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Sigurdsson E, Cardeña E. Dissociative Experiences Among Transgender Women: A Phenomenological Study. J Trauma Dissociation 2024:1-21. [PMID: 38946255 DOI: 10.1080/15299732.2024.2372563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/14/2024] [Indexed: 07/02/2024]
Abstract
There is little published research on dissociative experiences among transgender people, and none from an in-depth qualitative perspective. In-depth, open-ended interviews (N = 7, 6 trans women, 1 trans man) were conducted to explore how dissociation is experienced (particularly among trans women) and its possible relation to negative emotions. There were several similarities across the dissociative experiences described by participants: six felt themselves disconnected from their body as a whole (in contrast to feeling disconnected to a specific body part), and from the world around them and/or themselves. Four acted out different personalities, and five felt emotionally numb when they were dissociating. Six participants described that their dissociation lessened after they started hormone therapy. Respondents tended to distinguish between dysphoric and dissociative experiences: dysphoric phenomena were more clearly distressful while dissociative ones were more emotionally numb.
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Affiliation(s)
- Erika Sigurdsson
- Department of Psychology, Center for Research on Consciousness and Anomalous Psychology (CERCAP), Lund University, Lund, Sweden
| | - Etzel Cardeña
- Department of Psychology, Center for Research on Consciousness and Anomalous Psychology (CERCAP), Lund University, Lund, Sweden
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2
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Khemthong S, Scanlan JN, Hancock N. Measurement properties of the Thai translation of the Recovery Assessment Scale - Domains and Stages (RAS-DS) and comparison of recovery experiences between Thai and Australian consumers living with serious mental illness. Transcult Psychiatry 2024:13634615241250220. [PMID: 38755951 DOI: 10.1177/13634615241250220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Personal recovery, a western conceptualisation that focuses on hope and living meaningful lives of choice rather than focusing on symptom reduction, is a more recent concept in many Asian countries including Thailand. One way to promote recovery-oriented service delivery is to use outcome measures that capture self-reported personal recovery. This study aimed to evaluate a Thai translation of a self-report measure of mental health recovery, the Recovery Assessment Scale - Domains and Stages (RAS-DS). The study also explored the cultural similarities and differences between Thai (n = 190) and Australian (n = 301) recovery experiences by comparing Thai and Australian participant responses to RAS-DS items. Data were analysed using Rasch analysis. Analyses revealed that the Thai version of the RAS-DS had adequate measurement properties. Cultural comparisons suggested that most aspects contained within the RAS-DS appear to be applicable across both Thai and Australian contexts. Three findings suggest linguistic or cultural differences in Thai and Australian recovery experiences: (i) a ceiling effect for Thai participants, (ii) some items were "harder" or "easier" for one cultural group to endorse than the other, and (iii) a few items were "misfitting" for Thai participants.
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Affiliation(s)
- Supalak Khemthong
- Faculty of Physical Therapy, Division of Occupational Therapy, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Justin Newton Scanlan
- Faculty of Medicine and Health, Centre for Disability Policy and Research, The University of Sydney, Sydney, NSW, Australia
- Sydney Southeast Asia Centre, The University of Sydney, Sydney, NSW, Australia
| | - Nicola Hancock
- Faculty of Medicine and Health, Centre for Disability Policy and Research, The University of Sydney, Sydney, NSW, Australia
- Sydney Southeast Asia Centre, The University of Sydney, Sydney, NSW, Australia
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Fung HW, Cheung CTY. The bidirectional relationship between depression and dissociation: A longitudinal investigation. Asian J Psychiatr 2024; 94:103940. [PMID: 38367483 DOI: 10.1016/j.ajp.2024.103940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/24/2023] [Accepted: 01/31/2024] [Indexed: 02/19/2024]
Abstract
Depression is a major public health concern. Recent studies suggest that dissociative symptoms are associated with depressive symptoms, and the concept of "dissociative depression" has been proposed. Yet, only cross-sectional evidence is available in the literature. This study examined the bidirectional relationship between dissociative and depressive symptoms through the use of screening tools in a sample of Chinese young adults (N = 340) over four months. Baseline dissociative symptoms predicted depressive symptoms at follow-up (β = .262, p < .001), but not the other way around (β = .065, p = .121). Among different dissociative symptom clusters, identity dissociation was the only significant predictor of subsequent depressive symptoms (β = .177, p < .001). Furthermore, identity dissociation symptoms partially mediated the relationship between childhood trauma and subsequent depressive symptoms. This preliminary study is the first to test the bidirectional relationship between dissociative and depressive symptoms. The results highlight the importance of taking dissociative symptoms into account when preventing and treating depressive symptoms, especially among childhood trauma survivors.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
| | - Cherry Tin Yan Cheung
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Sajid S, Galfalvy HC, Keilp JG, Burke AK, Mann JJ, Grunebaum MF. Acute Dissociation and Ketamine's Antidepressant and Anti-Suicidal Ideation Effects in a Midazolam-Controlled Trial. Int J Neuropsychopharmacol 2024; 27:pyae017. [PMID: 38573154 PMCID: PMC11053360 DOI: 10.1093/ijnp/pyae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/03/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE We sought to explore relationships of acute dissociative effects of intravenous ketamine with change in depression and suicidal ideation and with plasma metabolite levels in a randomized, midazolam-controlled trial. METHODS Data from a completed trial in suicidal, depressed participants (n = 40) randomly assigned to ketamine was used to examine relationships between ketamine treatment-emergent dissociative and psychotomimetic symptoms with pre/post-infusion changes in suicidal ideation and depression severity. Nonparametric correlational statistics were used. These methods were also used to explore associations between dissociative or psychotomimetic symptoms and blood levels of ketamine and metabolites in a subset of participants (n = 28) who provided blood samples immediately post-infusion. RESULTS Neither acute dissociative nor psychotomimetic effects of ketamine were associated with changes in suicidal ideation or depressive symptoms from pre- to post-infusion. Norketamine had a trend-level, moderate inverse correlation with dissociative symptoms on Day 1 post-injection (P = .064; P =.013 removing 1 outlier). Dehydronorketamine correlated with Clinician-Administered Dissociative States Scale scores at 40 minutes (P = .034), 230 minutes (P = .014), and Day 1 (P = .012). CONCLUSION We did not find evidence that ketamine's acute, transient dissociative, or psychotomimetic effects are associated with its antidepressant or anti-suicidal ideation actions. The correlation of higher plasma norketamine with lower dissociative symptoms on Day 1 post-treatment suggests dissociation may be more an effect of the parent drug.
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Affiliation(s)
- Sumra Sajid
- New York State Psychiatric Institute, New York, New York, USA
| | - Hanga C Galfalvy
- Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - John G Keilp
- Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Ainsley K Burke
- Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - J John Mann
- Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Michael F Grunebaum
- Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
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Ahmadi F, Goodarzi MA, Taghavi MR, Imani M. Modeling the structural relationships between trauma exposure with substance use tendency, depression symptoms, and suicidal thoughts in individuals with earthquake trauma experience: the mediatory role of peritraumatic dissociation and experiential avoidance. BMC Psychiatry 2024; 24:171. [PMID: 38429677 PMCID: PMC10905816 DOI: 10.1186/s12888-024-05595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Despite the fact that studies indicate that earthquake trauma is associated with numerous psychological consequences, the mediating mechanisms leading to these outcomes have not been well-studied. Therefore, this study investigates the relationship between trauma exposure with substance use tendency, depression, and suicidal thoughts, with the mediating role of peritraumatic dissociation and experiential avoidance. METHODS The descriptive-correlational approach was employed in this study. The participants were people who had experienced the Kermanshah earthquake in 2017. A total of 324 people were selected by convenient sampling method. The Traumatic Exposure Severity Scale, the Peritraumatic Dissociative Experiences Questionnaire, the Acceptance and Action Questionnaire, the Iranian Addiction Potential Scale, Beck's Depression Inventory [BDI-II], and Beck's Suicidal Thoughts Scale were used to collect data. The gathered data was analyzed using structural equation modeling in SPSS Ver. 24 and LISREL Ver. 24. RESULTS The study findings indicated that the intensity of the trauma exposure is directly and significantly associated with depression symptoms, peritraumatic dissociation, and experiential avoidance. The severity of exposure to trauma had a significant indirect effect on the tendency to use substances through experiential avoidance. This is while the severity of the trauma experience did not directly correlate with substance use and suicidal thoughts. In addition, peritraumatic dissociation did not act as a mediator in the relationship between the severity of trauma exposure with substance use, depression, and suicidal thoughts. CONCLUSIONS The severity of exposure to the earthquake was associated with symptoms of depression and these findings indicate the importance of experiential avoidance in predicting the tendency to use drugs. Hence, it is essential to design and implement psychological interventions that target experiential avoidance to prevent drug use tendencies and to establish policies that lower depression symptoms following natural disasters.
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Affiliation(s)
- Farshad Ahmadi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran.
| | - Mohammad Ali Goodarzi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mohammad Reza Taghavi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mahdi Imani
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
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Fung HW, Hung SL, Ling HWH, Lee VWP, Lam SKK. A Preliminary Longitudinal Analysis of Symptom Management, Post-traumatic Stress, and Depressive Symptoms in Chinese Adults with Dissociative Symptoms. J Trauma Dissociation 2024; 25:129-143. [PMID: 37394873 DOI: 10.1080/15299732.2023.2231908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 06/04/2023] [Indexed: 07/04/2023]
Abstract
People with dissociative symptoms are generally poly-symptomatic and require high levels of healthcare resources. Post-traumatic stress disorder (PTSD) and depressive symptoms are two major disabling comorbid symptoms in people with dissociative symptoms. While the sense of control over symptoms may be associated with PTSD and dissociative symptoms, the interplay among these factors over time remains unexplored. This study examined the predictors of PTSD and depressive symptoms in people with dissociative symptoms. Longitudinal data from 61 participants with dissociative symptoms were analyzed. Participants completed self-report measures of dissociative, depressive, and PTSD symptoms and the sense of control over symptoms two times (T1 & T2) with an interval of over one month. PTSD and depressive symptoms were not transient or time-specific, but they persisted over time in our sample. Hierarchical multiple regression analyses revealed that, after controlling for age, treatment usage and baseline symptom severity, T1 symptom management scores (β = -.264, p = .006) negatively predicted T2 PTSD symptoms, while T1 PTSD symptoms (β = .268, p = .017) positively predicted T2 depressive symptoms. T1 depressive symptoms (β = -.087, p = .339) did not predict T2 PTSD symptoms. The findings highlight the importance of improving symptom management skills and treating comorbid PTSD symptoms when working with people with dissociative symptoms.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong
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Fung HW, Lam SKK, Chien WT, Ng ASY, Wong ENM, Ross CA, Hung SL, Lee VWP. Dissociative symptoms among community health service users in Hong Kong: a longitudinal study of clinical course and consequences. Eur J Psychotraumatol 2023; 14:2269695. [PMID: 37902274 PMCID: PMC10763863 DOI: 10.1080/20008066.2023.2269695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023] Open
Abstract
Background: Previous studies have demonstrated the high prevalence of dissociative symptoms and their association with considerable healthcare costs. However, there is a lack of studies that describe whether dissociative symptoms persist and lead to other clinical outcomes over time in the community.Objectives: This study investigated the persistence, predictors, and consequences of dissociative symptoms in the community.Methods: We analyzed longitudinal data in a sample of community health service users in Hong Kong (N = 173).Results: A relatively high proportion (63.6%) of participants with baseline dissociative symptoms continued to exhibit dissociative symptoms after approximately 9 months. Baseline non-betrayal trauma predicted subsequent dissociative symptoms (β = .141, p = .024). Participants with baseline dissociative symptoms were more likely to have received subsequent emergency mental health services (9.1% vs 0.7%, p = .005). Baseline dissociative symptoms significantly predicted subsequent post-traumatic symptoms (β = .165 to .191, p < .05) and difficulty in social and occupational participation (β = -.152 to -.182, p < .05) even after controlling for baseline scores, trauma exposure, and use of professional support. The predictive role of dissociative symptoms on subsequent disturbances in self-organization symptoms and social participation difficulty remained significant after applying the Bonferroni correction.Conclusions: This is one of the very few studies showing that dissociative symptoms are persistent to a certain degree and could predict other symptoms and subsequent impairments even in community settings. Factors that affect the trajectory of dissociative symptoms should be further investigated. Regular screening for dissociative symptoms is recommended. Considering its prevalence, persistence, and clinical and social consequences, dissociation should be given greater public health attention.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wai Tong Chien
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Albe Sin Ying Ng
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Braemar Hill, Hong Kong
| | - Emily Nga Man Wong
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Braemar Hill, Hong Kong
| | - Colin A. Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX, USA
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Vincent Wan Ping Lee
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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8
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Fung HW, Chau AKC, Hung SL, Lam SKK, Chien WT, Lee VWP. Persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms: a one-year follow-up study. Eur J Psychotraumatol 2023; 14:2263314. [PMID: 37818716 PMCID: PMC10569344 DOI: 10.1080/20008066.2023.2263314] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Recent studies found that post-traumatic and dissociative symptoms are common in people with depressive symptoms. Although a trauma-related subtype of depression has been proposed, little is known about the persistence and clinical consequences of these symptoms. OBJECTIVE This one-year follow-up study investigated the persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms. METHODS We analyzed longitudinal data from an international sample of people self-reporting depressive emotions (N = 152) (mean Patient Health Questionnaire-9 score = 17.27; SD = 6.31). RESULTS More than half (58.4%) of participants with baseline post-traumatic stress disorder (PTSD) still met the criteria for PTSD after one year. Participants with dissociative symptoms at baseline were significantly more likely to report lifetime psychiatric hospitalization (31.2% vs 14.7%), past-year use of psychiatric hospitalization (10.4% vs 0%) and emergency services (16.9% vs 4%) than those without dissociative symptoms. All post-traumatic and dissociative symptom clusters were cross-sectionally (r = .286 to .528, p < .001) and longitudinally (r = .181 to .462, p < .001) correlated with depressive symptoms. A sense of current threat (β = .146, p < .05) and negative self-concept (β = .173, p < .05) at baseline significantly predicted depressive symptoms after one year. CONCLUSIONS These findings contribute to the increasing body of knowledge regarding the PTSD/dissociation-depression comorbidity. Given their persistence and clinical consequences, we recommend that post-traumatic and dissociative symptoms be regularly screened for in clinical settings. The existence of a possible trauma-related subtype of depression should receive more attention in both research and clinical practice.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Anson Kai Chun Chau
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Wai Tong Chien
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Faustino B, Pilkington P, Pascoal PM. Dialectical Core Schemas Mediate the Relationships Between Dissociative Experiences and Symptomatology in a Community Sample. Psychol Rep 2023:332941231175065. [PMID: 37217316 DOI: 10.1177/00332941231175065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Maladaptive cognitions about the self and others are associated with a wide array of dysfunctional responses and psychopathological symptoms in non-clinical and clinical samples. Dissociative experiences (e.g., depersonalization and derealization) as a coping response to stressful situations lie on a continuum from healthy to unhealthy but are generally elevated in individuals experiencing mental illness. However, the extent to which Dialectical Core Schemas explain the relationship between dissociative experiences and symptomatology is unclear. Therefore, this study aimed to investigate the mediating role of Dialectical Core Schemas on the relationship between dissociative experiences and symptomatology. METHODS A community sample of 179 participants were recruited (Mage = 21.2 years, SD = 8.2). Data were gathered through self-report questionnaires using a cross-sectional design. RESULTS Maladaptive core schemas about self and others correlated positively with all dissociative experiences (e.g., depersonalization/derealization, amnesia), while adaptive core schemas about the self correlated negatively with depersonalization/derealization and distractibility. Maladaptive core schemas mediated the relationship between dissociative experiences and symptomatology. CONCLUSIONS The relationships between dissociative experiences and symptomatology are bi-directional. Exploring the mediating factors may help clinicians and researchers better understand how to enhance case conceptualization and clinical decision-making.
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Affiliation(s)
- Bruno Faustino
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Portugal
- Faculdade de Psicologia da Universidade de Lisboa, Lisboa, Portugal
| | | | - Patrícia M Pascoal
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Portugal
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Prevalence and correlates of dissociative symptoms among people with depression. J Psychiatr Res 2022; 154:132-138. [PMID: 35933857 DOI: 10.1016/j.jpsychires.2022.07.054] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND To improve the outcomes of depression treatment, personalized treatments that take individual needs into account are recommended. Recent research suggests that a subgroup of depressed people who suffer from co-occurring dissociation may be more likely to have encountered traumatic or stressful experiences and they may also have more psychosocial intervention needs. METHODS This study examined the prevalence and correlates of dissociative symptoms in an online convenience sample of people (N = 410) from 18 different countries/regions who reported clinically significant levels of depressive symptoms (indicated by Patient Health Questionnaire-9 score ≥10). RESULTS Over 60% of participants exhibited clinically significant levels of dissociative symptoms (indicated by a Multiscale Dissociation Inventory total score >66). Compared with those with low levels of dissociative symptoms, participants with high levels of dissociative symptoms reported more traumas, interpersonal stress, depression and trauma-related symptoms. Emotional constriction in particular had a weak but significant negative correlation with the level of perceived medication benefits. LIMITATIONS The use of an online convenience sample could limit the generalizability of our findings. Our cross-sectional data could not demonstrate causal relationships between the study variables. CONCLUSIONS The findings highlight a need for complex health interventions for depressed people with co-occurring dissociative symptoms, focusing not only on depressive symptoms but also addressing trauma and dissociation-related symptoms.
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11
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Fung HW, Chien WT, Ling HWH, Ross CA, Lam SKK. The mediating role of post-traumatic stress disorder symptoms in the relationship between childhood adversities and depressive symptoms in two samples. CHILD ABUSE & NEGLECT 2022; 131:105707. [PMID: 35714440 DOI: 10.1016/j.chiabu.2022.105707] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood adversities have been increasingly recognized as a significant risk factor for depression. However, the underlying mediating mechanism between childhood adversities and depression requires further investigation. The literature shows that childhood adversities are also closely associated with post-traumatic stress disorder (PTSD) symptoms and that PTSD symptoms can predict depressive symptoms. It remains unexplored whether PTSD symptoms can act as a mediator between childhood adversities and depression. OBJECTIVES The primary goal of this study was to examine whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. PARTICIPANTS AND SETTING We examined in a convenience sample of Hong Kong adults aged 18 or above (N = 418) whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. We then examined and compared the results with those in another convenience sample of Chinese-speaking young adults (mainly from Taiwan and Hong Kong) aged between 18 and 24 (N = 205). Participants in both samples completed online surveys that included measures of childhood adversities, PTSD symptoms and depressive symptoms. RESULTS Childhood adversities were significantly associated with depressive symptoms; and this relationship was mediated by PTSD symptoms in both samples. CONCLUSION This study is one of very few studies demonstrating that PTSD symptoms mediate the relationship between childhood adversities and depressive symptoms. Our findings suggest that addressing unresolved PTSD symptoms for adults with childhood adversities may help in preventing or treating depressive symptoms. Therefore, PTSD symptoms should be taken into account in the prevention and management of depression.
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Affiliation(s)
- Hong Wang Fung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; The Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX, United States
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Geng F, Lu H, Zhang Y, Zhan N, Zhang L, Liu M. Dissociative depression and its related clinical and psychological characteristics among Chinese prisoners: A latent class analysis. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02751-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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13
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Bertule M, Sebre SB, Kolesovs A. Childhood abuse experiences, depression and dissociation symptoms in relation to suicide attempts and suicidal ideation. J Trauma Dissociation 2021; 22:598-614. [PMID: 33427600 DOI: 10.1080/15299732.2020.1869652] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to examine associations between suicide attempts (SA), suicidal ideation (SI), depression, dissociative symptoms, emotional abuse, physical abuse and sexual abuse, and to explore predictors of SA and SI, as well as possible mediating factors. We also aimed to examine support for a dissociative depression subgroup. Participating in this study were 342 adults, of these were 138 respondents with a diagnosis of depression (DG), and 204 respondents comprising a community sample (CS). Respondents completed the Center for Epidemiologic Studies Depression Scale - Revised (CESD-R), Childhood Trauma Questionnaire - Short Form (CTQ-SF), and Dissociative Experience Scale (DES). All but two (DES-Absorption and DES - Depersonalization/Derealization) of the study variable mean scores were higher in the DG than in the CS group. Regression analysis showed that SA was predicted by sexual abuse and DES-Amnesia in the CS group. Structural equation modeling revealed that in both groups the types of abuse were reciprocally correlated, emotional abuse was linked to dissociation, which in turn was related to depression, which is turn was predictive of suicide ideation. Depression had a full mediating effect between dissociation and suicide ideation in the CS, and a partial mediating effect in the DG. Sexual abuse had a direct effect upon depression and suicide ideation in the DG. Cluster analysis provided support for a dissociative depression subtype.
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Affiliation(s)
- Marika Bertule
- Department of Psychology, University of Latvia, Riga, Latvia
| | - Sandra B Sebre
- Department of Psychology, University of Latvia, Riga, Latvia
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