Cultural pathoplasticity in a Mauritian woman with possession-form presentation: Is it dissociative or not?

A Cross-Cultural Investigation of the Association between Betrayal Trauma and Dissociative Features

Betrayal trauma theory proposes that betrayal and non-betrayal traumas are different in terms of their nature and impacts. The theory predicts that dissociation is more strongly related to betrayal than to non-betrayal trauma, however there is a lack of cross-cultural evaluation of the theory. One competing theory is the socio-cognitive model, which proposes that dissociative amnesia (DA) and identity dissociation (ID) are the results of social influence and are not trauma-related conditions. This study aimed to test the hypotheses based on betrayal trauma theory and investigated the relationship between trauma, dissociation and other mental health problems in two culturally different convenience samples of people seeking web-based educational interventions for dissociation (N = 83 English speakers and N = 82 Chinese speakers). Compared with childhood non-betrayal trauma, childhood betrayal trauma had a statistically stronger relationship with dissociation and borderline personality disorder (BPD) symptoms in both samples. DA and ID symptoms were cross-culturally associated with childhood betrayal trauma after controlling for other variables (including sample membership, age, depression levels, medication treatment and non-betrayal trauma). Participants with DA/ID symptoms reported significantly more trauma-related symptoms in both samples. The findings supported the cross-cultural application of the betrayal trauma theory for dissociative features and BPD symptoms. Implications for research and practice (e.g., child protection, assessment for survivors of childhood betrayal trauma) are highlighted.

Polish Catholics Attribute Trauma-related Symptoms to Possession: Qualitative Analysis of Two Childhood Sexual Abuse Survivors

In many cultures, people use the concept of spirit possession to explain abrupt changes in behavior and identity or problems with affect regulation. High incidence of traumatic experiences are also found among "possession" victims but there are few studies exploring in detail their clinical presentations. This study reports the symptoms of two women with a history of sexual abuse, labeled in their religious communities as possessed, and subjected to exorcisms. Following a thorough clinical assessment, interpretative phenomenological analysis was used to explore their meaning-making and help-seeking behavior. Accepting the demonic reappraisal of trauma-related symptoms and interventions offered by clergy contributed to receiving social support but discouraged them from seeking diagnostic consultations and trauma-focused therapy, leading to their continued symptoms. This justifies the need for educating religious leaders in recognizing and understanding basic psychopathological symptoms.

Trapped Between Theological and Medical Notions of Possession: A Case of Possession Trance Disorder With a 3-Year Follow-Up

Few studies on Possession Trance Disorder (PTD) describe diagnostic and research procedures in detail. This case study presents the clinical picture of a Caucasian Roman-Catholic woman who had been subjected to exorcisms because of her problems with affect regulation, lack of control over unaccepted sexual impulses, and somatoform symptoms accompanied by alterations in consciousness. It uses interpretative phenomenological analysis to explore meaning attributed by her to "possession" as a folk category and a medical diagnosis; how this affected her help-seeking was also explored. This study shows that receiving a PTD diagnosis can reinforce patients' beliefs about supernatural causation of symptoms and discourage professional treatment. Dilemmas and uncertainties about the diagnostic criteria and validity of this disorder are discussed.