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PubMed2006

Traumatic memories of war veterans: not so special after all.

Several authors have argued that traumatic experiences are processed and remembered in a qualitatively different way from neutral events. To investigate this issue, we interviewed 121 Croatian war veterans diagnosed with posttraumatic stress disorder (PTSD) about amnesia, intrusions (i.e., flashbacks and nightmares), and the sensory qualities of their most horrific war memories. Additionally, they completed a self-report scale measuring dissociative experiences. In contrast to what one would expect on the basis of theories emphasizing the special status of traumatic memories, amnesia, and high frequency intrusions were not particularly typical for our sample of traumatized individuals. Moreover, traumatic memories were not qualitatively different from neutral memories with respect to their stability and sensory qualities. The severity of PTSD symptoms was not significantly correlated with dissociative experiences. Our findings do not support the existence of special memory mechanisms that are unique to experiencing traumatic events.

Adult↗
PubMed1996

[Dyssocial identity disorder (double identity) in psychopathology and poetry].

Identity dissociation signifies: there seem to exist two identities in one personality that take turns-apparently without knowing about each other. Descriptions of this rare state are often spectacular. As scientifically proven they depend on culturally specific conditions and iatrogeneous influences. The disorder is to be analysed in this article for the case of both psychiatry and every-day-life-experiences in a matter-of-fact way. The first description of the phenomenon is not found in psychiatric literature but in poetry. The novellas of E.T.A. Hoffmann contain at least eight descriptions of 'double life'. The 'Fräulein von Scuderi' (1820) seems to be the most interesting of these and is therefore focused on in this article. E.T.A. Hoffmann himself was at the same time well respected jurist and significant artist of great versatility: poet as well as musician, composer, painter. Hoffmann's artistic and his civic life stood in sharp contrast, which gives reason to use of the term 'double life'.

Adult↗
PubMed2004

[Psychopathology of development and structural dynamics].

The mental structure provides every human with a potential repertoire of behavior. In every interaction a reactivation of past actualization- and representation processes concerning the particular prevailing context takes place. A child's mental structure should not be devaluated in comparison to a structure of an adult person. Levels of functioning depend on the developmental age. Structural dispositions consist of represented experiences of interaction. The so-called affect attenuement plays an important part in individual affect regulation. If the structural representation follows mechanisms of memory, procedural structural dispositions may be postulated, which affect the behavior besides iconic and symbolic representations. Within the structure affect dispositions are integrated. They are able to give value to certain contents of experience and reexperience. Disorders in the development of empathy are connected with impairments of the structural development. By inherent faintness of the regulation of affects or by sensitization and traumatization processes, which involve dissociative phenomena, the affective load of representations can be changed. This may result in structural deficits.

Affect↗
PubMed1986

Mutism: review, differential diagnosis, and report of 22 cases.

Mutism is a common manifestation of both psychiatric and neurologic illness. Psychiatric disturbances associated with mutism include schizophrenia, affective disorders, conversion reactions, dissociative states, and dementias. Neurologic disorders producing mutism involve the basal ganglia, frontal lobes, or limbic system structures. In psychiatric and neurologic conditions, mutism is often associated with other signs of catatonia. The authors review the literature on mutism, including psychiatric, neurologic, toxic-metabolic, and drug-induced causes. Methods to discriminate among the many causes of mutism in the clinical setting are discussed, and 22 new cases of mutism are reported to emphasize the wide differential diagnosis.

Adolescent↗
PubMed1995

Amphetamine on Rorschach measures in normal subjects.

Twenty-two normal undergraduate men were administered either d-amphetamine (0.2 mg/kg or 0.4 mg/kg) or placebo in a double-blind, counterbalanced design. The test sessions were exactly three weeks apart and included, among other measures, the Rorschach test. Rorschach anxiety and thought disorder variables were measured under drug and placebo conditions. The results suggest that amphetamine causes an increase in Rorschach anxiety indices but does not elevate Rorschach indices of thought disorder. The observed dissociation of anxiety and thought disorder on the Rorschach has implications for the role of the Rorschach in studying anxiety disorders and schizophrenic disorders.

Adult↗
PubMed1980

[Condition analysis of behavior disorders in children and adolescents in residential treatment in a district town].

The psychological-statistical analysis of the resolutions concerning accommodation in a home by the Youth Welfare Services of the town of Rostock in 1973 includes 75 children and young people with (dissocial) behaviour disorders, their average age at that time being 14.0 years. The main phenomena were playing truant or idling, running away as well as difficulties regarding discipline. A remarkable fact is the large percentage of parents with lacking vocational training and the frequency of families with more than four children (10 times as high as the average of the population) with the rate of divorces being at the same time high (39%). 55 per cent of the persons with behaviour disorders did not have a normal school development, for example the percentage of the children attending schools for backward children was 14 times as high as the average of the other school children. As a consequence, the necessity of making an early use of advisory and educational measures is pointed out, especially in cases of such families with many children who are lacking the basic conditions for an education.

Adolescent↗
PubMed2004

The epidemiology of depersonalisation and derealisation. A systematic review.

BACKGROUND: Symptoms of depersonalisation (DP) and derealisation (DR) are increasingly recognised in both clinical and non-clinical settings, but their importance and underlying pathophysiology is only now being addressed. METHODS: This paper is a systematic review of the current state of knowledge about the prevalence of depersonalisation and derealisation using computerised databases and citation searches. All potential studies were examined and numerical data included. Three categories of study are reviewed: questionnaire and interview surveys of selected student and non-clinical samples; population-based community surveys using standardised diagnostic interviews; and clinical surveys of depersonalisation/derealisation symptoms occurring within inpatients with psychiatric disorders. In addition, we present newly analysed data of the prevalence of depersonalisation/derealisation from five large population-based studies. RESULTS: Epidemiological surveys demonstrate that transient symptoms of depersonalisation/derealisation in the general population are common, with a lifetime prevalence rate of between 26 and 74% and between 31 and 66% at the time of a traumatic event. Community surveys employing standardised diagnostic interviews reveal rates of between 1.2 and 1.7 % for one month prevalence in a UK sample and a 2.4% current prevalence rate in a Canadian sample. Current prevalence rates in samples of consecutive inpatient admissions are reported between 1 and 16%, although screening measures employed may have resulted in these being an underestimate. Prevalence rates in clinical samples of specific psychiatric disorders vary between 30% of war veterans with PTSD and 60% of those with unipolar depression. There is a high prevalence within panic disorder with rates varying from 7.8 to 82.6%. DISCUSSION: DP and DR symptoms are common in normal and psychiatric populations, but prevalence estimates are hampered by inconsistent definitions and the use of variable time-frames. Population-based surveys using diagnostic interviews yield prevalence rates of clinically significant DP/DR in the region of 1-2%. Surveys of clinical populations in which common screening and assessment instruments were used also yield consistently high prevalence rates. The use of reliable diagnostic assessments and rating scales is needed. The relationship between DP/DR and certain other psychiatric disorders (e. g. panic) suggests possible common pathophysiological or aetiological factors.

Adult↗
PubMed1999

The transgenerational transmission of holocaust trauma. Lessons learned from the analysis of an adolescent with obsessive-compulsive disorder.

This paper outlines an attachment-theory based model of transgenerational trauma inspired by the successful psychoanalytic treatment of a severely disturbed adolescent with obsessive-compulsive disorder who was the first child of the first daughter of a holocaust survivor. It is proposed that the transmission of specific traumatic ideas across generations may be mediated by a vulnerability to dissociative states established in the infant by frightened or frightening caregiving, which, in its turn, is trauma-related. Disorganized attachment behaviour in infancy may indicate an absence of self-organization, or a dissociative core self. This leaves the child susceptible to the internalization of sets of trauma-related ideation from the attachment figure, which remain unintegrated in the self-structure and cannot be reflected on or thought about. The disturbing effect of these ideas may be relatively easily addressed by a psychotherapeutic treatment approach that emphasizes the importance of mentalization and the role of playful engagement with feelings and beliefs rather than a classical insight-oriented, interpretive approach.

Adolescent↗
PubMed1998

Twin study of dissociative experience.

The relative influence of genetic and environmental influences on measures of pathological and nonpathological dissociative experience was estimated using a classic twin-study design. Subjects were 177 monozygotic and 152 dizygotic volunteer general population twin pairs who completed two measures of dissociative capacity identified from the items comprising the Dissociative Experiences Scale (DES). Additive genetic influences accounted for 48% and 55% of the variance in scales measuring pathological and nonpathological dissociative experience, respectively. Heritability estimates did not differ by gender. The genetic correlation between these measures was estimated at .91, suggesting common genetic factors underlying pathological and nonpathological dissociative capacity. Genetic and environmental correlations between the DES scales and measures of personality disorder traits (Dimensional Assessment of Personality Pathology-Basic Questionnaire; DAPP-BQ) were also estimated. Significant genetic correlations (median = .38) were found between the DES scales and DAPP-BQ cognitive dysregulation, affective lability, and suspiciousness, suggesting that the genetic factors underlying particular aspects of personality disorder also influence dissociative capacity.

Adolescent↗
PubMed1995

The measurement of psychological maltreatment: early data on the Child Abuse and Trauma Scale.

This paper describes a self-report measure, the Child Abuse and Trauma Scale, which yields a quantitative index of the frequency and extent of various types of negative experiences in childhood and adolescence. Data on this measure are presented for two large samples of college students and for a small clinical sample of subjects with a diagnosis of Multiple Personality Disorder. The strong internal consistency and test-retest reliability of the scale in the college population is documented, and its validity is attested to by demonstrating that it correlates significantly with outcomes such as dissociation, depression, difficulties in interpersonal relationships, and victimization, all of which have previously been associated with childhood trauma or abuse. The extremely high scores of the Multiple Personality subjects confer additional validity to the measure. The authors suggest that the construct of psychological maltreatment underlies the destructive elements of numerous forms of abuse and neglect, and that the scale they have developed may provide a useful index of this construct.

Adolescent↗
PubMed1985

Two visual systems in mental imagery: dissociation of "what" and "where" in imagery disorders due to bilateral posterior cerebral lesions.

We studied two patients with impaired visual perception and imagery caused by bilateral posterior cerebral lesions. The first had prosopagnosia and achromatopsia, and the imagery disorder involved the description of objects from memory, especially faces and animals, and colors of objects. The second had visual disorientation; the imagery problem involved the description of spatial relations from memory. Impairments of visual imagery, like disorders of visual perception, can be dissociated. Object and color imagery may be dissociated from imagery for spatial relations. A given imagery deficit tends to be associated with the corresponding type of perceptual deficit.

Adolescent↗
PubMed2005

Acute stress disorder and posttraumatic stress disorder in children and adolescents involved in assaults or motor vehicle accidents.

OBJECTIVE: The authors investigated acute stress disorder and later posttraumatic stress disorder (PTSD) in children and adolescents who had been involved in assaults or motor vehicle accidents. METHOD: They interviewed 93 patients 10-16 years old who were seen in an emergency department for having been assaulted or involved in a motor vehicle accident within 4 weeks after the assault or accident to assess acute stress disorder. At 6 months, they reinterviewed 64 (68.8%) of the patients to assess PTSD. RESULTS: At initial interview, 18 (19.4%) of the 93 patients had acute stress disorder and 23 (24.7%) met all acute stress disorder criteria except dissociation. At 6 months, eight of the 64 patients (12.5%) had PTSD. Acute stress disorder and PTSD did not differ in prevalence between patients who had been assaulted and those who had been in accidents. Sensitivity and specificity statistics and regression modeling revealed that the diagnosis of acute stress disorder was a good predictor of later PTSD but that dissociation did not play a significant role. CONCLUSIONS: Acute stress disorder has merit as a predictor of later PTSD in children and adolescents, but dissociation has questionable utility.

Accidents, Traffic↗