Characteristics, Methods, And Functions Of Non-Suicidal Self-Injury Among Highly Dissociative Individuals.

Upto 86% of dissociative individuals engage in non-suicidal self-injury (NSSI). Research suggests that people who dissociate utilize NSSI to regulate posttraumatic and dissociative experiences, as well asrelated emotions. Despite high rates of NSSI, no quantitative study has examined the characteristics, methods, and functions of NSSIwithin a dissociative population. The present study examined thesedimensions of NSSI among dissociative individuals, as well aspotential predictors of intrapersonal functions of NSSI. The sample included 295 participants who indicated experiencing one or more dissociative symptoms and/or having been diagnosed with a trauma- or dissociation-related disorder. Participants were recruited through online trauma- and dissociation- related forums. Approximately 92% of participants endorsed a history of NSSI. The most common methods of NSSI were interfering with wound healing (67%), hitting oneself (66%), and cutting (63%). After controlling for age and gender, dissociation was uniquely associated with cutting, burning, carving, interfering with wound healing, rubbing skin against rough surfaces, swallowing dangerous substances, and other forms of NSSI. Dissociation was correlated with affect regulation, self-punishment,anti-dissociation, anti-suicide, and self-care functions of NSSI;however, after controlling for age, gender, depressive symptoms, emotion dysregulation, and PTSD symptoms, dissociation was no longer associated with any function of NSSI. Instead, only emotion dysregulation was associated with the self-punishment function ofNSSI and only PTSD symptoms were associated with the anti-dissociation function of NSSI. Understanding the unique properties of NSSI among dissociative individuals may improve the treatment of people who dissociate and engage in NSSI.

"They thought I was just making it up": Dissociative individuals' understandings of their dissociation, perceptions of their clinicians' conceptualizations of dissociation, and discrepancies between them.

OBJECTIVE: Dissociation is thought to be traumagenic, though this conceptualization is not without misunderstanding and stigma. There is little research regarding people's conceptualizations of their dissociative experiences and client-clinician discrepancies in understanding dissociation. METHOD: An online survey assessed 208 self-reported dissociative participants' understandings of their dissociation and their beliefs about their clinicians' understanding of dissociation via two open-ended questions. Template analysis, a codebook thematic analysis approach, was employed to explore and compare the ways people understand their dissociation and their perceptions of their clinicians' conceptualizations. RESULTS: Four themes were developed to capture participants' perspectives: (1) Dissociation as Stigmatized and Underexplored (n = 83; 39.90%); (2) Dissociation as Individualized and Normalized Lived Experience (n = 173; 83.17%); (3) Dissociation as Clinical and/or Pathological (n = 112; 53.85%); and (4) Dissociation Through Etiological Frameworks (n = 67; 32.21%). Overall, 73.48% of participants indicated discrepancies between their understandings of their dissociation and those of their clinicians. Participants understood their dissociation through a lens of individualized and normalized lived experiences (100.00%) more often than their clinicians (23.12%). They believed their clinicians held more clinical understandings of dissociation (81.25%) than themselves (69.64%). CONCLUSIONS: Given the perceived discrepancies between clients' and clinicians' understandings of dissociation, clinicians should engage in discussions with their clients about their dissociation-related lived experiences with awareness that they may have been misunderstood by previous providers. Client-clinician discrepancies should be addressed, as failure to do so could lead to misunderstandings and ruptures in the therapeutic relationship. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Helpful and meaningful aspects of a psychoeducational programme to treat complex dissociative disorders: a qualitative approach.

Purpose: Complex dissociative disorders (CDDs) are prevalent among psychotherapy clients, and research suggests carefully paced treatment for CDDs is helpful. The purpose of the present study is to qualitatively explore helpful and meaningful aspects of the TOP DD Network programme, a web-based adjunctive psychoeducational programme for the psychotherapeutic treatment of clients with CDDs.Methods: TOP DD Network programme participants (88 clients and 113 therapists) identified helpful and meaningful aspects of their participation in response to two open textbox questions. Framework analysis was used to qualitatively analyze client and therapist responses.Findings: Participants found the TOP DD Network programme helpful and meaningful in nuanced ways. Three themes were created: (1) Components of the Programme (subthemes: content, structure), (2) Change-Facilitating Processes (subthemes: heightened human connection, receiving external empathy and compassion, contributing to something bigger, improved therapeutic work and relationship), and (3) Outcomes (subthemes: insight, increased hope, self-compassion, increased safety and functioning). The most emphasized theme was components of the programme, which captured its content and structure.Conclusion: Clients and therapists in the TOP DD Network programme described the programme's components and processes as helpfully facilitating positive outcomes in the treatment of CDDs. Therapists may consider integrating the components and processes in the programme into their practice with clients with CDDs.

The aim of the present study was to qualitatively explore significant aspects of the TOP DD Network programme through the experiences of complex dissociative disorder (CDD) clients and psychotherapists.Helpful and meaningful aspects of the programme included its components (i.e. content and structure), processes, and outcomes.This psychoeducational programme can be effective and result in improved therapeutic processes and outcomes for individuals with CDDs in psychotherapy.

Coverage of child maltreatment in undergraduate psychopathology textbooks.

OBJECTIVE: Past research found that undergraduate psychopathology textbooks present child maltreatment (CM) and its consequences inadequately or inaccurately. Given the prevalence and psychological impact of CM, it is essential that mental health professionals receive adequate training in CM, including trauma-related dissociation. Updated research is needed to determine whether current psychopathology textbooks adequately present information about CM and its consequences. METHOD: Ten undergraduate psychopathology textbooks were analyzed for the number of times CM was mentioned, number of Diagnostic and Statistical Manual of Mental Disorders (5th ed., Text Revision; DSM-5-TR) diagnostic categories CM was associated with, number of citations used to support claims about CM and related psychopathology, and coverage of trauma-related dissociation. RESULTS: Textbooks varied in their coverage of CM and dissociation. The average number of times CM-related keywords mentioned per book was 259.00 (SD = 110.42; range: 113-508). Childhood sexual abuse and sex trafficking received the most attention, followed by general references of child abuse or childhood trauma. The average number of citations provided with mentions of CM or related psychopathology for each textbook was 123.2 (SD = 77.44; range: 44-316). CM was stated to be associated with many DSM-5-TR diagnostic categories, including but not limited to trauma, dissociative, anxiety, mood, somatic, and personality disorders. The textbooks' coverage of dissociation was found to be largely inadequate, with most textbooks emphasizing popular media, the fantasy model of dissociation, and myths about dissociation. CONCLUSIONS: Undergraduate psychopathology textbooks need to improve their scholarly coverage of CM and its mental health consequences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Inpatient outcomes following admission to stabilization-focused complex trauma- and dissociation-specific unit.

OBJECTIVE: Individuals with histories of complex psychological trauma, such as those with dissociative disorders, are often high utilizers of inpatient services and thus warrant further research attention. The present study sought to examine whether treatment on a specialized inpatient trauma unit was associated with improvements in adaptive functioning, emotion regulation, and dissociation among patients experiencing complex posttraumatic and dissociative symptoms. METHOD: This study used archival data collected as part of treatment provided to inpatients (N = 54), the majority of whom had a dissociative disorder, at a specialized trauma disorders unit to analyze differences in scores between intake and discharge on measures of adaptive functioning, emotion regulation, and dissociation. RESULTS: Adaptive functioning and emotion regulation were significantly improved at discharge compared to intake, t(299) = -11.28, p < .001; t(305) = 8.54, p < .001, respectively, with very large effect sizes (d = 1.60; d = 1.20), and there was a significant decrease, t(311) = 2.15, p = .032, d = .30, in dissociative absorption. CONCLUSIONS: Our findings suggest that inpatient treatment modeled after expert consensus treatment guidelines is associated with significant improvements in adaptive functioning and emotion regulation and reduced dissociative absorption in individuals experiencing severe and acute complex posttraumatic and dissociative symptoms. Appropriate screening and symptom-specific treatment of complex posttraumatic and dissociative symptoms are recommended to improve outcomes for this population during inpatient hospital admission. (PsycInfo Database Record (c) 2024 APA, all rights reserved).