Journal of Trauma & Dissociation最新文献

{"title":"Cast with Uncertainty: Doubt Regarding Abuse-Related Appraisals and Trauma-Related Distress in the Face of Intimate Partner Violence.","authors":"Yael Lahav, Sharon Avidor, Lee Gafter, Avital Lotan","doi":"10.1080/15299732.2026.2613388","DOIUrl":"10.1080/15299732.2026.2613388","url":null,"abstract":"<p><p>Survivors of abuse, such as intimate partner violence (IPV), may experience a range of mental health difficulties. A new theory introduces a harmful and often overlooked aspect of abuse: doubt regarding abuse-related appraisals (DARA). This concept refers to survivors' uncertainty about their assessments of the abuse, their own experiences during the abuse, and their perpetrator. According to this view, DARA not only deepens survivors' confusion but also hinders the healing process, increasing their vulnerability to trauma-related symptoms. This study aimed to explore these ideas by examining (1) the relationships between DARA and trauma-related symptoms following IPV, and (2) the contribution of DARA in explaining trauma-related symptoms beyond childhood abuse history, degree of IPV exposure, length of the abusive relationship, and IPV status. An online survey was conducted among a convenience sample of female adults. The sample consisted of 378 women aged 19-60 years (<i>M</i> = 35.50, <i>SD</i> = 8.64) who reported experiencing IPV and provided data on the study variables. Trauma-related symptoms, DARA, childhood abuse history, and IPV characteristics (degree of IPV exposure, length of the abusive relationship, and IPV status) were assessed through self-report measures. The results revealed significant associations between DARA and trauma-related symptoms. Furthermore, analyses indicated that DARA uniquely explained trauma-related symptoms beyond childhood abuse history, degree of IPV exposure, length of the abusive relationship, and IPV status. The current findings support the DARA theory and highlight the need for clinical interventions aimed at reducing DARA to alleviate trauma-related distress in survivors.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"348-369"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Validation of the Italian Multidimensional Inventory of Dissociation (I-MID).","authors":"Giuseppe Scimeca, Marianna Ardito, Monica Fiammetta, Jennifer A Madere, D Michael Coy, Giuseppe Giacalone","doi":"10.1080/15299732.2026.2641647","DOIUrl":"10.1080/15299732.2026.2641647","url":null,"abstract":"<p><p>The aim of the present study was to verify the reliability and validity of the Italian Multidimensional Inventory of Dissociation (I-MID) when applied to a clinical sample. The I-MID was administered to 100 outpatients presenting to a south-Italian public psychology service for psychotherapeutic treatment. Both self-report and interview-based methods were used to assess traumatic experiences and dissociative symptoms. The Dissociative Disorders Interview Schedule DSM-5 Version (DDIS-5) was utilized to identify dissociative disorders and psychiatric diagnoses commonly associated with dissociative and symptoms and disorders. The I-MID showed strong internal consistency, structural, convergent, and construct validity. Results addressing temporal stability were good for the MID mean score, but results for the different scales were more variable across time. Discriminant validity was good, but some limitations imposed by the clinical sample prevented a sound evaluation of this test property. Information about construct and discriminant validity for the Italian versions of the Dissociative Experiences Scale-II (DES-II) and the Dissociative Symptom Scale (DSS) is also provided. All instruments exhibited good psychometric properties. However, the I-MID showed better incremental validity compared to the DES-II, and provided some evidence of enhanced discriminant validity relative to both the DES-II and DSS. The findings of this study support the validity of the MID and its underlying subjective-phenomenological model of dissociation in an Italian clinical sample. Finally, the prevalence of dissociative disorders in our outpatient sample aligned with findings from other countries' epidemiological studies.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"279-299"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment in Public Centers for Adult Jewish Women Survivors of Childhood Sexual Abuse in Israel: Abuse Characteristics, Psychiatric Profiles, and One-Year Treatment Outcomes.","authors":"Lilac Lev-Ari, Keren Mintz Malchi, Edna Ludmir, Reut Lachter, Ido Lurie, Ayelet Nahir Peleg, Chen Spector-Dagan, Inbal Brenner","doi":"10.1080/15299732.2026.2648314","DOIUrl":"10.1080/15299732.2026.2648314","url":null,"abstract":"<p><strong>Background: </strong>Childhood sexual abuse (CSA) is associated with significant psychiatric morbidity and has been reported at notable rates among Jewish Israeli women. Yet data regarding abuse characteristics, psychiatric history and longitudinal treatment outcomes in this population are lacking.</p><p><strong>Objective: </strong>We assessed abuse experiences, clinical profiles and psychiatric histories of adult Jewish women CSA survivors and evaluated the effectiveness of designated psychotherapy over one year.</p><p><strong>Participants and setting: </strong>A clinical sample of women CSA survivors (<i>N</i> = 122) were treated in weekly psychotherapy in public specialized outpatient centers in Israel.</p><p><strong>Methods: </strong>Patients self-reported on Childhood Maltreatment (CM), posttraumatic stress disorder (PTSD) symptoms, dissociation, borderline personality (BPD) traits, and psychological well-being at treatment onset (T1), after six months (T2), and after one year of therapy (T3). CSA characteristics and psychiatric history were assessed by a semi-structured clinical interview at T1.</p><p><strong>Results: </strong>Most (85.3%) patients reported prolonged CSA histories, with 71.3% reporting intrafamilial abuse. At T1, 7.5% reported currently being abused and 8.3% were currently living with the abuser. Higher levels of CM were significantly associated with higher PTSD, dissociative and BPD symptoms and lower psychological well-being at T1. CM was significantly associated with suicide attempts, psychiatric hospitalizations and psychiatric medication use at T1. Specifically, nearly all individuals with these clinical histories reported moderate to extreme CM. Over the course of treatment (T1 to T3), PTSD symptoms significantly decreased and dissociative symptoms showed reductions from baseline to the one-year assessment, although the overall time effect approached statistical significance. Psychological well-being demonstrated a positive trend throughout the treatment year, with significant improvements observed between baseline and the one-year follow-up, while BPD traits did not change.</p><p><strong>Conclusions: </strong>These findings underscore the complex clinical needs of CSA survivors and demonstrate that specialized, long-term psychotherapy effectively reduces core trauma symptoms while fostering significant gains in psychological well-being.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"386-405"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissociation: New Findings on Assessment, Treatment, and Impact on the Therapist.","authors":"Julian D Ford","doi":"10.1080/15299732.2026.2648149","DOIUrl":"https://doi.org/10.1080/15299732.2026.2648149","url":null,"abstract":"","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":"27 3","pages":"257-261"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Dissociation in PTSD: A Meta-Analysis of Psychological Intervention Studies.","authors":"Melissa Akoral, Alison Hauenstein-Swan, Jala Rizeq, Andrew Gumley","doi":"10.1080/15299732.2026.2641635","DOIUrl":"10.1080/15299732.2026.2641635","url":null,"abstract":"<p><p>Dissociation has increasingly been acknowledged as a key factor in post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). However, there is evidence that it is not being recognized by clinicians and often trauma treatments do not target dissociation experiences. The purpose of this review was to investigate the effect of any psychological intervention compared to any control on dissociation in adults with PTSD and/or CPTSD. Systematic database searches (PsychINFO, COCHRANE, EMBASE and Medline) were conducted using a predetermined search strategy and inclusion criteria to identify controlled trials reporting psychological therapies for trauma, had a control group and measured dissociation as an outcome. To assess the risk of bias in studies, the Risk of Bias 2 (ROB-2) tool and the Mixed methods appraisal tool (MMAT) were used. Thirteen studies were included in the review. Using a random effect model to perform the meta-analysis, a small effect of current treatments on dissociation experiences was found (g =  -0.28, 95% CI [-0.41, -0.15]; Z =  -4.12, <i>p</i> < .001), with a small level of heterogeneity across studies (<i>I²</i> = 7.8%). Subgroup analyses showed some important effects across control conditions, therapy modalities and type of measures, albeit overall moderation was not significant in any of the models. While the overall treatment effect was observed when dissociation was a secondary outcome in most studies, for PTSD treatments to be effective on dissociation interventions they need to focus on dissociation more explicitly.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"300-315"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engagement with Psychoeducation Exercises Linked with Coping Skill Use and Treatment Outcomes in a Web-Based Program for Dissociative Individuals.","authors":"Hygge J Schielke, Shaina A Kumar, Bethany L Brand, Ruth A Lanius","doi":"10.1080/15299732.2026.2641649","DOIUrl":"10.1080/15299732.2026.2641649","url":null,"abstract":"<p><p>The Treatment of Patients with Dissociative Disorders (TOP DD) Network Study offered psychoeducation and exercises to help patients with complex trauma-related dissociation and their therapists learn how to reduce symptoms and increase adaptive capacities. This paper examines whether 227 dissociative disorder (DD) patients' engagement with TOP DD Network Study program exercises was associated with improvements in coping skill use, symptom severity, and adaptive functioning. Multilevel modeling techniques revealed that more engagement in written and practice exercises than usual for participants was associated with greater coping skill use across weeks in the study when controlling for time. Further, to the extent that participants reported more coping skill use than was typical for them, their mental health symptoms and dissociative symptoms decreased at a faster rate than would be expected as a function of time. More than usual use of coping skills was also associated with increased self-kindness and adaptive functioning, controlling for time. Finally, a Monte Carlo method for assessing mediation revealed that more engagement with the program's exercises was linked with improved treatment outcomes through their association with greater than average use of coping skills, controlling for weeks spent in the study. Completion of relevant written and practice exercises appears useful in encouraging coping skill use for individuals with dissociative disorders. Further, results suggest that the educational components of the TOP DD Network Study contributed to participants' ability to reduce symptoms, increase self-kindness, and develop adaptive capacities.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"316-331"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Had to Relive All of That Again\": Retraumatization, Invalidation, and Institutional Betrayal Among Veterans Filing Military Sexual Trauma-Related Disability Claims.","authors":"Aliya R Webermann, Sonia Rupcic, Erin E Hoffman, Galina A Portnoy, Marc I Rosen, Lindsey L Monteith, Ryan Holliday, Maureen Murdoch","doi":"10.1080/15299732.2026.2643660","DOIUrl":"10.1080/15299732.2026.2643660","url":null,"abstract":"<p><p>Thousands of Veterans file military sexual trauma (MST)-related PTSD disability claims annually through Department of Veterans Affairs (VA) for broadly covered healthcare benefits and monthly compensation. Although MST-related claims have been subject to much governmental reporting and oversight, no study has examined the perspectives or experiences of Veterans filing MST-related disability claims, including potential associations with institutional betrayal (i.e. wrongdoings perpetrated by an institution upon individuals dependent on that institution). Between March-October 2024, we interviewed 15 Veterans who recently filed MST claims. Data were analyzed inductively through thematic analysis. Most participants described MST-related claims process components that were retraumatizing, such as having to \"relive\" their MST experience through repeated telling of their MST across multiple individuals (e.g. therapists, disability evaluators, via the claim form). These experiences were retraumatizing even for individuals with a positive perception of those involved in evaluating their claims. Participants described feelings of invalidation through perceptions of needing to be a \"perfect victim\" and that their claim was impacted by aspects of their identity (e.g. race) or pre-military trauma. For some, being awarded MST-related disability was seen as validating. For others, retraumatization and invalidation contributed to perceptions of VA-enacted institutional betrayal, which impacted their trust in and likelihood of using VA healthcare. Veteran participants' experiences with the MST claims process extend prior work on institutional betrayal among MST survivors. These findings underscore the need for additional support during the MST claims process, such as increased information and expectation-setting ahead of claim filing and disability evaluations.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"370-385"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissociative Symptoms in Traumatized Treatment-Seeking Refugees: Rate of the Dissociative Subtype of Posttraumatic Stress Disorder and Associations with Complex PTSD Symptoms.","authors":"Mirjam Sophie Rueger, Kai Jannik Nehler, Franziska Lechner-Meichsner, Thomas Ehring, Hannah Preiss, Nexhmedin Morina, Ahlke Kip, Ricarda Mewes, Julia Giesebrecht, Cornelia Weise, Regina Steil","doi":"10.1080/15299732.2026.2641642","DOIUrl":"10.1080/15299732.2026.2641642","url":null,"abstract":"<p><p>DSM-5 and ICD-11 differ regarding their conceptualization of dissociation in relation to Posttraumatic Stress Disorder (PTSD). DSM-5 defines a subtype of PTSD characterized by dissociative symptoms (PTSD-DS), whereas ICD-11 only comprises some specific dissociative symptoms in their diagnosis of (complex) PTSD. To improve diagnostic assessments and treatment approaches, it is important to investigate the relationship between dissociation and (c)PTSD. Research on the relation of trauma and dissociation in refugees is very limited. The rate of PTSD-DS and the association of cPTSD symptoms and dissociation severity were investigated using the baseline data of treatment-seeking traumatized refugees participating in a multi-center randomized controlled clinical trial (registration: DRKS00019876). PTSD-DS was assessed with the Clinician-administered PTSD Scale for DSM-5 and cPTSD with the Complex PTSD Item Set additional to the CAPS. We used the Adolescent Dissociative Experiences Scale to assess dissociative symptoms. In a sample of <i>N</i> = 104, we found a rate of 36.54% for PTSD-DS. In an exploratory multiple regression analysis of dissociation severity, in which all cPTSD symptoms were entered as predictors, only reexperiencing and affective dysregulation emerged as relevant contributors. Our results support the notion that there is a subgroup of individuals with additional dissociative symptoms, while reexperiencing and affective dysregulation are associated with dissociation. We recommend to add a culturally sensitive assessment of dissociative symptoms to standard practices in clinical care of refugees so that appropriate interventions can be selected.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"262-278"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echoes of Trauma: Experiential Insights into Secondary Traumatic Stress Among Psychotherapists.","authors":"Hvovi Bhagwagar","doi":"10.1080/15299732.2026.2643674","DOIUrl":"10.1080/15299732.2026.2643674","url":null,"abstract":"<p><p>Secondary Traumatic Stress (STS) presents considerable emotional and psychological hazards to psychotherapists continually exposed to clients' trauma histories. While quantitative research has demonstrated an overlap between STS and post-traumatic stress disorder (PTSD), qualitative studies have not explicitly examined the extent to which psychotherapists' lived accounts align with the four PTSD clusters delineated in DSM-5. Using constructivist grounded theory and in-depth interviews with 16 psychotherapists from diverse clinical settings, this study found that therapists' experiences mirrored DSM-5 categories of intrusions, avoidance, alterations in arousal/reactivity, and alterations in cognition and mood. The findings also revealed additional domains, including moral distress, professional silencing, and cumulative emotional burden. The findings position STS as a multifaceted, embodied, and ethically complex phenomenon that necessitates a multilayered approach to intervention including trauma-informed supervision, reflective training, and organizational practices responsive to the cumulative toll of trauma work.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"332-347"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underlying Dissociative Adjustment in a Case of Same-Sex Sexual Compulsivity.","authors":"Christopher H Rosik","doi":"10.1080/15299732.2026.2641637","DOIUrl":"https://doi.org/10.1080/15299732.2026.2641637","url":null,"abstract":"<p><p>This case study describes the psychotherapeutic process of one man, Francesco, whose compulsive same-sex sexual behavior was found to be driven by an underlying dissociative state. Francesco's therapy experience draws attention to the psychodynamics and intersectional oppressions that may influence outcomes related to the experiences of childhood trauma, subsequent dissociation, traditional religion, and same-sex sexuality. Although treatment trajectories are unique to each person, Francesco's psychotherapy experience suggests the contribution of dissociation to sexual compulsivity can be reduced by bolstering new affect regulation strategies, attending to locus of control dynamics, and promoting a more secure attachment base both intrapsychically and, initially, within the therapy relationship.</p>","PeriodicalId":47476,"journal":{"name":"Journal of Trauma & Dissociation","volume":" ","pages":"1-18"},"PeriodicalIF":2.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}