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Dissociation in victims of childhood abuse or neglect: a meta-analytic review

Published online by Cambridge University Press:  10 April 2018

Ruben Vonderlin ,
Nikolaus Kleindienst ,
Georg W. Alpers ,
Martin Bohus ,
Lisa Lyssenko  and
Christian Schmahl
Ruben Vonderlin
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg University, Mannheim J5, D-68159, Germany Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
Nikolaus Kleindienst
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg University, Mannheim J5, D-68159, Germany
Georg W. Alpers
Affiliation:
Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
Martin Bohus
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg University, Mannheim J5, D-68159, Germany Department of Health, Antwerp University, Antwerp, Belgium
Lisa Lyssenko*
Affiliation:
Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg University, Mannheim J5, D-68159, Germany
Christian Schmahl
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
*
Author for correspondence: Lisa Lyssenko, E-mail: lisa.lyssenko@zi-mannheim.de
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Abstract

Childhood abuse and neglect are associated with dissociative symptoms in adulthood. However, empirical studies show heterogeneous results depending on the type of childhood abuse or neglect and other maltreatment characteristics. In this meta-analysis, we systematically investigated the relationship between childhood interpersonal maltreatment and dissociation in 65 studies with 7352 abused or neglected individuals using the Dissociative Experience Scale (DES). We extracted DES-scores for abused and non-abused populations as well as information about type of abuse/neglect, age of onset, duration of abuse, and relationship to the perpetrator. Random-effects models were used for data synthesis, and meta-regression was used to predict DES-scores in abused populations from maltreatment characteristics. The results revealed higher dissociation in victims of childhood abuse and neglect compared with non-abused or neglected subsamples sharing relevant population features (MAbuse = 23.5, MNeglect = 18.8, MControl = 13.8) with highest scores for sexual and physical abuse. An earlier age of onset, a longer duration of abuse, and parental abuse significantly predicted higher dissociation scores. This meta-analysis underlines the importance of childhood abuse/neglect in the etiology of dissociation. The identified moderators may inform risk assessment and early intervention to prevent the development of dissociative symptoms.

Keywords

Childhood abusechildhood neglectchildhood traumadissociationmeta-analysis
Type
Review Article
Information
Psychological Medicine , Volume 48 , Issue 15 , November 2018 , pp. 2467 - 2476
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

*

These authors contributed equally to this work

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