Helen Kennerley

Somatoform dissociation, psychological dissociation, and specific forms of trauma

Abstract Background: Childhood trauma is clearly associated with psychological dissociation a failure to integrate cognitive, behavioural and emotional aspects of experience. However, there is also evidence that trauma results in somatoform dissociation, where the individual fails to process somatic experiences adequately. Somatoform dissociation is linked to a number of psychiatric disorders that are relatively resistant to treatment. The present study addresses the hypothesis that somatoform dissociation will be associated specifically with childhood trauma that involves physical contact, rather than with non-contact forms of trauma. Methods: An unselected clinical group of 72 psychiatric patients completed standardized measures of childhood trauma, psychological dissociation, and somatoform dissociation. Results: The findings supported the hypothesis, with a specific link between somatoform dissociation and the severity of reported childhood trauma involving physical contact or injury. In contrast, psychological dissociation was associated with a wider range of non-contact trauma. Conclusions: Somatoform dissociation can be understood as a set of adaptive psychophysiologic responses to trauma where there is a threat of inescapable physical injury. Those responses are related to a range of psychiatric disorders, and are likely to interfere with treatment of those disorders. Clinicians may need to assess the nature and severity of childhood trauma and somatoform dissociation when there are high levels of somatic symptoms within psychiatric disorders that cannot be explained medically. Further research is needed to determine methods of treating somatoform dissociation, especially in the context of a history of trauma involving physical contact or injury.

A preliminary study examining relationships between childhood maltreatment, dissociation, and self-injury in psychiatric outpatients

This study aimed to examine the relationships between childhood maltreatment, dissociation, and self-injury. Unlike much previous research, this study included 5 different types of childhood maltreatment in addition to sexual and physical abuse, and it looked at parameters of maltreatment such as onset and duration. Participants (n = 58) were psychiatric outpatients. The different types of maltreatment co-occurred, with most participants suffering 4 or all 5 types. It was found that childhood maltreatment rather than dissociation predicted self-injury. Furthermore, physical abuse rather than the other kinds of childhood maltreatment was significantly related to self-injury.

Bipolar risk and mental imagery susceptibility in a representative sample of Chinese adults residing in the community

Background: We need to better understand the cognitive factors associated with risk for bipolar disorders. Recent research suggests that increased susceptibility to mental imagery may be one such factor. However, since this research was primarily conducted with Western students and at a single time-point, it is not known whether the relationship between imagery susceptibility and bipolar symptoms exists across cultures or within the general community, or whether this relationship remains stable over time. Aim: This study evaluated whether Chinese adults identified as being at high (HR) versus low (LR) risk of developing bipolar disorders showed greater mental imagery susceptibility. We aimed to test whether such a relationship was stable over time by measuring imagery characteristics at baseline and at the 7-week follow-up. Method: This prospective study recruited a community sample of N = 80 Chinese adults screened for the absence of neurotic and psychotic disorders. The sample was split into HR (n = 18) and LR (n = 62) groups at baseline based on a criterion cut-off score on a measure of hypomania, the Mood Disorder Questionnaire (MDQ). Participants completed measures of imagery susceptibility and its impact: the Spontaneous Use of Imagery Scale (SUIS) and the Impact of Future Events Scale (IFES), at baseline and 7 weeks later. Results: HR group reported greater tendency to use imagery in daily life (SUIS) and greater emotional impact of prospective imagery (IFES) than LR group at baseline. These results remained stable at follow-up. Conclusion: This study provides preliminary evidence for increased susceptibility to mental imagery in individuals at high risk of bipolar disorders recruited from a community sample of Chinese adults. This extends previous research in Western student samples suggesting that imagery (both levels of use and its emotional impact) may be a cognitive factor with cross-cultural relevance that is stable over time.