Ann Begin

The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation

The overall purpose of the present study was to further our understanding of the mechanisms of self-mutilative behavior in a sample of female inpatients. The study found that self-mutilators (n = 103) displayed a greater degree of dissociative symptoms and alexithymia and a greater number of self-injurious behaviors, as well as higher rates of childhood sexual abuse, than nonmutilators (n = 45). In addition, the study found that among these variables, the number of self-injurious behaviors had the strongest relationship to self-mutilation. However, both dissociative symptoms and alexithymia were independently associated with self-mutilative behavior. Implications of our findings for clinicians and researchers are discussed.

The long-term sequelae of sexual abuse: support for a complex posttraumatic stress disorder

This study examined the relationship between childhood sexual abuse and symptoms of a newly proposed complex posttraumatic stress disorder or disorder of extreme stress not otherwise specified (DESNOS). Compared to 34 women without histories of sexual abuse, 74 survivors of sexual abuse showed increased severity on DESNOS symptoms of somatization, dissociation, hostility, anxiety, alexithymia, social dysfunction, maladaptive schemas, self-destruction and adult victimization. In addition, a logistic regression found that a complex of symptoms representing DESNOS was significantly related to a history of sexual abuse. Consistent with other studies, the results of this study provide support for the idea that symptoms of DESNOS characterize survivors of sexual abuse.

Evaluation of a Program Designed to Help Family and Significant Others to Motivate Resistant Alcoholics into Recovery

Little empirical work has been done in the alcohol field on the issue of motivating reticent people into treatment. This study explored the impact of a program that involved counseling an alcoholics social network to eventually confront the alcoholic in urging him or her to seek treatment. Twenty-four social networks (relatives plus significant others) participated in this study and of these, seven formally confronted the alcoholic. Social networks were not randomized to confronting vs nonconfronting conditions, although the comparison groups were equivalent on several important dimensions. Results indicate that alcoholics who were confronted were significantly more likely to enter an alcohol detox or rehabilitation program and to remain continuously abstinent than were nonconfronted alcoholics. This study suggests that the alcoholics social network can be helped to become highly influential in motivating the alcoholic to seek treatment.

The validation of the Trauma Symptom Checklist-40 (TSC-40) in a sample of inpatients

This study examined the construct validity of the Trauma Symptom Checklist-40 (TSC-40; Elliot & Briere, 1992) in a sample of 130 female psychiatric inpatients. Consistent with other findings, the TSC-40 displayed criterion-related validity in relation to childhood sexual abuse. Survivors of sexual abuse obtained significantly higher scores than those without such a history on the overall TSC-40 and on each of the six subscales, except the Depression subscale. Convergent validity of three subscales was demonstrated, and divergent validity on the total TSC-40 and each of its subscales was established. Further, among a range of abuse-effects measures, the Sexual Abuse Trauma Index (SATI) subscale was the most powerful predictor of sexual abuse. The SATI and Dissociation subscales were the subscales most sensitive to the specific features of the sexual abuse.

The relationship between characteristics of sexual abuse and dissociative experiences

Childhood sexual abuse has been associated with adult dissociative symptomatology. The purpose of this study was to examine the relationship between specific characteristics of sexual abuse and dissociative experiences in adulthood. Fifty-six female inpatients with a history of physical abuse and severe sexual abuse reported on their history of abuse and dissociative experiences. A logistic regression that controlled for physical revictimization showed that sexual abuse by a greater number of different sex abuse offenders was significantly related to an elevated level of dissociation. In exploring how many sex abuse offenders are associated with dissociative experiences, a logistic regression revealed a significant relationship between four or more sex abuse offenders and greater dissociative symptomatology. The reported age of onset of the sexual abuse was not a significant predictor of dissociation when sexual revictimization was included in the analysis. These findings suggest that severely traumatized patients with a history of multiple sex abuse offenders are highly likely to use dissociation as a primary psychological defense. The implications of the study are discussed.

Differences in dissociative experiences between survivors of childhood incest and survivors of assault in adulthood

The present study attempted to investigate whether women with histories of incest before 13 years of age were likely to report more dissociative symptomatology than women with their first experience of interpersonal violence in adulthood (i.e., histories of physical or sexual assault after the age of 17).

Stressors and close relationships during childhood and dissociative experiences in survivors of sexual abuse among inpatient psychiatric women

The purpose of this study was to examine which childhood events were associated with more extensive use of adult dissociative states in 90 female inpatients with histories of sexual abuse. The study found that childhood stressors of maltreatment (physical neglect, witnessing sexual abuse, and witnessing physical abuse) were associated with higher levels of dissociative symptoms. In contrast, childhood stressors of loss (parental separation and death of a close relative) were not related to increased severity of dissociative symptoms. The study also demonstrated that a close relationship with either a parent, sibling, extraparental adult, or friend did not have a mediating effect on the degree of adult dissociative symptoms. Directions for future research are presented.

Suppression, Acceptance, and Monitoring of Personally-Relevant Unwanted Thoughts in Women Diagnosed with Borderline Personality Disorder:

Recent evidence suggests that patients with Borderline Personality Disorder (BPD) experience less immediate distress while suppressing unwanted thoughts, despite the negative long-term outcomes of that strategy longitudinally and in treatment settings. The present study investigated the impact of 8-minute audiotaped suppression/thought control, acceptance, and monitoring instructions on moderately distressing and personally relevant thoughts in women (N = 51; 17 per condition) diagnosed with BPD. Strategies were applied in a 5-minute think-aloud period, followed by a similar period without the strategy, and then a wind-down task. Those in the suppression condition reported less subjective distress throughout but showed evidence of attempts at distraction through increased talking in the second period. Participants in the suppression group with higher experiential avoidance showed more thought intrusions during the main task period and lower positive affect during the wind-down task than those in other conditions. Suppression appears to produce some negative outcomes in this population despite resulting in less self-reported distress.