An exploration of dissociation in Australia: measurement issues, predictors and phenomenology

This project incorporated three related but independent studies examining measurement issues, possible predictors, and processes of dissociation. Study 1 reinvestigated the measurement of dissociation by replicating previous studies suggesting there is a pathological dissociative taxon. The sample comprised 602 participants, 322 males from the Austin Repatriation Hospital PTSD treatment program for Vietnam War Veterans (approximate age 50 to 75 years), and 280 participants from clinical and nonclinical sources ranging in age from 17 to 67 years (47 males, M = 26.98 years, SD = 11.72, and 232 females, M = 27.97 years, SD = 12.99). The participants completed the Dissociative Experiences Scale (DES). Taxometric analyses, both MAMBAC and MAXEIG, were performed using two possible sets of taxon indicators extracted from the DES, the 8-item DES-T as suggested by the three previous studies, and a novel set of nine amnesic indicators. Contrary to expectations, there was little evidence of a dissociative taxon based on either set of indicators. It was concluded that caution is needed in sub-typing individuals exhibiting high dissociation scores according to the 8- item DES-T, and that there is a need for further research with other samples. Study 2 investigated possible predictors of dissociation: childhood abuse, particularly sexual abuse, personality, and fantasy proneness, with an emphasis on exploring whether the predictors of pathological dissociation are the same as those for normal dissociation. The sample comprised the 280 participants mentioned in Study 1, who each completed a paper or internet based survey that included demographics, personality, dissociation, childhood trauma, fantasy proneness, and resilience measures. Multiple regression analyses and structural equation modelling (SEM) were conducted. Results showed that childhood abuse, sexual abuse, fantasy proneness, and resilience were direct predictors of dissociation and pathological dissociation. Vulnerable personality only indirectly predicted dissociation. Fantasy proneness mediated the association between childhood abuse and dissociation, and fantasy proneness rather than childhood abuse remained the strongest predictor of both dissociation and pathological dissociation. Resilience was found to reduce dissociativeness, and age differences were found. The patterns across the SEM models comparing dissociation and pathological dissociation suggest that pathological dissociation is not a construct that can be set apart from normal dissociation, thus adding weight to the findings of the continuum of dissociation in Study 1. Study 3 examined aspects of the lived experience of pathological dissociation. There were nine participants (7 females, 2 males, M = 42.2 years), four belonging to a non-DID (Dissociative Identity Disorder) group and five who were in a DID group. Each was interviewed and the data analysed using an interpretative phenomenological method of analysis. Evidence of two broad types of dissociation emerged from the data: (a) an absence of connection with reality or an altered state of consciousness; and (b) the presence of another state or personality. Each of the participants reported experiencing the first type, but only those in the DID group reported experiencing the second type. Most participants reported experiencing childhood abuse which underlay their ability to dissociate, and none reported that therapy experiences increased dissociativeness. Triggers of dissociation were emotional responses to internal and external stimuli. Dissociation was experienced as a double bind, unable to be lived without, but difficult to live with. Participants' stories highlight the fact that “borders” between dissociative degrees of severity are blurred and not clearly defined. In conclusion, the findings of the current project are consistent with the continuum model of dissociation, and with the traumagenic model of dissociation. However, there are other important mediating factors involved in the development of a dissociative disorder. Fantasy proneness was shown to influence the development of dissociative disorders, and to mediate the association between trauma and dissociation. Vulnerable personality also plays a part, especially neuroticism, which has a strong association with decreased resilience in some individuals. Results also suggest that increasing individuals' resilience levels has the potential to decrease their dissociativeness and some aspects of fantasy-proneness. The nine qualitative participants demonstrated that the process of dissociation differs markedly between people and there is no simple pathway through which we can catch the lived experience of dissociation. The current project adds incrementally to our understanding of dissociation, and the seemingly polarised views of dissociative aetiology espousing the trauma, adjustment, and personality models are added to and reconciled.