Background: Emotion dysregulation (ED) is an important feature of trauma spectrum disorders like dissociative identity disorder (DID). Dissociative experiences of compartmentalization and detachment from one’s sense of self and surroundings are common in DID, and it is thought that they protect individuals from overwhelming affect dysregulation related to traumatic experiences. However, few empirical studies have examined the relationship between trauma, dissociation, and ED – and none specifically in DID. To test whether ED is a mechanism linking trauma to dissociation, we examined the associations between childhood trauma, ED, and dissociative symptoms in a sample of individuals with DID. We predicted that childhood trauma and different types of dissociation would all be associated with more ED. Furthermore, we hypothesized that greater ED would predict higher levels of dissociative symptoms in DID.
Methods: Participants were 21 treatment-seeking individuals with histories of childhood abuse and neglect. All participants met diagnostic criteria for posttraumatic stress disorder (PTSD) and DID using the Clinician-Administered PTSD Scale for DSM-5 and the Structured Clinical Interview for Dissociative Disorders, respectively. In addition, participants completed a battery of self-report measures including the Childhood Trauma Questionnaire, PTSD Checklist for DSM-5, the Multidimensional Inventory of Dissociation, and the Emotion Dysregulation Scale.
Results: Higher ED scores were associated with a higher severity of PTSD symptoms, and with more detachment and compartmentalization dissociation (p’s<.05), but not with childhood trauma severity. A linear regression analysis showed that when controlling for childhood trauma and PTSD symptom severity, ED significantly predicted compartmentalization (b=.72, t=3.39, p=.004), but not detachment dissociation.
Conclusions: Our results suggest that ED, above and beyond childhood trauma and PTSD symptom severity, is an important factor in the development and maintenance of dissociative symptoms in DID. This supports treatment guidelines targeting emotion regulation as a therapeutic goal for individuals with DID.
Live Zoom Session – April 21st
Chloe S. Kaplan, BA, Cori A. Palermo, MA, Milissa L. Kaufman, MD, PhD & Lauren A. M. Lebois, PhD
Milissa L. Kaufman, MD, PhD & Lauren A. M. Lebois, PhD