Inhibition, Attentional Control and Binding Abilities in Relation to Dissociative Symptoms Among PTSD Patients

ABSTRACT

Introduction

The relationship between dissociation and cognitive abilities remains controversial. Empirical studies have reported positive, negative and non-existent associations between dissociation and cognition. These inconsistent results may be due to the fact that the studies focused mainly on trait dissociation, while dissociation is not stable but transient. After validating the French version of the Clinician Administered Dissociative States Scale (CADSS), the aim of the present study was to evaluate the relationship between state dissociation and cognitive abilities.

Method

We recruited 83 patients suffering from post-traumatic stress disorder (PTSD) and assessed them twice. At T1, they performed a neutral Stroop task and a neutral binding task. At T2 (one to three weeks later), after a script-driven dissociative induction, they performed an emotional Stroop task and an emotional binding task. Between the two sessions, they completed questionnaires at home evaluating PTSD severity, trait dissociation and cognitive difficulties. State dissociation was assessed at T1 and T2 using the Clinician-Administered Dissociative States Scale (CADSS).

Results

We found good psychometric properties of the French version of the CADSS. After inducing dissociation, significantly lower attentional performance was found among patients with than without dissociative reactions. We found a significant positive correlation between state dissociation and increased attention and memory difficulties after induction.

Conclusion

The French version of the CADSS is a reliable and valid tool to assess state dissociation, which is correlated with attentional difficulties. Attentional training is recommended to help patients control dissociative symptoms.

KEYWORDS:

• Attention
• dissociation
• cognition
• memory
• binding
• PTSD

Authors’ contributions

All authors contributed to the study conception and design, and gathered the data. The first author performed statistical analysis and wrote the first version of the manuscript. The final version of the manuscript was approved by all authors.

Ethical approval and consent to participate

The experiment and informed consent procedures were approved by the ethics committee of the University (Comité d’Ethique de la Recherche Tours-Poitiers n° 2020-05-23).

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.