The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.

Journal Article (Journal Article)

OBJECTIVE: The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broader set of dissociation symptoms. METHOD: A sample of treatment-seeking, trauma-exposed adolescents 12 to 16 years old (N = 3,081) from the National Child Traumatic Stress Network Core Data Set was used to meet the study objectives. Two models of PTSD/dissociation co-occurrence were estimated using latent class analysis, one with 2 dissociation symptoms and the other with 10 dissociation symptoms. After model selection, groups within each model were compared on demographics, trauma characteristics, and psychopathology. RESULTS: Model A, the depersonalization/derealization model, had 5 classes: dissociative subtype/high PTSD; high PTSD; anxious arousal; dysphoric arousal; and a low symptom/reference class. Model B, the expanded dissociation model, identified an additional class characterized by dissociative amnesia and detached arousal. CONCLUSION: These 2 models provide new information about the specific ways PTSD and dissociation co-occur and illuminate some differences between adult and adolescent trauma symptom expression. A dissociative subtype of PTSD can be distinguished from PTSD alone in adolescents, but assessing a wider range of dissociative symptoms is needed to fully characterize adolescent traumatic stress responses.

Full Text

Duke Authors

Cited Authors

  • Choi, KR; Seng, JS; Briggs, EC; Munro-Kramer, ML; Graham-Bermann, SA; Lee, RC; Ford, JD

Published Date

  • December 2017

Published In

Volume / Issue

  • 56 / 12

Start / End Page

  • 1062 - 1072

PubMed ID

  • 29173740

Pubmed Central ID

  • PMC5726572

Electronic International Standard Serial Number (EISSN)

  • 1527-5418

Digital Object Identifier (DOI)

  • 10.1016/j.jaac.2017.09.425


  • eng

Conference Location

  • United States