Relationships Between Maltreatment, Posttraumatic Symptomatology, and the Dissociative Subtype of PTSD Among Adolescents

ABSTRACT

The purpose of this study was to explore relationships between maltreatment, posttraumatic stress disorder, and the dissociative subtype of posttraumatic stress disorder among adolescents. This descriptive study used secondary data from the National Child Traumatic Stress Network Core Data Set. A clinical sample of adolescents exposed to potentially traumatizing events ages 12 to 16 was selected (N = 3081) to explore associations between trauma history characteristics, sociodemographic factors, posttraumatic stress disorder, and the dissociative subtype of PTSD which includes depersonalization and derealization. More than half of adolescents who met criteria for posttraumatic stress disorder also met criteria for the posttraumatic stress disorder dissociative subtype with significant depersonalization/derealization symptoms. No particular maltreatment type was associated with increased odds of posttraumatic stress disorder, with or without the dissociative subtype. All posttraumatic stress disorder-affected adolescents, with or without the dissociative subtype, experienced more overall potentially traumatizing events and maltreatment events than those without a posttraumatic stress disorder diagnosis. Girls and adolescents in residential treatment were more likely to have posttraumatic stress disorder with the dissociative subtype. This study provides evidence about the dissociative subtype of posttraumatic stress disorder among adolescents and provides new directions for research on trauma and dissociation. Future research studies should explore the co-occurrence of posttraumatic stress disorder and dissociation with broader range of dissociative symptoms than only depersonalization/derealization to further understand how to diagnose and treat traumatic stress disorders among adolescents.

KEYWORDS:

• Posttraumatic stress disorder
• dissociative subtype
• maltreatment
• adolescent

Acknowledgments

Dr. Choi acknowledges pre-doctoral support from the Rita & Alex Hillman Foundation Hillman Scholars Program in Nursing Innovation and the Eunice Kennedy Shriver National Institutes of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) through an individual National Research Service Award (NRSA) (1F31HD088091-01). Dr. Choi also acknowledges post-doctoral support from the National Clinician Scholars Program at UCLA and Kaiser Permanente. This project was developed in part under grant number 2U79SM054284 from the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of the funding sources listed above. We would also like to acknowledge the 56 sites within the NCTSN that have contributed data to the Core Data Set as well as the children and families that have contributed to our growing understanding of child traumatic stress.

Additional information

Funding

This work was supported by the Center for Mental Health Services [2U79SM054284]; Eunice Kennedy Shriver National Institute of Child Health and Human Development [1F31HD088091-01]; Rita & Alex Hillman Foundation [NA].