The psychometric properties of the adolescent dissociative experiences scale (A-DES) in a sample of Portuguese at-risk adolescents

Abstract

Dissociation is a process that often occurs as a sequela of psychological trauma, and it is interrelated with psychological and behavioral problems. In the at-risk adolescent population, dissociation is often underdiagnosed and undertreated. Having reliable measures to assess this phenomenon can help in identifying adolescents at-risk and improve treatment outcomes. This study assessed the psychometric properties of the Adolescent Dissociative Experiences Scale (A-DES) with a sample of 402 Portuguese adolescents recruited from three at-risk populations. Participants completed self-report measures of trauma exposure, posttraumatic symptoms, psychological and behavioral problems, and the A-DES. A subset of the sample also completed test-retest measures. Confirmatory factor analyses revealed a best-fitting 3-factor model. Analyses revealed good internal consistencies and good agreement test-retest reliability for the scale overall and the factor-based sub-scales. Construct and predictive validity was supported with results showing that A-DES discriminates between youth reporting high versus low levels of cumulative trauma exposure and youth who meet or do not meet criteria for a probable PTSD diagnosis. Study findings replicate prior research supporting a 3-factor model of dissociation and the usefulness of A-DES to identify adolescents with dissociative symptoms. Clinical and research implications are discussed.

Posttraumatic stress disorder symptoms and dissociation as serial mediators of the relationship between cumulative victimization and adjustment problems among poly-victimized at-risk youth.

“…Another possibility is that dissociation related to cumulative victimization and PTSD may lead to adjustment problems as a result of its association with severe emotion dysregulation. Research has shown that dissociation and emotional dysregulation are highly correlated in both adult (Hagan et al, 2015; McDonald et al, 2013) and adolescent samples (Correia-Santos, Sousa, et al, 2022; Gušić et al, 2018), although the interconnections between them are complex (e.g., Bridges-Curry et al, 2021; Ross et al, 2020). For instance, attachment insecurity is also associated with emotion dysregulation (Crow et al, 2021) and as such should also be assessed as a potential moderator (Gušić et al, 2016) or mediator (Byun et al, 2016) of the relationship between cumulative victimization and dissociation.…”

“…Dissociation symptoms also represented an indirect effect for the link between cumulative victimization and adjustment problems. Research has shown that poly-victimized youth, besides having a higher likelihood of PTSD, also tend to report pathological levels of loss of conscious control (Correia-Santos, Sousa, et al, 2022; Kerig et al, 2016), which is a subset of the larger dissociation construct. This loss of conscious control comprises experiences of not having self-control of one’s behavior, consciousness, or thoughts, meaning emotion deregulation, which is associated with adjustment problems (Chaplo et al, 2015; Hébert et al, 2018).…”

“…We used the Traumatic Events Screening Inventory—Child/Self Report (Ford et al, 2000; Portuguese version: Correia-Santos, Azevedo, et al, 2022) to assess exposure to 15 types of adversities or potentially traumatic events (see Table 1). The assessed events’ types relate to accidents, natural disasters, severe injury/illness, interpersonal losses, physical and emotional abuse, domestic violence, community violence, and sexual abuse that participants’ may have experienced, witnessed, or learned about…”

“…Adolescents who experience PV tend to present with an array of adjustment problems (Correia-Santos et al, 2019; Farrell & Zimmerman, 2017; Finkelhor et al, 2007; Ford et al, 2010, 2011; Grasso et al, 2016), including impulsivity, social isolation, peer relationship problems, self-harm, delinquency, academic underachievement, and substance abuse (D’Andrea et al, 2012; Ford, 2017, 2018; Ford & Gómez, 2015; Le et al, 2016). Research also shows that PV is associated with dissociation (Correia-Santos, Sousa, et al, 2022; D’Andrea et al, 2012) and that poly-victimized youth also tend to have 2 times greater likelihood of mood disorders and 3 times greater risk of developing posttraumatic stress disorder (PTSD) than their nontraumatized peers (Ford et al, 2010; Segura et al, 2016).…”

“…Both PTSD (e.g., Schafer et al, 2022) and dissociation (e.g., Fragkaki et al, 2019) are linked to PV and adjustment problems (Dierkhising et al, 2019; Ford et al, 2010, 2018; Grasso et al, 2016). Moreover, PTSD tends to be highly correlated with dissociation (Correia-Santos, Sousa, et al, 2022; Hagan et al, 2015; McDonald et al, 2013), and specifically to persistent dissociation (e.g., McDonald et al, 2013; Zerach et al, 2014). Moreover, a dissociative subtype also has been identified with adolescents (e.g., Choi et al, 2017; Modrowski & Kerig, 2017).…”