The symptom criteria for the dissociative subtype of posttraumatic stress disorder.

OBJECTIVE: The dissociative subtype of posttraumatic stress disorder (PTSD) was incorporated into the diagnostic criteria for PTSD in Diagnostic and Statisical Manual of Mental Disorders, Fifth Edition (DSM-5). The subtype requires the presence of persistent or recurrent depersonalization or derealization; however, several authors have suggested that a broader array of dissociative symptoms could be included in the criteria. The objective of the present study was to gather data on a wide range of dissociative symptoms in a sample of highly traumatized individuals. METHOD: The authors administered a set of measures to 62 inpatients in a private psychiatric inpatient program specializing in PTSD and dissociative disorders. RESULTS: Almost every participant met International Classification of Diseases, 11th Edition criteria for complex PTSD, DSM-5 criteria for the dissociative subtype of PTSD, and DSM-5 criteria for dissociative identity disorder or other specified dissociative disorder; these four diagnoses seem to identify largely the same patients and may not be separate disorders. CONCLUSIONS: A broad range of dissociative symptoms was endorsed on the Dissociative Experiences Scale and the Dissociative Disorders Interview Schedule. The results support a recommendation that a broad array of symptoms be included in the criteria for the dissociative subtype of PTSD in future editions of the Diagnostic and Statistical Manual of Mental Disorders. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reversal of Amnesia for Trauma in a Sample of Psychiatric Inpatients with Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified.

The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.

Maladaptive Daydreaming, Dissociation, and the Dissociative Disorders.

Objective: Studies on maladaptive daydreaming have shown that it has a number of comorbidities including dissociative disorders, yet no studies have examined the reciprocal relationship. The aim of this study was to determine the frequency of maladaptive daydreaming in a sample of psychiatric inpatients with high levels of dissociation. Methods: The Dissociative Experiences Scale (DES), Self-Report Dissociative Disorders Interview Schedule, Maladaptive Daydreaming Scale-16 (MDS-16), Structured Clinical Interview for Maladaptive Daydreaming, and the Obsessive Compulsive Inventory were administered to a sample of 100 inpatients in a psychiatric hospital program specializing in dissociative disorders. Results: Of the 100 participants, 93 reported childhood physical and/or sexual abuse, 33 met criteria for dissociative identity disorder; 56 met criteria for other specified dissociative disorder, 49 met criteria for maladaptive daydreaming disorder, and 23 met criteria for unspecified maladaptive daydreaming. The average score on the DES was 39.1 and the average score on the MDS-16 was 33.9. Individuals with maladaptive daydreaming disorder scored significantly higher than those without on many different symptom clusters. Conclusions: This sample of 100 highly traumatized and dissociative inpatients reported high levels of maladaptive daydreaming along with many other forms of comorbidity. Maladaptive daydreaming is a previously under-recognized aspect of complex dissociative disorders and requires further attention in both research and clinical practice.