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PubMed1981

Dissociation of pleasure in psychopathology.

This paper analyzes the development of the concept of dissociation from 19th century psychological theory through 20th century neurophysiological thought. Recent research is discussed, indicating that normal individuals show an "association" between emitted pleasurable behavior and self-perception of pleasurable activity, whereas depressives and schizophrenics show a lack of association, or "dissociation," between these measures. concomitantly, depressives show an abnormal degree of association between the experience and expression of negative affect. Such a discrepancy in systems of affect is considered as both an important pathological element in mental disorder and also as a valuable new research tool for studying etiology, differential diagnosis, and therapeutic efficacy in psychobiological illness.

Anxiety↗
PubMed2003

Perceptually oriented hypnosis.

This theoretical article explores postulates representative of a perceptual frame of reference for a better understanding of hypnotic experiencing. This author contends that Perceptual Psychology, a theory first conceptualized by Snygg and Combs, as revised by Combs, Richards, and Richards in 1988, and Perceptually Oriented Hypnosis provide an effective way of understanding hypnosis, the therapist-client relationship, and has some implications as well for better comprehending psychopathology. Perceptually oriented hypnotic principles are shown to enhance the characeristics of the adequate personality, expand the phenomenal field, change personal meanings, and change aspects of the phenomenal self in the context of hypnosis. Implications for understanding differing views and conflicting perceptions of reality held by scientists and researchers are discussed. Implications for Dissociative Identity Disorder are also addressed. Research utilizing Giorgi's research methodology and Wasicsko's qualitative procedure for assessing educators' dispositions is suggested.

Culture↗
PubMed1995

Mediation of abusive childhood experiences: depression, dissociation, and negative life outcomes.

A study of 301 college undergraduates is employed to test a causal model which proposes that dissociation and depression act as mediator variables that develop from child abuse and lead to various negative outcomes. As predicted, child maltreatment was found to be related to negative life experiences, with depression and dissociation differentially mediating the various outcomes.

Adaptation, Psychological↗
PubMedDate not supplied

[The Dissociation Questionnaire DIS-Q: preliminary results with a French-speaking Swiss population].

Vanderlinden and his collegues (1993) proposed a first european clinical scale to assess dissociative symptoms, the DIS-Q. The DIS-Q was studied in a psychiatric (n = 154) and a control (n = 65). Swiss French speaking sample. Our results reflected that The Dissociation Questionnaire (DIS-Q) has a good criterion-related validity since it discriminates between patients (Axes I and II of the DSM IV classification) and controls. Statistical comparisons indicated significant differences between three subgroups (axis I only, n = 60; axis II only, n = 24; axes I et II together, n = 70), and controls (n = 65). The total DIS-Q score was the highest for the patients with axes I and II together. About 12% of the psychiatric sample studied obtained DIS-Q score > or = 2.5, suggesting the presence of pathological dissociative symptoms. Our results seem not to be influenced by cultural factors.

Adult↗
PubMed2005

Self-burning versus self-cutting: patterns and implications of self-mutilation; a preliminary study of differences between self-cutting and self-burning in a Japanese juvenile detention center.

The purpose of the present paper was to examine the differences in clinical features between self-cutters and self-burners, to clarify clinical implications of self-mutilating behaviors other than self-cutting. Subjects were 201 delinquent adolescents consecutively entering a Japanese juvenile detention center from February 2003 to March 2003. The subjects were assessed using a self-reporting questionnaire to evaluate self-mutilation, traumatic events, and problematic behaviors. Beck Depression Inventory-2 (BDI-2) and Adolescent Dissociative Experience Scale (A-DES) were also tested. Subjects were classified into four groups according to self-mutilating behaviors: non-self-cutting or -burning (NSCB), self-cutting (SC), self-burning (SB), and self-cutting and self-burning (SCB). The questionnaire answers and scores of the BDI-2 and A-DES were compared between the four groups. Of 201 subjects, 33 (16.4%) had cut their wrists or forearms at least once, and 72 of 201 (35.8%) had burned themselves at least once. The SC and SCB group had traumatic events, problematic behavior, and various types of self-mutilating behavior more frequently than the other two groups. The SCB group reported additional types of self-mutilating behavior more than the SC group. The SCB group also experienced multiple body customizations compared to the SC group, and exhibited higher scores on the BDI-2 and A-DES than the other three groups. The self-burning without self-cutting may have limited clinical implications. However, the self-burning with self-cutting may suggest depression and dissociation, as well as possible indication of self-mutilating behavior.

Adolescent↗
PubMedDate not supplied

Somatosensory evoked potentials in patients with sensitive dissociation.

The purpose of the study was to reconsider the somatosensory evoked potential (SEP) morphology in case of thermalgic versus proprioceptive sensory loss. The study was carried out on 70 inpatients affected by uni- or bilateral dissociated sensory disorders and on 45 normal controls. The median or tibial nerves were stimulated (at wrist or ankle), the stimulus intensity being adjusted to elicit a visible muscle response with liminal pain. SEPs were measured with regard to 7 negative components parameters (latency, amplitude) and statistically compared in the three groups. Results show that the initial SEP components (N18, N30, N70) are specifically affected in case of proprioceptive and the late components (N150, N220, N340) in case of thermalgic sensory disorders (N150 having an intermediate position). The intergroup differences were statistically significant. The results are thought to be used in clinical diagnosis.

Adolescent↗
PubMed2000

Cognitive, dissociative and psychotogenic effects of ketamine in recreational users on the night of drug use and 3 days later.

AIMS: Recreational use of the N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine, is increasing. The present study aimed to examine both the acute and residual effects of this drug on cognitive function, dissociation and schizotypal symptomatology in recreational users. DESIGN AND PARTICIPANTS: A parallel group design was used to compare 20 volunteers who reported having taken ketamine with 19 volunteers who reported no consumption of ketamine on the relevant night (day 0). All 39 participants were tested on day 0 and again 3 days later. On each test occasion a battery of tests was administered which tapped a wide range of memory functions, attention, dissociation, schizotypal symptomatology and mood. FINDINGS: Groups were broadly matched for polydrug use apart from ketamine. Acute effects on day 0 replicated previous laboratory studies showing a broad spectrum of cognitive impairments following ketamine administration as well as marked dissociative effects and schizotypal symptomatology. Three days later, ketamine users had significantly higher scores than controls on both dissociation and schizotypal symptomatology. On some cognitive measures there were no group differences on day 3; however, on tests tapping semantic memory, the ketamine users showed persisting impairments compared with controls. CONCLUSIONS: Ketamine appears to induce acute and severe impairments of working, episodic and semantic memory as well as psychotogenic and dissociative effects. Three days after drug ingestion, recreational users display semantic memory impairment and dissociative and schizotypal symptomatology which could reflect chronic or residual effects of taking the drug or pre-existing differences in ketamine users.

Adolescent↗
PubMed1996

The validation of the Trauma Symptom Checklist-40 (TSC-40) in a sample of inpatients.

This study examined the construct validity of the Trauma Symptom Checklist-40 (TSC-40; Elliot & Briere, 1992) in a sample of 130 female psychiatric inpatients. Consistent with other findings, the TSC-40 displayed criterion-related validity in relation to childhood sexual abuse. Survivors of sexual abuse obtained significantly higher scores than those without such a history on the overall TSC-40 and on each of the six subscales, except the Depression subscale. Convergent validity of three subscales was demonstrated, and divergent validity on the total TSC-40 and each of its subscales was established. Further, among a range of abuse-effects measures, the Sexual Abuse Trauma Index (SATI) subscale was the most powerful predictor of sexual abuse. The SATI and Dissociation subscales were the subscales most sensitive to the specific features of the sexual abuse.

Adolescent↗
PubMed1984

Dissociated rage attacks in a Vietnam veteran: a Rorschach study.

A case study of a Vietnam combat veteran with episodic rage attacks is discussed with emphasis on Rorschach formal scoring and content analysis. Rorschach data suggest a near neurotic level of ego organization with massive repression in the form of dissociated violent outbursts. Vietnam combat trauma appears to be a precipitant. Developmental differences between preoedipal splitting and higher level dissociation are discussed. Dissociative states are posited to represent a developmental level of ego organization midway between borderline and neurotic levels and are not easily encompassed by either borderline or neurotic classifications.

Anger↗
PubMed2000

Acalculia, aphasia and spatial disorders in left and right brain-damaged patients.

The paper reports the performance of 50 left- and 26 vascular right-brain-damaged (LBD, RBD) patients in the EC301 Calculation Battery, which explores different aspects of number and calculation processing. All patients underwent a comprehensive neuropsychological testing that also included evaluation for the presence and type of aphasia in LBD patients, and of spatial disorders in RBD patients. LBD were subdivided in three groups: non-aphasic (NA), Broca and Wernicke aphasics. Results indicate that language and calculation disorders can dissociate. The relationship between spatial and calculation disorders in RBD patients is less clear. No significant difference was found between Broca and Wernicke aphasics, nor between NA and RBD patients. In the transcoding tasks (reading or writing to dictation numbers and number words, for instance) syntactic errors were the most frequent type of errors in all groups. They were also present when neither the input nor the required response was in the Arabic code, and a word-by-word strategy could have been used to read the number word or write a spoken number in the orthographic code.

Adult↗
PubMed1999

Hypnotic recall: a positive criterion in the differential diagnosis between epileptic and pseudoepileptic seizures.

PURPOSE: Because the diagnosis of pseudoepileptic seizures (PESs) is mostly made by excluding epilepsy, availability of a positive criterion for PESs is of great importance. This study was aimed at the validation of a diagnostic technique that intends to provide in such a positive criterion. METHODS: In 17 patients with epileptic seizures (ESs) and 20 patients with PESs, a hypnotic procedure was performed by an investigator blind to other data to recover amnesia for the ictus. If recall was obtained, the experimental diagnosis PES was given; if not, ES was diagnosed. The experimental diagnoses were compared with the clinical, EEG-confirmed diagnoses. Hypnotizability was measured to determine the relation between the outcome of the test and hypnotizability of the patients. RESULTS: Recall for the ictus was obtained in 17 patients. Each of these had a clinical diagnosis of PES. Seventeen patients with "no recall" had a clinical diagnosis of ES, and three patients had PESs. This result yields a specificity of 100% and a sensitivity of 85% for the recall technique. Hypnotizability was significantly higher in patients with PESs than in patients with ESs. In some "low hypnotizables," recall was obtained, and in some "high hypnotizables," no recall was obtained. CONCLUSIONS: A positive recall test indicates PES. A sub-group of patients with PESs is characterized by a high level of hypnotizability. Hypnotizability is not crucial for outcome of the recall test. High hypnotic abilities are especially found in disorders in which it is supposed that "dissociation" is involved. It can be speculated that PES may be one of the dissociative phenomena.

Adolescent↗
PubMed1998

The concept of mental disorder in Greek cinema.

Mental patients in Greek society have never been considered as 'sacred', but on the contrary as handicapped, and cinema largely reflects these concepts. A total of 30 films that appeared to deal with mental disorder in a direct or indirect way have been reviewed. The identification of each mental disorder was made according to DSM-IV criteria. Five of these cases were presented as having a factitious disorder, seven were psychotic and two had dissociative (hysterical) disorders. The remaining eight cases related to personality disorder or character deviance. In two cases diagnosis was impossible. The image of mental disorder is consistent with psychiatric nosology, and disorders with 'dramatic' or 'impressive' manifestation of symptomatology are chosen. No real solutions, proposals or ideology on mental illness emerge.

Greece↗
PubMed2005

Development of the Hebrew-Multidimensional Inventory of Dissociation (H-MID): a valid and reliable measure of pathological dissociation.

The Multidimensional Inventory of Dissociation (MID; Dell, 2004b) has 168 dissociation items and 50 validity items. The MID assesses 14 major facets of dissociation, 23 symptoms of dissociation, and has 5 validity scales. The MID operationalizes (a) the subjective/ phenomenological domain of dissociation, and (b) 23 hypothesized symptoms of dissociative identity disorder (DID). This article describes the development of a Hebrew version of the MID (H-MID). In a sample of clinical and nonclinical research participants, the H-MID had strong internal consistency, temporal stability, and strong structural, convergent, discriminant, and construct validity. In addition, mean H-MID scores demonstrated incremental validity over the Hebrew Dissociative Experiences Scale (H-DES) by predicting an additional 17% of the variance in weighted trauma scores on the Traumatic Experiences Questionnaire (TEQ). Factor analysis of the H-MID extracted a single factor: dissociation. Both the MID and the subjective/phenomenological concept of pathological dissociation appear to have applicability not only in North America, but also in a heterogeneous Middle Eastern culture.

Adult↗
PubMedDate not supplied

Reduction in dissociation due to aging and cognitive deficit.

Our objective was to investigate whether dissociative experiences occur less frequently in older psychiatric patients than in younger adult patients, and to examine the role of cognitive deficits in the frequency of dissociative events. Fifty-two outpatients 60 years and older were administered the Dissociative Experiences Scale (DES) and the Mini-Mental State Exam (MMSE). Their scores were compared with those of 50 outpatients 35 to 55 years old. Each group included patients sampled from the Mental Health Center (MHC) and University Medical Center clinics. Older patients showed significantly lower DES and MMSE median scores than younger patients. Cognitive deficit reflected by reduced MMSE scores also was associated with reduced DES scores for younger and older patients. Older patients with little or no cognitive deficit continued to show reduced DES scores. Decreases in dissociativity continue well beyond the fourth decade and do not rely on age-related cognitive deficit. Factors related to the aging process seem to mediate reductions in dissociativity independent of reductions mediated by cognitive deficit. The use of the DES for screening without adjusting for age and cognitive status is questioned.

Adult↗
PubMed1996

The Bargarran witchcraft trial--a psychiatric reassessment.

In 1697, seven people were condemned at Paisley for using witchcraft to torment Christian Shaw, daughter of the laird of Bargarran. For seven months, Christian had bizarre seizures during which she claimed to see the Devil and her tormentors assaulting her. She also exhibited pica and said that the foreign material had been forced into her mouth by her invisible assailants. The notable Glasgow physician, Matthew Brisbane, was consulted and gave evidence at the trial; he could find no natural explanation for the pica. It is likely that Christian had a dissociative (conversion) disorder after being cursed by a servant. Christian recovered and later married the minister of Kilmaurs. After his untimely death, she established a highly successful spinning business which lead to the Paisley cotton industry.

Dissociative Disorders↗
PubMed1989

Post-traumatic aspects of the treatment of victims of sexual abuse and incest.

This study assesses the frequency of childhood abuse and adult traumatization and the presence of symptomatology of post-traumatic stress and dissociation across different DSM-III diagnostic categories including affective disorder, schizophrenia, eating disorders, PTSD, borderline personality disorder, and multiple personality disorder. Findings revealed high levels of child abuse among patients with dissociative disorder and borderline personality disorder. The patients with dissociative disorders were found to have an increased incidence of rape and wife battery in adulthood. Patients with dissociative and post-traumatic stress disorders were found to experience similar symptomatology. The findings from this study highlight the need to assess all psychiatric patients for a history of physical and sexual trauma. Major treatment issues in patients who suffer from either type of trauma include the development of trust and the abreaction and working through of traumatic memories. Conjoint sessions with concerned others may be beneficial.

Adolescent↗
PubMed2005

Validation of the Peritraumatic Dissociative Experiences Questionnaire self-report version in two samples of French-speaking individuals exposed to trauma.

OBJECTIVE: Peritraumatic dissociation is a risk factor for developing PTSD. The Peritraumatic Dissociative Experiences Questionnaire (PDEQ) is a self-report inventory used to assess dissociation that occurred at the time of a trauma. The aim of this study was the validation the PDEQ in French. METHOD: Ninety French speaking traumatized victims presenting to the emergency department were recruited. They were administered the PDEQ shortly after exposure and others trauma-related measures 2 weeks and 1 month posttrauma. RESULTS: Principal components factor analyses suggested a single factor solution for the PDEQ. Significant correlations between the PDEQ and acute and posttraumatic stress symptoms indicated moderate to strong convergent validity. The PDEQ also showed satisfactory test-retest reliability and internal consistency. CONCLUSION: This study is the first one to investigate such detailed psychometric findings on the PDEQ. This confirms the unity of the concept of peritraumatic dissociation and the value of the PDEQ-French Version to assess it.

Accidents, Traffic↗
PubMed2006

Borderline personality organization and dissociation.

The relationship between Kernberg's psychodynamic model of personality organization (PO) and dissociation has not yet been explored. Seventy-two nonclinical subjects and 222 psychiatric patients completed the Dissociative Experiences Scale and the Inventory of Personality Organization. Its Reality Testing subscale emerged as the most important predictor for all facets of dissociation. Discussing our results in the framework of Fonagy and coworkers' model of mentalization, we suggest that dissociation may reflect the preoedipal "pretend" mode of psychic functioning while impaired reality testing and psychotic experiences might be indicative of the "psychic equivalent" mode.

Adolescent↗