Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders

Figures & data

Table 1. Items from the Multidimensional Inventory of Dissociation (MID) descriptions of trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC) across the four-dimensional (4-D) model dimensions of time, thought, body and emotion.

	TRASC	NWC
Time	Items 14, 114, 145 and 146 Cronbach’s α = .688 Example: ‘Reliving a past trauma so vividly that you see it, hear it, feel it, smell it, etc.’	Item 115 ‘Bad memories coming into your mind and you can’t get rid of them.’
Thought	Items 6, 30, 42, 61, 84, 118, 140, 159, 171, 199 and 207 Cronbach’s α = .936 Example: ‘Hearing a voice in your head that tries to tell you what to do.’	Items 22 and 151 Cronbach’s α = .696 Example: ‘Strong thoughts in your head that “come from out of nowhere”.’
Body	Items 3, 91, 126 164, 172, 191, 197 and 203 Cronbach’s α = .889 Example: ‘Standing outside of your body, watching yourself as if you were another person.’	Item 125 ‘Re-experiencing body sensations from a past traumatic event.’
Emotion	Items 27, 60, 169 and 196 Cronbach’s α = .688 Example: ‘Very strong feelings (e.g. fear, or anger, or emotional pain and hurt) that suddenly go away.’	Items 32, 57 and 185 Cronbach’s α = .743 Example: ‘Your mood changing rapidly without any reason.’

Table 2. Sample characteristics and clinical comorbidity.

	PTSD with CDD^a (N = 46)	PTSD without CDD^a (N = 96)	Difference between groups
Age (years)	36.1 (10.4)	40.5 (9.7)	2.442(138), p = .016*
Gender, male	4.3%	14.6%	χ^2 = 3.259, p = .71
Married or partner	52.4%	43.9%	χ^2 = 0.802, p = .371
College-level education	46.3%	45.7%	χ^2 = 0.005, p = .945
GSI	1.95 (0.661)	1.66 (0.664)	t(118) = −2.252, p = .026*
MINI number of comorbid axis-I disorders	5.2 (2.5)	4.5 (2.3)	t(135) = −1.783, p = .077
MINI any depressive disorder (present or lifetime)	90.7%	91.5%	χ^2 = 0.023, p = .879
MINI any bipolar disorder (present or lifetime)	23.3%	19.1%	χ^2 = 0.306, p = .580
MINI severe suicidality (scored above 2)	72.1%	20.2%	χ^2 = 34.26, p = < .001**
MINI any anxiety disorder (present or lifetime)	88.4%	85.1%	χ^2 = 0.263, p = .608
MINI substance abuse	11.6%	13.8%	χ^2 = 0.125, p = .723
MINI any psychotic disorder (present or lifetime)	30.2%	13.8%	χ^2 = 5.162, p = .0023*
MINI any eating disorder	18.6%	8.5%	χ^2 = 2.914, p = .088
SCID-II number of comorbid axis-II disorders	.907 (1.06)	.904 (1.06)	t(135) = −.14, p = .702
SCID-II borderline personality disorder	14%	12.8%	χ^2 = 0.035, p = .849
Inpatient treatment ever	74.3%	46.5%	χ^2 = 7.345, p = .007*
Inpatient treatment last year	35.3%	18.3%	χ^2 = 3.656, p = .056
Work incapacity	80.5%	75%	χ^2 = 0.459, p = .498
CTQ total	77.29 (20.235)	71.15 (18.057)	t(120) = −1.704, p = .091
CTQ – Emotional abuse	17.85 (5.332)	17.63 (5.458)	t(120) = −0.216, p = .830
CTQ – Physical abuse	12.05 (6.253)	10.40 (5.647)	t(120) = −1.473, p = .143
CTQ – Sexual abuse	16.17 (7.11)	14.47 (7.27)	t(119) = −1.223, p = .224
CTQ – Emotional neglect	19.49 (4.879)	17.44 (5.153)	t(120) = −2.106, p = .037
CTQ – Physical neglect	11.73 (5.301)	11.38 (4.931)	t(120) = −0.360, p = .719
MID mean score	42.13 (17.486)	21.74 (15.318)	t(140) = −7.083, p < .001**
SDQ-20	40.667 (12.249)	30.900 (9.057)	t(101) = −4.545, p < .001**
DES total	42.785 (19.822)	18.912 (16.387)	t(103) = −6.519, p < .001**

^aData are shown as mean (SD) or percentages. PTSD, post-traumatic stress disorder; CDD, complex dissociative disorder; GSI, Global Severity Index; MINI, Mini-International Neuropsychiatric Interview; SCID-II, Structured Clinical Interview for DSM-IV Axis II Personality Disorders; CTQ, Childhood Trauma Questionnaire; MID, Multidimensional Inventory of Dissociation; SDQ, Somatoform Dissociation Questionnaire; DES, Dissociative Experiences Scale. *p < .05, **p < .01.

Table 3. Correlations between dimensions of trauma-related altered states of consciousness (TRASC) or normal waking consciousness (NWC), and measures of dissociation and childhood abuse.

	DES	SDQ	CTQ – total	EA	PA	SA	EN	PN
TRASC – Time	.731**	.678**	.178*	.127	.165	.271**	−.017	.006
NWC – Time	.566**	.338**	.127	.157	.015	.099	.121	.042
TRASC – Thought	.662**	.608**	.139	.094	.091	.237**	.034	−.075
NWC – Thought	.515**	.409**	−.047	−.052	−.049	.054	−.100	−.057
TRASC – Body	.777**	.787**	.230*	.146	.162	.280**	.072	.095
NWC – Body	.548**	.447**	.267**	.208*	.169	.244**	.140	.115
TRASC – Emotion	.801**	.718**	.327**	.225*	.269**	.213*	.189*	.182*
NWC – Emotion	.546**	.364**	.057	.033	.047	.108	.043	−.075

DES, Dissociative Experiences Scale; SDQ, Somatoform Dissociation Questionnaire; CTQ, Childhood Trauma Questionnaire; EA, emotional abuse; PA, physical abuse; SA, sexual abuse; EN, emotional neglect; PN, physical neglect. All forms of childhood abuse were measured with the CTQ.*p < .05, **p < .01.

Table 4. Logistic regressions predicting a comorbidity of complex dissociative disorder.

Dimension		β (SE)	OR	Model χ^2 (df)	Model r^2 (Nagelkerke)
Mean				22.902 (114)**	.250
	TRASC	.758 (.218)**	2.133
	NWC	−.042 (.157)	0.959
Time				6.360 (112)*	.075
	TRASC	.233 (.112)*	1.263
	NWC	.039 (.094)	1.040
Thought				12.091 (114)**	.138
	TRASC	.353 (.115)**	1.424
	NWC	.010 (.094)	1.010
Body				14.284 (111)**	.165
	TRASC	.393 (.125)**	1.482
	NWC	.022 (.078)	1.022
Emotion				25.419 (114)**	.275
	TRASC	.526 (.145)**	1.446
	NWC	.144 (.100)	1.155

TRASC, trauma-related altered states of consciousness; NWC, normal waking consciousness. Age and Global Severity Index were included as parameters. *p < .05, **p < .01.

Figure 1. Mean symptom endorsement for each dimension of trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC) compared in patients with and without complex dissociative disorder (CDD).*p < .05, **p < .01.

Figure 2. Intercorrelations between the four different dimensions of trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC). All correlations are significant at p < .001.