Predicting a dissociative disorder from type of childhood maltreatment and abuser–abused relational tie

Krüger, Christa; Fletcher, Lizelle

doi:10.1080/15299732.2017.1295420

Cited by 19 publications

(15 citation statements)

References 28 publications

(31 reference statements)

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“…Specifically in PNES, Ozcetin et al ( 59 ) found emotional abuse and emotional neglect to be significantly more frequent than in healthy controls. Kruger and Fletcher ( 69 ) showed that childhood emotional neglect by the biological parents and later emotional abuse by intimate partners predict the development of dissociative disorders. Importantly, emotional abuse has been associated with insular volume ( 70 ) and abnormal connectivity between the right TPJ and left insula ( 42 ) in FND patients.…”

Section: Methodsmentioning

confidence: 99%

Processing of Emotion in Functional Neurological Disorder

et al. 2018

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Emotions have traditionally been considered crucial in the development of functional neurological disorder, but the evidence underpinning this association is not clear. We aimed to summarize evidence for association between functional neurological disorder and emotions as formulated by Breuer and Freud in their conception of hysterical conversion. Based on a systematic literature search, we identified 34 controlled studies and categorized them into four groups: (i) autonomic arousal, (ii) emotion-motion interactions, (iii) social modulation of symptoms, and (iv) bodily awareness in FND. We found evidence for autonomic dysregulation in FND; convergent neuroimaging findings implicate abnormal limbic-motor interactions in response to emotional stimuli in FND. Our results do not provide enough empirical evidence for social modulation of the symptoms, but there is a clinical support for the role of suggestion and placebo in FND. Our results provide evidence for abnormal bodily awareness in FND. Based on these findings, we propose that functional neurological symptoms are forms of emotional reactions shaped into symptoms by previous experience with illness and possibly reinforced by actual social contexts. Additional research should investigate the effect of social context on the intensity of functional neurological symptoms and associated brain regions.

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Section: Methodsmentioning

confidence: 99%

Processing of Emotion in Functional Neurological Disorder

et al. 2018

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“…By using corroborating documentation from hospital, police, and child protection agencies or witnesses, several studies have confirmed histories of severe abuse in DID 29,34,35. In most clinical series, childhood abuse and/or neglect is reported by 90–100% of the patients directly during the study examination 36,37. Dissociative amnesia for childhood events may prevent such reports by some of the patients 38…”

Section: Developmental Traumatizationmentioning

confidence: 98%

“…29 , 34 , 35 In most clinical series, childhood abuse and/or neglect is reported by 90–100% of the patients directly during the study examination. 36 , 37 Dissociative amnesia for childhood events may prevent such reports by some of the patients. 38 …”

Section: Developmental Traumatizationmentioning

confidence: 99%

“…In a study conducted on a large group of college students, Şar et al 39 demonstrated that emotional neglect predicted a dissociative disorder (including DID) diagnosis. Krüger and Fletcher 37 demonstrated that self-reported emotional neglect by biological parents or siblings in childhood was the strongest individual predictor of an adult diagnosis of a dissociative disorder (including DID) in psychiatric patients (out of all other combinations of abuse type and abuser-abused relational ties).…”

Section: Developmental Traumatizationmentioning

confidence: 99%

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Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective

Şar¹,

Dorahy²,

Krüger³

2017

PRBM

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Dissociative identity disorder (DID) is a chronic post-traumatic disorder where developmentally stressful events in childhood, including abuse, emotional neglect, disturbed attachment, and boundary violations are central and typical etiological factors. Familial, societal, and cultural factors may give rise to the trauma and/or they may influence the expression of DID. Memory and the construction of self-identity are cognitive processes that appear markedly and centrally disrupted in DID and are related to its etiology. Enduring decoupling of psychological modes may create separate senses of self, and metamemory processes may be involved in interidentity amnesia. Neurobiological differences have been demonstrated between dissociative identities within patients with DID and between patients with DID and controls. Given the current evidence, DID as a diagnostic entity cannot be explained as a phenomenon created by iatrogenic influences, suggestibility, malingering, or social role-taking. On the contrary, DID is an empirically robust chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress. While current evidence is sufficient to firmly establish this etiological stance, given the wide opportunities for innovative research, the disorder is still understudied. Comparison of well-selected samples of DID patients with non-dissociative subjects who have other psychiatric disorders would further delineate the neurobiological and cognitive features of the disorder, whereas genetic research on DID would further illuminate the interaction of the individual with environmental stress. As such, DID may be seen as an exemplary disease model of the biopsychosocial paradigm in psychiatry.

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“…Krüger and Fletcher (2017) in a well‐designed study of 116 women, via self‐reported questionnaire found that there is a strong correlation between emotional neglect (i.e. NO overt physical or sexual abuse) by biological parents with an involvement, later in life, in an overtly abusive relationship.…”

Section: Predisposing Factorsmentioning

confidence: 99%

A psychoanalytic perspective on victims of domestic violence and coercive control

Brandt

Rudden

2020

Appl Psychoanal Studies

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Based on long clinical and forensic experience in the assessment and treatment of victims of domestic violence, the authors discuss some predisposing psychological factors that can lead to a woman's vulnerability to forming and maintaining an attachment to an abusive partner. Clinical vignettes to illustrate some kinds of observed vulnerabilities along with the authors' ideas as to their origins are presented. The authors argue that these women present with some common but hidden difficulties that may go unrecognized even in a psychoanalytic setting. This is, in part, because of our profession's lack of familiarity with the nature of domestic violence. A more nuanced understanding of the phenomenon of domestic violence is obscured by two crucial factors: first, there is an initial clinical focus on the reality of significant external obstacles to terminating these often intense bonds – even in the face of foreseeable danger to the victim and children; second, and perhaps more limiting, are psychoanalytically based assumptions about “characterological masochism” that often reflect simplistic, moralistic, misogynistic assumptions about women that continue to inform psychoanalytic theory in the area of family life. In addition, the authors discuss some of the interactions contained within the perpetrator/victim relationship that reflect and reinforce the internal liabilities observed in this group of victims.

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Predicting a dissociative disorder from type of childhood maltreatment and abuser–abused relational tie

Cited by 19 publications

References 28 publications

Processing of Emotion in Functional Neurological Disorder

Processing of Emotion in Functional Neurological Disorder

Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective

A psychoanalytic perspective on victims of domestic violence and coercive control

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