A network analysis of peritraumatic dissociation and subsequent intrusive memories

Abstract

Background: Cognitive models of posttraumatic stress disorder (PTSD) propose that disturbed processing during a traumatic event results in a distinctive encoding style, which contributes to the subsequent occurrence of re-experiencing symptoms. Objective: Despite this claim, there is a lack of evidence regarding the distinctive relationship between peritraumatic dissociation and subsequent re-experiencing symptoms. Method: This study used a longitudinal sample of traumatic injury survivors (n = 443) who were assessed during hospital admission and within one month of trauma exposure for peritraumatic dissociation (using the Peritraumatic Dissociative Experiences Questionnaire), and subsequently 382 (86.2%) participants were re-assessed three months later for PTSD (using the Clinician-Administered PTSD Scale). Network analyses were applied to determine the relationships between peritraumatic dissociation and each of the DSM-IV PTSD symptoms three months later. Results: Eighty-two (9.5%) patients met criteria for PTSD at three-months post injury. There were strong positive edges between peritraumatic dissociation and subsequent amnesia, as well as the re-experiencing symptoms of physical reactivity to reminders, flashbacks, intrusions and dreams, and to a lesser extent emotional numbness and hypervigilance. Conclusions: The finding that peritraumatic dissociation is related to subsequent re-experiencing symptoms more strongly than other PTSD symptoms is consistent with cognitive models that emphasize the role of aberrant encoding of a traumatic event in the etiology of PTSD re-experiencing symptoms.