The Relationship Between Peritraumatic Distress and Peritraumatic Dissociation

Abstract

This study examined whether peritraumatic dissociation serves to protect trauma-exposed individuals from experiencing high levels of peritraumatic distress or is an epiphenomenon of high levels of peritraumatic distress. The sample was comprised of 709 police officers and 317 peer-nominated civilians exposed to a variety of critical incidents. Participants filled out measures of trauma exposure, traumatic stress, peritraumatic distress, and peritraumatic dissociation. There was an overall moderate-to-strong linear relationship between peritraumatic distress and dissociation. Among those with high levels of dissociation, very few reported low levels of distress. Among those with high levels of distress, a significant number--but not all--reported high levels of dissociation. Our results do not provide support for the idea that dissociation protects individuals from experiencing high levels of distress at the time of the trauma but rather suggest that dissociation is an epiphenomenon of high levels of distress observed in a subset of individuals.

Human responses to disasters: A pilot study on peritraumatic emotional and cognitive processing

“…Firstly, recent studies support the finding that peritraumatic distress and dissociation are conceptually different, both 118 predicting in unique ways PTSD symptoms (Birmes et al, 2005;Fikretoglu et al, 2006). Secondly, dissociation is closely linked with memory disorganization (Halligan et al, 2003).…”

Peritraumatic distress fully mediates the relationship between posttraumatic stress symptoms preoperative and three months postoperative in patients undergoing spine surgery

“…This effect could be shown for main symptom clusters of PTSD, intrusions, avoidance and hyperarousal, as well as general PSS, proving that no over- or undermodulation on symptom level occurs. Peritraumatic factors are subject to controversial discussions, as opinions differ whether they are influential at all (O’Donnell, Creamer, McFarlane, Silove, & Bryant, 2010) and whether peritraumatic distress or dissociation has a stronger impact on the development of PTSD (Fikretoglu et al, 2006). In the DSM-5, the criterion A2 – describing the experience of intensive fear, helplessness or horror during the trauma – was removed.…”

“…Although peritraumatic dissociation attained the highest effect size ( r  = .35) in the meta-analysis performed by Ozer et al (2003), more recent findings question whether peritraumatic dissociation can be considered an independent predictor (Hagenaars, van Minnen, & Hoogduin, 2007; van der Velden & Wittmann, 2008). Peritraumatic dissociation may rather be an epiphenomenon of high levels of peritraumatic distress (Fikretoglu et al, 2006). In addition to pretrauma and peritrauma variables, variables occurring after the traumatic event (posttraumatic variables, e.g.…”

Behavioural, emotional, and cognitive responses in European disasters: results of survivor interviews

“…This would appear to complement results from a meta-analysis conducted by Ozer et al (2003), which revealed that peri-traumatic variables were better predictors of PTSD than pre-or post-traumatic variables, and that peri-traumatic dissociation was the strongest predictor. Furthermore, Fikretoglu et al (2006) found physiological symptoms of a panic attack during the traumatic event to be a good predictor of later posttraumatic distress. A relationship with post-traumatic stress would also be expected based on other research on this topic, concerning perceived life threat and fear (Basoglu, Salcioglu, and Livanou, 2002;Simeon et al, 2003;Basoglu et al, 2004).…”

“…Studies have shown that post-traumatic stress symptoms are best predicted by peri-traumatic factors, such as emotions and cognitions displayed by survivors during the event (Ozer et al, 2003), including negative feelings and perceived threats (Brunet et al, 2001), dissociation (Marmar et al, 1994), and physiological factors related to a panic attack (Fikretoglu et al, 2006). However, while the influence of peritraumatic emotional and cognitive processing on post-traumatic outcome is well-established, to our knowledge no studies have investigated the relationship between peri-traumatic behavioural responses and post-traumatic stress.…”