Unveiling the intersection: Dissociative and psychotic-like experiences among a trauma-exposed clinical sample including postpartum women.

Abstract

Objective: Trauma exposure is associated with elevated risk for psychotic-like experiences, including subthreshold hallucinations and delusions. Dissociative symptoms may link these two experiences and warrant further exploration.

Method: The present study examined if dissociative symptoms accounted for additional variance in the association between posttraumatic stress disorder (PTSD) symptoms and hallucinations and delusions in a sample of patients (n = 63) seeking treatment for PTSD using the Dissociative Subtype of PTSD Scale; PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; and Diagnostic Interview for Anxiety, Mood, and Obsessive-Compulsive Disorder and Related Neuropsychiatric Disorders hallucinations and delusions screener in a sample of predominantly White women, the majority of whom met criteria for PTSD. Exploratory analyses were conducted to examine if the postpartum subsample endorsed our variables of interest more frequently than our overall sample.

Results: As hypothesized, PTSD symptoms and dissociative symptoms exhibited a small, significant correlation with psychotic-like experiences. Furthermore, dissociative symptoms accounted for additional variance in our models in psychotic-like experiences; however, the additional variance accounted for did not reach the level of significance. However, this study was limited by cross-sectional data with a predominantly White, woman sample. Future studies should examine these associations longitudinally among marginalized groups.

Conclusions: Clinicians must provide thorough assessments to parse out PTSD symptoms, dissociative symptoms, and psychotic-like experiences, especially for clients seeking treatment for complex PTSD and/or a history of traumatic birth experience. Clinicians must conduct thorough assessments using validated tools like the Dissociative Experiences Scale and the Structured Interview for Psychosis-Risk Syndromes and could use interventions such as narrative exposure therapy that address maladaptive thoughts and dissociative experiences related to traumatic experiences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).