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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
neuroscience
Dissociation in posttraumatic stress disorder: Evidence from the world mental health surveys
Biological Psychiatry, Volume 73, No. 4, Year 2013
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Description
Background: Although the proposal for a dissociative subtype of posttraumatic stress disorder (PTSD) in DSM-5 is supported by considerable clinical and neurobiological evidence, this evidence comes mostly from referred samples in Western countries. Cross-national population epidemiologic surveys were analyzed to evaluate generalizability of the subtype in more diverse samples. Methods: Interviews were administered to 25,018 respondents in 16 countries in the World Health Organization World Mental Health Surveys. The Composite International Diagnostic Interview was used to assess 12-month DSM-IV PTSD and other common DSM-IV disorders. Items from a checklist of past-month nonspecific psychological distress were used to assess dissociative symptoms of depersonalization and derealization. Differences between PTSD with and without these dissociative symptoms were examined across a variety of domains, including index trauma characteristics, prior trauma history, childhood adversity, sociodemographic characteristics, psychiatric comorbidity, functional impairment, and treatment seeking. Results: Dissociative symptoms were present in 14.4% of respondents with 12-month DSM-IV/Composite International Diagnostic Interview PTSD and did not differ between high and low/middle income countries. Symptoms of dissociation in PTSD were associated with high counts of re-experiencing symptoms and net of these symptom counts with male sex, childhood onset of PTSD, high exposure to prior (to the onset of PTSD) traumatic events and childhood adversities, prior histories of separation anxiety disorder and specific phobia, severe role impairment, and suicidality. Conclusion: These results provide community epidemiologic data documenting the value of the dissociative subtype in distinguishing a meaningful proportion of severe and impairing cases of PTSD that have distinct correlates across a diverse set of countries. © 2013 Society of Biological Psychiatry.
Authors & Co-Authors
Stein, Dan J.
South Africa, Cape Town
University of Cape Town
Koenen, Karestan Chase
United States, New York
Mailman School of Public Health
Friedman, Matthew J.
United States, Washington, D.c.
U.s. Department of Veterans Affairs
Hill, Eric D.
United States, Boston
Harvard Medical School
McLaughlin, Katie A.
United States, Boston
Boston Children's Hospital
Petukhova, Maria V.
United States, Boston
Harvard Medical School
Ruscio, Ayelet Meron
United States, Philadelphia
University of Pennsylvania
Shahly, Victoria
United States, Boston
Harvard Medical School
Spiegel, David
United States, Stanford
Stanford University School of Medicine
Borges, Guilherme Luiz Guimaraes
Mexico, Mexico
Universidad Autónoma Metropolitana
Bunting, Brendan P.
United Kingdom, Coleraine
Ulster University
Caldas-de-Almeida, José M.
Portugal, Lisbon
Universidade Nova de Lisboa
de Girolamo, Giovanni
Italy, Brescia
Irccs Centro San Giovanni Di Dio Fatebenefratelli
Demyttenaere, Koen
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Florescu, Silvia E.
Romania, Bucharest
National School of Public Health, Management and Professional Development
Haro, Josep Maria
Spain, Sant Boi de Llobregat
Parc Sanitari Sant Joan de Déu
Karam, Elie Georges
Lebanon, Beirut
Saint George Hospital University Medical Center
Kovess - Masfety, Viviane
France, Paris
Université Paris Cité
Lee, Sing
Hong Kong, Hong Kong
Chinese University of Hong Kong
Matschinger, Herbert
Germany, Leipzig
Universität Leipzig
Mladenova, Maya
Bulgaria, Sofia
New Bulgarian University
Posada-Villa, J. A.
Colombia, Bogota
Pontificia Universidad Javeriana
Tachimori, Hisateru
Japan, Kodaira
National Center of Neurology and Psychiatry
Viana, Maria Carmen
Brazil, Vitoria
Universidade Federal do Espírito Santo
Kessler, Ronald C.
United States, Boston
Harvard Medical School
Statistics
Citations: 276
Authors: 25
Affiliations: 22
Identifiers
Doi:
10.1016/j.biopsych.2012.08.022
ISSN:
00063223
e-ISSN:
18732402
Research Areas
Maternal And Child Health
Mental Health
Study Design
Cross Sectional Study
Participants Gender
Male