Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders

Abstract

Background: The four-dimensional (‘4-D’) model has been proposed as a theoretical framework to understand and delineate trauma-related dissociative experiences, categorizing symptoms into trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC), which occur along four dimensions: time, thought, body and emotion.Objective: The main aim of the present study was to evaluate the validity of this model in patients with post-traumatic stress disorder (PTSD), with and without comorbid dissociative disorders.Method: The predictions of the 4-D model were tested in 142 patients with PTSD, with (N = 46) and without (N = 96) comorbid dissociative disorders.Results: As predicted by the 4-D model, experiences of TRASC were less frequent and more specifically related to other measures of dissociation, dissociative disorder comorbidity and a history of childhood sexual abuse compared to experiences of NWC. The predicted lower intercorrelation of TRASC was not supported.Conclusion: The 4-D model represents a promising framework for understanding dissociation across trauma-related disorders.

Screening for consequences of trauma – an update on the global collaboration on traumatic stress

“…Moreover, symptoms frequently co-occur, especially after interpersonal trauma (e.g. Baekkelund, Frewen, Lanius, Ottesen Berg, & Arnevik, 2018;Cramer, Waldorp, van der Maas, & Borsboom, 2010;Kessler et al, 2017;McLaughlin et al, 2015;Olff et al, 2019;van der Kolk, Ford, & Spinazzola, 2019).…”

A decennial review of psychotraumatology: what did we learn and where are we going?

“…What we do not know is how the neurobiological (Lanius & Olff, 2017), psychological (Baekkelund, Frewen, Lanius, Ottesen Berg, & Arnevik, 2018;Schafer, Becker, King, Horsch, & Michael, 2019), affective (Strøm, Aakvaag, Birkeland, Felix, & Thoresen, 2018), and relational (Heeke, Kampisiou, Niemeyer, & Knaevelsrud, 2019;van Dijke, Hopman, & Ford, 2018) alterations associated with different forms, durations, and structures (Armour, Fried, & Olff, 2017;Murphy, Elklit, Dokkedahl, & Shevlin, 2018) of psychotrauma exposure (and reexposure) emerge and take different courses or trajectories across the lifespanand across generations (Burnette & Cannon, 2014;Crombach & Bambonye, 2015;Schick, Morina, Klaghofer, Schnyder, & Muller, 2013). Biopsychosocial mechanisms and processes involved in the long-term adverse impact of childhood trauma over decades into mid-life and old age (Glück, Knefel, Tran, & Lueger-Schuster, 2016) and across generations (Kuffer, Thoma, & Maercker, 2016) have been preliminarily conceptualized but remain understudied.…”

Group treatment for complex dissociative disorders: a randomized clinical trial

“…CDDs are among the most costly psychiatric conditions, both in terms of societal resources and individual suffering [ 3 ]. Patients with CDD suffer from severe psychiatric symptoms, high levels of comorbidity with other disorders, low level of psychosocial functioning, and frequent suicidality and self-destructive behavior [ 4 – 8 ]. Studies indicate that the prevalence of DID in psychiatric populations might be as high as 5% [ 9 ].…”