Dissociation, Reality Monitoring, Trauma, and Thought Suppression

Dissociation and emotion regulation strategies: A meta-analytic review

OBJECTIVE

Clinical and neurobiological models posited that dissociative mechanisms might affect processes involved in emotional generation and regulation. However, there is a lack of a comprehensive theoretical framework that systematically includes dissociation within emotional functioning.

METHODS

The current study aims at conducting a meta-analytic review on the relationship between dissociation and emotion regulation in order to empirically estimate to what extent dissociation is related to emotion regulation processes. The meta-analysis was based on r coefficient as effect size measure, using a random-effect approach.

RESULTS

The meta-analysis included 57 independent studies for a total of 11596 individuals. Findings showed an overall moderate relationship between dissociation and emotion regulation (r_w = .32; p < .05). The association between dissociation and emotion regulation was the same among clinical samples than non-clinical ones. Furthermore, dissociation showed moderate to large relationships with maladaptive domains of emotion regulation, namely disengagement (r_w = 0.34; p < .01) (i.e., behavioral avoidance, experiential avoidance, thought and emotional suppression) and aversive cognitive perseveration (r_w = 0.38; p < .001) (i.e., rumination, worry and nonacceptance). The analysis did not find significant relationship between dissociation and adaptive domain of emotional regulation (i.e., problem solving, mindfulness).

CONCLUSION

Dissociation in the context of emotion regulation might be viewed as a basic neuro-mental mechanism that automatically contribute to the over-modulation of emotional states through avoidance reactions from internal and external reality. Future longitudinal studies are needed to clarify the causal relationships between dissociation and emotion regulation.

[Development and validation of the Reality-Monitoring Error Experience Questionnaire]

This study developed a valid and reliable questionnaire measuring individual differences in reality-monitoring error experiences in everyday life. A 50-item preliminary questionnaire was constructed on the basis of the findings from a pilot diary study. In study 1, we administered the questionnaire to 316 undergraduates, along with a dissociative experience scale to examine criterion-referenced validity. Using factor analysis, we obtained the 32-item Reality-Monitoring Error Experience Questionnaire (RMEEQ). A significant positive correlation was found between scores on the RMEEQ and the dissociative experience scale, thereby which indicates the RMEEQ's criterion-referenced validity. In Study 2, we examined the test-retest reliability of the RMEEQ by administering it to 66 undergraduates on two occasions separated by three weeks. We found a significant test-retest correlation. Taken together, these results show that the RMEEQ is a valid and reliable measure of reality-monitoring error experiences in everyday life.

Dissociation related to subjective memory fragmentation and intrusions but not to objective memory disturbances

The present study was a replication of Kindt and Van den Hout (Behaviour Research and Therapy 41 (2003) 167) with several methodological adaptations. Two experiments were designed to test whether state dissociation is related to objective memory disturbances, or whether dissociation is confined to the realm of subjective experience. High trait dissociative participants (N(exp.1)=25; N(exp.2)=25) and low trait dissociative participants (N(exp.1)=25; N(exp.2)=25) were selected from normal samples (N(exp.1)=372; N(exp.2)=341) on basis of scores on the Dissociative Experience Scale (DES). Participants watched an extremely aversive film, after which state dissociation was measured by the Peri-traumatic Dissociative Experience Questionnaire (PDEQ). Memory disturbances were assessed 4h later (Exp. 1) or 1 week later (Exp. 2). Objective memory disturbances were assessed by a sequential memory task, items tapping perceptual representations (Exp. 1), or an open question with respect to the remembrance of the film (Exp. 2). Subjective memory disturbances were measured by means of visual analogue scales assessing fragmentation and intrusions. The two experiments provided a fairly exact replication of an earlier experiment (Behaviour Research and Therapy 41 (2003) 167-178), indicating a relation between dissociation and memory disturbances that appeared to be confined to the subjective experience of memory.

Dissociation and memory fragmentation: experimental effects on meta-memory but not on actual memory performance

The relation between state dissociation and fragmentary memory was investigated by assessing both actual memory performance and meta-memory. From a sample of 330 normal subjects, two subsamples were selected on basis of trait dissociation, as measured by the Dissociative Experience Scale. Twenty subjects scoring above 30 and 20 subjects scoring below 10 were selected. Subjects watched an extremely aversive film, after which state dissociation was measured by the Peri-traumatic Dissociative Experience Scale. Four hours later memory fragmentation was assessed in two ways. Actual fragmentation was measured by a sequential memory task, and perceived fragmentation (meta-memory) was measured using a visual analogue scale. Subjects who tended to dissociate during the film judged their recollections of the film as more fragmentary. Although this finding is in line with clinical reports given by trauma victims, it was not sustained by objective evidence. That is, no effect was observed of state dissociation on the sequential memory task. The present findings suggest that the claim that dissociation induces memory fragmentation may have to be confined to meta-memory. Implications of this divergence between actual memory and meta-memory are discussed.

Memory and suggestibility in maltreated children: age, stress arousal, dissociation, and psychopathology

The present study was designed to assess children's memory and suggestibility in the context of ongoing child maltreatment investigations. One hundred eighty-nine 3-17-year-olds involved in evaluations of alleged maltreatment were interviewed with specific and misleading questions about an anogenital examination and clinical assessment. For the anogenital examination, children's stress arousal was indexed both behaviorally and physiologically. For all children, individual-difference data were gathered on intellectual and short-term memory abilities, general psychopathology, and dissociative tendencies. Interviewers' ratings were available for a subset of children concerning the amount of detail provided in abuse disclosures. Results indicated that general psychopathology, short-term memory, and intellectual ability predicted facets of children's memory performance. Older compared to younger children evinced fewer memory errors and greater suggestibility resistance. Age was also significantly related to the amount of detail in children's abuse disclosures. Neither dissociation nor stress arousal significantly predicted children's memory. Implications for understanding maltreated children's eyewitness memory are discussed.

Intrusive Thoughts in Depression

This article traces the origins of intrusive thoughts in depression, devoting special attention to how misguided attempts to gain mental control can ironically fuel unwanted thoughts. A review of the research highlights the ways in which cognitive biases, stress, and thought suppression can contribute to the development and maintenance of depression. The article concludes with a consideration of the implications for treatment.

The causal link between self-reported trauma and dissociation: a critical review

The idea that traumatic experiences cause dissociative symptoms is a recurrent theme in clinical literature. The present article summarizes evidence that cast doubts on the commonly voiced view that the connection between self-reported trauma and dissociation is a simple and robust one. It is argued that: (1) the correlations between self-reported traumatic experiences and dissociative symptoms reported in the literature are, at best, modest; (2) other factors may act as a third variable in the relationship between trauma and dissociation; and (3) high scores on the Dissociative Experiences Scale are accompanied by fantasy proneness, heightened suggestibility, and susceptibility to pseudomemories. These correlates of dissociation may promote a positive response bias to retrospective self-report instruments of traumatic experiences. Thus, the possibility that dissociation encourages self-reported traumatic experiences rather than vice versa merits investigation. While attractive, simple models in which trauma directly causes dissociation are unlikely to be true.

Thought suppression

Although thought suppression is a popular form of mental control, research has indicated that it can be counterproductive, helping assure the very state of mind one had hoped to avoid. This chapter reviews the research on suppression, which spans a wide range of domains, including emotions, memory, interpersonal processes, psychophysiological reactions, and psychopathology. The chapter considers the relevant methodological and theoretical issues and suggests directions for future research.