

Moene

et al. 2004

Int J Psychiatry Med

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Objective: The purpose of this study was to: a) assess the link between sexual and/or physical abuse and dissociation in conversion disorder and chronic pelvic pain patients; and b) assess whether this effect is independent of level of general psychopathology. Method: This report examines data from four separate samples. Fifty-two patients with chronic pelvic pain, 61 patients with non-epileptic seizures, and two samples of patients (102 and 54) with predominantly motor or sensory types of conversion disorder were studied. Results: Using point-biserial correlations no compelling evidence for a consistent and positive association of sexual and/or physical abuse with dissociation was found. After statistically controlling for level of psychopathology using multiple regression analyses, in most of the cases the association of 305 Ó 2004, Baywood Publishing Co., Inc. abuse with dissociation was no longer statistically significant. Only physical abuse predicted level of somatoform dissociation over and above level of psychopathology. Conclusion: In future clinical studies of dissociation in patients with conversion disorder and chronic pelvic pain more complex models may be needed with less exclusive reliance on historical antecedents such as childhood abuse and more emphasis on recent potentially traumatizing experiences or co-morbid psychiatric disorders.

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Section: Discussionsupporting

confidence: 82%

Section: Subject Characteristicssupporting

confidence: 50%

Trauma and Dissociation in Conversion Disorder and Chronic Pelvic Pain

Spinhoven

Roelofs

Moene

et al. 2004

Int J Psychiatry Med

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“…Two core symptoms (identity alteration, amnesia) differentiate DID from other disorders (Steinberg, 1994a). So, too, does the combined frequency of other dissociative symptoms, including identity confusion, depersonalisation/derealisation, and somatoform dissociation (Dell, 2006;Nijenhuis et al, 1999).…”

Section: Construct Validity -Discriminant Type: Distinctiveness From mentioning

confidence: 99%

Dissociative identity disorder: An empirical overview

Dorahy

Brand

Şar

et al. 2014

Aust N Z J Psychiatry

164

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Objective: Despite its long and auspicious place in the history of psychiatry, dissociative identity disorder (DID) has been associated with controversy. This paper aims to examine the empirical data related to DID and outline the contextual challenges to its scientific investigation. Method: The overview is limited to DID-specific research in which one or more of the following conditions are met: 1) a sample of participants with DID was systematically investigated, 2) psychometrically-sound measures were utilised, 3) comparisons were made with other samples, 4) DID was differentiated from other DID: An empirical overview 2 disorders, including other Dissociative Disorders, 5) extraneous variables were controlled or 6) DID diagnosis was confirmed. Following an examination of challenges to research, data is organised around the validity and phenomenology of DID, its aetiology and epidemiology, the neurobiological and cognitive correlates of the disorder, and finally its treatment. Results: DID was found to be a complex yet valid disorder across a range of markers. It can be accurately discriminated from other disorders, especially when structured diagnostic interviews assess identity alterations and amnesia. DID is aetiologically associated with a complex combination of developmental and cultural factors, including severe childhood relational trauma. The prevalence of DID appears highest in emergency psychiatric settings and affects approximately 1% of the general population. Psychobiological studies are beginning to identify clear correlates of DID associated with diverse brain areas and cognitive functions. They are also providing an understanding of the potential metacognitive origins of amnesia. Phase-oriented empirically-guided treatments are emerging for DID. Conclusions: The empirical literature on DID is accumulating, although some areas remain under-investigated.Existing data show DID as a complex, valid, and not uncommon disorder, associated with developmental and cultural variables, that is amenable to psychotherapeutic intervention. KeywordsDissociative identity disorder, validity, phenomenology, aetiology, psychobiology, [see Taylor, 1983 ], Janet, 1907Prince, 1905). More recently DID has become the subject of considerable debate (e.g., Dalenberg et al., 2012;Gleaves, 1996;McHugh and Putnam, 1995;Merskey, 1992), especially around its validity, aetiology and prevalence. Often This overview is designed to provide a current "broad-brush" outline of the scientific foundation of DID by focusing on DID-specific research. Thus the overview excludes opinion pieces and papers without DID data and is confined to studies identified in searches of major psychological (e.g., Psycinfo) and psychiatric databases (e.g., Medline) which investigated individuals with DID where one or more of the following conditions were met: 1) a sample of participants with DID was systematically investigated, 2) psychometrically-sound measures were utilised, 3) comparisons were made with other samples, 4) DID was differentiat...

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“…Phenomenological studies comparing DID with other psychiatric groups have reported high incidences of dissociative, psychotic, borderline, anxiety and depressive symptoms in DID groups (Middleton and Butler, 1998;Nijenhuis et al, 1999;Rodewald et al, 2011;Ross and Ness, 2010;Şar et al, 1996;see Dorahy et al, 2014). In therapy emotions like shame and guilt, as well as anxiety and fear associated with relationships are likely to be centrally important, especially in the development of a working relationship and addressing dissociative and trauma dynamics (Boon et al, 2011;Chu, 2011;Howell, 2011).…”

mentioning

confidence: 99%

Dissociation, shame, complex PTSD, child maltreatment and intimate relationship self-concept in dissociative disorder, chronic PTSD and mixed psychiatric groups

Dorahy

Middleton

Seager

et al. 2015

Journal of Affective Disorders

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a b s t r a c tBackground: Whilst a growing body of research has examined dissociation and other psychiatric symptoms in severe dissociative disorders (DDs), there has been no systematic examination of shame and sense of self in relationships in DDs. Chronic child abuse often associated with severe DDs, like dissociative identity disorder, is likely to heighten shame and relationship concerns. This study investigated complex posttraumatic stress disorder (PTSD), borderline and Schneiderian symptoms, dissociation, shame, child abuse, and various markers of self in relationships (e.g., relationship esteem, relationship depression, fear of relationships). Methods: Participants were assessed via clinical interview with psychometrically sound questionnaires. They fell into three diagnostic groups, dissociative disorder (n ¼ 39; primarily dissociative identity disorder), chronic PTSD (Chr-PTSD; n ¼13) or mixed psychiatric presentations (MP; n ¼ 21; primarily mood and anxiety disorders). All participants had a history of child abuse and/or neglect, and the groups did not differ on age and gender. Results: The DD group was higher on nearly all measured variables than the MP group, and had more severe dissociative, borderline and Schneiderian symptoms than the Chr-PTSD sample. Shame and complex PTSD symptoms fell marginally short of predicting reductions in relationship esteem, pathological dissociative symptoms predicted increased relationship depression, and complex PTSD symptoms predicted fear of relationships. Limitations: The representativeness of the samples was unknown. Conclusion: Severe psychiatric symptoms differentiate DDs from chronic PTSD, while dissociation and shame have a meaningful impact on specific markers of relationship functioning in psychiatric patients with a history of child abuse and neglect.

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Somatoform Dissociation Discriminates Among Diagnostic Categories Over and Above General Psychopathology

Cited by 68 publications

References 42 publications

Trauma and Dissociation in Conversion Disorder and Chronic Pelvic Pain

Trauma and Dissociation in Conversion Disorder and Chronic Pelvic Pain

Dissociative identity disorder: An empirical overview

Dissociation, shame, complex PTSD, child maltreatment and intimate relationship self-concept in dissociative disorder, chronic PTSD and mixed psychiatric groups

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