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Author Bae, H.; Kim, D.; Park, Y.C. url  doi
openurl 
  Title Dissociation predicts treatment response in eye-movement desensitization and reprocessing for posttraumatic stress disorder Type Journal Article
  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  
  Volume Issue Pages 1-19  
  Keywords Posttraumatic stress disorder; comorbidity; dissociation; eye-movement desensitization and reprocessing; treatment response  
  Abstract Using clinical data from a specialized trauma clinic, this study investigated pretreatment clinical factors predicting response to eye-movement desensitization and reprocessing (EMDR) among adult patients diagnosed with posttraumatic stress disorder (PTSD). Participants were evaluated using the Clinician-Administered PTSD Scale (CAPS), the Symptom Checklist-90-Revised, the Beck Depression Inventory, and the Dissociative Experiences Scale before treatment and were reassessed using the CAPS after treatment and at 6-month follow-up. A total of 69 patients underwent an average of 4 sessions of EMDR, and 60 (87%) completed the posttreatment evaluation, including 8 participants who terminated treatment prematurely. Intent-to-treat analysis revealed that 39 (65%) of the 60 patients were classified as responders and 21 (35%) as nonresponders when response was defined as more than a 30% decrease in total CAPS score. The nonresponders had higher levels of dissociation (depersonalization and derealization) and numbing symptoms, but other PTSD symptoms, such as avoidance, hyperarousal, and intrusion, were not significantly different. The number of psychiatric comorbidities was also associated with treatment nonresponse. The final logistic regression model yielded 2 significant variables: dissociation (p < .001) and more than 2 comorbidities compared to none (p < .05). These results indicate that complex symptom patterns in PTSD may predict treatment response and support the inclusion of the dissociative subtype of PTSD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.  
  Address b Department of Psychiatry , Hanyang University Medical School , Seoul , South Korea  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1529-9732 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:26156867 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42179  
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Author Daniels, J.K.; Frewen, P.; Theberge, J.; Lanius, R.A. url  doi
openurl 
  Title Structural brain aberrations associated with the dissociative subtype of post-traumatic stress disorder Type Journal Article
  Year 2015 Publication Acta Psychiatrica Scandinavica Abbreviated Journal Acta Psychiatr Scand  
  Volume Issue Pages  
  Keywords dissociation; grey matter; post-traumatic stress disorder; voxel-based morphometry  
  Abstract OBJECTIVE: One factor potentially contributing to the heterogeneity of previous results on structural grey matter alterations in adult participants suffering from post-traumatic stress disorder (PTSD) is the varying levels of dissociative symptomatology. The aim of this study was therefore to test whether the recently defined dissociative subtype of PTSD characterized by symptoms of depersonalization and derealization is characterized by specific differences in volumetric brain morphology. METHOD: Whole-brain MRI data were acquired for 59 patients with PTSD. Voxel-based morphometry was carried out to test for group differences between patients classified as belonging (n = 15) vs. not belonging (n = 44) to the dissociative subtype of PTSD. The correlation between dissociation (depersonalization/derealization) severity and grey matter volume was computed. RESULTS: Patients with PTSD classified as belonging to the dissociative subtype exhibited greater grey matter volume in the right precentral and fusiform gyri as well as less volume in the right inferior temporal gyrus. Greater dissociation severity was associated with greater volume in the right middle frontal gyrus. CONCLUSION: The results of this first whole-brain investigation of specific grey matter volume in dissociative subtype PTSD indentified structural aberrations in regions subserving the processing and regulation of emotional arousal. These might constitute characteristic biomarkers for the dissociative subtype PTSD.  
  Address Department of Psychiatry, Western University, London, ON, Canada  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0001-690X ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:26138235 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42180  
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Author Holterbach, L.; Baumann, C.; Andreani, B.; Desre, D.; Auxemery, Y. url  doi
openurl 
  Title [Correlation between specific and nonspecific posttraumatic stress disorder symptoms with healthcare consumption among 340 French soldiers] Type Journal Article
  Year 2015 Publication L'Encephale Abbreviated Journal Encephale  
  Volume 41 Issue 5 Pages 444-453  
  Keywords Army; Armees; Consommation de soins; Detection; Depistage; Epidemiology; Healthcare consumption; Militaires; Pcls; Posttraumatic stress disorder; Psychopathologie; Psychopathology; Soldiers; Epidemiologie; Etat de stress post-traumatique  
  Abstract BACKGROUND: The psychotraumatic disorders are often difficult to diagnose because the specific symptoms of posttraumatic stress disorder (revival, hyperarousal, avoidance) are rarely a direct demand for health care: for reasons determined by the psychopathological structure of trauma, its symptomatology and course, the psychotraumatised subjects seek a care system for nonspecific psychological or somatoform symptoms: depressive episode, cognitive disorders, other anxiety disorders, histrionic and obsessive symptoms, changes in personality, pain disorders and somatization. Somatic pain may also result from a war injury and psychosomatic complications, addictive or consequences of risk behaviours during the evolution of posttraumatic stress disorder. OBJECTIVES: To establish a correlation between the PCLS and the evaluation of the healthcare consumption in a military population. METHODS: We conducted a multicenter epidemiological study analyzing the PCLS and a questionnaire assessing health care consumption. The PCLS has been studied in various forms: quantitative (17 to 85), in qualitative classes (<33, 33 to 43 and >/=44), and in five sub-dimensions (flashbacks, avoidance, dissociation, depression and hyperactivity). The sub-dimension revival was then studied item by item. The criteria used care consumption over the last twelve months is the numbers of days of sick leave, days of unavailability (of certain jobs or military activities) and consultations. RESULTS: Our population of 340 subjects cannot be considered representative of the French military population even if only a few characteristics differ. Sixteen of 340 subjects show a positive PCLS is 4.70% of our sample. PCLS average of 23 (+/-9.4) with a median of 19 objectifying much of PCLS have almost zero score. Validating our main hypothesis, we found a statistically significant relationship between elements of the PCLS and variables care consumption: this link exists mainly between the score, classes and sub-dimensions of the PCLS in one hand and number of days of sick leave and unavailability on the other hand. DISCUSSION: Towards a strategy for tracking psychotraumatic disorders, could be developed a score of health care consumption which would include the number of days of sick leave and unavailability, the number and quality of medical consultations, the number and quality of drug and laboratory requirements, the number of hospitalisations. To the identification of posttraumatic stress disorder, the PCLS score as well as the consumer healthcare score are valuable tools but do not replace the subjectivity of the clinical relationship: return to this shared subjectivity with the practitioner remains a diagnostic dimension, but also therapeutic, fundamental.  
  Address HIA Percy, 101, avenue Henri-Barbusse, BP 406, 92140 Clamart, France. Electronic address: yann.auxemery@hotmail.fr  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language French Summary Language Original Title Etat de stress post-traumatique et consommation de soins sur l'annee ecoulee : etude menee aupres de 340 militaires francais de cinq unites combattantes de l'armee de terre  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0013-7006 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:26049671 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42181  
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Author Bennett, D.C.; Modrowski, C.A.; Kerig, P.K.; Chaplo, S.D. url  doi
openurl 
  Title Investigating the dissociative subtype of posttraumatic stress disorder in a sample of traumatized detained youth Type Journal Article
  Year 2015 Publication Psychological Trauma : Theory, Research, Practice and Policy Abbreviated Journal Psychol Trauma  
  Volume 7 Issue 5 Pages 465-472  
  Keywords  
  Abstract In this study, we tested the validity of a dissociative subtype in a sample of 225 detained adolescents (142 boys, 83 girls) likely meeting full or partial criteria for posttraumatic stress disorder (PTSD). Competing theories of dissociation pose controversy regarding dissociation as a taxon versus a continuum, and results of the current study contribute to this debate by providing evidence of distinct group differences between those high and low in dissociation. Mixture modeling revealed 2 groups of youth with differing levels of depersonalization/derealization dissociative symptoms. Differences between the 2 groups of youth were investigated regarding trauma exposure and several posttraumatic reactions: posttraumatic stress symptoms (PTSS), emotion dysregulation, and emotional numbing. Compared with youth classified in the low-dissociation group, youth who exhibited high levels of dissociation demonstrated higher levels of total PTSS, posttraumatic symptom clusters of emotional numbing, intrusion, and associated features, as well as reporting more difficulties with emotion dysregulation. To test theory regarding the factors that increase the likelihood of persistent dissociation, bootstrapped regression analyses were performed to examine the possibility of an indirect effect of peritraumatic dissociation. Results consistent with statistical mediation suggested that the presence of peritraumatic dissociation at the time of trauma may contribute to the continuation of dissociative symptoms as a more generalized pattern. The results of the current study have implications for clinical treatment with traumatized youth.  
  Address Department of Psychology, University of Utah  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1942-969X ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:26010107 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42182  
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Author Lanius, R.A. url  openurl
  Title Trauma-related dissociation and altered states of consciousness: a call for clinical, treatment, and neuroscience research Type Journal Article
  Year 2015 Publication European Journal of Psychotraumatology Abbreviated Journal Eur J Psychotraumatol  
  Volume 6 Issue Pages 27905  
  Keywords Dissociation; anterior cingulate; complex PTSD; consciousness; dissociative subtype; emotion; insula; interoceptive awareness  
  Abstract The primary aim of this commentary is to describe trauma-related dissociation and altered states of consciousness in the context of a four-dimensional model that has recently been proposed (Frewen & Lanius, 2015). This model categorizes symptoms of trauma-related psychopathology into (1) those that occur within normal waking consciousness and (2) those that are dissociative and are associated with trauma-related altered states of consciousness (TRASC) along four dimensions: (1) time; (2) thought; (3) body; and (4) emotion. Clinical applications and future research directions relevant to each dimension are discussed. Conceptualizing TRASC across the dimensions of time, thought, body, and emotion has transdiagnostic implications for trauma-related disorders described in both the Diagnostic Statistical Manual and the International Classifications of Diseases. The four-dimensional model provides a framework, guided by existing models of dissociation, for future research examining the phenomenological, neurobiological, and physiological underpinnings of trauma-related dissociation.  
  Address Western University, Lawson Health Research Institute, London, ON, Canada; Ruth.Lanius@lhsc.on.ca  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2000-8066 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:25994026 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42183  
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Author Schalinski, I.; Schauer, M.; Elbert, T. url  openurl
  Title The shutdown dissociation scale (shut-d) Type Journal Article
  Year 2015 Publication European Journal of Psychotraumatology Abbreviated Journal Eur J Psychotraumatol  
  Volume 6 Issue Pages 25652  
  Keywords Ptsd; Shutdown dissociation; assessment; multiple trauma; subtype  
  Abstract The evolutionary model of the defense cascade by Schauer and Elbert (2010) provides a theoretical frame for a short interview to assess problems underlying and leading to the dissociative subtype of posttraumatic stress disorder. Based on known characteristics of the defense stages “fright,” “flag,” and “faint,” we designed a structured interview to assess the vulnerability for the respective types of dissociation. Most of the scales that assess dissociative phenomena are designed as self-report questionnaires. Their items are usually selected based on more heuristic considerations rather than a theoretical model and thus include anything from minor dissociative experiences to major pathological dissociation. The shutdown dissociation scale (Shut-D) was applied in several studies in patients with a history of multiple traumatic events and different disorders that have been shown previously to be prone to symptoms of dissociation. The goal of the present investigation was to obtain psychometric characteristics of the Shut-D (including factor structure, internal consistency, retest reliability, predictive, convergent and criterion-related concurrent validity). A total population of 225 patients and 68 healthy controls were accessed. Shut-D appears to have sufficient internal reliability, excellent retest reliability, high convergent validity, and satisfactory predictive validity, while the summed score of the scale reliably separates patients with exposure to trauma (in different diagnostic groups) from healthy controls. The Shut-D is a brief structured interview for assessing the vulnerability to dissociate as a consequence of exposure to traumatic stressors. The scale demonstrates high-quality psychometric properties and may be useful for researchers and clinicians in assessing shutdown dissociation as well as in predicting the risk of dissociative responding.  
  Address Department of Psychology, University of Konstanz, Konstanz, Germany  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2000-8066 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:25976478 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42184  
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Author Briere, J.; Runtz, M. url  doi
openurl 
  Title Dissociation in individuals denying trauma exposure: findings from two samples Type Journal Article
  Year 2015 Publication The Journal of Nervous and Mental Disease Abbreviated Journal J Nerv Ment Dis  
  Volume 203 Issue 6 Pages 439-442  
  Keywords Adult; Affective Symptoms/*psychology; Aged; Dissociative Disorders/*psychology; Female; Humans; Male; Middle Aged; Young Adult  
  Abstract A number of studies suggest that dissociation is reliably related to trauma exposure, and that inadequate regulation of posttraumatic distress may be a significant factor. We examined whether affect dysregulation predicts dissociation in those denying any lifetime exposure to trauma. These relationships were evaluated in a general population sample and a second sample of nontraumatized university students. In the first study, multivariate analyses indicated that, along with gender, affect dysregulation was a relatively strong predictor, accounting for 27% of the variance in dissociation. In the replication study, dissociation was associated with affect dysregulation, but not gender. Affect dysregulation seems to predict dissociative symptomatology in nontraumatized individuals. It is hypothesized that emotional distress, whether from trauma or other etiologies, motivates dissociation to the extent that it challenges the individual's compromised capacity for affect regulation. Treatment implications may include the potential helpfulness of interventions that increase emotion regulation skills.  
  Address *Departments of Psychiatry and the Behavioral Sciences and Psychology, Keck School of Medicine University of Southern California, Los Angeles, CA; and daggerDepartment of Psychology, University of Victoria, Victoria, British Columbia, Canada  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0022-3018 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:25974057 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42185  
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Author Tsai, J.; Armour, C.; Southwick, S.M.; Pietrzak, R.H. url  doi
openurl 
  Title Dissociative subtype of DSM-5 posttraumatic stress disorder in U.S. veterans Type Journal Article
  Year 2015 Publication Journal of Psychiatric Research Abbreviated Journal J Psychiatr Res  
  Volume 66-67 Issue Pages 67-74  
  Keywords Dissociation; Posttraumatic stress disorder; Substance abuse; Veterans  
  Abstract The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) formally introduced a dissociative subtype of posttraumatic stress disorder (PTSD). This study examined the proportion of U.S. veterans with DSM-5 PTSD that report dissociative symptoms; and compared veterans with PTSD with and without the dissociative subtype and trauma-exposed controls on sociodemographics, clinical characteristics, and quality of life. Multivariable analyses were conducted on a nationally representative sample of 1484 veterans from the National Health and Resilience in Veterans Study (second baseline survey conducted September-October, 2013). Of the 12.0% and 5.2% of veterans who screened positive for lifetime and past-month DSM-5 PTSD, 19.2% and 16.1% screened positive for the dissociative subtype, respectively. Among veterans with PTSD, those with the dissociative subtype reported more severe PTSD symptoms, comorbid depressive and anxiety symptoms, alcohol use problems, and hostility than those without the dissociative subtype. Adjusting for PTSD symptom severity, those with the dissociative subtype continued to report more depression and alcohol use problems. These results underscore the importance of assessing, monitoring, and treating the considerable proportion of veterans with PTSD and dissociative symptoms.  
  Address Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, United States  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0022-3956 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:25969340 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42186  
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Author van Dijke, A.; Ford, J.D.; Frank, L.E.; van der Hart, O. url  doi
openurl 
  Title Association of Childhood Complex Trauma and Dissociation With Complex Posttraumatic Stress Disorder Symptoms in Adulthood Type Journal Article
  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  
  Volume 16 Issue 4 Pages 428-441  
  Keywords childhood trauma; complex posttraumatic stress disorder; dissociation  
  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.  
  Address a Yulius Academy & Colk Yulius , Rotterdam , The Netherlands  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1529-9732 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:25905664 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42187  
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Author Frewen, P.A.; Brown, M.F.D.; Steuwe, C.; Lanius, R.A. url  openurl
  Title Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype Type Journal Article
  Year 2015 Publication European Journal of Psychotraumatology Abbreviated Journal Eur J Psychotraumatol  
  Volume 6 Issue Pages 26406  
  Keywords Posttraumatic stress disorder; dissociation; dissociative subtype; psychological trauma; trauma-related altered states of consciousness  
  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.  
  Address Graduate Program in Neuroscience, Western University, London, Ontario, Canada  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2000-8066 ISBN Medium  
  Area Expedition Conference (up)  
  Notes PMID:25854673 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42188  
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