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Author |
van Dijke, A.; Ford, J.D.; Frank, L.E.; van der Hart, O. |
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Title |
Association of Childhood Complex Trauma and Dissociation With Complex Posttraumatic Stress Disorder Symptoms in Adulthood |
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Journal Article |
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Year |
2015 |
Publication |
Journal of Trauma & Dissociation : the Official Journal of the International Society for the Study of Dissociation (ISSD) |
Abbreviated Journal |
J Trauma Dissociation |
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Volume |
16 |
Issue |
4 |
Pages |
428-441 |
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Keywords |
childhood trauma; complex posttraumatic stress disorder; dissociation |
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Abstract |
This study replicates and extends prior research on the relationship of childhood complex trauma (CCT) and complex posttraumatic stress disorder (cPTSD) in adulthood, examining the role of psychoform and somatoform dissociation as a potential mediator. CCT, dissociation, and cPTSD were assessed in a large sample of adult psychiatric inpatients. Almost two thirds of participants reported having experienced CCT. Path analyses with bootstrap confidence intervals demonstrated a relationship between CCT, psychoform (but not somatoform) dissociation, and cPTSD. In addition, psychoform dissociation partially mediated the relationship between CCT and adult cPTSD symptoms. Dissociation (pathological or nonpathological psychoform and somatoform symptoms) warrants further clinical and scientific study as a potential link between CCT and the presence of adult cPTSD symptoms and/or the dissociative subtype of PTSD. |
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a Yulius Academy & Colk Yulius , Rotterdam , The Netherlands |
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1529-9732 |
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PMID:25905664 |
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UU @ jana.mullerova @ |
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42187 |
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Frewen, P.A.; Brown, M.F.D.; Steuwe, C.; Lanius, R.A. |
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Title |
Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype |
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Journal Article |
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Year |
2015 |
Publication |
European Journal of Psychotraumatology |
Abbreviated Journal |
Eur J Psychotraumatol |
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6 |
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26406 |
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Keywords |
Posttraumatic stress disorder; dissociation; dissociative subtype; psychological trauma; trauma-related altered states of consciousness |
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Abstract |
OBJECTIVE: A dissociative subtype has been recognized based on the presence of experiences of depersonalization and derealization in relation to DSM-IV posttraumatic stress disorder (PTSD). However, the dissociative subtype has not been assessed in a community sample in relation to the revised DSM-5 PTSD criteria. Moreover, the 20-item PTSD Checklist for DSM-5 (PCL-5) currently does not assess depersonalization and derealization. METHOD: We therefore evaluated two items for assessing depersonalization and derealization in 557 participants recruited online who endorsed PTSD symptoms of at least moderate severity on the PCL-5. RESULTS: A five-class solution identified two PTSD classes who endorsed dissociative experiences associated with either 1) severe or 2) moderate PTSD symptom severity (D-PTSD classes). Those in the severe dissociative class were particularly likely to endorse histories of childhood physical and sexual abuse. A principal axis factor analysis of the symptom list identified six latent variables: 1) Reexperiencing, 2) Emotional Numbing/Anhedonia, 3) Dissociation, 4) Negative Alterations in Cognition & Mood, 5) Avoidance, and 6) Hyperarousal. CONCLUSIONS: The present results further support the presence of a dissociative subtype within the DSM-5 criteria for PTSD. |
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Graduate Program in Neuroscience, Western University, London, Ontario, Canada |
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2000-8066 |
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PMID:25854673 |
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UU @ jana.mullerova @ |
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42188 |
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Minshew, R.; D'Andrea, W. |
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Title |
Implicit and explicit memory in survivors of chronic interpersonal violence |
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Journal Article |
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Year |
2015 |
Publication |
Psychological Trauma : Theory, Research, Practice and Policy |
Abbreviated Journal |
Psychol Trauma |
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7 |
Issue |
1 |
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67-75 |
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Keywords |
*Domestic Violence; Female; Humans; *Memory; Psychological Tests; Self Report; Stress Disorders, Post-Traumatic/psychology/therapy; Surveys and Questionnaires; Survivors/*psychology |
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We investigated the relationship of implicit and explicit memory to a range of symptoms in a sample of 27 women with exposure to chronic interpersonal violence (IPV). Participants viewed the first 3 letters (“stems”) of trauma-related, general threat, and neutral words; valenced words were matched with neutral words with the same stem. Free recall and a word-stem completion task were used to test explicit and implicit memory, respectively. Participants exhibited increased implicit memory for trauma-related words as compared with both general threat words and neutral “match” words. They also showed increased explicit memory for both general threat and trauma-related words. Finally, although neither implicit nor explicit memory was correlated with PTSD symptoms, implicit memory for trauma-related words was significantly correlated with symptoms associated with ongoing IPV. Interpersonal sensitivity, hostility, and alexithymia were significantly correlated with implicit, but not explicit, memory for trauma words. Somatization, dissociation, and alexithymia were negatively correlated with explicit, but not implicit, memory for general-threat words. These findings suggest that memory processes in survivors of IPV are closely related to the symptom profile associated with complex trauma. Exploring memory processes in survivors of IPV may lend unique insight into the development and maintenance of the symptom profile associated with IPV. |
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Department of Psychology |
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1942-969X |
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PMID:25793595 |
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UU @ jana.mullerova @ |
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42189 |
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Frankfurt, S.; Anders, S.L.; James, L.M.; Engdahl, B.; Winskowski, A.M. |
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Title |
Evaluating the dimensionality of PTSD in a sample of OIF/OEF veterans |
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Journal Article |
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Year |
2015 |
Publication |
Psychological Trauma : Theory, Research, Practice and Policy |
Abbreviated Journal |
Psychol Trauma |
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7 |
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5 |
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430-436 |
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Both categorical and dimensional models of mental disorders, including posttraumatic stress disorder (PTSD), are useful for diagnostic and heuristic purposes; however, few empirical studies have compared categorical and dimensional models of PTSD side-by-side or compared these models to a hybrid (dimensional and categorical) model. In the present study, the dimensionality of PTSD was examined by fitting latent profile analytic, confirmatory factor analytic, and factor mixture models in 271 Operation Iraqi Freedom/Operation Enduring Freedom veterans 6 months after return from deployment. Latent profile analysis was used to identify subgroups of individuals with similar PTSD symptom profiles and predictors of subgroup membership, confirmatory factor analysis was used to identify the underlying continuous structure of PTSD in this sample, and factor mixture modeling was used to test whether a hybrid categorical and continuous model of PTSD best fit our sample. A factor mixture model consisting of a 4-factor dysphoria model of PTSD with 2 classes characterized by low and moderate symptom severity was the best-fitting model. Dissociation and deployment concerns emerged as significant predictors of membership in the moderate symptoms class. Implications for PTSD diagnostic conceptualization and treatment planning are discussed. |
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Brain Science Center, Minneapolis Veterans Affairs Medical Center |
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1942-969X |
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PMID:25793318 |
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no |
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UU @ jana.mullerova @ |
Serial |
42190 |
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Nicholson, A.A.; Densmore, M.; Frewen, P.A.; Theberge, J.; Neufeld, R.W.; McKinnon, M.C.; Lanius, R.A. |
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Title |
The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes |
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Journal Article |
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Year |
2015 |
Publication |
Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology |
Abbreviated Journal |
Neuropsychopharmacology |
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40 |
Issue |
10 |
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2317-2326 |
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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 resting-state 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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Lawson Health Research Institute, Western University, London, Ontario, Canada |
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English |
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0893-133X |
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PMID:25790021 |
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no |
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UU @ jana.mullerova @ |
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42191 |
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Author |
Hansen, M.; Armour, C.; Wang, L.; Elklit, A.; Bryant, R.A. |
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Title |
Assessing possible DSM-5 ASD subtypes in a sample of victims meeting caseness for DSM-5 ASD based on self-report following multiple forms of traumatic exposure |
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Journal Article |
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Year |
2015 |
Publication |
Journal of Anxiety Disorders |
Abbreviated Journal |
J Anxiety Disord |
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Volume |
31 |
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Pages |
84-89 |
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Keywords |
Crime Victims/*psychology; Diagnostic and Statistical Manual of Mental Disorders; Disaster Victims/*psychology; Dissociative Disorders/diagnosis; Female; Humans; Male; Rape/psychology; Self Report; Stress Disorders, Traumatic, Acute/*diagnosis/psychology; Violence/psychology; ASD subtypes; Acute stress disorder; Dsm-5; Icd-11; Latent profile analysis |
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Acute stress disorder (ASD) was introduced into the DSM-IV to recognize early traumatic responses and as a precursor of PTSD. Although the diagnostic criteria for ASD were altered and structured more similarly to the PTSD definition in DSM-5, only the PTSD diagnosis includes a dissociative subtype. Emerging research has indicated that there also appears to be a highly symptomatic subtype for ASD. However, the specific nature of the subtype is currently unclear. The present study investigates the possible presence of ASD subtypes in a mixed sample of victims meeting caseness for DSM-5 ASD based on self-report following four different types of traumatic exposure (N=472). The results of latent profile analysis revealed a 5-class solution. The highly symptomatic class was marked by high endorsement on avoidance and dissociation compared to the other classes. Findings are discussed in regard to its clinical implications including the implications for the pending the ICD-11 and the recently released DSM-5. |
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School of Psychology, University of New South Wales, NSW, Australia |
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0887-6185 |
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PMID:25768397 |
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UU @ jana.mullerova @ |
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42192 |
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Zaba, M.; Kirmeier, T.; Ionescu, I.A.; Wollweber, B.; Buell, D.R.; Gall-Kleebach, D.J.; Schubert, C.F.; Novak, B.; Huber, C.; Kohler, K.; Holsboer, F.; Putz, B.; Muller-Myhsok, B.; Hohne, N.; Uhr, M.; Ising, M.; Herrmann, L.; Schmidt, U. |
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Identification and characterization of HPA-axis reactivity endophenotypes in a cohort of female PTSD patients |
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Journal Article |
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2015 |
Publication |
Psychoneuroendocrinology |
Abbreviated Journal |
Psychoneuroendocrinology |
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55 |
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102-115 |
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Fkbp5; Gene expression; Ptsd; PTSD subtypes; Posttraumatic stress disorder; Stress reactivity; Trier Social Stress Test |
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Abstract |
Analysis of the function of the hypothalamic-pituitary-adrenal (HPA)-axis in patients suffering from posttraumatic stress disorder (PTSD) has hitherto produced inconsistent findings, inter alia in the Trier Social Stress Test (TSST). To address these inconsistencies, we compared a sample of 23 female PTSD patients with either early life trauma (ELT) or adult trauma (AT) or combined ELT and AT to 18 age-matched non-traumatized female healthy controls in the TSST which was preceded by intensive baseline assessments. During the TSST, we determined a variety of clinical, psychological, endocrine and cardiovascular parameters as well as expression levels of four HPA-axis related genes. Using a previously reported definition of HPA-axis responsive versus non-responsive phenotypes, we identified for the first time two clinically and biologically distinct HPA-axis reactivity subgroups of PTSD. One subgroup (“non-responders”) showed a blunted HPA-axis response and distinct clinical and biological characteristics such as a higher prevalence of trauma-related dissociative symptoms and of combined AT and ELT as well as alterations in the expression kinetics of the genes encoding for the mineralocorticoid receptor (MR) and for FK506 binding protein 51 (FKBP51). Interestingly, this non-responder subgroup largely drove the relatively diminished HPA axis response of the total cohort of PTSD patients. These findings are limited by the facts that the majority of patients was medicated, by the lack of traumatized controls and by the relatively small sample size. The here for the first time identified and characterized HPA-axis reactivity endophenotypes offer an explanation for the inconsistent reports on HPA-axis function in PTSD and, moreover, suggest that most likely other factors than HPA-axis reactivity play a decisive role in determination of PTSD core symptom severity. |
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Max Planck Institute of Psychiatry, Clinical Department, Kraepelinstrasse 10, 80804 Munchen, Germany. Electronic address: uschmidt@mpipsykl.mpg.de |
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0306-4530 |
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PMID:25745955 |
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UU @ jana.mullerova @ |
Serial |
42193 |
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Chalavi, S.; Vissia, E.M.; Giesen, M.E.; Nijenhuis, E.R.S.; Draijer, N.; Barker, G.J.; Veltman, D.J.; Reinders, A.A.T.S. |
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Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder |
Type |
Journal Article |
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Year |
2015 |
Publication |
Psychiatry Research |
Abbreviated Journal |
Psychiatry Res |
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Volume |
231 |
Issue |
3 |
Pages |
308-319 |
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Keywords |
Adolescent; Adult; Cerebral Cortex/*pathology; Comorbidity; Corpus Striatum/*pathology; Female; Gray Matter/*pathology; Hippocampus/pathology; Humans; *Life Change Events; Magnetic Resonance Imaging; Middle Aged; Multiple Personality Disorder/epidemiology/*pathology; Stress Disorders, Post-Traumatic/epidemiology/*pathology; Young Adult; Cortical surface area; Cortical thickness; Cortical volume; FreeSurfer; Neuroimaging; Subcortical volume |
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Neuroanatomical evidence on the relationship between posttraumatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5. |
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Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychosis Studies, Institute of Psychiatry (IoP), Kings College London, De Crespigny Park, P.O. Box 40, London SE5 8AF, United Kingdom. Electronic address: a.a.t.s.reinders@gmail.com |
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0165-1781 |
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PMID:25670646 |
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UU @ jana.mullerova @ |
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42194 |
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Author |
Tursich, M.; Ros, T.; Frewen, P.A.; Kluetsch, R.C.; Calhoun, V.D.; Lanius, R.A. |
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Title |
Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters |
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Journal Article |
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Year |
2015 |
Publication |
Acta Psychiatrica Scandinavica |
Abbreviated Journal |
Acta Psychiatr Scand |
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Volume |
132 |
Issue |
1 |
Pages |
29-38 |
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adult survivors of child abuse; functional neuroimaging; multivariate analysis; post-traumatic stress disorders |
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OBJECTIVE: Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. METHOD: Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. RESULTS: Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montreal Neurological Institute (MNI): -44, -8, 0, t = -4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, -4; t = -3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. CONCLUSION: Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype. |
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Department of Neuroscience, The University of Western Ontario, London, ON, Canada |
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0001-690X |
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PMID:25572430 |
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no |
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UU @ jana.mullerova @ |
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42195 |
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Author |
Armour, C.; Hansen, M. |
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Assessing DSM-5 latent subtypes of acute stress disorder dissociative or intrusive? |
Type |
Journal Article |
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Year |
2015 |
Publication |
Psychiatry Research |
Abbreviated Journal |
Psychiatry Res |
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Volume |
225 |
Issue |
3 |
Pages |
476-483 |
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Keywords |
Adult; Age Factors; *Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders/classification/*diagnosis/psychology; Female; Humans; Male; Middle Aged; Risk Factors; Social Support; Stress Disorders, Traumatic, Acute/classification/*diagnosis/psychology; ASD subtypes; Dissociative ASD; Intrusive ASD; Latent profile analysis; Risk factors |
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Abstract |
Acute Stress Disorder (ASD) was first included in the DSM-IV in 1994. It was proposed to account for traumatic responding in the early post trauma phase and to act as an identifier for later Posttraumatic Stress Disorder (PTSD). Unlike PTSD it included a number of dissociative indicators. The revised DSM-5 PTSD criterion included a dissociative-PTSD subtype. The current study assessed if a dissociative-ASD subtype may be present for DSM-5 ASD. Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in symptomatic compared to a baseline ASD profile. We used data from 450 bank robbery victims. Latent profile analysis (LPA) was used to uncover latent profiles of ASD. Multinomial logistic regression was used to determine if female gender, age, social support, peritraumatic panic, somatization, and number of trauma exposures increased or decreased the probability of profile membership. Four latent profiles were uncovered and included an intrusion rather than dissociative subtype. Increased age and social support decreased the probability of individuals being grouped into the intrusion subtype whereas increased peritraumatic panic and somatization increased the probability of individuals being grouped into the intrusion subtype. Findings are discussed in regard to the ICD-11 and the DSM-5. |
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National Centre for Psychotraumatology, Institute for Psychology, University of Southern Denmark, Denmark |
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English |
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0165-1781 |
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PMID:25535010 |
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UU @ jana.mullerova @ |
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42196 |
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