Predicting a dissociative disorder from type of childhood maltreatment and abuser–abused relational tie

ABSTRACT

We investigate the types of childhood maltreatment and abuser–abused relational ties that best predict a dissociative disorder (DD). Psychiatric inpatients (n = 116; mean age = 35; F:M = 1.28:1) completed measures of dissociation and trauma. Abuse type and abuser–abused relational ties were recorded in the Traumatic Experiences Questionnaire. Multidisciplinary team clinical diagnosis or administration of the SCID-D-R to high dissociators confirmed DD diagnoses. Logit models described the relationships between abuser–abused relational tie and the diagnostic grouping of patients, DD present (n = 16) or DD absent (n = 100). Fisher’s exact tests measured the relative contribution of specific abuse types. There was a positive relationship between abuse frequency and the presence of DD. DD patients experienced more abuse than patients without DDs. Two combinations of abuse type and relational tie predicted a DD: childhood emotional neglect by biological parents/siblings and later emotional abuse by intimate partners. These findings support the early childhood etiology of DDs and subsequent maladaptive cycles of adult abuse. Enquiries about childhood maltreatment should include a history of emotional neglect by biological parents/siblings. Adult emotional abuse by intimate partners should assist in screening for DDs.

KEYWORDS:

• Abuser–abused relational ties
• biological parents/siblings
• childhood maltreatment
• dissociative disorders
• emotional abuse
• emotional neglect
• intimate partners

Acknowledgments

The authors are grateful to Mrs J Sommerville of the Department of Statistics, University of Pretoria for her assistance with electronic data management and statistical analyses; to Mr BB Versfeld, Ms R Liprini, and Ms L Meiring (research assistants in the Department of Psychiatry, University of Pretoria) for their assistance with questionnaire-based data collection and data management to Dr. C Tosh for language editing; and to the patients for their willingness to participate in this research study.

Funding

This research was funded by grants from the South African National Research Foundation, as well as the Department of Psychiatry and Faculty of Health Sciences of the University of Pretoria. These sponsors had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Declaration of interest

There are no conflicts of interest.

Additional information

Funding

This research was funded by grants from the South African National Research Foundation, as well as the Department of Psychiatry and Faculty of Health Sciences of the University of Pretoria. These sponsors had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.