According to 19th century French psychiatry and contemporary clinical observations, dissociation pertains to both psychological and somatoform components of experience, reactions, and functions. Because such an instrument was lacking, we aimed to develop a self-reporting questionnaire measuring what we propose to call somatoform dissociation. Patients with dissociate disorder and with other DSM-IV psychiatric diagnoses completed a list of 75 items that, according to clinical experience and expert judgment, could reflect instances of somatoform dissociation. Separate logistic analyses and determination of discriminant indices per item revealed 20 items that best discriminated between those with and without dissociative disorders. Mokken analysis showed that these items are strongly scalable on a dimensional latent scale interpreted to measure somatoform dissociation. Reliability of the scale was high. Construct validity was supported by high intercorrelations with the Dissociation Questionnaire, which measures psychological dissociation, and higher scores of patients with dissociative identity disorder compared with patients with dissociative disorders not otherwise specified. In conclusion, the Somatoform Dissociation Questionnaire (SDQ-20) is a scale of good psychometric quality, which measures somatoform dissociation. The symptoms pertain to negative and positive dissociative phenomena, which were well known in 19th century French psychiatry as the mental stigmata and mental accidents of hysteria.
In this study, the prevalence and severity of traumatic experiences as reported by patients with dissociative disorders and with other DSM-IV psychiatric diagnoses were compared. Furthermore, the predictive value of emotional, physical, and sexual trauma with respect to somatoform and psychological dissociation was analyzed. In contrast with comparison patients, dissociative disorder patients reported severe and multifaceted traumatization. Physical and sexual trauma predicted somatoform dissociation, sexual trauma predicted psychological dissociation as well. According to the memories of the dissociative disorder patients, this abuse occurred in an emotionally neglectful and abusive social context. Pathological dissociation was best predicted by early onset of reported intense, chronic and multiple traumatization. Methodological limitations restricting causal inferences between reported trauma and dissociation are discussed.
A new self‐report instrument for the screening of dissociative symptoms, the Dissociation Questionnaire (DIS‐Q), has been administered to a representative sample of the Dutch and Flemish population on two occasions (N = 374 and N = 378). Four subscales were found, which together accounted for 77% of the common variance: (1) identity confusion; (2) loss of control over behaviour, thoughts and emotions; (3) amnesia; and (4) absorption. The DIS‐Q shows good to excellent internal consistency and test–retest reliability together with good construct and congruent validity. The authors conclude that the DIS‐Q might be of great help in the assessment of dissociative symptoms.
Patients with complex dissociative disorders remain in alternating psychophysiological states which are discrete, discontinuous, and resistant against integrative tendencies. In this contribution, a parallel is drawn between animal defensive and recuperative states that are evoked in the face of severe threat and the characteristic responses of dissociative disorder patients as displayed in major dissociative states. Empirical data and clinical observations seem to be supportive of the idea that there are similarities between freezing, concomitant development of analgesia and anesthesia, and acute pain in threatened animals and severely traumatized human beings.
The paucity and heterogeneity of available studies limits overall conclusions and highlights the need for further research. Implications for Rehabilitation Supervised physical therapy might increase weight in anorexia nervosa patients. Aerobic exercise, massage, basic body awareness therapy and yoga might reduce eating pathology in patients with anorexia and bulimia nervosa. Aerobic exercise, yoga and basic body awareness therapy might improve mental and physical quality of life in patients with an eating disorder.
Background and aimsSeveral studies report a positive association between adverse life experiences and adult obesity. Despite the high comorbidity between binge eating disorder (BED) and obesity, few authors have studied the link between trauma and BED. In this review the association between exposure to adverse life experiences and a risk for the development of obesity and BED in adulthood is explored.MethodsBased on a scientific literature review in Medline, PubMed and PsycInfo databases, the results of 70 studies (N = 306,583 participants) were evaluated including 53 studies on relationship between adverse life experiences and obesity, 7 studies on post-traumatic stress disorder (PTSD) symptoms in relation to obesity, and 10 studies on the association between adverse life experiences and BED. In addition, mediating factors between the association of adverse life experiences, obesity and BED were examined.ResultsThe majority of studies (87%) report that adverse life experiences are a risk factor for developing obesity and BED. More precisely a positive association between traumatic experiences and obesity and PTSD and obesity were found, respectively, in 85% and 86% of studies. Finally, the great majority of studies (90%) between trauma and the development of BED in adulthood strongly support this association. Meanwhile, different factors mediating between the trauma and obesity link were identified.Discussion and conclusionsAlthough research data show a strong association between life adverse experiences and the development of obesity and BED, more research is needed to explain this association.
Present research findings on alexithymia in the field of dermatology suggest important implications for the treatment of some specific dermatological disorders. Besides treating comorbid psychological problems such as anxiety and depression, dermatologists should also be aware of alexithymia and its possible association with an underlying dermatologic disease.
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