TY - JOUR
T1 - Dissociative Subtype of Posttraumatic Stress Disorder or PTSD With Comorbid Dissociative Disorders
T2 - Comparative Evaluation of Clinical Profiles
AU - Swart, Sanne
AU - Wildschut, Marleen
AU - Draijer, Nel
AU - Langeland, Willemien
AU - Smit, Jan H.
N1 - Publisher Copyright:
© 2019 American Psychological Association
PY - 2020
Y1 - 2020
N2 - Introduction: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) introduced a dissociative subtype for patients with posttraumatic stress disorder (PTSD) and depersonalization and/or derealization symptoms. Despite high comorbidity rates between PTSD and dissociative disorders (DDs), research has not paid attention to the differentiation or overlap between the dissociative subtype of PTSD and DDs. This raises a question: To what extent do patients with dissociative PTSD differ from patients with PTSD and comorbid DDs? Method: We compared three groups of complex patients with trauma-related disorders and/or personality disorders (n = 150): a dissociative PTSD, a nondissociative PTSD, and a non-PTSD group of patients with mainly personality disorders. We used structured clinical interviews and self-administered questionnaires on dissociative symptoms and disorders, personality disorders, trauma histories, depression, anxiety, and general psychopathology. The Dissociative Experiences Scale (DES; ≥20) and the depersonalization/ derealization subscale of the DES were used for differentiating dissociative PTSD from nondissociative PTSD. Results: Of all patients, 33% met criteria for dissociative PTSD. More than half of the dissociative PTSD patients (54%) met criteria for one or more DDs; using the depersonalization/derealization subscale of the DES, even 66% had a comorbid DD. But also of the non-PTSD patients, 24% had a mean DES score of ≥20. There were no symptomatic differences (e.g., depression and anxiety) between dissociative PTSD with and without comorbid DDs. Conclusion: Overlap between dissociative PTSD and DD is large and we recommend replication of previous studies, using structured clinical assessment of DDs.
AB - Introduction: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) introduced a dissociative subtype for patients with posttraumatic stress disorder (PTSD) and depersonalization and/or derealization symptoms. Despite high comorbidity rates between PTSD and dissociative disorders (DDs), research has not paid attention to the differentiation or overlap between the dissociative subtype of PTSD and DDs. This raises a question: To what extent do patients with dissociative PTSD differ from patients with PTSD and comorbid DDs? Method: We compared three groups of complex patients with trauma-related disorders and/or personality disorders (n = 150): a dissociative PTSD, a nondissociative PTSD, and a non-PTSD group of patients with mainly personality disorders. We used structured clinical interviews and self-administered questionnaires on dissociative symptoms and disorders, personality disorders, trauma histories, depression, anxiety, and general psychopathology. The Dissociative Experiences Scale (DES; ≥20) and the depersonalization/ derealization subscale of the DES were used for differentiating dissociative PTSD from nondissociative PTSD. Results: Of all patients, 33% met criteria for dissociative PTSD. More than half of the dissociative PTSD patients (54%) met criteria for one or more DDs; using the depersonalization/derealization subscale of the DES, even 66% had a comorbid DD. But also of the non-PTSD patients, 24% had a mean DES score of ≥20. There were no symptomatic differences (e.g., depression and anxiety) between dissociative PTSD with and without comorbid DDs. Conclusion: Overlap between dissociative PTSD and DD is large and we recommend replication of previous studies, using structured clinical assessment of DDs.
KW - Assessment
KW - Differential diagnosis
KW - Dissociative disorders
KW - Ptsd
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85065793638&partnerID=8YFLogxK
U2 - 10.1037/tra0000474
DO - 10.1037/tra0000474
M3 - Article
C2 - 31107045
AN - SCOPUS:85065793638
SN - 1942-9681
VL - 12
SP - 38
EP - 45
JO - Psychological Trauma: Theory, Research, Practice, and Policy
JF - Psychological Trauma: Theory, Research, Practice, and Policy
IS - 1
ER -