Dissociation in non-clinical and clinical sample of Czech adolescents. Reliability and validity of the Czech version of the Adolescent Dissociative Experiences Scale

The psychometric properties of the adolescent dissociative experiences scale (A-DES) in a sample of Portuguese at-risk adolescents

Dissociation is a process that often occurs as a sequela of psychological trauma, and it is interrelated with psychological and behavioral problems. In the at-risk adolescent population, dissociation is often underdiagnosed and undertreated. Having reliable measures to assess this phenomenon can help in identifying adolescents at-risk and improve treatment outcomes. This study assessed the psychometric properties of the Adolescent Dissociative Experiences Scale (A-DES) with a sample of 402 Portuguese adolescents recruited from three at-risk populations. Participants completed self-report measures of trauma exposure, posttraumatic symptoms, psychological and behavioral problems, and the A-DES. A subset of the sample also completed test-retest measures. Confirmatory factor analyses revealed a best-fitting 3-factor model. Analyses revealed good internal consistencies and good agreement test-retest reliability for the scale overall and the factor-based sub-scales. Construct and predictive validity was supported with results showing that A-DES discriminates between youth reporting high versus low levels of cumulative trauma exposure and youth who meet or do not meet criteria for a probable PTSD diagnosis. Study findings replicate prior research supporting a 3-factor model of dissociation and the usefulness of A-DES to identify adolescents with dissociative symptoms. Clinical and research implications are discussed.

Factor Structure, Measurement Invariance, and Abbreviated Versions of The Adolescent Dissociative Experiences Scale (A-DES)

The purpose of this study was to examine the factor structure of the Adolescent Dissociative Experiences Scale (A-DES) questionnaire with item response theory (IRT) methods, including an assessment of measurement invariance with differential item functioning (DIF) analysis. Three abbreviated versions of the A-DES (with 20, 10, and 5 items) were constructed based on the IRT and DIF statistics. The respondents in this population-based study (N = 4,072) were 12- to 19-year-old Finnish junior and senior high school students. A one-factor model of the A-DES was best supported, and the original theoretical four-factor model showed poor fit. The A-DES turned out to have high measurement invariance with respect to age, gender, transgender tendencies, having multiple friends, the use of illegal substances, and experience of being bullied. Compared to the full 30-item A-DES, abbreviated versions of the questionnaire retained acceptable information value and empirical reliability in the clinically relevant range of symptomatology. Further psychometric studies are needed especially with regards to clinical use.

Partial mediator role of physical abuse on the relationship between attention-deficit/hyperactivity disorder symptoms and severity of dissociative experiences in a sample of inpatients with alcohol use disorder

AIM

This study aimed to evaluate the relationship of attention-deficit/hyperactivity disorder (ADHD) symptoms with dissociative experiences, and the mediator role of childhood traumas on this relationship, while controlling the effect of depression in alcohol use disorder (AUD).

SETTINGS AND DESIGN

It was a hospital-based, cross-sectional study.

MATERIALS AND METHODS

One hundred and ninety inpatients with AUD were evaluated with the Beck Depression Inventory, the Adult ADHD Self-Report Scale (ASRS), Childhood Trauma Qestionnaire, and Dissociative Experiences Scale (DES).

STATISTICAL ANALYSIS

One-way ANOVA, Chi-squared test, and hierarchical linear regression model were performed.

RESULTS

The ratio of those who receive 10 points or less from DES was 26.8%, those who receive points between 11 and 30 was 45.3%, and those who receive more than 30 points was 27.9%. The latter group that was considered as a group with high risk of dissociative disorder had higher scores from depression, childhood trauma, and ADHD scores than the other groups. Rate of those with high probability of ADHD was higher among this group. ASRS total score and inattentive subscale scores were moderately (r = 0.552 and r = 0.547, respectively) and hyperactive/impulsive subscale was mildly (r = 0.430) correlated with DES score. Severity of ADHD was related with the severity of dissociative symptoms, and physical abuse had partial mediator effect on this relationship, even after controlling the depressive symptoms.

CONCLUSIONS

These findings demonstrate that the presence of severe IN symptoms is an important factor related with dissociative tendency in AUD population with a history of physical abuse.

Validity and reliability of the Turkish version of the DSM-5 Dissociative Symptoms Severity Scale-Child Form

The goal of this study was to assess the validity and reliability of the Turkish version of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) Dissociative Symptoms Severity Scale-Child Form. The scale was prepared by translating and then back-translating the DSM-5 Dissociative Symptoms Severity Scale. The study groups included one group of 30 patients diagnosed with posttraumatic stress disorder who were treated in a child and adolescent psychiatry unit and another group of 83 healthy volunteers from middle and high schools in the community. For assessment, the Adolescent Dissociative Experiences Scale (ADES) was used in addition to the DSM-5 Dissociative Symptoms Severity Scale. Regarding the reliability of the DSM-5 Dissociative Symptoms Severity Scale, Cronbach's alpha was .824 and item-total score correlation coefficients were between .464 and .648. The test-retest correlation coefficient was calculated to be r = .784. In terms of construct validity, one factor accounted for 45.2% of the variance. Furthermore, in terms of concurrent validity, the scale showed a high correlation with the ADES. In conclusion, the Turkish version of the DSM-5 Dissociative Symptoms Severity Scale-Child Form is a valid and reliable tool for both clinical practice and research.

Psychometric properties of the Adolescent Dissociative Experiences Scale in a sample of Italian adolescents

The purpose of this study was to examine the psychometric properties of the Italian translation of the Adolescent Dissociative Experiences Scale (A-DES). A sample of 1,806 high-school students between the ages of 13 and 18 years, recruited in 6 Italian cities, completed the A-DES. The A-DES showed high internal consistency, excellent item-to-scale homogeneity, good split-half reliability, and a single-factor structure. The scores of the Italian adolescents were comparable to those found in previous research with the measure. No gender differences were found in mean A-DES scores, but boys and girls showed different patterns of responses on A-DES items. Age differences were also found, with 13- and 18-year-old students scoring higher on the measure than the other participants. A cluster analysis showed that participants could be consistently grouped into 2 clusters of low- and high-dissociative adolescents. This study supports the A-DES as a reliable and valid screening measure for dissociative symptoms in adolescents.

Prevalence and correlates of depersonalization in students aged 12-18 years in Germany

BACKGROUND

Depersonalization (DP) involves unpleasant experiences of detachment from one's sense of self or unreality in the environment. DP may occur in a broad range of conditions, among healthy persons due to sleep loss, drug induced, secondary to anxiety disorders or primary in depersonalization disorder. Although DP has an early age of onset, little is known about the prevalence and correlates of DP among adolescents.

METHODS

Between January and June 2011, we conducted a questionnaire-based representative survey of pupils aged 12-18 years in the federal state Rhineland-Palatinate of Germany. The final sample comprised 3,809 pupils. We analyzed the prevalence of depersonalization and its correlates regarding sociodemographic characteristics, substance abuse, global mental distress and resilience factors.

RESULTS

One-third of the sample showed severe global mental distress, and 11.9 % were in the range of clinically significant depersonalization. Depersonalized students were less often living with both parents (67.3 vs. 75.7 %), came more often from an disadvantaged socioeconomic background, had a very severe level of global mental distress (comparable to psychiatric inpatients), were more often smoking and abusing cannabis and they suffered from specific impairments regarding social insecurity, global self-efficacy and active coping abilities.

CONCLUSIONS

Experiences of depersonalization were very common among adolescents and may indicate an increased risk for poor academic achievement and mental health in the long term. Prospective studies are needed to investigate the course and clinical relevance of depersonalization for the development of the adolescents.

Psychoform and somatoform dissociation in a clinical sample of Australian adolescents

Psychoform dissociation has been researched more than somatoform dissociation. The Somatoform Dissociation Questionnaire (SDQ-20), a commonly used adult measure of somatoform dissociation, is increasingly being used with adolescents internationally. We compared psychoform and somatoform dissociation in a mixed clinical adolescent sample. A total of 71 adolescents (12-18 years old) attending Australian community mental health and counseling services completed the SDQ-20 and the Adolescent Dissociative Experiences Scale, a commonly used measure of adolescent psychoform dissociation. The participants' treating clinicians provided participants' demographic details and mental health diagnoses. We found that 41% of participants reported high levels of psychoform dissociation and 21% reported high levels of somatoform dissociation. Both dissociation types were positively correlated. Neither was significantly related to participants' age, gender, or mental health diagnoses. Participants with more than 1 Axis I mental health diagnosis had higher levels of somatoform dissociation than participants with only 1 or no Axis I mental health diagnosis. This study is the first to examine somatoform dissociation in Australian adolescents and enables initial international comparisons.

Dissociative and psychotic experiences of adolescents admitted to a psychiatric inpatient unit

A positive correlation between the incidences of dissociative and psychotic experiences has been consistently reported in a variety of adult populations. The present study was a preliminary investigation of the association between dissociative and psychotic experiences in adolescents requiring inpatient mental health care. No previous research has investigated this relationship in an adolescent cohort. Adolescents currently under inpatient care (n = 18) completed questionnaires assessing their experience of dissociative and psychotic phenomena. In line with previous research, a significant positive correlation was found between dissociative and psychotic experiences that remained highly significant once similarities between measures were taken into account. Recognizing the relationship between psychotic and dissociative experiences may be important in developing appropriate and effective treatment for young people experiencing mental health difficulties. Although the study is cross-sectional in nature and has a small sample, the results offer further evidence of the robust relationship between dissociative and psychotic experiences.

Epigenetics in Developmental Disorder: ADHD and Endophenotypes

Heterogeneity in attention-deficit/hyperactivity disorder (ADHD), with complex interactive operations of genetic and environmental factors, is expressed in a variety of disorder manifestations: severity, co-morbidities of symptoms, and the effects of genes on phenotypes. Neurodevelopmental influences of genomic imprinting have set the stage for the structural-physiological variations that modulate the cognitive, affective, and pathophysiological domains of ADHD. The relative contributions of genetic and environmental factors provide rapidly proliferating insights into the developmental trajectory of the condition, both structurally and functionally. Parent-of-origin effects seem to support the notion that genetic risks for disease process debut often interact with the social environment, i.e., the parental environment in infants and young children. The notion of endophenotypes, markers of an underlying liability to the disorder, may facilitate detection of genetic risks relative to a complex clinical disorder. Simple genetic association has proven insufficient to explain the spectrum of ADHD. At a primary level of analysis, the consideration of epigenetic regulation of brain signalling mechanisms, dopamine, serotonin, and noradrenaline is examined. Neurotrophic factors that participate in the neurogenesis, survival, and functional maintenance of brain systems, are involved in neuroplasticity alterations underlying brain disorders, and are implicated in the genetic predisposition to ADHD, but not obviously, nor in a simple or straightforward fashion. In the context of intervention, genetic linkage studies of ADHD pharmacological intervention have demonstrated that associations have fitted the "drug response phenotype," rather than the disorder diagnosis. Despite conflicting evidence for the existence, or not, of genetic associations between disorder diagnosis and genes regulating the structure and function of neurotransmitters and brain-derived neurotrophic factor (BDNF), associations between symptoms-profiles endophenotypes and single nucleotide polymorphisms appear reassuring.