The relationship of peritraumatic dissociation and posttraumatic stress: Findings in female Vietnam theater veterans.

Abstract

This study examined the relationship of dissociation at the time of trauma, as assessed by the Peritraumatic Dissociation Experiences Questionnaire, Rater Version (PDEQ-RV; C.R. Marmar, D.S. Weiss, & T.J. Metzler, in press), and posttraumatic stress symptoms in a group of 77 female Vietnam theater veterans. PDEQ-RV ratings were found to be associated strongly with posttraumatic stress symptomatology, as measured by the Impact of Event Scale (M.J. Horowitz, N. Wilner, & W. Alvarez, 1979), and also positively associated with level of stress exposure and general dissociative tendencies, measured by the Dissociative Experiences Scale. The PDEQ-RV was unassociated with general psychiatric symptomatology, as assessed by the clinical scales of the Minnesota Multiphasic Personality Inventory-2 (J.N. Butcher, W.G. Dahlstrom, J.R. Graham, A. Tellegen, & B. Kaemmer, 1989). The PDEQ-RV was predictive of posttraumatic stress symptoms beyond the contributions of level of stress exposure and general dissociative tendencies. The findings provide further support for the reliability and validity of the PDEQ-RV as a measure of peritraumatic dissociation.

Trauma-related Structural Dissociation of the Personality

“…As we said before, this failure can be mani-fested as a sense that the registered event is not happening to one personally. Models proposing that trauma can evoke dissociative phenomena have been strongly supported by a range of retrospective and prospective studies (e.g., Koopman, Classen, & Spiegel, 1994, 1996Nijenhuis, Van Engen et al, 2001;Shalev, Peri, Canetti, & Schreiber, 1996;Tichenor, Marmar, Weiss, Metzler, & Ronfeldt, 1996;Weiss, Marmar, Metzler, & Ronfeldt, 1995). Janet (1909) postulated that trauma produces its disintegrating effects in proportion to its severity as expressed in terms of intensity, duration, and repetition.…”

“…This avoidance may become a chronic adaptation, taking the form of phobia of normal life Van der Hart & Steele, 1999). As a result of expanding fears and phobias, even individuals who functioned at a high level prior to trauma, or who in the initial aftermath of trauma functioned rather well, may get caught in a spiral of posttraumatic decline (Janet, 1909;Tichener, 1986) in which ever less of "apparent normality" remains. Apart from phobia of traumatic memory, the ANP may also develop phobia of EP, which is a specific form of phobia of dissociative parts of the personality (Nijenhuis, 1994).…”

Adaptação para a língua portuguesa do Questionário de Experiências Dissociativas Peritraumáticas (QEDP) numa amostra de bombeiros

“…Esse instrumento, especialmente vocacionado para apreender as respostas dos profissionais que trabalham em situações de emergência, tem sido utilizado em vários estudos 7,14,27 , estando fortemente associado com medidas de estresse traumático, tendências dissociativas gerais e nível de exposição ao estresse, mas não associado com medidas gerais de psicopatologia 14 . Não existindo, tanto quanto sabemos, publicações ou literatura que se debrucem sobre uma versão portuguesa do Peritraumatic Dissociative Experiences Questionnaire (PDEQ), a não ser um estudo de equivalência transcultural para português do Brasil 28 foi nosso ensejo adaptar este instrumento para o nosso país.…”

Peritraumatic Dissociation and Emotions as Predictors of PTSD Symptoms Following Childbirth

“…Peritraumatic dissociation was found to be the strongest predictor for PTSD as compared to prior trauma, prior psychological adjustment, family history of psychopathology, perceived life threat during trauma, posttrauma social support, and peritraumatic emotional responses. Measures of peritraumatic dissociation have been found to predict PTSD and posttraumatic stress symptoms beyond the level of stress exposure, general dissociative tendencies, locus of control, and social support (Marmar et al, 1999;Shalev, Peri, Canetti, & Schreiber, 1996;Tichenor, Marmar, Weiss, Metzler, & Ronfeldt, 1996). Peritraumatic dissociation was also predictive in various groups of victims of trauma: Vietnam combat veterans (Kaufman et al, 2002;Tichenor et al, 1996), motor vehicle accident victims (Delahanty, Royer, Raimonde, & Spoonster, 2003;Fullerton et al, 2001;Ursano et al, 1999), victims of natural disasters (Koopman, Classen, & Spiegel, 1994), emergency service personnel (Marmar et al, 1999), and survivors of crime and assault (Freedman, Brandes, Peri, & Shalev, 1999;Shalev et al, 1996).…”