Are Major Dissociative Disorders Characterized by a Qualitatively Different Kind of Dissociation?

Abstract

A total of 66 patients with a major dissociative disorder, 54 patients with nondissociative disorders, and 30 nonclinical controls were administered the Structured Clinical Interview for DSM–IV Dissociative Disorders–Revised, the Dissociative Experiences Scale, the Multidimensional Inventory of Dissociation, and the Symptom Checklist 90–Revised. Dissociative patients reported significantly more dissociative and nondissociative symptoms than did nondissociative patients and nonclinical controls. When general psychopathology was controlled, the dissociation scores of dissociative patients were still significantly higher than those of both other groups, whereas the dissociation scores of nondissociative patients and nonclinical controls no longer differed. These findings appear to be congruent with a typological model of dissociation that distinguishes between 2 qualitatively different kinds of dissociation. Specifically, the results of this study suggest that the dissociation that occurs in major dissociative disorders (i.e., dissociative identity disorder [DID] and dissociative disorder not otherwise specified, Type 1 [DDNOS-1]) is qualitatively different from the dissociation that occurs in persons who do not have a dissociative disorder. In contrast to previous research, the dissociation of persons who do not have a dissociative disorder is not limited to absorption; it covers a much wider range of phenomena. The authors hypothesize that different mechanisms produce the dissociation of persons with DID and DDNOS-1 as opposed to the dissociation of persons who do not have a dissociative disorder.

Keywords:

• dissociation
• dissociative identity disorder
• dissociative disorder not otherwise specified
• dissociation
• general psychopathology
• typological model of dissociation
• absorption

Acknowledgments

The study was supported in part by Grant EM18/16-2 from the Deutsche Forschungsgemeinschaft. The authors thank Prof. Dr. med. Dr. phil. Hinderk M. Emrich and Prof. Dr. med. Luise Reddemann for their support and the opportunity to conduct the research project at Hannover Medical School's Clinic for Psychiatry, Social Psychiatry and Psychotherapy and at the Evangelical Hospital Bielefeld, Clinic for Psychotherapeutic and Psychosomatic Medicine. We also thank Dr. med. Bastian Claaßen, Dr. med. Cornelia Dehner-Rau, OÄ Veronika Engl, Dipl.-Psych. Evelyn Kovalewski, and Greta Wehmeyer for their contributions and assistance with data collection.

Notes

Frauke Rodewald and Claudia Wilhelm-Gößling are now at AMEOS Klinikum Hildesheim, Hildesheim, Germany . Ursula Gast now works in private practice.

1. DDNOS-1 refers to the first example of DDNOS in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.): “1. Clinical presentations similar to Dissociative Identity Disorder that fail to meet full criteria for this disorder. Examples include presentations in which a) there are not two or more distinct personality states, or b) amnesia for important personal information does not occur” (American Psychiatric Association, 2000, p. 490).