Elsevier

Clinical Psychology Review

Volume 28, Issue 7, October 2008, Pages 1138-1151
Clinical Psychology Review

Relations among peritraumatic dissociation and posttraumatic stress: A meta-analysis

https://doi.org/10.1016/j.cpr.2008.03.006Get rights and content

Abstract

A meta-analysis was performed on the empirical literature which addressed the relationship of peritraumatic dissociation to posttraumatic stress (PTS). Extensive literature searches were conducted to identify as many relevant studies as possible, and revealed 59 independent eligible studies. All studies were coded using a detailed code sheet that included effect measures, variables that indicated the methodological quality of the studies, and substantial variables that might theoretically affect the relationship between peritraumatic dissociation and PTS. A significant positive relation between peritraumatic dissociation and PTS was found. Differences in the methodological rigor between studies — time elapsed since peritraumatic dissociation, design, sample type, and study type — significantly and sufficiently explained the variability in effect sizes between studies. Theoretical variables did not explain such variability. Although results underline earlier findings, due to designs of the reviewed studies no conclusions could be drawn as to causal relations between peritraumatic dissociation and PTS.

Section snippets

Retrieval and selection of studies

Between January and May 2007 we conducted a comprehensive search for empirical studies on the predictive relation between peritraumatic dissociation and PTS(D). A systematic computer search was performed using the international silver platter system of the library of Utrecht University, which included the bibliographical databases of JSTOR (Journal Storage Archive), OMEGA, PsychINFO, PUBMED (including MEDLINE and PreMedline), and SSCI (Social Sciences Citation Index). We also searched the

Analysis

The data set includes 59 independent studies with 83 outcomes, thus the data structure can be defined as a multilevel model, with conditions nested within studies (Hox, 2002). Such a data set warrants a multilevel approach to meta-analysis (Lensvelt-Mulders et al., 2005, Maas et al., 2004). However, preliminary analyses using multilevel meta-analysis showed that the sample size of about 1.4 conditions per study is too small to reliably separate study-level and condition-level variance (Hox and

Descriptors

Of the 59 independent studies, 54 were published in peer reviewed journals, along with one book chapter, and four technical reports. The publication year ranged from 1992 to 2007, peaking in 2005 with 15 eligible papers. Twenty-nine studies were conducted in the USA, 19 in Europe (UK = 9, The Netherlands = 6, France = 2, Germany = 2), and 11 in other countries. Forty-seven studies reported on a one wave study, twelve reported studies involving multiple waves (longitudinal studies).

Eight

Discussion

In this article we explored the relationship between peritraumatic dissociation and subsequent PTS. To find evidence for this relationship, a meta-regression was conducted including 59 independent empirical studies. We coded 59 eligible studies, with 83 conditions within studies and the final data file included the results of 16,547 participants. A significant positive effect was established, the across study correlation between peritraumatic dissociation and the development of PTS later in

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