Cognitive appraisals of dissociation in psychosis: a new brief measure

The relationship between dissociation and panic symptoms in adolescence and the exploration of potential mediators

Background

Dissociative experiences have been linked to panic symptoms in adolescents, yet the nature of the association remains unclear.

Methods

In the present study, we investigated the longitudinal relationship between dissociative experiences (focusing on the felt sense of anomaly subtype) and panic, as well as the potential mediating roles of emotion regulation strategies (expressive suppression and cognitive reappraisal), alexithymia, and cognitive appraisals of dissociation. Four thousand five hundred one adolescents aged 13-18 years were recruited via social media advertising to take part in an online survey at two timepoints, 1 month apart.

Results

Analysis of 421 datasets found a significant positive relationship between initial dissociative experiences and panic symptoms reported 1 month later. This was mediated by the emotion regulation strategy of cognitive reappraisal, and cognitive appraisals of dissociation. These two variables were no longer significant mediators when controlling for panic symptoms at the first time point, likely due to the stability of panic symptoms across both assessments. Neither alexithymia nor expressive suppression were significant mediators.

Conclusions

Thus, dissociative experiences that are persistently misinterpreted in a catastrophic manner may lead to escalating anxiety and panic symptoms, which could in turn heighten and maintain the feared dissociation sensation. These results indicate that dissociative experiences are associated with panic symptoms in adolescence, with cognitive appraisals of dissociation and cognitive reappraisal playing a role in this relationship.

Developing an understanding of the relationship between anxiety and dissociation in adolescence

Anxiety is a common problem in adolescence which is hypothesised to be associated with dissociation, a range of distressing symptoms linked to reduced psychosocial functioning. Yet, to date, research into the mechanisms of dissociation in adolescents has been limited. The present study investigated the link between trait anxiety and dissociative experiences (depersonalisation and 'felt sense of anomaly') using an online survey. Cognitive appraisals of dissociation, perseverative thinking, and body vigilance were assessed as potential mediating factors of this relationship. 1211 adolescents aged 13-18 years were recruited via social media advertisements and local schools. Linear regression showed a moderate positive relationship between trait anxiety and both dissociation constructs. Hierarchical regression indicated that cognitive appraisals of dissociation and perseverative thinking mediated the relationship between trait anxiety and both dissociation constructs, but trait anxiety was a significant predictor for felt sense of anomaly but not depersonalisation after including the mediators. The final models accounted for 58.7% of variance in depersonalisation and 68.4% of variance in felt sense of anomaly. These results support the hypothesis that dissociation is associated with anxiety in adolescence. They also demonstrate that cognitive-behavioural conceptualisations may be valid for understanding dissociation in adolescence.

High dissociatives, nature versus nurture?

Non-pathological dissociative experiences are common among the general population, and anyone may experience them to some degree. Thus, the aim of this study was to assess the degree of dissociative experiences such as fantasy proneness, imagination, and absorption in fine arts undergraduates prior to beginning their artistic studies, and at the end of their studies at the faculty of fine arts. Moreover, education undergraduates were used as a comparison group. The sample consisted of 440 undergraduates (204 fine arts, and 236 education undergraduates; 224 first-year undergraduates, and 216 fourth-year undergraduates), who were administered three dissociative experiences tests: Dissociative Ability Scale, Dissociative Experiences Scale, and Questionnaire of Experiences of Dissociation. The working hypotheses were substantiated with dissociative experiences being a distinctive personality trait of fine arts undergraduates. We have found a grade level difference between first-year and fourth-year fine arts undergraduates, although the study does not examine the nature of the change itself. The results are discussed in the light of previous studies, and new lines of research proposed.