Investigating the dissociative subtype of post-traumatic stress disorder in single- and multi-event trauma-exposed youth: Prevalence, course, prognosis, severity and functional impairment.

Autor: White WF; Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK., Burgess A; Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK., Dalgleish T; Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK., Dixon C; Sussex Partnership National Health Service Foundation Trust, Sussex, UK., Halligan SL; Department of Psychology, University of Bath, Bath, UK., Hiller RM; Division of Psychology and Language Sciences, University College London, London, UK.; Anna Freud Centre for Children and Families, London, UK., McKinnon A; Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia., Smith P; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.; South London & Maudsley NHS Foundation Trust, London, UK., Meiser-Stedman R; Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.
Jazyk: angličtina
Zdroj: The British journal of clinical psychology [Br J Clin Psychol] 2024 Sep; Vol. 63 (3), pp. 330-346. Date of Electronic Publication: 2024 Mar 15.
DOI: 10.1111/bjc.12461
Abstrakt: Objectives: This study aimed, following both single- and multi-event trauma, to ascertain prevalence and course of the dissociative subtype of post-traumatic stress disorder (PTSD-DS) in youth; how well early PTSD-DS predicts later PTSD; and whether dissociation accounts for unique variance in post-traumatic stress symptoms (PTSS) and functional impairment over and above the effect of other post-trauma cognitive processing factors and PTSS respectively.
Design and Methods: This study is a secondary analysis of data from the Acute Stress Programme for Children and Teenagers study (n = 234) and the Coping in Care After Trauma study (n = 110) in which children had experienced single- and multi-event trauma respectively.
Results: PTSD-DS diagnosis was common in children with PTSD regardless of trauma experienced (>39.0%). PTSD-DS showed a similar trajectory of natural recovery to PTSD, and it was similarly predictive of later PTSD following single-event trauma. Finally, dissociation was a significant factor in PTSS and functional impairment.
Conclusions: These results should be viewed in the context of several limitations including narrow sample of participants which reduces the generalizability of results, concerns around children's ability to conceptualize challenging concepts such as dissociation and the use of self-report measures to form diagnostic groups. The PTSD-DS diagnosis may offer clinical utility to the extant PTSD diagnosis in children and adolescents, as dissociation has been shown to be a contributory factor in the maintenance of both PTSS and functional impairment. Further research is required to inform further editions of the DSM and other diagnostic systems.
(© 2024 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)
Databáze: MEDLINE
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