Exploring the complex relationship between anxiety and dissociation in a clinical population

Abstract

Objective: To examine the relationship between anxiety symptoms and dissociative experiences in a clinical sample, using severity scores from standardised screening instruments. Method: Secondary data were analysed from 482 Australian clients, primarily from private outpatient psychology services. All clients completed the Multidimensional Inventory of Dissociation–60 (MID-60), with subsets completing the Depression Anxiety Stress Scale-21 (DASS-21; n = 295) or Generalised Anxiety Scale-7 (GAD-7; n = 223); 36 completed both. Clients were grouped by symptom severity based on established cut-offs for each measure. Differences in dissociation were assessed using ANOVA and odds ratios. Results: Clients with moderate to severe anxiety (according to screening thresholds) were significantly more likely to score in the clinical range for dissociation. A six-fold risk was observed for physiological anxiety (DASS-21; OR = 5.87; r =.54, ηp2 = 0.24) and a two-and-a-half-fold risk for generalised anxiety (GAD-7; OR = 2.57, r =.35, ηp2 = 0.11). Anxiety was most predictive of depersonalisation/derealisation, distress about memory problems, self-confusion, flashbacks, and conversion symptoms. Conclusion: Anxiety severity predicted higher dissociation, especially for physiological symptoms. Findings highlight the need for routine dissociation screening in clients with anxiety to support more accurate formulation and tailored interventions to improve treatment outcomes.