The relationship between trauma and dissociation: Is the development of dissociative symptoms mediated by family functioning?

Wendy Jean Nilsen, Purdue University

Abstract

Despite 100 years of theory in research on dissociative process, our understanding of these symptoms and disorders is limited. Past theories have highlighted the importance of trauma—especially childhood sexual abuse—in the etiology of dissociative symptomatology, but the relationship between child abuse and dissociation has found mixed support. Past research has also overlooked other life experiences that might be important in the etiology of dissociative experiences such as support in the family of origin (i.e., family functioning) and other experiences of trauma outside of child abuse. To determine the relationship between trauma, abuse, family functioning, and dissociation, 415 female undergraduates completed the Dissociative Experiences Scale (DES), the Family Functioning Scales, and extensive questionnaires about their sexual, physical, and emotional abuse and trauma histories. All participants were also interviewed with the Structured Clinical Interview for DSM-IV-Dissociative Disorders (SCID-D) to determine dissociative disorders diagnoses. A majority of the women reported experiencing a traumatic event (82.4%) and 31 participants were diagnosed with a dissociative disorder. No relationship was found between sexual abuse and DES scores. Physical abuse was only predictive of DES scores when it was examined alone: when analyzed with the other traumata it was no longer predictive. Emotional maltreatment was the only “trauma” that was predictive of DES scores. Further, family functioning—conflict, external locus of control, and enmeshment—predicted a significant amount of the variance in DES scores (15%). Using SCID-D diagnoses, sexual abuse was a significant risk factor for developing a dissociative disorder (2.16:1). In addition, having experienced an event in which one's life had been endangered (2.09:1) and family functioning—in terms of cohesiveness (2.17:1)—were significant risk factors in the development of a dissociative disorder. This study indicates that not only child abuse, but also family functioning and other traumata must be considered when exploring dissociative symptoms. It also highlights substantial differences between the predictors of the DES and SCID-D, suggesting that the two measures may not tap similar constructs in non-clinical populations. Researchers should be careful not to assume relationships identified with the DES are generalizable to dissociative disorders diagnosed by the SCID-D.

Degree

Ph.D.

Advisors

Merritt, Purdue University.

Subject Area

Psychotherapy

COinS