Associations among dissociative experiences, handedness, and demographic variables in a nonclinical population

The Neuropsychiatric Approach to the Assessment of Patients in Neurology

Neuropsychiatry is a clinical neuroscience specialty focused on the evaluation and treatment of patients who present with symptoms at the intersection of neurology and psychiatry. Neuropsychiatrists assess and manage the cognitive, affective, behavioral, and perceptual manifestations of disorders of the central nervous system. Although fellowship training in behavioral neurology-neuropsychiatry exists in the United States and several other countries internationally, the need for neuropsychiatric expertise greatly outweighs the number of specialists in practice or training. This article serves as a primer for both neurologists and psychiatrists seeking to improve or refresh their knowledge of the neuropsychiatric assessment, including detailing aspects of the history-taking, physical exam, psychometric testing, and associated diagnostic work-up. In doing so, we urge the next generation of neurologists and psychiatrists to take on both the opportunity and challenge to work at the intersection of both clinical neuroscience specialties using an integrated neuropsychiatric perspective.

The Relationship Between Experiential Avoidance and Posttraumatic Stress Symptoms: A Moderated Mediation Model Involving Dissociation, Guilt, and Gender

Experiential avoidance, dissociation, and guilt have been shown to be associated with trauma exposure and to play an important role in explaining the development and maintenance of posttraumatic stress symptoms. However, there is a lack of studies that simultaneously address the relationship between these variables, which has never been studied within the framework of emotional processing theory. Furthermore, gender differences in traumatic victimization, posttraumatic stress symptoms, experiential avoidance, dissociation, and guilt have also been reported. Therefore, this study had a double aim: a) to assess the mediating roles of dissociation and guilt in the relationship between experiential avoidance and posttraumatic stress symptoms; and b) to investigate whether gender moderates any such relationship. The final sample comprised 683 undergraduate students (150 men and 533 women) with a history of exposure to traumatic events and with posttraumatic stress symptoms. Mediation and moderated mediation analyses were conducted. Dissociation and guilt independently mediated the association between experiential avoidance and posttraumatic stress symptoms: however, this mediation effect was not moderated by gender. The findings suggest that interventions aimed at controlling psychological variables linked to PTSD (i.e. experiential avoidance, dissociation, and guilt) may be of help to both men and women.

Association of Cognitive Abilities and Brain Lateralization among Primary School Children in Kuwait

Background. Many studies have explored the cognitive variation between left- and right-handed individuals; however, the differences remain poorly understood. Aim of the Work. To assess the association between brain lateralization indicated by handedness and cognitive abilities. Material and Methods. A total of 217 students aged between 7 and 10 years of both genders were identified for the study. Males and females were equally distributed. All left-handed students were chosen. An equal group with right-handed students was randomly selected. Handedness was assessed using traditional writing hand approach as well as the WatHand Cabient Test and the Grooved Pegboard Test. Cognition was measured using Cambridge University's CANTAB eclipse cognitive battery. Pearson Correlation Coefficient Test “r” was calculated to measure the strength of association between quantitative data. Results. Right-handed children had superior visuospatial abilities (p = 0.011, r = 0.253), visual memory (p = 0.034, r = 0.205), and better scores in reaction time tests which incorporated elements of visual memory (p = 0.004, r = −0.271). Left-handed children proved to have better simple reaction times (p = 0.036, r = 0.201). Conclusion. Right-handed children had superior visuospatial abilities and left-handed children have better simple reaction times.

Psychophysiological correlates of dissociation, handedness, and hemispheric lateralization

Dissociation involves a disruption of typically integrated functions including consciousness, information perception, and memory; however, dissociation may not always be of a pathologic nature. Increasingly, studies are identifying relations between inconsistent handedness, mixed hemispheric lateralization, and dissociative symptomatology in both clinical and nonclinical populations. The current study explored whether a nonclinical sample of individuals scoring high in dissociation would display an inconsistent handedness in conjunction with a left hemispheric lateralization as measured by electroencephalography. Twenty-seven participants (12 males and 15 females) aged between 20 and 59 years (M = 29.1 year, SD = 11.2 years), completed the Dissociative Experiences Scale and Waterloo Handedness Questionnaire Revised after determining laterality. As predicted, inconsistently handed participants scoring high in dissociation displayed left hemispheric lateralization across frontal, central, and parietal regions. Conversely, right lateralization was found within Delta frequency band across temporal regions. The study provides a good framework for future research investigating the neurophysiological correlates underpinning dissociative symptomatology.

Factors associated with pathological dissociation in the general population

OBJECTIVE

This study assessed the prevalence of pathological dissociation in the general population, and the relationship between pathological dissociation and sociodemographic and several psychiatric variables.

METHOD

The stratified population sample consisted of 2001 subjects. The study questionnaires included the Dissociative Experiences Scale, the Dissociative Experiences Scale-Taxon, the Toronto Alexithymia Scale, the Beck Depression Inventory, and sociodemographic background.

RESULTS

The prevalence of pathological dissociation (DES-T >/= 20) was 3.4% in the general population and did not differ significantly between genders. Men scored higher than women in the amnesia subscale, and women in the absorption and imaginative involvement subscale. The relationship between pathological dissociation, alexithymia, depression and suicidality was strong. The likelihood of pathological dissociation was nearly nine-fold higher among depressive subjects, more than seven-fold higher among alexithymic subjects, and more than four-fold higher among suicidal subjects than among the others. Frequent alcohol consumption also associated significantly with pathological dissociation.

CONCLUSIONS

A significant relationship between pathological dissociation, depression, alexithymia, and suicidality was found in the general population. The importance of these factors should be examined in a prospective study design to determine causality.

Gender differences in dissociation. A dimensional approach

Considering that epidemiological research on dissociative disorders has suggested a 9 to 1 predominance of female cases, this study investigated the relationship between gender and dissociation using a dimensional approach. A total of 2,153 participants from different diagnostic groups completed the Dissociative Experience Scale. In order to control for the confounding effect of current psychopathology a subgroup 790 subjects additionally completed the SCL-90. We did not find any differences in the general or pathological dissociation scores. Hypothetical gender differences in dissociative psychopathology were not a function of diagnostic categories. There were no significant sex differences in the distribution of high dissociators. Our findings suggest that men and women do not generally differ in dissociative psychopathology. The implications for future investigations on the epidemiology, etiology, and psychobiology of dissociative symptoms are discussed.