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Psychological and Physiological Trauma Research
Seize Your Journeys
_______________________ Traumatic stress is found in many competent, healthy, strong, good people. No one can completely protect themselves from traumatic experiences. Many people have long-lasting problems following exposure to trauma. Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy. What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences. Having symptoms after a traumatic event is NOT a sign of personal weakness. Given exposure to a trauma that is bad enough, probably all people would develop PTSD. By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment. _______________________
DID-PTSD-EMDR Dissociative Identity Disorder (DID) "The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations. Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities." Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. PTSD, DID, and EMDR Posttraumatic Stress Disorder "The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F). Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase. The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator). Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7). The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
EMDR Eye Movement Desensitization and Reprocessing "Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach. During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com
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PTSD Dissociation
PTSD and DID
Title: Clinical features of survivors of sexual abuse with major depression. Author(s)/Editor(s): Zlotnick, Caron; Mattia, Jill; Zimmerman, Mark Source/Citation: Child Abuse & Neglect: Special Issue: Vol 25(3) Mar 2001, US: Elsevier Science Inc; 2001, 357-367 Abstract/Review/Citation: Examined differences in rates of trauma-related disorders between patients with histories of childhood sexual abuse (CSA) and those without such histories in a sample of depressed outpatients. Another aim of this study was to determine whether CSA is associated with recent suicidal attempts, affect dysregulation and duration of index depressive episode, independent of posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD). Ss were 235 treatment-seeking outpatients with major depression. Structured interviews were administered to assess for Axis I and Axis II disorders, CSA, and various clinical features. Patients with sexual abuse compared to those without sexual abuse histories had higher rates of comorbidity, primarily BPD, PTSD and multiple Axis I diagnoses. CSA status was linked to a longer duration of the index depressive episode, independent of BPD and/or PTSD. However, CSA status was not independently related to affect dysregulation and suicidal attempts. The findings suggest that patients with histories of sexual abuse represent a subgroup of depressed patients who are at especially high risk for psychiatric morbidity and a prolonged episode of depression. ========================================
Title: Response to sexual assault: A relational perspective. Author(s)/Editor(s): Regehr, Cheryl; Marziali, Elsa Source/Citation: Journal of Nervous & Mental Disease; Vol 187(10) Oct 1999, US: Lippincott Williams & Wilkins; 1999, 618-623 Abstract/Review/Citation: It has been suggested that although the severity of the stressor is the primary determinant of acute posttraumatic stress disorder (PTSD) symptoms, pre-existing personality patterns may be the primary contributors to the development of chronic PTSD symptomatology. The authors postulate that of the multiple personality factors that influence behavior and response to traumatic events, relational capacity or the ability to sustain interpersonal relationships provides an overarching construct for understanding the contribution of social contextual factors to post-trauma response. The results of an exploratory study support the authors' hypothesis that relational capacity is a significant factor in explaining persistent PTSD symptoms in a sample of 71 women (aged 17-47 yrs) who have been raped. Significant correlations were found between measures of relational capacity, the Bell Object Relations Inventory, the Inventory of Interpersonal Problems and measures of distress, the Posttraumatic Symptom Scale, and the Beck Depression Inventory. ========================================
Title: The Minnesota Multiphasic Personality Inventory - 2, Post-Traumatic Stress Disorder, and women domestic violence survivors. Author(s)/Editor(s): Morrell, John Somers Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 59(7-B) Jan 1999, US: Univ. Microfilms International; 1999, 3704 Abstract/Review/Citation: Empirical evidence and diagnostic decision rules for diagnosing Post-Traumatic Stress Disorder (PTSD) with Minnesota Multiphasic Personality Inventory - 2 were originally developed with a narrow and heterogeneous sample of trauma victims, Vietnam veterans. Relatively little empirical study has been given to the use of the MMPI-2 among domestic violence survivors, especially as it pertains to the issue of Post-Traumatic Stress Disorder. The utility and validity of prior empirical findings, based primarily on Vietnam veterans, cannot be extrapolated to other trauma victims without further empirical evidence supporting such application. In this study the MMPI-2 was administered to 93 women domestic violence survivors from domestic violence (a) shelters, (b) support groups, (c) outreach centers, and (d) other social service agencies. The Post-Traumatic Stress Diagnostic Scale (Foa, 1995) was used to identify which of 93 women survivors met diagnostic criteria for Post-Traumatic Stress Disorder. Multivariate analysis of variance, using nine MMPI-2 scales, found significant differences between women domestic violence survivors with and without PTSD on the F, K, 1(Hs), 2(D), 6(Pa), B(Sc), and PK-PTSD scales. Stepwise discriminant function analysis produced one significant discriminant function, including the K validity and the 1(Hs) scales, a 78% correct classification rate, and a sensitivity and specificity of 88% and 60%, respectively. The PK-PTSD scale correctly classified 68% of all cases, and a sensitivity and specificity of 81% and 45%, respectively, were found. Canonical correlation of MMPI-2 scales with sub-scales from Foa's (1995) Post-Traumatic Stress Diagnostic Scale revealed significant multiple correlations. Major findings suggest the MMPI-2 is sensitive to PTSD symptomatology and capable of discriminating between domestic violence survivors with and without PTSD. The MMPI-2 is as diagnostically efficient for assessing PTSD in domestic violence survivors as it is been found to be for Vietnam veterans. Implications for theory, research, practice, and limitations of this research are discussed. ========================================
Title: The comorbidity of Post-Traumatic Stress Disorder and Antisocial Personality Disorder: An epidemiological and genetic study. (men, twins). Author(s)/Editor(s): Koenen, Karestan Chase Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(4-B) Oct 1999, US: Univ. Microfilms International; 1999, 1858 Abstract/Review/Citation: Although previous research has documented a high rate of comorbidity between post-traumatic stress disorder (PTSD) and antisocial personality disorder (APD) in Vietnam veterans, little is known about the contribution of genetic and environmental factors to the relationship between these two disorders This study investigated the nature of the relationship between PTSD and APD by analyzing data from the Harvard-Twin study of Drug Abuse and Dependence (1992). Data from 8,039 male-male twin pairs were collected by telephone interview. Chi-square analyses revealed that PTSD was significantly associated with both conduct disorder (CD) and APD and that individuals with PTSD were more than twice as likely as those without PTSD to have a lifetime CD diagnosis and almost five times as likely to have a lifetime APD diagnosis. Analyses across twin pairs demonstrated a significant familial association between PTSD and both CD and APD. Genetic influences could not be distinguished from family environment as the basis for the association between PTSD and CD while the association between PTSD and APD was significantly influenced by genetic factors. This study also examined whether childhood behavior problems were a vulnerability for combat related PTSD and whether adult antisocial behaviors were a vulnerability or consequence of combat related PTSD. Multiple regression analyses indicated that childhood behavior problems were significantly associated both with higher levels of combat exposure and with higher levels of PTSD symptoms. Combat exposure was also a significant predictor of adult antisocial behavior, even after controlling for genetic and familial influences on that behavior. A high-risk twin design comparing PTSD probands, combat controls, and their co-twins revealed that PTSD probands and their high-risk co-twins had higher levels of adult antisocial behavior than combat controls and their low-risk co-twins. These results indicate that while childhood behavior problems are a vulnerability for PTSD, adult antisocial behaviors are both a vulnerability for developing PTSD following combat exposure and a consequence of PTSD. ========================================
Title: Etiological factors in a sample of convicted women felons in North Carolina. Author(s)/Editor(s): Jordan, B. Kathleen; Schlenger, William E.; Caddell, Juesta M.; Fairbank, John A. Source/Citation: Role of sexual abuse in the etiology of borderline personality disorder., Washington, DC, US: American Psychiatric Press, Inc; 1997, (xii, 247), 45-69 Progress in psychiatry, No. 49. Source editor(s): Zanarini, Mary C. (Ed) Abstract/Review/Citation: examine risk factors for BPD [borderline personality disorder], using data collected from an in-depth survey and structured clinical interviews with women prison inmates in North Carolina, all of whom had been convicted of a felony // provide distributions on a set of sociodemographic, etiological, and other variables (e.g., personal and lifestyle characteristics, including comparisons of those with and without BPD) / present results from a multivariate analysis of potential risk factors for BPD / overall, the following 15 predictor variables were studied: age, race, urbanicity, bed-wetting after age 6, family violence, economic and physical deprivation index, other family problems (e.g., psychiatric disorders and/or antisocial behavior), feeling safe and protected, loss, number of conduct disorder groups, sexual assault before age 11, physical assault before age 11, other traumatic event before age 11, ASPD [antisocial personality disorder], and posttraumatic stress disorder (PTSD) / these results allow examination of the relative importance of multiple risk factors in this population while controlling for other such factors / discuss the implications of these findings // [argue that] the development of borderline psychopathology "arises out of a history in which abusive experiences join other factors to help shape enduring aspects of the character" (J. G. Gunderson and A. N. Sabo 1993, p. 23) ========================================
Title: Traumatic stress personality disorder (TrSPD): Intertheoretical therapy for the PTSD/PD dissociogenic organization. Author(s)/Editor(s): Parson, Erwin Randolph Source/Citation: Journal of Contemporary Psychotherapy: Special Issue: Personality disorders: Theory, pathogenesis, diagnosis, comorbidity, research and practice.; Vol 27(4) Win 1997, US: Kluwer Academic Publishers; 1997, 323-367 Abstract/Review/Citation: Discusses a new personality disorder entity, traumatic stress personality disorder (TrSPD), conceptualized as a composite organization with transactional properties that mutually structure posttraumatic stress disorder (PTSD) and personality disorders (PDs). An intertheoretical therapy model is presented, and consists of multiple therapies actively integrated to meet the patient's complex post-trauma needs. This article argues for the development of theoretical, investigatory, and therapeutic measures to address PTSD/PD configurations in traumatized victims. The position espoused is that PTSD/PD should be measured as 1 rather than 2 entities, with neither component being considered as a confounding but integral factor in measurement. The 8 components of TrSPD are discussed, along with a case study to demonstrate the model's clinical applications. The integration of cognitive, behavioral, psychodynamic, and existential treatment approaches is geared to assist the victim to developmentally progress to survivor status, and then beyond this level of integration to thriver, a person whose adaptational learning in therapy created a "vital psychological immune system" that consistently protects against dissociative regression in response to the daily stresses of life. ========================================
Title: The relationship between dissociation and object-relations impairment in adult female incest survivor clients with and without personality splitting. Author(s)/Editor(s): Stuppy, Linda Jean Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 57(5-B) Nov 1996, US: Univ. Microfilms International; 1996, 3425 Abstract/Review/Citation: Problem. Childhood incest appears to play a role in the formation of Dissociative Identity Disorder (DID) (formerly Multiple Personality Disorder). This study investigated whether a relationship exists between dissociation and object-relations impairment in incest survivors and whether DID incest survivors have higher levels of these characteristics than non-DID incest survivors. Method. The Dissociative Experience Scale, Bell Object Relations Reality Testing Inventory and Childhood Maltreatment Interview Schedule-Short Form were completed by a sample of 60 adult female incest survivor clients, 29 who met the diagnosis for DID and 31 who did not. The results. All three hypotheses were supported at a.05 level. A significant relationship between dissociation and object-relations impairment was found. The DID group reported significantly higher levels of dissociation and object-relations impairment than the non-DID group and higher incidences of childhood maltreatment and adult traumas. A discriminant analysis found that DID clients can be differentiated from non-DID clients based on dissociative experiences and object-relations scores. The DID group consistently reported higher incidences of childhood maltreatment, psychological abuse, and adult traumatization than the non-DID group. Conclusions. The findings support an object-relations model for incest and suggest that personality splitting found in DID clients may be related to a developmental arrest in early-life intrapsychic splitting mechanisms described by Kernberg (1966, 1975, 1976) and others. It is possible that therapists may serve as 'transitional objects' for incest survivors with object-relations deficits. Past research has viewed incest as leading to a variety of PTSD symptoms, however some effects, especially personality splitting, may originate even before the incest occurs when very young children are exposed to harsh or psychologically overwhelming situations.
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Title: Dissociative identity disorder. Author(s): Barry-Walsh, Justin Source: Australian & New Zealand Journal of Psychiatry, Vol 39(1-2), Jan 2005. pp. 109-110.
Journal URL: http://www.blackwell-science.com/~cgilib/jnlpage.asp?Journal=xanjp&File= xanjp Publisher: United Kingdom: Blackwell Publishing
Publisher URL: http://www.blackwellpublishing.com ISSN: 0004-8674 (Print) Digital Object Identifier: 10.1111/j.1440-1614.2005.01521.x Language: English Keywords: working memory; dissociative identity disorder; markers; memory functioning; depression; posttraumatic stress disorder; psychosis
Abstract: Comments on an article by Martin J. Dorahy, Harvey J. Irwin and Warwick Middleton (see record 2004-10394-007). The author expresses his surprise as he has always understood dissociative identity disorder (DID) to be a controversial iatrogenic diagnosis whose origins and rise to prominence was related to social forces and American diagnostic fashion. He is concerned by research which uncritically accepts as valid, diagnoses such as DID. Such research in a circular way reifies ideas, giving them the appearance of solid, scientifically based diagnoses when they may be anything but that. Given the uncertainty about dissociative identity disorder, should research not be attempting to answer a more fundamental question: is there any place for dissociative identity disorder and why does this disorder have so much currency in some circles yet have none in others? _____
Record: 2
Title: "Assessing markers of working memory function in dissociative identity disorder using neural stimuli: A comparison with clinical and general samples": Reply. Author(s): Dorahy, Martin J., Queen's University of Belfast, Northern Ireland
Middleton, Warwick, Belmont Private Hospital, Brisbane, QLD, Australia Source: Australian & New Zealand Journal of Psychiatry, Vol 39(1-2), Jan 2005. pp. 110-112.
Journal URL: http://www.blackwell-science.com/~cgilib/jnlpage.asp?Journal=xanjp&File= xanjp Publisher: United Kingdom: Blackwell Publishing
Publisher URL: http://www.blackwellpublishing.com ISSN: 0004-8674 (Print) Digital Object Identifier: 10.1111/j.1440-1614.2005.01531.x Language: English Keywords: working memory; dissociative identity disorder; markers; memory functioning; depression; posttraumatic stress disorder; psychosis
Abstract: Reply by the current author to the comments made by Justin Barry-Walsh (see record 2005-00815-014) on the original article (see record 2004-10394-007). The author argues that in dissociative identity disorder (DID) is a culture bound phenomena, created by social forces and overzealous North American DID-enthusiasts. This statement makes reference to the controversy, particularly prevalent before the ICD-10's publication in the early 1990's, rather than whether DID is an iatrogenic or culture-bound condition. We assume that the ICD-10's conclusion regarding the rarity of DID was made without awareness of, and in some cases before, the publication of the many DID prevalence studies from around the world. Our response to author's comments regarding the Dissociative Experiences Scale (DES) are limited to two points. Firstly, we cite one of the many studies that highlight the impressive psychometric properties of the instrument. Secondly, no serious student of DID, including the authors of the DES have suggested that the DES be used as a diagnostic instrument for DID, rather it was designed to quantify dissociative experiences and symptoms. _____
Record: 3
Title: Dissociation: A developmental psychoneurobiological perspective.
Author(s): Panzer, Annie, Department of Physiology, University of Pretoria, Pretoria, South Africa
Viljoen, Margaretha, Department of Physiology, University of Pretoria, Pretoria, South Africa, mviljoen@medic.up.ac.za Address: Viljoen, Margaretha, Department of Physiology, School of Medicine, University of Pretoria, PO Box 2034, Pretoria, South Africa, 0001, mviljoen@medic.up.ac.za Source: South African Psychiatry Review, Vol 7(3), Aug 2004. pp. 11-14. Publisher: South Africa: In House Publications ISSN: 1560-0181 (Print) Language: English Keywords: dissociation; developmental psychoneurobiology; psychopathology; dissociative disorders; bodily sensations; dorsal motor nucleus; motivation Abstract: Dissociation can be defined as the failure to integrate experience. Dissociation is a common symptom of a spectrum of severe psychopathologies, from reactive attachment disorder of infants to dissociative identity disorders, psychotic experiences, borderline personality disorders and post-traumatic stress disorders of adults. The incidence of abuse in the childhood histories of adults with dissociative disorders is extremely high. The adaptational value of dissociation is that it allows survival in catastrophic events. The disadvantage is that when dissociation occurs frequently, the development of neural networks is impaired. Especially disadvantageous are problems which develop with a) higher circuit control over lower circuits, b) primitive parasympathetic regulation by the dorsal motor nucleus, c) memory, d) left hemisphere, e) integration of bodily sensations, f) sense of self, and g) affect and motivation. These aspects are discussed in more detail. The clinician's primary function is as an affect regulator and therapy should focus on integration. _____
Record: 4
Title: Commentary. Author(s): Schore, Allan N., University of California School of Medicine, Los Angeles, CA, US, anshore@aol.com Address: Schore, Allan N., University of California School of Medicine, 9817 Sylvia Avenue, Northridge, Los Angeles, CA, US, anshore@aol.com Source: South African Psychiatry Review, Vol 7(3), Aug 2004. pp. 16-17. Publisher: South Africa: In House Publications ISSN: 1560-0181 (Print) Language: English Keywords: dissociation; developmental psychoneurobiology; psychopathology; dissociative disorders; bodily sensations; dorsal motor nucleus; motivation Abstract: Comments on an article by Annie Panger and Margaretha Viljoen (see record 2004-18832-004). This article offers a cogent overview of recent models of the etiology of pathological dissociation. This interdisciplinary information is drawn from the fields of developmental psychology, developmental neuroscience, and infant psychiatry. In this integration, recent data on the mechanisms that underlie the attachment bond of emotional communications between the mother and infant have been integrated with current studies on the developmental neurobiology of attachment. In a number of contributions I have offered interdisciplinary evidence which suggests that severe relational trauma, especially neglect and/or abuse, alters the development of specifically the right brain, the biological substrate of the human unconscious. In my work I suggest that attachment trauma embedded in a growth-inhibiting interpersonal environment induces a developmental failure of the experience-dependent maturation of the right-lateralized emotional brain. The authors appropriately conclude their incisive article with thoughts about the application of this developmental psychoneurobiological knowledge to the psychotherapy of severe psychopathologies. Their contribution has direct implications for not only intervention but also for models of early prevention. _____
Record: 5
Title: Assessing markers of working memory function in dissociative identity disorder using neutral stimuli: A comparison with clinical and general population samples. Author(s): Dorahy, Martin J., Clinical Psychology Program, School of Psychology, Queens University, Belfast, Northern Ireland, M.Dorahy@qub.ac.uk
Irwin, Harvey J., School of Psychology, University of New England, Armidale, NSW, Australia
Middleton, Warwick, The Cannan Research Institute, Belmont Private Hospital, Brisbane, QLD, Australia Address: Dorahy, Martin J., Clinical Psychology Program, School of Psychology, Queens University, David Keir Building, Malone Road, Belfast, Northern Ireland, BT9 5BP, M.Dorahy@qub.ac.uk Source: Australian & New Zealand Journal of Psychiatry, Vol 38(1-2), Jan 2004. pp. 47-55.
Journal URL: http://www.blackwell-science.com/~cgilib/jnlpage.asp?Journal=xanjp&File= xanjp Publisher: United Kingdom: Blackwell Publishing
Publisher URL: http://www.blackwellpublishing.com ISSN: 0004-8674 (Print) Language: English Keywords: working memory; dissociative identity disorder; markers; memory functioning; depression; posttraumatic stress disorder; psychosis
Abstract: Memory functioning is a central conceptual and phenomenological aspect of dissociative identity disorder (DID). Most empirical work on memory functions in DID has focused on retrieval deficits either within or between dissociated identities. The current study attempted to remedy the scant attention given to working memory functioning. In samples representing the DID, non-clinical, depressed, posttraumatic stress disorder (PTSD) and psychosis populations (n=10 per group), neutral stimuli were used to examine three markers of working memory functioning: one measuring inhibition; one assessing facilitation; and one measuring interference. With the exception of the psychosis sample all groups displayed significant negative priming in the distractor inhibition condition. Facilitation effects were demonstrated by the DID and PTSD groups only. Interference effects were evident in all samples, though the DID and non-clinical groups demonstrated significantly more interference than the psychosis cohort. Distractor inhibition was related to overall schizotypy scores, and dissociation was related to scores in the facilitation condition. _____
Record: 6
Title: Some Gender Biases in Diagnosing Traumatized Women. Series Title: A project of the association for women in psychology Author(s): Fish, Vincent, School of Social Work, University of Wisconsin, Madison, WI, US Source: Bias in psychiatric diagnosis. Caplan, Paula J. (Ed); Cosgrove, Lisa (Ed); pp. 213-220. Northvale, NJ, US: Jason Aronson, Inc, 2004. xxxiii, 269 pp. ISBN: 0-7657-0375-0 (hardcover)
0-7657-0001-8 (paperback) Language: English Keywords: gender bias; traumatized women; differential diagnosis; borderline personality disorder; schizophrenia, posttraumatic stress disorder; PTSD Abstract: (from the chapter) When mental health professionals diagnose people as mentally disordered, we do so from within strong institutional, societal, and cultural contexts that systematically influence how clients' data are elicited, presented, and perceived and how we use these data to assign diagnostic labels. One frequently harmful systematic shaper of diagnostic practice is gender bias. Females are misdiagnosed more than males with chronic, stigmatizing disorders such as Borderline Personality Disorder (BPD) and Schizophrenia, while more treatable posttraumatic conditions caused largely by overwhelming situational stress, such as Post-traumatic Stress Disorder (PTSD) and Dissociative Identity Disorder (DID), tend to be underdiagnosed in females. This chapter discusses the overdiagnosis of BPD and schizophrenia, the underdiagnosis of PTSD and DID and offers explanations for gender bias in diagnosing these disorders. Better training of therapists in the differential diagnosis of PTSD, BPD, Schizophrenia, and DID, as well as increased discussion of the institutional, societal, and cultural underpinnings that promote such systematic gender bias, are necessary to address this consequential issue. _____
Record: 7
Title: On the threshold of adulthood: ISSD at age 21. Author(s): Gold, Steven N., Trauma Resolution & Integration Program, Nova Southeastern University, Fort Lauderdale, FL, US Source: Journal of Trauma & Dissociation, Vol 5(1), 2004. pp. 1-12.
Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229 Publisher: US: Haworth Press
Publisher URL: http://www.haworthpress.com ISSN: 1529-9732 (Print) Digital Object Identifier: 10.1300/J229v05n01_01 Language: English Keywords: International Society for the Study of Dissociation's; multiple personality disorder; dissociative identity disorder Abstract: The year-2004-marks the International Society for the Study of Dissociation's (ISSD) twentieth year and the twenty-first International Fall Conference on dissociation. At the same time, the Journal of Trauma & Dissociation, the official journal of the ISSD, is already entering its fifth year. The ISSD has been through a remarkable series of substantive changes in a relatively brief period of time. The original title of the organization, the International Society for the Study of Multiple Personality & Dissociation (ISSMP&D), unambiguously indicated that its primary focus was on the syndrome then known as Multiple Personality Disorder (MPD). In the decade since the shift from MPD to DID and from the ISSMP&D to the ISSD, the territory covered by the ISSD has expanded considerably. Probably the most decisive of these developments is reflected in the title of this journal, the Journal of Trauma & Dissociation, which was first published in 2000. trauma, ISSD is especially strongly involved in the investigation and treatment of Complex Posttraumatic Stress Disorder. It is essential that the ISSD actively encourage investigation of non-pathological as well as pathological dissociation, and of the presence of dissociative symptoms in syndromes other than the dissociative disorders. _____
Record: 8
Title: Investigating Cognitive Inhibition in Dissociative Identity Disorder Compared to Depression, Posttraumatic Stress Disorder and Psychosis. Author(s): Dorahy, Martin J., School of Psychology, Queen's University of Belfast, Belfast, Northern Ireland, M.Dorahy@qub.ac.uk
Middleton, Warwick, The Cannan Research Institute, Belmont Private Hospital, Australia
Irwin, Harvey J., School of Psychology, University of New England, Australia Address: Dorahy, Martin J., Clinical Psychology Program, School of Psychology, Queens University, David Keir Building, Malone Road, Belfast, Northern Ireland, BT9 5BP, M.Dorahy@qub.ac.uk Source: Journal of Trauma & Dissociation, Vol 5(4), 2004. pp. 93-110.
Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229 Publisher: US: Haworth Press
Publisher URL: http://www.haworthpress.com ISSN: 1529-9732 (Print) Digital Object Identifier: 10.1300/J229v05n04_06 Language: English Keywords: cognitive inhibition; dissociative identity disorder; depression; posttraumatic stress disorder; psychosis; mental capacity; distracting stimuli; word stimuli; cognitive inhibitory functioning Abstract: Cognitive inhibition refers to the mental capacity to suppress distracting stimuli that compete with target stimuli for processing resources. Using neutral word stimuli in a flanker task, a recent study suggested that dissociative identity disorder (DID) is characterized by weakened cognitive inhibitory functioning (Dorahy, Irwin, & Middleton, 2002). The current study used single digit stimuli in the flanker task and tested cognitive inhibitory ability in samples with DID, depression, posttraumatic stress disorder and psychosis. The DID, depressed and PTSD groups displayed no evidence of weakened cognitive inhibitory functioning. Consistent with previous research, however, the psychosis sample displayed a reduced capacity to engage in cognitive inhibition. Cognitive inhibitory ability was not related to measures of dissociation, childhood traumatic experience or schizotypy. Results are discussed in terms of the positive symptoms of schizophrenia and the nature of stimuli used in the flanker task. _____
Record: 9
Title: Dissociative Disorders: Not Empirically Proven. Author(s): Spanos, Nicholas P., Department of Psychology, Carleton University, Ottawa, ON, Canada Source: PsycCRITIQUES, 2004. pp. [np]. Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org Reviewed Item: David Spiegel (Ed.) (1993). Dissociative Disorders: A Clinical Review; Lutherville, MD: Sidran Press, 1993. 134 pp. ISBN 0-9629164-1-2. $13.95 paperback ISSN: 1553-0138 (Electronic) Digital Object Identifier: 10.1037/003500 Language: English Keywords: dissociative disorders; posttraumatic stress disorder; multiple personality disorder Abstract: Originally published in Contemporary Psychology: APA Review of Books, 1995, Vol 40(3), 261-262. Dissociative Disorders: A Clinical Review, edited by David Spiegel (see record 1993-97251-000), includes six chapters by prominent clinical investigators in the area of dissociative disorders. In the first paper, Putnam describes dissociation as a normal as well as pathological phenomenon and reviews work on several aspects of this topic. In the second paper, Kluft deals with multiple personality disorder (MPD), and in the third paper Loewenstein provides a review of psychogenic amnesia and fugues. Steinberg reviews work on depersonalization and its relationship to traumatic and near death experiences in Chapter 4, and in Chapter 5 Nemiah relates the notion of dissociation to conversion and somatization symptoms. The final chapter by Spiegel deals with dissociation and trauma and relationships between hypnosis, posttraumatic stress disorder (PTSD), and MPD. The papers differ in quality and in the extent to which the authors critically examine available empirical data. In summary, the chapters in this book provide one general point of view toward dissociation and dissociative disorders. The inclusion of alternative viewpoints and a more critical approach to some of the literature would have been preferable. _____
Record: 10
Title: The impact of childhood and adult trauma on the use of dissociation by adult men. Author(s): Hardt, Dan A., Indiana U., US Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 64(6-B), 2003. pp. 2920. Publisher: US: Univ Microfilms International
Publisher URL: http://www.il.proquest.com/umi/ ISSN: 0419-4217 (Print) Order Number: AAI3094178 Language: English Keywords: childhood trauma; adult trauma; dissociation; adult men; coping mechanism; male veterans; posttraumatic stress disorder Abstract: Dissociation has an extensive history in psychology. It's described in DSM-IV (American Psychiatric Association, 1994, p. 477) as "a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment". Dissociation can range from normative (driving for miles without remembering what you saw or did) to severe dissociative identity disorder, where traumatic material is separated into individual alters (personalities). Terms like "battle fatigue" have described the impact of combat on soldiers, and dissociation can be an important component of this response. Recent trauma research suggests that severe or chronic childhood trauma may produce dissociation and be a precursor to adult pathology. This study looked at the connection between dissociation used as a coping mechanism by male veterans and the trauma they experienced as children and/or adults. The hypotheses were: (a) trauma during childhood and adulthood will be positively related to the use of dissociation, and childhood trauma will be a stronger predictor than will adult trauma; (b) the proportion of veterans using dissociation as a coping mechanism will be greater for men with childhood trauma than for those with adult trauma; and (c) men with PTSD will use more dissociation than men without PTSD. The protocol included completing seven questionnaires, followed by an in-depth interview. The sample size was limited to sixteen men because of several uncontrollable factors. The quantitative data were analyzed using multiple correlation/regression techniques; the interviews and other data were analyzed using qualitative methods. No hypotheses were supported, possibly because of the limited sample size. Substantial amounts of trauma were reported, both in childhood and adulthood. High levels of dissociative symptoms were also described. The group with dissociation scores above the cut-off used in the research had scores consistent with those found in the literature for people with PTSD or dissociative disorders; the scores were higher than for people with schizophrenia, borderline personality disorder, or anxiety disorders. This finding has significant implications to consider during therapy with veterans from similar backgrounds. _____
Record: 11
Title: Persönlichkeitsstörungen und die Psychopathologie in der Folge yon Traumen Übedegungen zur diagnostischen Klassifikation. Translated Title: Personality disorders and psychopathology following trauma. Thoughts on diagnostic classification. Author(s): Wöller, W., Klinik Wersbach, Klinik für Psychosomatische Medizin und Psychotherapie, Leichlingen-Witzhelden, Germany, woeller@klinikwersbach.de
Kruse, J., Klinik für Psychotherapeutische Medizin, Heinrich-Heine-Universität Düsseldorf, Germany Address: Wöller, W., Klinik Wersbach, Klinik fur Psychosomatische Medizin und Psychotherapie, Wersbach 20, 42799, Leichlingen-Witzhelden, Germany, woeller@klinikwersbach.de Source: Nervenarzt, Vol 74(11), 2003. pp. 972-976.
Journal URL: http://link.springer.de/link/service/journals/00115/index.htm Publisher: Germany: Springer Verlag
Publisher URL: http://www.springeronline.com ISSN: 0028-2804 (Print)
1433-0407 (Electronic) Digital Object Identifier: 10.1007/s00115-003-1492-7 Language: German Keywords: personality disorders; physical traumatization; sexual traumatization; post traumatic stress disorders; borderline personality disorder; dissociative personality; diagnostic classification Abstract: Pervasive personality disorders have been shown to be long-term sequelae of cumulative childhood physical and sexual traumatization. This finding is not reflected in DSM-IV and ICD-10 classifications where post-traumatic stress disorder is confined to intrusions, avoidance, numbing, and hyperarousal. However, there is growing evidence that trauma etiology should be taken into account in planning treatment for personality disorders. It is not yet clear whether childhood traumatization is more strongly associated with borderline personality disorder than with other personality disorders. The finding of a substantial overlap between borderline personality disorder and dissociative identity disorder gives rise to discussions concerning the relationship of these two pathologies. _____
Record: 12
Title: Retrospective assessment of malingering in insanity defense cases. Author(s): Resnick, Phillip J., Case Western U School of Medicine, Cleveland, OH, US
Harris, Michael R., Case Western U School of Medicine, Div of Forensic Psychiatry, Cleveland, OH, US Source: Retrospective assessment of mental states in litigation: Predicting the past. Simon, Robert I. (Ed); Shuman, Daniel W. (Ed); pp. 101-134. Washington, DC, US: American Psychiatric Publishing, Inc., 2002. xxiii, 471 pp. ISBN: 1-58562-001-7 (hardcover) Language: English Keywords: retrospective assessment; malingering of mental disorders; insanity defense cases Abstract: (from the chapter) Discusses the use of retrospective assessment in the detection of various types of mental disorders malingered by defendants pleading not guilty by reason of insanity. Topics addressed include: legal definitions of insanity; specialized interview techniques to ascertain truth; clinical methods for detecting malingering; malingered hallucinations; malingered delusions; malingered psychosis; malingered insanity; malingered amnesia; malingered posttraumatic stress disorder; malingered dissociative identity disorder; other malingered disorders. _____
Record: 13
Title: Assessing the validity of dissociative identity disorder: Examining its interface with other trauma-related disorders of adulthood. Author(s): Aracri, Katherine Baur, U Hartford, US Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 62(1-B), Jul 2001. pp. 534. Publisher: US: Univ Microfilms International
Publisher URL: http://www.il.proquest.com/umi/ ISSN: 0419-4217 (Print) Order Number: AAI3001705 Language: English Keywords: dissociative identity disorder; borderline personality disorder; PTSD; comorbity; trauma Abstract: Dissociative Identity Disorder (DID), Borderline Personality Disorder (BPD), and Posttraumatic Stress Disorder (PTSD) are perceived to be similar disorders by practicing clinicians despite the fact that they are classified as separate and distinct in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). A comprehensive review of the current clinical, theoretical, and empirical literature was conducted to explore the complex relations among DID, BPD, and PTSD and the validity of DID as it relates to the extensive comorbidity among these disorders. Evidence garnered through the literature review supports the hypothesis that the three disorders are related. DID, BPD, and PTSD appear to share an etiology in trauma, and to represent different adaptions to trauma exposure. It is suggested that PTSD, BPD, and DID compose a syndrome of Trauma Spectrum Disorders. Evidence was also found suggesting that DID can be differentiated from BPD and PTSD, despite the shared etiology and symptomatology of the disorders. The diagnostic criteria for and classification of these disorders in the DSM is in need of modification to more closely align with the empirical evidence and clinical observation. _____
Record: 14
Title: The wreathing protocol: The imbrication of hypnosis and EMDR in the treatment of dissociative identity disorder and other dissociative responses. Author(s): Fine, Catherine G.
Berkowitz, Ami S. Source: American Journal of Clinical Hypnosis, Vol 43(3-4), Jan-Apr 2001. pp. 275-290. Publisher: US: American Society of Clinical Hypnosis
Publisher URL: http://www.asch.net/ajch.htm ISSN: 0002-9157 (Print) Language: English Keywords: Wreathing Protocol for use of Eye Movement Desensitization Therapy & hypnosis, patients with dissociative identity disorder or chronic PTSD Abstract: Proposes a protocol, called Wreathing Protocol, for the imbricated use of Eye Movement Desensitization and Reprocessing (EMDR) and hypnosis in the treatment of dissociative identity disorder (DID), Dissociative Disorder Not Otherwise Specified and chronic posttraumatic stress disorder (PTSD). The author maintains that this protocol is useful to advanced clinicians skilled in both modalities independently. The sequential steps of the Wreathing Protocol will be described and illustrated by a clinical vignette on DID. The clinical implications of the use of the Wreathing Protocol will be discussed in DID as well as the chronic post traumatic spectrum. _____
Record: 15
Title: HMPAO SPECT study of regional cerebral blood flow in dissociative identity disorder. Author(s): Sar, Vedat, Istanbul U, Instanbul Medical Faculty, Dept of Psychiatry, Clinical Psychotherapy Unit & Dissociative Disorders Program, US, vsar@instanbul.edu.tr
Unal, Seher N.
Kiziltan, Emre
Kundakci, Turgut
Ozturk, Erdinc Address: Sar, Vedat, Instanbul Tip Fakültesi Psikiyatri Klinigi, 34390, Capa, Instanbul, Turkey, vsar@instanbul.edu.tr Source: Journal of Trauma & Dissociation, Vol 2(2), 2001. pp. 5-25.
Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229 Publisher: US: Haworth Press
Publisher URL: http://www.haworthpress.com ISSN: 1529-9732 (Print) Language: English Keywords: regional cerebral blood flow; dissociative identity disorder; comorbid psychiatric conditions Abstract: Investigated characteristics of regional cerebral blood flow (rCBF) in dissociative identity disorder (DID). Ss were 15 patients with DID and 8 healthy volunteers. The clinical diagnosis of DID was confirmed using the Structured Clinical Interview (SCI) for Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) Dissociative Disorders. The SCI for Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) was also administered to all Ss in order to screen comorbid psychiatric conditions. To study rCBF, a SPECT system was used with Tc99m-hexamethyl-propylenamine (HMPAO) as a tracer. The rCBF ratio was decreased in orbito-frontal region bilaterally and increased in left (dominant hemisphere) lateral temporal region among Ss with DID when compared to control Ss. The SCI diagnoses of concurrent or lifetime major depression, posttraumatic stress disorder (PTSD), psychotic disorder, or ongoing drug treatment were not significantly related to perfusion in these regions. There was no statistically meaningful difference in rCBF ratios between host and alter personality states. Findings suggest that orbito-frontal and left (dominant hemisphere) lateral temporal regions are affected in DID. It is argued that a replication of this study on a larger group of drug-free dissociative patients and various psychiatric control groups would lead to more definitive findings. Conference: Annual Conference of the International Society for Traumatic Stress Studies, 14th, Nov, 1998, Washington, DC, US Conference Notes: A portion of this paper was presented at the aforementioned conference. _____
Record: 16
Title: Factitious and malingered dissociative identity disorder: Clinical features observed in 18 cases. Author(s): Thomas, Ann, U Western Ontario, London, ON, Canada, athomas2@julian.uwo.ca Address: Thomas, Ann, 99 Edward Street, St. Thomas, ON, Canada, N5P 1Y8, athomas2@julian.uwo.ca Source: Journal of Trauma & Dissociation, Vol 2(4), 2001. pp. 59-77.
Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229 Publisher: US: Haworth Press
Publisher URL: http://www.haworthpress.com ISSN: 1529-9732 (Print) Language: English Keywords: factitious dissociative identity disorder; malingered dissociative identity disorder; dissociative identity disorder; clinical features; diagnosis Abstract: Compared the clinical features of 18 Ss given a diagnosis of factitious or malingered dissociative identity disorder with those of 18 matched Ss who were given a diagnosis of genuine dissociative identity disorder, taken from a sample of 129 2nd opinion consultations. Clinical features suggesting a factitious diagnosis or malingering included having a score above 60 on the Dissociative Experiences Scale (DES), reporting dissociative symptoms inconsistent with the reporting on the DES, being able to tell a chronological life story and to sequence temporal events, using the 1st person over a range of affect, being able to express strong negative affect, bringing "proof" of a dissociative diagnosis to the consultation, having told persons other than close confidants about the alleged abuse or alleged dissociative diagnosis, reporting alleged abuse that was inconsistent with the medical or psychiatric history or volunteering allegations of cult or ritualized abuse, telling of alleged abuse without accompanying shame, guilt, or suffering, having been involved in community self-help groups, not having symptoms of co-morbid posttraumatic stress disorder (PTSD), and having obvious secondary gain in having a dissociative diagnosis. Conference: International Fall Conference of the International Society for the Study of Dissociation, 16th, Nov, 1999, Miami, FL, US Conference Notes: This article was presented at the aforementioned conference. _____
Record: 17
Title: Casebook in abnormal psychology (2nd ed.). Author(s): Brown, Timothy A., Boston U, Ctr for Anxiety & Related Disorders, Boston, MA, US
Barlow, David H. Source: Belmont, CA, US: Wadsworth/Thomson Learning, 2001. xvi, 334 pp.
ISBN: 0-534-36316-4 (paperback) Language: English Keywords: case histories; treatment outcomes; DSM IV disorders; effective interventions Abstract: (from the preface) This book presents cases based on actual clinical histories and treatment outcomes, although patient names and identifying characteristics have been changed to ensure confidentiality. The wide range of Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) disorders discussed in the book is presented using an integrative approach that emphasizes how multidimensional influences that are interrelated and interacting combine into unified models of the causes and maintenance of the disorder and its treatment. The treatments presented in this book represent the most effective interventions developed to date for each particular disorder, as documented by the scientific literature. _____
Record: 18
Title: Trait dissociation among Vietnam veterans with combat-related posttraumatic stress disorder. Author(s): Schapiro, Jack Andrew, Pepperdine U., US Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 60(8-B), Mar 2000. pp. 4251. Publisher: US: Univ Microfilms International
Publisher URL: http://www.il.proquest.com/umi/ ISSN: 0419-4217 (Print) Order Number: AAI9942219 Language: English Keywords: childhood sexual/physical abuse & trait dissociation, Vietnam veterans with combat-related PTSD Abstract: Self-report data from forty-two Vietnam veterans with combat-related PTSD were examined to explore relationships among important premilitary variables, war-zone variables, and long-standing dissociative symptomatology. The particular focus of the study was on associations between childhood sexual/physical abuse, combat exposure, participation in war-zone atrocities, and trait dissociation. Results indicated significant relationships between combat exposure and trait dissociation, as well as between participation in war-zone atrocities and trait dissociation. The relationship between exposure to childhood physical/sexual abuse and trait dissociation was not significant. Implications for future studies are explored; in particular, the need for larger-scale studies in which the differential effects of participation in war-zone atrocities can be better assessed. _____
Record: 19
Title: "The Rorschach test in clinical diagnosis": A critical review, with a backward look at Garfield (1947). Author(s): Wood, James M., U Texas, Dept of Psychology, El Paso, TX, US
Lilienfeld, Scott O.
Garb, Howard N.
Nezworski, M. Teresa Source: Journal of Clinical Psychology, Vol 56(3), Mar 2000. pp. 395-430.
Journal URL: http://www.interscience.wiley.com/jpages/0021-9762/ Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/ ISSN: 0021-9762 (Print)
1097-4679 (Electronic) Digital Object Identifier: 10.1002/(SICI)1097-4679(200003)56:3<395::AID-JCLP15>3.3.CO;2-F Language: English Keywords: use of Rorschach test in clinical diagnoses, consecutive psychiatric cases with either schizophrenia or psychoneurosis, commentary Abstract: The present article comments on the reprinted study by S. L. Garfield regarding the use of the Rorschach test in clinical diagnoses. The article then reviews research on the Rorschach and psychiatric diagnoses. Despite a few positive findings, the Rorschach has demonstrated little validity as a diagnostic tool. Deviant verbalizations and bad form on the Rorschach, and indices based on these variables, are related to Schizophrenia and perhaps to Bipolar Disorder and Schizotypal Personality Disorder. Patients with Borderline Personality Disorder also seem to give an above-average number of deviant verbalizations. Otherwise the Rorschach has not shown a well-demonstrated relationship to these disorders or to Major Depressive Disorder, Posttraumatic Stress Disorder (PTSD), anxiety disorders other than PTSD, Dissociative Identity Disorder, Dependent, Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or psychopathy. _____
Record: 20
Title: Israeli mental health professionals' attitudes towards dissociative disorders, reported incidence and alternative diagnoses considered. Author(s): Somer, Eli, U Hafia, School of Social Work, Hafia, Israel Source: Journal of Trauma & Dissociation, Vol 1(1), 2000. pp. 21-44.
Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229 Publisher: US: Haworth Press
Publisher URL: http://www.haworthpress.com ISSN: 1529-9732 (Print) Language: English Keywords: mental health professionals; attitudes; dissociative disorders; alternative diagnoses; incidence Abstract: Clinical diagnoses of dissociative disorders (DDs), including Dissociative Identity Disorder (DID), are controversial because there are mental health professionals in North America and elsewhere who are skeptical about whether these psychiatric disorders actually exist. This paper explores the attitudes of mental health professionals in Israel toward DDs and DID through a survey of 211 practicing clinicians. Of the sample, 95.5% scored at or above the point on a 5-point Likert scale measuring belief in the validity of DDs; 84.5% declared at least a moderate belief in the validity of DID. The average Israeli clinician surveyed had made 4.8 career-long DD diagnoses and carried and average of 1.05 DD patients in his/her caseload. The 5 most frequently considered alternative diagnoses to DID in Israel were Borderline Personality Disorder, Psychotic Disorder/Schizophrenia, posttraumatic stress disorder (PTSD)/Anxiety Disorder, Malingering, and Depressive Disorder. The findings suggest that attitudes of Israeli clinicians are similar to those of North American clinicians despite the geographical and cultural differences between them. _____
Record: 21
Title: Group psychotherapy for psychological trauma. Author(s): Klein, Robert H., (Ed), Yale U, School of Medicine, New Haven, CT, US
Schermer, Victor L., (Ed) Source: New York, NY, US: Guilford Press, 2000. xx, 364 pp. ISBN: 1-57230-557-6 (hardcover) Language: English Keywords: group psychotherapy, individuals experiencing psychological & physical trauma Abstract: (from the jacket) This volume is designed to help practitioners create, initiate, and maintain therapy groups for traumatized individuals. This book addresses general aspects of trauma group therapy as well as issues specific to working with different populations and clinical problems. Part I provides an in-depth review of the clinical concept of trauma and examines both the benefits and the possible liabilities of the group treatment modality. Demonstrating an incisive understanding of group processes, contributors present clear guidelines for screening and selecting members, understanding the impact of trauma on group dynamics, managing the effects of flashbacks, addressing dissociative states, working with countertransference reactions, and dealing with clients' emotional crises. Issues specific to different populations are elaborated in Part II. Presented are clinical strategies and techniques for working with such populations as survivors of sexual and physical abuse, clients with severe medical illnesses, bereaved children, survivors of catastrophic events in the community, victims of torture and ethnic persecution, and those with diagnosed mental disorders in which trauma plays a significant role. _____
Record: 22
Title: Hypnosis, dissociation, and absorption: Theories, assessment, and treatment. Author(s): Sapp, Marty, U Wisconsin, Dept of Educational Psychology, Counseling Area, Milwaukee, WI, US Source: Springfield, IL, US: Charles C. Thomas Publisher, Ltd, 2000. xv, 166 pp. ISBN: 0-398-07054-7 (hardcover)
0-398-07055-5 (paperback) Language: English Keywords: psychological theories and applications on the use of hypnosis, clients with dissociation & absorption & fantasy proneness & imaginative capabilities Abstract: (from the preface) This book presents the psychological theories and applications of how to use hypnosis with clients who display dissociation, absorption, fantasy proneness, and imaginative capabilities. It discusses hypnosis, dissociation, and absorption from a theoretical, assessment, and clinical perspective. Moreover, this text discusses the clinical implications of applying hypnosis to several overlapping psychological disorders such as dissociative identity disorder, borderline personality disorder, somatoform disorder, and posttraumatic stress disorder. The uses of hypnosis for pain control, anxiety and stress, ego-strengthening, unipolar depression, smoking cessation, weight loss, and rehabilitation are described. The text provides treatment transcripts including, but not limited to, the following theoretical approaches: cognitive-behavioral, psychodynamic, and Ericksonian. The text brings together assessment, research, dissociative disorders, and hypnotic treatment in one place. Even though the treatment of dissociative disorders is a widely published area, this book adds to the literature by providing a step-by-step approach to the clinical interview and preparation of the client for hypnosis. _____
Record: 23
Title: Functional magnetic resonance imaging of personality switches in a woman with dissociative identity disorder. Author(s): Tsai, Guochuan E., McLean Hosp, Mailman Research Ctr, Lab of Molecular & Psychiatric Neuroscience, Belmont, MA, US
Condie, Donald
Wu, Ming-Ting
Chang, I-Wen Source: Harvard Review of Psychiatry, Vol 7(2), Jul-Aug 1999. pp. 119-122.
Journal URL: http://hrp.oupjournals.org/ Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/ ISSN: 1067-3229 (Print)
1465-7309 (Electronic) Digital Object Identifier: 10.1093/hrp/7.2.119 Language: English Keywords: neuronal substrate involved in personality switches, 47 yr old female with dissociative identity & PTSD Abstract: Investigated the neuronal substrate involved in the personality switches of dissociative identity disorder (DID) by conducting an functional magnetic resonance imaging (MRI) of a 47-yr-old with DID while she was switching personalities. It was found that bilateral reduction of hippocampal volume in this S with comorbid posttraumatic stress disorder (PTSD) and DID, consistent with the reported reduction of hippocampal volume in patients with PTSD secondary to childhood trauma. In addition functional MRI during volitionally induced personality switch showed changes in hippocampal and medial temporal activity correlated with the switch, suggesting that personality switch may result from changes in hippocampal and temporal function. _____
Record: 24
Title: A comparison of dissociative experiences in adult female outpatients with and without histories of early incestuous abuse: A replication and expansion. (women outpatients). Author(s): Mcknight, Noble Lee, Auburn U., US Source: Dissertation Abstracts International Section A: Humanities & Social Sciences, Vol 59(11-A), May 1999. pp. 4069. Publisher: US: Univ Microfilms International
Publisher URL: http://www.il.proquest.com/umi/ ISSN: 0419-4209 (Print) Order Number: AEH9912937 Language: English Keywords: reliability & validity of Dissociative Experiences Scale, adult female mental disorder outpatients with vs without histories of early incestuous abuse Abstract: Histories of early incestuous abuse and other sexual and physical abuse are frequently disclosed by patients diagnosed as having Dissociative Identity Disorder (formerly MPD) and other dissociative disorders. It has been suggested that early incestuous abuse is a critical factor in the development of high levels of dissociative symptoms. The present study examines the reliability and validity of the Dissociative Experiences Scale for use with an outpatient population and compares the extent of dissociative experiences in adult female outpatients with and without histories of early incestuous abuse. The Dissociative Experiences Scale (DES) and a Background Information Questionnaire (BIQ) were administered to a sample of 61 adult female outpatients from five diagnostic categories: Affective Disorder, Panic Disorder, Dependent Personality Disorder, Borderline Personality Disorder (BPD), and Posttraumatic Stress Disorder (PTSD). Cronbach's alpha within each diagnostic category indicated good internal consistency for the DES with this sample. The Kruskal Wallis analysis demonstrated support for criterion related validity of the DES by indicating a significant difference among diagnostic categories. Ryan's procedure demonstrated a distinction between all pairs of diagnostic categories except Borderline Personality Disorder and Panic Disorder. Forty and nine-tenths percent (N = 25) of the participants reported incestuous abuse before the age of 16. The DES scores for participants with histories of early incestuous abuse were significantly higher than those who reported no early incestuous abuse history. Matching was employed to reduce the contribution of chance differences due to diagnostic category and age to the estimation of the effect of a history of incestuous abuse. When matched on diagnostic category and age, DES scores remained significantly higher in the participants with histories of early incestuous abuse than in those without such histories. _____
Record: 25
Title: Protecting the integrity of the legal system: The admissibility of testimony from mental health experts under Daubert/Kumho analyses. Author(s): Grove, William M., U Minnesota, Dept of Psychology, Minneapolis, MN, US
Barden, R. Christopher Source: Psychology, Public Policy, & Law, Vol 5(1), Mar 1999. Special issue: Daubert's meanings for the admissability of behavioral and social science evidence. pp. 224-242.
Journal URL: http://www.apa.org/journals/law.html Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org ISSN: 1076-8971 (Print) Digital Object Identifier: 10.1037//1076-8971.5.1.224 Language: English Keywords: admissibility of social science & mental health expert testimony based on "Daubert/Kumho" decisions & psychological assessment of mental disorders using Rorschach test Abstract: The authors discussed to what degree testimony from social science and mental health experts (psychologists, psychiatrists, social workers, therapists, others) meets admissibility requirements expressed by the U.S. Supreme Court in Daubert (1993), Joiner ( General Electric Co. v. Joiner , 1997) and the recent Kumho (1999) decision. They reviewed data on Daubert/Kumho indicia of reliability using 2 exemplar areas of mental health testimony: psychodiagnostic assessment by means of the Rorschach and other "projective" assessment techniques and the diagnoses of posttraumatic stress disorder and multiple personality disorder (dissociative identity disorder). They concluded that some testimony offered by mental health professionals relating to these concepts should not survive scrutiny under the framework of Daubert , Joiner , and Kumho . _____
Record: 26
Title: Pierre Janet and modern views of dissociation. Series Title: Essential papers in psychoanalysis Author(s): Putnam, Frank W. Source: Essential papers on posttraumatic stress disorder. Horowitz, Mardi J. (Ed); pp. 116-135. New York, NY, US: New York University Press, 1999. vii, 548 pp. Publisher URL: http://www.nyupress.nyu.edu ISBN: 0-8147-3558-4 (hardcover)
0-8147-3559-2 (paperback) Language: English Keywords: P. Janet's contributions to understanding & treatment of & role of trauma in dissociation & dissociative disorders Abstract: (from the chapter) Reviews P. Janet's contributions to our understanding of dissociative phenomena and the psychological effects of trauma. Janet explored dissociative symptoms extensively and first articulated most of the basic clinical principles. He made the connection between dissociative psychopathology and traumatic experiences and pioneered hypnotic and abreactive treatment techniques to recover and rework what he termed the "traumatic memory of an unassimilated event." This chapter reviews the principles of dissociation, including pathological dissociation, the linkage to trauma, and dissociation as an adaptive response to acute trauma; the dissociative disorders; and the treatment of dissociative disorders. _____
Record: 27
Title: Neurotherapy in the treatment of dissociation. Author(s): Brownback, Thomas, Brown, Mason & Assoc, Group Psychological Practice, Allentown, PA, US
Mason, Linda Source: Introduction to quantitative EEG and neurofeedback. Evans, James R. (Ed); Abarbanel, Andrew (Ed); pp. 145-156. San Diego, CA, US: Academic Press, Inc, 1999. xxi, 406 pp. ISBN: 0-12-243790-X (hardcover) Language: English Keywords: integration of psychodynamic psychotherapy & cognitive-behavioral therapy & neurotherapy, patients with dissociative identity disorder Abstract: (from the chapter) States that because of its psychobiological components, dissociation may be seen as a psychological defense mechanism for which neurotherapy holds promise as an adjunctive treatment. Because of the central role dissociation plays in the creation and persistence of dissociative identity disorder (DID), the latter may be considered a litmus test for the value of neurotherapy in the treatment of dissociation. The neurotherapy protocol used by E. G. Peniston and P. J. Kukolsky (1991) in their treatment of posttraumatic stress disorder (PTSD) and its dissociative features is discussed in reference to their protocol using temperature training biofeedback followed by neurotherapy sessions. The work of C. Manchester et al (1994) using neurotherapy in the treatment of patients with DID is described. The Brownback-Mason protocol for fully incorporating psychodynamic psychotherapy, cognitive-behavioral therapy, group therapy, and neurotherapy is described for the treatment of DID. _____
Record: 28
Title: Dissociative identity disorder and substance abuse: The forgotten relationship. Author(s): McDowell, David M., New York State Psychiatric Inst, New York, NY, US
Levin, Frances R.
Nunes, Edward V. Source: Journal of Psychoactive Drugs, Vol 31(1), Jan-Mar 1999. Special issue: Treatment of alcohol and other drug users with severe mental illness. pp. 71-83. Publisher: US: Haight-Ashbury Publications
Publisher URL: http://www.hafci.org ISSN: 0279-1072 (Print) Language: English Keywords: features & epidemiology & phenomenology & treatment & relation to PTSD, 32-52 yr old substance abuse patients with dissociative identity disorder Abstract: Presents 6 cases (4 females, 2 gay males; aged 32-52 yrs) illustrative of features of substance abuse patients with dissociative identity disorder (DID). The epidemiology, phenomenology, presentation, and treatment of DID, and its relation to posttraumatic stress disorder (PTSD), are discussed. It is asserted that little systematic investigation exists on the treatment of DID in general, and substance abuse in DID in particular. The authors draw upon the existing literature and their experience to discuss treatment strategies aimed at treating patients wit both diagnoses. It is contended that by ignoring either diagnosis, it is likely to be detrimental to patients and that both disorders and their coexistence need to be addressed. _____
Record: 29
Title: Somatoform dissociative phenomena: A Janetian perspective. Author(s): Nijenhuis, Ellert R. S., General Psychiatric Hosp, Outpatient Dept, Assen, Netherlands
van der Hart, Onno Source: Splintered reflections: Images of the body in trauma. Goodwin, Jean (Ed); Attias, Reina (Ed); pp. 89-127. New York, NY, US: Basic Books, Inc, 1999. xvi, 315 pp. ISBN: 0-465-09544-5 (hardcover) Language: English Keywords: connection between trauma & psychological & somatoform dissociative phenomena postulated by P. Janet & its symptoms & development of Somatoform Dissociative Questionnaire Abstract: (from the chapter) Attempts to reaffirm the connection between actual trauma and psychological and somatoform dissociative phenomena postulated by P. Janet (1907). The authors also report on an application of these concepts to the development of a self-report instrument measuring somataform dissociation, the Somatoform Dissociation Questionnaire, and a dissociative disorders screening version derived from it. Other issues of focus include mental stigmata and mental accidents, negative dissociative symptoms, and positive dissociative symptoms. _____
Record: 30
Title: Case studies in abnormal psychology (5th ed.). Author(s): Oltmanns, Thomas F., U Virginia, Charlottesville, VA, US
Neale, John M.
Davison, Gerald C. Source: New York, NY, US: John Wiley & Sons, Inc, 1999. xi, 399 pp. ISBN: 0-471-25216-6 (paperback) Language: English Keywords: clinical case studies in abnormal psychology Abstract: (from the cover) This book takes mental disorders from the realm of theory into the complex reality of human lives. In all, 22 in-depth cases are presented that focus on symptoms, the client's history, treatment, and the outcome. These cases illustrate a variety of problems, including mood disorders, anxiety disorders, schizophrenia, personality disorders, and various disorders of childhood and aging. Many cases include excerpts of dialog from therapy interviews, and each case is compared with Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnostic criteria for relevant disorders. Both treatment failures and successes are presented. All cases end with a discussion of etiology and treatment that illustrates the application of research to individual client's problems, and alerts readers to important gaps in our knowledge of abnormal psychology. These cases also allow students to see how theories in the field can be applied to real-life problems. _____
Record: 31
Title: Cost-effectiveness of psychotherapy: A guide for practitioners, researchers, and policymakers. Author(s): Miller, Nancy E., (Ed), National Insts of Health, Office of Director, Bethesda, MD, US
Magruder, Kathryn M., (Ed) Source: London,: Oxford University Press, 1999. xxx, 354 pp. ISBN: 0-19-511458-2 (hardcover) Language: English Keywords: efficacy & effectiveness & cost-effectiveness & analysis of psychotherapy Abstract: (from the jacket) Psychotherapy is now a widespread mode of mental health rehabilitation, but little is known about how psychotherapy is used, its cost, or its outcome. In response to skyrocketing costs and private sector forces, this handbook provides clinical psychologists, psychiatrists, social workers, health care policy-makers, and economists an extensive guide to this rapidly developing area of inquiry. Cost-Effectiveness of Psychotherapy helps readers better understand psychotherapy utilization, practice, costs, and outcomes in "real world" settings. What makes this handbook useful is its detailed discussion of major costs in mental health treatment on a disorder-by-disorder basis.
More precisely, this volume consolidates and analyzes what is known about the efficacy, effectiveness, and cost-effectiveness of psychosocial interventions tailored for specific disorders; it outlines new paths for cost-effective psychotherapy; and it provides a timely introduction to grasping and instituting the approaches economists commonly use to assess treatment cost-effectiveness.
Not only mental health professionals, but also professionals in health policy, business, and economics will find this book of value. _____
Record: 32
Title: Splintered reflections: Images of the body in trauma. Author(s): Goodwin, Jean, (Ed), U Texas, Medical Branch, Dept of Psychiatry & Behavioral Sciences, Galveston, TX, US
Attias, Reina, (Ed) Source: New York, NY, US: Basic Books, Inc, 1999. xvi, 315 pp. ISBN: 0-465-09544-5 (hardcover) Language: English Keywords: symptoms resulting from bodily responses to & body image & psychotherapy following trauma Abstract: (from the introduction) Part I of this book reviews the body's acute responses to overwhelming trauma and the long-term bodily symptoms reported in traumatized individuals. Part II introduces the concept of body image and discusses its manifestations, the impacts produced on it by psychological trauma or bodily damage and the consequences of distorted body image in terms of symptoms and ego functioning. Part II further explores the concepts of body-ego functioning and effectiveness in light of attachment theory and gives clinical examples from psychotherapeutic encounters in which these are addressed. Part IV continues this theme into the rehabilitation phase of psychotherapy, when symptoms are contained, the traumatic distortions of body image are understood and the task is to bring body and self into dialogue so that problems of living can be solved in a more integrated way. _____
Record: 33
Title: The containing double as part of the Therapeutic Spiral Model for treating trauma survivors. Author(s): Hudgins, M. Katherine, Ctr for Experiential Learning, Charlottesville, VA, US
Drucker, Karen Source: International Journal of Action Methods: Psychodrama, Skill Training, and Role Playing, Vol 51(2), Sum 1998. Special issue: Treating trauma survivors. pp. 63-74.
Journal URL: http://www.heldref.org/html/ijam.html Publisher: US: Heldref Publications
Publisher URL: http://www.heldref.org ISSN: 1096-7680 (Print) Language: English Keywords: containing uncontrolled regression in Therapeutic Spiral Model for psychodramatic group psychotherapy, trauma survivors Abstract: In this article, the authors describe the "containing double," one intervention from a clinically driven model of psychodramatic therapy called the Therapeutic Spiral Model. That model is used to treat trauma survivors through an integration of classical psychodrama, self-psychology, and object-relations theory. Developed by the authors during 20 yrs of clinical psychodramatic practice with patients diagnosed with posttraumatic stress disorder (PTSD), borderline personality disorder, and dissociative identity disorders, the model has the potential for uncontrolled regression and retraumatization. The containing double was developed specifically to prevent uncontrolled regression when therapists use experiential methods with trauma survivors. The article includes clinical examples and suggestions for future research. _____
Record: 34
Title: Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS). Author(s): Bremner, J. Douglas, Yale Psychiatric Inst, New Haven, CT, US
Krystal, John H.
Putnam, Frank W.
Southwick, Steven M.
Marmar, Charles
Charney, Dennis S.
Mazure, Carolyn M. Source: Journal of Traumatic Stress, Vol 11(1), Jan 1998. pp. 125-136.
Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867 Publisher: Netherlands: Kluwer Academic Publishers
Publisher URL: http://www.wkap.nl ISSN: 0894-9867 (Print) Digital Object Identifier: 10.1023/A:1024465317902 Language: English Keywords: reliability & validity of Clinician Administered-Dissociative States Scale, adult patients with PTSD/dissociative disorder & schizophrenia & affective disorder Abstract: Tested the reliability and validity of the Clinician Administered-Dissociative States Scale (CADSS), a standardized measure of present-state dissociative symptomatology. 68 posttraumatic stress disorder (PTSD)/dissociative disorder (mean age 46.6 yrs), 22 schizophrenia (mean age 45.1 yrs), and 15 affective disorder (mean age 48.5 yrs) patients of West Haven VA Medical Center, Connecticut, and 8 healthy (mean age 30.6 yrs) and 11 combat (mean age 48.8 yrs) controls were given the CADSS, Dissociative Experiences Scale, and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) for Dissociative Disorders. Ss were either White, Black, or Hispanic. Statistical analyses showed the reliability and validity of CADSS. CADSS had a high level of agreement between different raters, high degree of internal consistency, and high level of sensitivity to discriminate Ss with PTSD and comorbid dissociative disorders from Ss with schizophrenia and affective disorders, as well as from normal Ss. _____
Record: 35
Title: "Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm": Comment. Author(s): French, Oliver Source: American Journal of Psychiatry, Vol 154(11), Nov 1997. pp. 1628-1629.
Journal URL: http://ajp.psychiatryonline.org/ Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org ISSN: 0002-953X (Print) Language: English Keywords: consistency of memory for combat-related traumatic events, National Guard veterans of Operation Desert Storm, prospective study, commentary, letter Abstract: Provides additional support for the finding of S. M. Southwick et al (1997) that posttraumatic stress disorder (PTSD) is not directly related to the memory of traumatic events. It is postulated that PTSD and dissociative disorders arise in response to confusion, shame, isolation, and possibly survivor guilt, rather than trauma, pain, and abuse. It is also posited that memory of a traumatic incident is immaterial to the development of PTSD or dissociative identity disorders, since these disorders are the result of feelings not memories. _____
Record: 36
Title: Assessing posttraumatic dissociation with the Structured Clinical Interview for DSM-IV Dissociative Disorders. Author(s): Steinberg, Marlene, Yale U, School of Medicine, Dept of Psychiatry, New Haven, CT, US Source: Assessing psychological trauma and PTSD. Wilson, John Preston (Ed); Keane, Terence Martin (Ed); pp. 429-447. New York, NY, US: Guilford Press, 1997. xiv, 577 pp. ISBN: 1-57230-162-7 (hardcover) Language: English Keywords: Structured Clinical Interview for DSM-IV Dissociative Disorders, assessment of posttraumatic dissociative symptoms & syndromes
Abstract: Examines the assessment of posttraumatic dissociative symptoms and syndromes using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D).
(from the chapter) posttraumatic stress disorder (PTSD) and dissociation / populations at risk for dissociative symptoms and disorders [persons with known histories of trauma; persons with covert histories of trauma; persons with histories of amnesia of their past, including traumatic events; vicariously traumatized persons] / organizing and assessing dissociation: 5 measurable components [the SCID-D, assessing the 5 core dissociative symptoms, assessing amnesia with the SCID-D, assessing depersonalization with the SCID-D, assessing derealization with the SCID-D, assessing identity confusion with the SCID-D, assessing identity alteration with the SCID-D, assessing intrainterview dissociative cues, severity ratings, diagnostic assessment] / directions for future research in the dissociative disorders and PTSD using the SCID-D _____
Record: 37
Title: History of dissociation in Western psychology. Author(s): Wright, Peggy A., Lesley Coll, Graduate School of Arts & Sciences, Cambridge, MA, US Source: Broken images, broken selves: Dissociative narratives in clinical practice. Krippner, Stanley (Ed); Powers, Susan Marie (Ed); pp. 41-60. Philadelphia, PA, US: Brunner/Mazel, Inc, 1997. xi, 372 pp. Publisher URL: http://www.taylorandfrancis.com/ ISBN: 0-87630-851-5 (hardcover) Language: English Keywords: history of concepts & theories of Western dissociative disorders Abstract: (from the chapter) Provides a sense of how the concepts and theories of Western dissociative disorders have progressed, particularly through the last century. A historical review of the manifestations of dissociation in Western culture is presented, beginning with possession syndromes; continuing with magnetism, double consciousness, and hysteria; and culminating with contemporary hypnotic phenomena, dissociative identity disorder, and posttraumatic stress disorder (PTSD). Current issues in various theories of dissociation are discussed. _____
Record: 38
Title: Trauma and memory: Clinical and legal controversies. Author(s): Appelbaum, Paul S., (Ed), U Massachusetts, Medical Ctr, Dept of Psychiatry, Worcester, MA, US
Uyehara, Lisa A., (Ed)
Elin, Mark R., (Ed) Source: London,: Oxford University Press, 1997. xv, 552 pp. ISBN: 0-19-510065-4 (hardcover) Language: English Keywords: clinical & legal issues in trauma & recovered memory of childhood sexual abuse, child & adult victims Abstract: (from the jacket) The authenticity of memories of childhood sexual abuse has become one of the major social controversies of the 1990s.
This volume provides a comprehensive picture of the psychological, physiological, and legal aspects of trauma. Beginning by defining the opposing positions in the debate, the contributors offer a variety of perspectives on the nature of memory, including reviews of recent developments in this fast-growing area of research. Next, consideration is given to the impact of trauma on memory, both in adults and in children. The authors then examine a variety of treatment approaches available to victims of trauma, who are trying to cope with the painful consequences of those events.
The book is intended for clinicians treating patients with traumatic memories. It is also intended for psychologists, physicians, social workers, and lawyers who need a reference on trauma and sexual abuse during childhood. _____
Record: 39
Title: Lifetime Axis I and II comorbidity and childhood trauma history in dissociative identity disorder. Author(s): Ellason, Joan W., Charter Health System of Dallas, Plano, TX, US
Ross, Colin A.
Fuchs, Dayna L. Source: Psychiatry: Interpersonal & Biological Processes, Vol 59(3), Aug 1996. pp. 255-266.
Journal URL: http://www.guilford.com/cartscript.cgi?page=periodicals/jnps.htm&cart_id =547216.21319 Publisher: US: Guilford Publications
Publisher URL: http://www.guilford.com ISSN: 0033-2747 (Print) Language: English Keywords: childhood physical & sexual abuse, DSM Axis I and II comorbidity, inpatients with dissociative identity disorder Abstract: Examined the overall pattern of DSM Axis I and Axis II comorbidity in 135 inpatients with dissociative identity disorder to provide more information on the effects of childhood physical and sexual abuse on mental state and character development. Measures included the Dissociative Experiences Scale, the Dissociative Disorders Interview Schedule, the Structured Clinical Interview for DSM-III--R, The Beck Depression Inventory, the Hamilton Rating Scale for Depression, and the SCL-90 (Revised). 117 Ss (90%) reported a history of physical abuse, 120 Ss (92.3%) reported a history of sexual abuse, and 125 Ss (96.2%) reported childhood physical and/or sexual abuse. Findings on Axis I comorbidity with 107 Ss show 88 Ss (82.2%) received a diagnosis of a severe mental disorder. Major depressive episode was found in 104 (97.2%) Ss, but only 12 (11.2%) Ss met the Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for this diagnosis when exclusion rules for psychosis were applied. 57 (79.2%) Ss were diagnosed with posttraumatic stress disorder (PTSD). Findings on Axis II comorbidity with 103 Ss show 30 Ss (29.1%) endorsed 2 cluster areas with Cluster BC as the most common pattern. Over one third of Ss endorsed all 3 cluster areas. The most common Axis II diagnoses were borderline, avoidant, and self-defeating personality disorders. _____
Record: 40
Title: Impact of child abuse on adult psychopathology: A case report. Author(s): Lubin, Hadar, Post Traumatic Stress Ctr, New Haven, CT, US
Johnson, David Read
Southwick, Steven M. Source: Dissociation: Progress in the Dissociative Disorders, Vol 9(2), Jun 1996. pp. 134-139. Publisher: US: Ridgeview Inst ISSN: 0896-2863 (Print) Language: English Keywords: child abuse & comorbid psychopathology, 34 yr old female with PTSD & borderline personality disorder & multiple personality disorder, case report Abstract: Present the case of a multiply traumatized 34 yr old woman who satisfies the criteria for posttraumatic stress disorder (PTSD), borderline personality disorder, and multiple personality disorder. The authors provide support for the hypothesis that these 3 diagnoses may be viewed as separate phenotypic expressions of a common origin: childhood trauma. A hierarchical model of primary, secondary, and tertiary adaptations to childhood abuse is proposed to order the clinical data. _____
Record: 41
Title: Hypnosis. Author(s): Spiegel, David, Stanford U, School of Medicine, Stanford, CA, US Source: American Psychiatric Press synopsis of psychiatry. Hales, Robert E. (Ed); Yudofsky, Stuart C. (Ed); pp. 1039-1062. Washington, DC, US: American Psychiatric Association, 1996. xxvi, 1449 pp. ISBN: 0-88048-889-1 (paperback) Language: English Abstract: Discusses the use of hypnosis in the treatment of psychiatric and somatic illnesses.
(from the chapter) clarification of myths / measuring hypnotizability [hypnotizability scales, prediction of treatment responsiveness] / hypnotizability and psychiatric disorders [hypnotizability in dissociative identity disorder, hypnotizability in schizophrenia and affective disorders] / hypnosis in treatment [dissociative disorders, posttraumatic stress disorder (PTSD)] / forensic uses / brief treatment: symptom restructuring with hypnosis / habit control [smoking cessation, weight control, anxiety disorders and phobias] / treatment outcome studies [insomnia, psychosomatic disorders, gastrointestinal system, pain syndromes]. _____
Record: 42
Title: Interviewing strategies for assessing dissociative disorders in children and adolescents. Author(s): Silberg, Joyanna L., Sheppard Pratt Health System, Towson, MD, US Source: Dissociative child: Diagnosis, treatment, and management (2nd ed.). Silberg, Joyanna L. (Ed); pp. 47-68. Baltimore, MD, US: The Sidran Press, 1996. xxvi, 368 pp. Publisher URL: http://www.sidran.org ISBN: 1-886968-06-3 (hardcover) Language: English Keywords: interviewing strategies for assessment & diagnosis of dissociative identity & other dissociative disorders, children & adolescents Abstract: (from the chapter) Highlights interviewing techniques that may be helpful to clinicians interviewing child and adolescent patients whose therapists suspected a possible dissociative disorder. These techniques include framing the interview as a unique and special time, educating the child about dissociative defenses, eliciting indirect communication, and inquiring about imaginative processes. These techniques may be used to elicit frank disclosures about feelings of dividedness, fluctuations, trance states, and other imaginal processes in patients that may suggest the pathological use of dissociative defenses. Methods for discrimination between dissociative patients' reports and those of other diagnostic groups (e.g., developmental or psychotic disorders or posttraumatic stress disorder) are presented. _____
Record: 43
Title: Supportive group psychotherapy for adolescents with dissociative disorders. Author(s): Brand, Bethany, Towson U, Baltimore, MD, US Source: Dissociative child: Diagnosis, treatment, and management (2nd ed.). Silberg, Joyanna L. (Ed); pp. 219-234. Baltimore, MD, US: The Sidran Press, 1996. xxvi, 368 pp. Publisher URL: http://www.sidran.org ISBN: 1-886968-06-3 (hardcover) Language: English Keywords: development & format & reactions to supportive group therapy as adjunct to individual therapy, 12-18 yr old inpatient & outpatient females with dissociative identity & other dissociative disorders Abstract: (from the chapter) Outlines a rationale for a group for inpatient and outpatient dissociative female adolescents (aged 12-18 yrs), its history and format, a summary of the common themes and difficulties encountered, and patients' reactions to the group. The group was intended to be supportive, educational, and structured in its format to avoid provoking disruptive symptoms such as flashbacks and uncontrolled switching to unmanageable alter personalities. It was viewed as an adjunct to individual psychotherapy with specific goals of increasing the girls' knowledge about their symptoms, enhancing self-esteem, and decreasing the girls' sense of isolation. Discussion topics included dissociation, dissociative identity disorder, trust, feelings, safety, interacting systems, group decision making and compromising, posttraumatic stress disorder (PTSD), and ways to respond to fear. Special problems, including group dynamics, family issues, and cohesion, are discussed. The group helped the girls feel better about themselves, their disorders, and other people. _____
Record: 44
Title: Hypnotherapeutic techniques to facilitate psychotherapy with PTSD and dissociative clients. Author(s): Peterson, Judith A., Phoenix Counseling, Consulting & Forensic Services, Houston, TX, US Source: Handbook of dissociation: Theoretical, empirical, and clinical perspectives. Michelson, Larry K. (Ed); Ray, William J. (Ed); pp. 449-474. New York, NY, US: Plenum Press, 1996. xviii, 645 pp. ISBN: 0-306-45150-6 (hardcover) Language: English Keywords: hypnotherapeutic techniques, patients with dissociative disorders & PTSD Abstract: (from the chapter) describe some of the more helpful hypnotherapeutic techniques to incorporate into psychotherapy as the clinician works with dissociative clients [and those with posttraumatic stress disorder (PTSD)] / the degree of dissociation, the therapeutic task at hand, and the comfort level between the therapist and the client will help determine the hypnotic techniques most useful throughout therapy / beyond describing techniques, examples of how to use these skills with particular clients will be illustrated / specific words for hypnotic treatment are included
diagnosis / understanding trance in the client's life / therapeutic tasks for each phase of treatment of trauma victims [ideomotor signals, safe place, affect modulation and toleration, containment techniques, age progression and age regression (hypnotic time distortion), hypnotic distancing techniques] / more advanced hypnotic techniques [advanced ideomotor signaling, fractionation, deepening of trance, mobilization of affect and cognition, age regression, penetrating or creating barriers in DIDs (dissociative identity disorders), contracting for safety] / complex hypnotic techniques [processing the memory in reverse, combining memories, working with "decision makers," dividing a memory through several therapy sessions, examples of hypnotic techniques found helpful in processing the existential crises and promoting cognitive restructuring, examples of other special hypnotic techniques found helpful with trauma survivors during the processing of a memory] _____
Record: 45
Title: The personal construction of traumatic stress. Author(s): Cromwell, Rue L., U Kansas, Dept of Psychology, Lawrence, KS, US
Sewell, Kenneth W., (Comp)
Langelle, Charyle Source: Personal construct theory: A psychology for the future. Walker, Beverly M. (Ed); Costigan, Jacqui (Ed); et al; pp. 173-197. Carlton South VIC, (Not Assigned), OH, Australia US: Australian Psychological Society Ltd Zipper Press, Inc, 1996. viii, 278 pp. ISBN: 0-909881-09-X (paperback) Language: English Keywords: application of personal construct theory to PTSD & dissociative identity disorder & memories of early childhood abuse, implications for understanding of traumatic stress Abstract: (from the chapter) The purpose of this chapter is to illustrate the application of personal construct theory (G. A. Kelly, 1955) to the understanding of traumatic stress, to present some empirical and clinical findings about those who show traumatic stress effects, and thereby to describe implications both for the personal construct study of stress and for the structure of assumptions in personal construct theory itself.
To provide background on current traditional constructs in psychopathology, posttraumatic stress disorder (PTSD), multiple personality disorder (MPD, now called dissociative identity disorder [DID]), and dissociation will be described. To complete this background, we describe current etiological formulations of the posttraumtic stress response, and then a current issue concerning recovered vs false memories of early childhood abuse.
Empirical studies and clinical observations are presented: (a) the Vietnam combat study, (b) the Killeen massacre study, (c) the study of those "not sure" of personal childhood abuse, and (d) observations of DID. From these studies, an argument is made that important effects of psychological trauma may be described in terms of prolonged failure of the individual to integrate the trauma construct or constructs into the total personal conceptual structure via overarching (superordinal) constructs. _____
Record: 46
Title: Anxiety disorders, dissociative disorders, and adjustment disorders. Author(s): Ballenger, James C., Medical U of South Carolina, Dept of Psychiatry & Behavioral Sciences, Inst of Psychiatry, Charleston, SC, US
Lydiard, R. Bruce
Turner, Samuel M.
Schneier, Franklin R.
et al. Source: Synopsis of treatments of psychiatric disorders (2nd ed.). Gabbard, Glen O. (Ed); Atkinson, Sarah D. (Ed); pp. 605-720. Washington, DC, US: American Psychiatric Association, 1996. xxxvi, 1107 pp. ISBN: 0-88048-859-X (paperback) Language: English Keywords: psychotherapy & pharmacotherapy & other treatment approaches, patients with anxiety &/or dissociative &/or adjustment disorders Abstract: (from the book) [book section covering several chapters]
"Panic Disorder and Agoraphobia" / James C. Ballenger, R. Bruce Lydiard and Samuel M. Turner / review the principal treatments for panic disorder and agoraphobia / most of the treatment recommendations apply to both uncomplicated panic disorder and panic disorder complicated by agoraphobic avoidance
"Social Phobia and Specific Phobias" / Franklin R. Schneier, Randall D. Marshall, Linda Street, Richard G. Heimberg and Harlan R. Juster / review the treatment of social phobia and specific phobias
"Obsessive-Compulsive Disorder" / John H. Greist and James W. Jefferson / [discusses psychotherapeutic and pharmacotherapeutic issues in treating patients with obsessive-compulsive disorder]
"Posttraumatic Stress Disorder" / Edna B. Foa, Jonathan Davidson and Barbara Olasov Rothbaum / [discusses pharmacotherapeutic and psychosocial interventions in treating patients with posttraumatic stress disorder (PTSD)]
"Acute Stress Disorder" / David Spiegel and Catherine Classen / [discusses] the [general principles and models of] treatment of acute stress disorder
"Generalized Anxiety Disorder" / Rudolf Hoehn-Saric, Thomas D. Borkovec and John C. Nemiah / [discusses the use of psychological therapy and pharmacotherapy for treating patients with generalized anxiety disorder]
"Dissociative Amnesia and Dissociative Fugue" / Richard J. Loewenstein / [discusses] assessment and treatment of dissociative amnesia and of dissociative fugue
"Dissociative Identity Disorder" / Richard P. Kluft / [discusses treatment of patients with dissociative identity disorder]
"Depersonalization" / Marlene Steinberg / [discusses psychotherapeutic and biological approaches to treatment of patients with depersonalization disorder]
"Adjustment Disorders" / James J. Strain / [discusses treatment of patients with adjustment disorders] _____
Record: 47
Title: Adventure programming with an individual who has multiple personality disorder: A case history. Author(s): Witman, J. P., Philhaven, PA, US
Preskenis, Karen Source: Therapeutic Recreation Journal, Vol 30(4), 1996. pp. 289-296. Publisher: US: NRPA Publications ISSN: 0040-5914 (Print) Language: English Keywords: adventure program experience, 37 yr old with multiple personality disorder & major depression & PTSD, case report Abstract: Describes a 37-yr-old male diagnosed with multiple personality disorder, major depression, and posttraumatic stress disorder (PTSD).The implementation of an adventure program experience presented. The S's goals for and response to treatment are detailed. In addition, the therapists' perspective on these outcomes and the experience of working with this individual are discussed. _____
Record: 48
Title: Dissociation and information processing in posttraumatic stress disorder. Author(s): van der Kolk, Bessel A., Human Resources Inst Hosp, Trauma Ctr, Brookline, MA, US
van der Hart, Onno
Marmar, Charles R. Source: Traumatic stress: The effects of overwhelming experience on mind, body, and society. van der Kolk, Bessel A. (Ed); McFarlane, Alexander C. (Ed); et al; pp. 303-327. New York, NY, US: Guilford Press, 1996. xxv, 596 pp. ISBN: 1-57230-088-4 (hardcover) Language: English Keywords: traumatic experience, information processing & dissociation, individuals with PTSD Abstract: (from the preface) examine how trauma affects an individual's ability to perceive and integrate the overwhelming experience / arousal and dissociative responses during the trauma lead to fragmentation of the experience / focuses on both the dissociative responses during traumatic experiences and on the continuing role of dissociation in subsequent adaptation, including the organization of experience in dissociated fragments of the self, such as occurs in dissociative identity disorder
(from the chapter) the cognitive organization of traumatic experience / information processing in posttraumatic stress disorder (PTSD) / the history of dissociation in psychiatry / contemporary views on trauma and dissociative processes / clinical and research issues / principles of treatment. _____
Record: 49
Title: Casebook of clinical hypnosis. Author(s): Lynn, Steven Jay, (Ed), State U New York, Binghamton, NY, US
Kirsch, Irving, (Ed)
Rhue, Judith W., (Ed) Source: Washington, DC, US: American Psychological Association, 1996. xix, 429 pp. Publisher URL: http://www.apa.org/books ISBN: 1-55798-365-8 (hardcover) Language: English Keywords: techniques & strategies of clinical hypnosis, case reports Abstract: (from the jacket) When is hypnosis brought into play with various theoretical and clinical approaches to psychotherapy? What does a hynotherapist actually do on a case-by-case and a session-by-session basis? What specific strategies can be implemented? What are the scope and nature of the challenges that hypnotherapists and their clients face? What interpersonal issues emerge in hypnotherapeutic treatment?
The editors of the "Casebook of Clinical Hypnosis" have marshalled [a] group of . . . hypnotherapists to consider these issues and to illustrate them with . . . cases from their own experience. Each chapter is devoted to the explication of clinical techniques and strategies, and many chapters contain transcripts of actual sessions and suggestions administered. Contributing therapists offer the presenting background and assessment information of a client, the treatment rationale, the role of hypnosis within the treatment, outcome and follow-up data, and concluding commentary.
This book . . . will be useful to both the novice hypnotherapist and seasoned clinician. _____
Record: 50
Title: Handbook of dissociation: Theoretical, empirical, and clinical perspectives. Author(s): Michelson, Larry K., (Ed), Pennsylvania State U, University Park, PA, US
Ray, William J., (Ed) Source: New York, NY, US: Plenum Press, 1996. xviii, 645 pp. ISBN: 0-306-45150-6 (hardcover) Language: English Keywords: history & developmental perspectives & theoretical models & assessment & diagnostic classification & treatment of & special topics in dissociative disorders, handbook Abstract: Presents a handbook providing theoretical, empirical, and clinical information on dissociative disorders. _____ _____
Record: 1
Title: The Hatherleigh guide to psychiatric disorders. Series Title: The Hatherleigh guides series, #1 Author(s): No authorship indicated. Source: New York, NY, US: Hatherleigh Press, 1996. xiv, 290 pp. ISBN: 1-886330-05-0 (paperback) Language: English Keywords: diagnostic issues & etiological factors & treatment approaches, patients with emotional & behavioral disorders, guide Abstract: (from the cover) The "Hatherleigh Guide to Psychiatric Disorders" surveys [an] array of emotional and behavioral disorders encountered in contemporary American culture. Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) is used as a framework within which some of the most notable experts in their fields present up-to-date information about diagnostic issues, etiologic factors, and |
