Dissociation predicts later attention problems in sexually abused children

Abstract

Objective-The goals of this research are to develop and test a prospective model of attention problems in sexually abused children that includes fixed variables (e.g., gender), trauma, and disclosure-related pathways.Methods-At Time 1, fixed variables, trauma variables, and stress reactions upon disclosure were assessed in 156 children aged 8 to 13 years. At the Time 2 follow-up (8 to 36 months following the initial interview), 56 of the children were assessed for attention problems.Results-A path analysis involving a series of hierarchically-nested, ordinary least squares multiple regression analyses indicated two direct paths to attention problems including the child's relationship to the perpetrator (β = .23) and dissociation measured immediately after disclosure (β = .53), while controlling for concurrent externalizing behavior (β = .43). Posttraumatic stress symptoms were only indirectly associated with attention problems via dissociation. Taken together, these pathways accounted for approximately 52% of the variance in attention problems and provided an excellent fit to the data.Conclusions-Children who report dissociative symptoms upon disclosure of CSA and/or were sexually abused by someone within their family are at an increased risk of developing attention problems.Practice Implications: Findings from this study indicate that children who experienced sexual abuse at an earlier age, by someone within their family, and/or report symptoms of dissociation during disclosure are especially likely to benefit from intervention. Effective interventions should involve (1) providing emotion regulation and coping skills; and (2) helping children to process traumatic aspects of the abuse to reduce the cyclic nature of traumatic reminders leading to unmanageable stress and dissociation.

Childhood abuse and neglect in adult attention-deficit/hyperactivity disorder

“…Another possibility is that dissociative symptoms may mediate the relationship between traumatic experiences and attention problems. In fact, it has been shown that abused children who later develop attention problems have more common dissociative symptoms [5]. To make causality claims even more complex, it has also been reported that childhood ADHD symptoms were associated with dissociative symptoms in adulthood [9].…”

“…Dissociative symptoms may also be risk factors for later attention problems in children who were abused [5]. To a lesser extent, ADHD is associated with traumatic experiences itself.…”

Interpersonal early‐life trauma alters amygdala connectivity and sustained attention performance

“…Sustained attention, the ability to maintain focus over a period of seconds to minutes while suppressing distractions, is highly sensitive to stress/arousal (Scholz et al., 2009). Significant evidence points to an impact of I‐ELT on sustained attention ability (De Bellis, Woolley, & Hooper, 2013; DePrince, Weinzierl, & Combs, 2009; Kaplow, Hall, Koenen, Dodge, & Amaya‐Jackson, 2008; Navalta, Polcari, Webster, Boghossian, & Teicher, 2006; Porter, Lawson, & Bigler, 2005; Samuelson, Krueger, Burnett, & Wilson, 2010), yet no study to date has examined how I‐ELT‐related amygdala dysregulation may contribute to impairments in sustained attention or cognitive performance in neutral contexts more broadly. Evidence that amygdala functioning can impact sustained attention in nonemotional contexts can be found in animal studies suggesting that the amygdala serves as a general relevance detector (Gallagher & Holland, 1994; Holland, 2007; Holland & Gallagher, 1999; Holland, Han, & Gallagher, 2000; Sander, Grafman, & Zalla, 2003).…”

Dissociation and the Adult Attachment Interview in artists and performing artists

“…Indirect support for an Unresolved-dissociation model can be found in research conducted on dissociation, attention, and memory. Sexually abused children who reported dissociative symptoms were at increased risk for attentional problems (Kaplow, Hall, Koenen, Dodge, & Amaya-Jackson, 2008). High levels of dissociation were found to be related to fragmentation (lack of integration) of retrospective memory, in particular, emotional memory (Candel, Merckelbach, & Kuijpers, 2003), a finding that was supported in a study on PTSD patients (David, Akerib, Gaston, & Brunet, 2010).…”