Child Dissociation: The Descriptive Psychopathology Analysis of a Case.

Abstract

With a reliable retrospective link to early-life traumatic stress, dissociation has been formulated as a pathology of abnormal socioemotional development. Dissociation hence should be identifiable and diagnosable in childhood. This study aimed to address the extent to which current formulation and diagnostic criteria of adult dissociation is applicable to children. This case study documented and analyzed the potentially dissociative experiences and behaviors in a 11-year-old boy from a residential facility accommodating children from high-risk families. The first-person account from the child client about his potentially dissociative experiences and the observations of the clinician witnessing the targeted behaviors were documented, revealing a symptom profile similar to adult dissociation. Dissociation disrupted multiple domains of typically integrated mental functioning including memory, consciousness, and the sense of self. The child client presented unusual forgetfulness that was observed by others, while the child himself was able to describe experiences involving gaps in consciousness and a fragmented and disconnected sense of self. This case study renders support for the current formulation of dissociative pathology and its applicability to high-risk cases in early developmental stages. This finding also indicates the importance of trauma-informed care in child residential settings. With gentle guiding prompts, children are able to recognize and articulate unusual experiences, facilitating the early identification of dissociation.