Assessment of dissociation among combat-exposed soldiers with and without posttraumatic stress disorder

Abstract

Background

Dissociation is a disruption of and/or discontinuity in the normal, subjective integration of one or more aspects of psychological functioning, including memory, identity, consciousness, perception, and motor control. A limited number of studies investigated combat-related dissociation.

Objective

The primary aim of this study was to evaluate the relationship between dissociative symptoms and combat-related trauma.

Method

This study included 184 individuals, including 84 patients who were exposed to combat and diagnosed with posttraumatic stress disorder (PTSD) (Group I), 50 subjects who were exposed to combat but were not diagnosed with PTSD (Group II), and 50 healthy subjects without combat exposure (Group III). The participants were evaluated using the Dissociative Experiences Scale (DES) to determine their total and sub-factor (i.e., amnesia, depersonalization/derealization, and absorption) dissociative symptom levels. In addition, Group I and Group II were compared with respect to the relationship between physical injury and DES scores.

Results

The mean DES scores (i.e., total and sub-factors) of Group I were higher than those of Group II (p<0.001), and Group II's mean DES scores (i.e., total and sub-factors) were higher than those of Group III (p<0.001). Similarly, the number of subjects with high total DES scores (i.e.,>30) was highest in Group I, followed by Group II and Group III. When we compared combat-exposed subjects with high total DES scores, Group I had higher scores than Group II. In contrast, no relationship between the presence of bodily injury and total DES scores could be demonstrated. In addition, our results demonstrated that high depersonalization/derealization factor scores were correlated with bodily injury in PTSD patients. A similar relationship was found between high absorption factor scores and bodily injury for Group II.

Conclusions

Our results demonstrated that the level of dissociation was significantly higher in subjects with combat-related PTSD than in subjects without combat-related PTSD. In addition, combat-exposed subjects without PTSD also had higher dissociation levels than healthy subjects without combat experience.

• Combat exposure
• posttraumatic stress disorder
• dissociation
• dissociative symptoms
• physical injury

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’

Conflict of interest and funding

There is no conflict of interest in the present study for any of the authors.

Notes

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’