Abstract
Recent research has provided evidence for a dissociative subtype of posttraumatic stress disorder (PTSD). However, previous research has primarily utilized samples of adults exposed to acute traumatic stressors. Therefore, further research is needed to investigate the dissociative subtype in samples of youth and those exposed to more chronic forms of trauma. Further, studies have not yet tested empirically- and theoretically-derived constructs that are purported to increase the likelihood of subtype membership. This study investigated whether peritraumatic dissociation, emotion dysregulation, gender, and betrayal trauma exposure affected the likelihood of dissociative subtype membership in trauma-exposed detained youth. Results indicated that half of the sample met subtype criteria and peritraumatic dissociation and emotion dysregulation were associated with subtype membership. Results suggest that dissociative subtype membership may be more common in youth, particularly among those youth involved in the justice system, and highlights the clinical utility of screening for dissociative symptoms in young persons.
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Abram, K. M., Teplin, L. A., Charles, D. R., Longworth, S. L., McClelland, G. M., & Dulcan, M. K. (2004). Posttraumatic stress disorder and trauma in youth in juvenile detention. Archives of General Psychiatry, 61(4), 403–410. doi:10.1001/archpsyc.61.4.403.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.
Armour, C., Karstoft, K. I., & Richardson, J. D. (2014). The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD. Social Psychology and Psychiatry Epidemiology, 49(8), 1297–1306. doi:10.1007/s00127-014-0819-y.
Bennett, D. C., Modrowski, C. A., Kerig, P. K., & Chaplo, S. D. (2015). Investigating the dissociative subtype of posttraumatic stress disorder in a sample of traumatized detained youth. Psychological Trauma: Theory, Research, Practice, and Policy, 7(5), 465–472. doi:10.1037/tra0000057.
Blevins, C. A., Weathers, F. W., & Witte, T. K. (2014). Dissociation and posttraumatic stress disorder: a latent profile analysis. Journal of Traumatic Stress, 27, 1–9. doi:10.1002/jts.21933.
Brand, B. L., Lanius, R., Vermetten, E., Loewenstein, R. J., & Spiegel, D. (2012). Where are we going? An update on assessment, treatment, and neurobiological research in dissociative disorders as we move toward the DSM-5. Journal of Trauma & Dissociation, 13(1), 9–31. doi:10.1080/15299732.2011.620687.
Breh, D. C., & Seidler, G. H. (2007). Is peritraumatic dissociation a risk factor for PTSD? Journal of Trauma and Dissociation, 8, 53–69. doi:10.1300/J229v08n01_04.
Briere, J. (2006). Dissociative symptoms and trauma exposure: specificity, affect dysregulation, and posttraumatic stress. The Journal of Nervous and Mental Disease, 194(2), 78–82. doi:10.1097/01.nmd.0000198139.47371.54.
Briere, J., Scott, C., & Weathers, F. (2005). Peritraumatic and persistent dissociation in the presumed etiology of PTSD. The American Journal of Psychiatry, 162(12), 2295–2301. doi:10.1176/appi.ajp.162.12.2295.
Bui, E., Brunet, A., Olliac, B., Allenou, C., Raynaud, J.-P., Claudet, I., et al. (2011). Validation of the peritraumatic dissociative experiences questionnaire and peritraumatic distress inventory in school-aged victims of road traffic accidents. European Psychiatry, 26(2), 108–111. doi:10.1016/j.eurpsy.2010.09.007.
Carlson, E. A., Yates, T. M., & Sroufe, L. A. (2009). Dissociation and development of the self. In P. F. Dell & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders: DSM-V and beyond (pp. 39–52). New York: Routledge.
Carlson, E., Dalenberg, C., & McCade-Montez, E. (2012). Dissociation in posttraumatic stress disorder part I: definitions and review of research. Psychological Trauma: Theory, Research, Practice, and Policy, 4(5), 479–489. doi:10.1037/a0027748.
Carmassi, C., Akiskal, H. S., Yong, S. S., Stratta, P., Calderani, E., Massimetti, E., & Dell'Osso, L. (2013). Post-traumatic stress disorder in DSM-5: estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors. Journal of Affective Disorders, 151, 843–848. doi:10.1016/j.jad.2013.07.020.
Carrion, V. G., & Steiner, H. (2000). Trauma and dissociation in delinquent adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 39(3), 353–359. doi:10.1097/00004583-200003000-00018.
Chaplo, S. D., Kerig, P. K., Bennett, D. C., & Modrowski, C. A. (2015). Emotion dysregulation and dissociation as mediators of the association between sexual abuse and self-injury among delinquent youth. Journal of Trauma and Dissociation, 16(3), 272–285. doi:10.1080/15299732.2015.989647.
Chaplo, S. D., Kerig, P. K., Modrowski, C. A., & Bennett, D. C. (2017). Gender differences in the associations among sexual abuse, posttraumatic stress symptoms, and delinquent behaviors in a sample of detained adolescents. Journal of Child & Adolescent Trauma, 10(1), 29–39. doi:10.1007/s40653-016-0122-z.
Cohen, J. A., & Scheeringa, M. S. (2009). Post-traumatic stress disorder diagnosis in children: challenges and promises. Dialogues in Clinical Neuroscience, 11, 91–99.
Cole, P. M., Alexander, P. C., & Anderson, C. L. (1996). Dissociation in typical and atypical development. In L. K. Michelson & W. J. Ray (Eds.), Handbook of dissociation (pp. 69–89). New York: Plenum Press.
DePrince, A. P., & Freyd, J. J. (2007). Trauma-induced dissociation. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 219–233). New York: The Guilford Press.
DePrince, A. P., Brown, L. S., Cheit, R. E., Freyd, J. J., Gold, S. N., Pezdek, K., & Quina, K. (2012). Motivated forgetting and misremembering: Perspectives from betrayal trauma theory. In R. F. Belli (Ed.), True and false recovered memories: Toward a reconciliation of the debate (pp. 193–242). Vol. 58: Nebraska Symposium on Motivation. New York: Springer.
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. doi:10.3758/BRM.41.4.1149.
Ford, J. D., Chapman, J., Connor, D. F., & Cruise, K. R. (2012). Complex trauma and aggression in secure juvenile justice settings. Criminal Justice and Behavior, 39(6), 694–724. doi:10.1177/0093854812436957.
Frewen, P. A., & Lanius, R. A. (2006). Toward a psychobiology of posttraumatic self-dysregulation: reexperiencing, hyperarousal, dissociation, and emotional numbing. Annals of the New York Academy of Sciences, 1071, 110–121. doi:10.1196/annals.1364.010.
Freyd, J. J. (1996). Betrayal trauma. Cambridge: Harvard University Press.
Goldberg, L. R., & Freyd, J. J. (2006). Self-reports of potentially traumatic experiences in an adult community sample: gender differences and test-retest stabilities of the items in a brief betrayal-trauma survey. Journal of Trauma & Dissociation, 7, 39–63. doi:10.1300/J229v07n03_04.
Goodman, G. S., Ghetti, S., Quas, J. A., Edelstein, R. S., Alexander, K. W., Redlich, A. D., et al. (2003). A prospective study of memory of child sexual abuse: new findings relevant to the repressed-memory controversy. Psychological Science, 14(2), 113–118.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. doi:10.1023/B:JOBA.0000007455.08539.94.
Hagenaars, M. A., Fisch, I., & van Minnen, A. (2011). The effect of trauma onset and frequency on PTSD-associated symptoms. Journal of Affective Disorders, 132(1–2), 192–199.
Kerig, P. K., & Becker, S. P. (2015). Early abuse and neglect as risk factors for the development of criminal and antisocial behavior. In J. Morizot & L. Kazemian (Eds.), The development of criminal and antisocial behavior (pp. 181–199). New York: Springer.
Kerig, P. K., & Bennett, D. C. (2013). Beyond fear, helplessness, and horror: peritraumatic reactions associated with posttraumatic stress symptoms among traumatized delinquent youth. Psychological Trauma: Theory, Research, Practice, and Policy, 5(5), 431–438. doi:10.1037/a0029609.
Kerig, P. K., Moeddel, M. A., & Becker, S. P. (2011). Assessing the sensitivity and specificity of the MAYSI-2 for detecting trauma among youth in juvenile detention. Child & Youth Care Forum, 40(5), 345–362. doi:10.1007/s10566-010-9124-4.
Lanius, R. A., Wolf, E. J., Miller, M. W., Frewen, P. A., Vermetten, E., Brand, B., & Spiegel, D. (2014). The dissociative subtype of PTSD. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 234–250). New York: The Guilford Press.
Marmar, C. R., Weiss, D. S., Schlenger, W. E., Fairbank, J. A., Jordan, B. K., & Kulka, R. A. (1994). Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans. The American Journal of Psychiatry, 151, 902–907.
Modrowski, C. A., & Kerig, P. K. (2014, November). Posttraumatic stress, emotion dysregulation, and dissociation in traumatized delinquent adolescents. Paper presented at the International Society for Traumatic Stress Studies, Miami.
Modrowski, C. A., Bennett, D. C., Chaplo, S. D., & Kerig, P. K. (2017). Screening for PTSD among detained adolescents: Implications of the changes in DSM-5. Psychological Trauma: Theory, Research, Practice, and Policy, 9(1), 10–17. doi:10.1037/tra0000156.
Olff, M., Langeland, W., Draijer, N., & Gersons, B. P. R. (2007). Gender differences in posttraumatic stress disorder. Psychological Bulletin, 133(2). doi:10.1037/0033-2909.133.2.183.
Ozar, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychological Bulletin, 129, 52–73. doi:10.1037/1942-9681.S.1.3.
Plattner, B., Silvermann, M. A., Redlich, A. D., Carrion, V. G., Feucht, M., Friedrich, M. H., & Steiner, H. (2003). Pathways to dissociation: intrafamilial versus extrafamilial trauma in juvenile delinquents. Journal of Nervous and Mental Disease, 191(12), 781–788. doi:10.1097/01.nmd.0000105372.88982.54.
Powers, A., Cross, D., Fani, N., & Bradley, B. (2015). PTSD, emotion dysregulation, and dissociative symptoms in a highly traumatized sample. Journal of Psychiatric Research, 61, 174–179. doi:10.1016/j.jpsychires.2014.12.011.
Schafer, I., Barkmann, C., Riedesser, P., & Schulte-Markwort, M. (2004). Peritraumatic dissociation predicts posttraumatic stress in children and adolescents following road traffic accidents. Journal of Trauma & Dissociation, 5, 79–92. doi:10.1300/J229v05n04_05.
Spiegel, D., & Cardeña, E. (1991). Disintegrated experience: the dissociative disorders revisited. Journal of Abnormal Psychology, 100, 366–378. doi:10.1037/0021-843X.100.3.366.
Stein, D. J., Koenen, K. C., Friedman, M. J., Hill, E., McLaughlin, K. A., Petukhova, M., et al. (2013). Dissociation in posttraumatic stress disorder: evidence from the world mental health surveys. Biological Psychiatry, 73, 302–312. doi:10.1016/j.biopsych.2012.08.022.
Steinberg, A. M., Brymer, M. J., Decker, K. B., & Pynoos, R. S. (2004). The University of California at Los Angeles post-traumatic stress disorder reaction index. Current Psychiatry Reports, 6(2), 96–100. doi:10.1007/s11920-004-0048-2.
Steuwe, C., Lanius, R. A., & Frewen, P. A. (2012). Evidence for a dissociative subtype of PTSD by latent profile and confirmatory factor analyses in a civilian sample. Depression and Anxiety, 29, 689–700. doi:10.1002/da.21944.
Sugar, J., & Ford, J. D. (2012). Peritraumatic reactions and posttraumatic stress disorder in psychiatrically impaired youth. Journal of Traumatic Stress, 25(1), 41–49. doi:10.1002/jts.21668.
Swannell, S., Martin, G., Page, A., Hasking, P., Hazell, P., Taylor, A., & Protani, M. (2012). Child maltreatment, subsequent non-suicidal self-injury and the mediating roles of dissociation, alexithymia and self-blame. Child Abuse & Neglect, 36, 572–584. doi:10.1016/j.chiabu.2012.05.005.
Tichenor, V., Marmar, C. R., Weiss, D. S., Metzler, T. J., & Ronfeldt, H. (1996). The relationship of peritraumatic dissociation and post-traumatic stress: findings in female Vietnam theater veterans. Journal of Consulting and Clinical Psychology, 64, 1054–1059. doi:10.1037/0022-006X.64.5.1054.
Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychological Bulletin, 132(6), 959–992. doi:10.1037/0033-2909.132.6.959.
Trickett, P. K., Noll, J. G., & Putnam, F. W. (2011). The impact of sexual abuse on female development: lessons from a multigenerational, longitudinal research study. Development and Psychopathology, 23, 453–476. doi:10.1017/S0954579411000174.
Tull, M. T., Barrett, H. M., McMillan, E. S., & Roemer, L. (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38(3), 303–313.
Weiss, N. H., Tull, M. T., Davis, L. T., Dehon, E. E., Fulton, J. J., & Gratz, K. L. (2012). Examining the association between emotion regulation difficulties and probable posttraumattic stress disorder within a sample of African Americans. Cognitive Behaviour Therapy, 41(1), 5–14. doi:10.1080/16506073.2011.621970.
Wolf, E. J., Miller, M. W., Reardon, A. F., Ryabchenko, K. A., Castillo, D., & Freund, R. (2012a). A latent class analysis of dissociation and posttraumatic stress disorder. Archives of General Psychology, 69(7), 698–705. doi:10.1001/archgenpsychiatry.2011.1574.
Wolf, E. J., Lunney, C. A., Miller, M. W., Resick, P. A., Friedman, M. J., & Schnurr, P. P. (2012b). The dissociative subtype of PTSD: A replication and extension. Depression and Anxiety, 29, 679–688. doi:10.1002/da.21946.
Wood, J., Foy, D. W., Goguen, C. A., Pynoos, R., & James, C. B. (2002). Violence exposure and PTSD among delinquent girls. Journal of Aggression, Maltreatment & Trauma, 6(1), 109–126. doi:10.1300/J146v06n01_06.
Yates, T. M., Carlson, E. A., & Egeland, B. (2008). A prospective study of child maltreatment and self-injurious behavior in a community sample. Development and Psychopathology, 20, 651–671. doi:10.1017/S0954579408000321.
Zona, K., & Milan, S. (2011). Gender differences in the longitudinal impact of exposure to violence on mental health in urban youth. Journal of Youth and Adolescence, 40, 1674–1690. doi:10.1007/s10964-011-9649-3.
Acknowledgements
This work was funded in part by a National Science Foundation Graduate Research Fellowship (1256065) to the first author and a grant from the National Institute of Justice (2014-90914-UT-IJ) to the second author.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all individuals included in the study.
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Modrowski, C.A., Kerig, P.K. Investigating Factors Associated with PTSD Dissociative Subtype Membership in a Sample of Traumatized Justice-Involved Youth. Journ Child Adol Trauma 10, 343–351 (2017). https://doi.org/10.1007/s40653-017-0153-0
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DOI: https://doi.org/10.1007/s40653-017-0153-0