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

Publication ,  Journal Article
Choi, KR; Seng, JS; Briggs, EC; Munro-Kramer, ML; Graham-Bermann, SA; Lee, RC; Ford, JD
Published in: J Am Acad Child Adolesc Psychiatry
December 2017

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.

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Published In

J Am Acad Child Adolesc Psychiatry

DOI

EISSN

1527-5418

Publication Date

December 2017

Volume

56

Issue

12

Start / End Page

1062 / 1072

Location

United States

Related Subject Headings

  • Stress Disorders, Post-Traumatic
  • Psychiatric Status Rating Scales
  • Models, Statistical
  • Models, Psychological
  • Male
  • Humans
  • Female
  • Dissociative Disorders
  • Developmental & Child Psychology
  • Depersonalization
 

Citation

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Choi, K. R., Seng, J. S., Briggs, E. C., Munro-Kramer, M. L., Graham-Bermann, S. A., Lee, R. C., & Ford, J. D. (2017). The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms. J Am Acad Child Adolesc Psychiatry, 56(12), 1062–1072. https://doi.org/10.1016/j.jaac.2017.09.425
Choi, Kristen R., Julia S. Seng, Ernestine C. Briggs, Michelle L. Munro-Kramer, Sandra A. Graham-Bermann, Robert C. Lee, and Julian D. Ford. “The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.J Am Acad Child Adolesc Psychiatry 56, no. 12 (December 2017): 1062–72. https://doi.org/10.1016/j.jaac.2017.09.425.
Choi KR, Seng JS, Briggs EC, Munro-Kramer ML, Graham-Bermann SA, Lee RC, et al. The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms. J Am Acad Child Adolesc Psychiatry. 2017 Dec;56(12):1062–72.
Choi, Kristen R., et al. “The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.J Am Acad Child Adolesc Psychiatry, vol. 56, no. 12, Dec. 2017, pp. 1062–72. Pubmed, doi:10.1016/j.jaac.2017.09.425.
Choi KR, Seng JS, Briggs EC, Munro-Kramer ML, Graham-Bermann SA, Lee RC, Ford JD. The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms. J Am Acad Child Adolesc Psychiatry. 2017 Dec;56(12):1062–1072.
Journal cover image

Published In

J Am Acad Child Adolesc Psychiatry

DOI

EISSN

1527-5418

Publication Date

December 2017

Volume

56

Issue

12

Start / End Page

1062 / 1072

Location

United States

Related Subject Headings

  • Stress Disorders, Post-Traumatic
  • Psychiatric Status Rating Scales
  • Models, Statistical
  • Models, Psychological
  • Male
  • Humans
  • Female
  • Dissociative Disorders
  • Developmental & Child Psychology
  • Depersonalization