The impact of childhood trauma on the emergence and development of dissociative disorders

Abstract

Dissociative experiences are common both in children and adults. Their frequency and sever-ity range from normal dissociation to pathological fragmentation of identity. High rates of dissociation and Dissociative Disorders have been documented in both community and clinical samples. Trauma, especially chronic trauma, plays an es-sential role in the development and long-term presence of dissociative symptoms. During overwhelming and often traumatic experiences dissociation protects the individual by psychological detachment from the unbearable reality. Chronic dissociative experiences might cause severe disintegration of the individual’s mental experience. The Trauma Model suggests that dissociation is a psychobiological response which enables sur-vival during and after the traumatic event. The Developmental Model is based on an assump-tion that disturbed attachment, especially early interpersonal trauma, might lead to the development of severe dissociation in children and ado-lescents, often lasting into adulthood. Diagnostic systems include three diagnoses which deal with the specific relationship between trauma and dissociation. Two of these diagnoses have been recognized recently-Complex PTSD (ICD-11) and the Dissociative Subtype of PTSD (DSM-5); one has already been established-the Dissociative Identity Disorder. Patients with Dissociative Disorders suffer from a range of symptoms. The most severe symptoms include chronic suicidal ideation and fre-quent suicide attempts. Therefore, researchers and clinicians should routinely assess dissociation in their everyday practice. In patients with Dissociative Disorders the main treatment goal is the integration of their mental experience.