Evidence for a Dissociative Subtype of PTSD by Latent Profile and Confirmatory Factor Analyses in a Civilian Sample

Steuwe, Carolin; Lanius, Ruth A.; Frewen, Paul A.

doi:10.1002/da.21944

Cited by 164 publications

(197 citation statements)

References 55 publications

(124 reference statements)

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“…Both of these findings may reflect differences in social factors such as gender roles or differences in biological factors (sex) in relation to extreme stress. Finally, this finding supports the creation of a dissociative subtype of PTSD as suggested by, for example, Steuwe, Lanius, and Frewen (2012), however further research is needed.…”

Section: Discussionsupporting

confidence: 84%

Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students

Aho

Svedin

2017

European Journal of Psychotraumatology

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Background: Exposure to traumatic events is clearly associated with a diversity of subsequent mental health problems, with posttraumatic stress disorder (PTSD) as the most prevalent disorder. Epidemiologically, trauma exposure rates are more prevalent than PTSD, indicating that most trauma victims do not develop PTSD. More knowledge is needed to understand the development of the different posttraumatic pathways including the significance of pretraumatic, peritraumatic and posttraumatic risk factors. Objective: To study peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress and to enhance our understanding of peritraumatic reactions as mediators between trauma and later symptomatology. Method: The study was composed of a representative community sample of 5332 second year high school students (mean age 17.3 years) who completed the Juvenile Victimization Questionnaire (SAQ/JVQ), Trauma Symptom Checklist for Children (TSCC) and answered questions about peritraumatic reactions. Mediation effects of peritraumatic reactions on the trauma exposure relationship to symptoms was tested using the PROCESS macro for SPSS. Results: Traumatic events are common (84.1%) and are accompanied in three-quarters of the students with at least one form of peritraumatic reaction. Peritraumatic reactions, especially peritraumatic dissociative reactions, mediate the relationship between trauma exposure and symptoms, and gender moderates the effect of peritraumatic dissociation. This moderating effect was found to be larger for boys than for girls, indicating gender differences in response to trauma. Conclusions: The results indicate the need to screen for peritraumatic reactions as early as possible after a traumatic event in order to identify those at risk for PTSD.

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Section: Discussionsupporting

confidence: 84%

Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students

Aho

Svedin

2017

European Journal of Psychotraumatology

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“…; DSM-5) (American Psychiatric Association, 2013). For instance, recent studies of veterans and civilian PTSD populations have identified a subgroup with elevated dissociation scores with an emphasis on depersonalization and derealization symptoms (Steuwe, Lanius, & Frewen, 2012; Tsai, Armour, Southwick, & Pietrzak, 2015; Wolf et al, 2012a, 2012b). …”

Section: Introductionmentioning

confidence: 99%

Pre-deployment dissociation and personality as risk factors for post-deployment post-traumatic stress disorder in Danish soldiers deployed to Afghanistan

León

Andersen

Karstoft

et al. 2018

European Journal of Psychotraumatology

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Objective: This study investigated whether pre-deployment dissociation was associated with previously identified post-traumatic stress disorder (PTSD) symptom trajectories from before to 2.5 years after military deployment. Furthermore, it examined whether the tendency to dissociate, pre-deployment personality factors, conceptualized by the Big Five model, and previous trauma represented independent risk factors for post-deployment PTSD symptoms.Method: This prospective study included the entire team of 743 soldiers from the Danish Contingent of the International Security Assistance Force 7 deployed to Afghanistan in 2009. Data consisted of self-report measures and were collected six times: before deployment; during deployment; and 1–3 weeks, 2 months, 7 months and 2.5 years after homecoming.Results: The findings indicate significant associations between pre-deployment dissociation and six PTSD trajectories (p < 0.001, η2 = 0.120). Based on mean differences in dissociation for the six trajectories, two main groups emerged: a group with high dissociation scores at pre-deployment, which had moderate PTSD symptom levels at pre-deployment and fluctuated over time; and a group with low dissociation scores at pre-deployment, which had low initial PTSD symptom levels and diverged over time. Our study also confirmed previous findings of a positive association between neuroticism and dissociation (r = 0.31, p < 0.001). This suggests that negative emotionality may be a vulnerability that enhances dissociative experiences, although a causal link cannot be concluded from the findings. Finally, pre-deployment dissociation, pre-deployment neuroticism and a history of traumatic events, as independent factors, were significant predictors of post-deployment PTSD (p < 0.001, R2 = 0.158).Conclusions: The study emphasizes the multiplicity of factors involved in the development of PTSD, and group differences in dissociative symptoms support the heterogeneity in PTSD. Further, this study points to specific aspects of personality that may be targeted in a clinical setting and in pre-deployment assessments in the military.

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“…The dissociative subtype of posttraumatic stress disorder (PTSD+DS)-exhibited by 13-30% of PTSD patients-has recently been added to the fifth revision of the Diagnostic and Statistical Manual (American Psychiatric Association, 2013;Lanius et al, 2012;Stein et al, 2013;Steuwe et al, 2012;Wolf et al, 2012). In addition to genetic predispositions associated with the emergence of PTSD+DS (Wolf et al, 2014), epidemiological evidence points to several risk factors also associated with PTSD+DS, including prior trauma, childhood adversities, and childhood onset of PTSD (Stein et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes

Nicholson

Densmore

Frewen

et al. 2015

Neuropsychopharmacol

146

138

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Previous studies point towards differential connectivity patterns among basolateral (BLA) and centromedial (CMA) amygdala regions in patients with posttraumatic stress disorder (PTSD) as compared with controls. Here we describe the first study to compare directly connectivity patterns of the BLA and CMA complexes between PTSD patients with and without the dissociative subtype (PTSD+DS and PTSD − DS, respectively). Amygdala connectivity to regulatory prefrontal regions and parietal regions involved in consciousness and proprioception were expected to differ between these two groups based on differential limbic regulation and behavioral symptoms. PTSD patients (n = 49) with (n = 13) and without (n = 36) the dissociative subtype and age-matched healthy controls (n = 40) underwent restingstate fMRI. Bilateral BLA and CMA connectivity patterns were compared using a seed-based approach via SPM Anatomy Toolbox. Among patients with PTSD, the PTSD+DS group exhibited greater amygdala functional connectivity to prefrontal regions involved in emotion regulation (bilateral BLA and left CMA to the middle frontal gyrus and bilateral CMA to the medial frontal gyrus) as compared with the PTSD − DS group. In addition, the PTSD+DS group showed greater amygdala connectivity to regions involved in consciousness, awareness, and proprioception-implicated in depersonalization and derealization (left BLA to superior parietal lobe and cerebellar culmen; left CMA to dorsal posterior cingulate and precuneus). Differences in amygdala complex connectivity to specific brain regions parallel the unique symptom profiles of the PTSD subgroups and point towards unique biological markers of the dissociative subtype of PTSD.

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Evidence for a Dissociative Subtype of PTSD by Latent Profile and Confirmatory Factor Analyses in a Civilian Sample

Cited by 164 publications

References 55 publications

Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students

Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students

Pre-deployment dissociation and personality as risk factors for post-deployment post-traumatic stress disorder in Danish soldiers deployed to Afghanistan

The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes

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