AT THE EDGE OF THE SELF: DISSOCIATION AS A TRANSDIAGNOSTIC MARKER IN YOUTH PSYCHOPATHOLOGY.

Abstract

Background: Dissociative symptoms are increasingly recognised as early indicators of psychopathological vulnerability in adolescence and young adulthood. This study investigates the correlates of dissociation in a sample of youths referred to a psychiatric outpatient service.

Subjects and methods: This study was conducted on a sample of 45 patients aged 14-25 referred to the second-level outpatient clinic for adolescent and young adult psychopathology at the University Hospital of Perugia, Italy. Patients were grouped based on their Dissociative Experiences Scale-II (DES-II) scores (≤30% vs. >30%), and data were analysed using bivariate comparisons.

Results: Youths with clinically significant dissociation showed earlier psychiatric onset, reduced social connectedness, increased rates of social withdrawal and non-suicidal self-injury, and elevated attentional impulsivity. Higher scores on depressive, cyclothymic, and anxious temperaments were also observed, along with more severe depressive and anxiety symptoms. The high dissociation group reported greater psychological distress and a broader range of psychotic-like experiences on the Prodromal Questionnaire-Brief (PQ-B).

Conclusions: These findings suggest that dissociation in youths is linked to two partially overlapping trajectories: one involving emotional dysregulation and behavioural impulsivity, and another marked by cognitive-perceptual anomalies and unreality experiences. Dissociation may thus act as a transdiagnostic risk factor across mood and psychotic-spectrum vulnerability. Early identification and integrated treatment strategies focusing on affect regulation, cognitive control, and interpersonal functioning may help prevent the progression to more severe psychopathological states.