The role of panic in acute dissociative reactions following trauma

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Objective.‘Peritraumatic dissociation’ refers to alterations in awareness and memory for events that occur during and shortly after a traumatic experience. Despite the prevalence of reported peritraumatic dissociation, little is known about the mechanisms that mediate dissociative responses in the initial period after trauma. One theory suggests that peritraumatic dissociation may be a response to elevated arousal and panic symptoms during trauma. This study investigated panic symptoms that occurs at the time of the trauma and their relationship to ongoing dissociation in acute stress disorder.Design.A sample of traumatized people with acute stress disorder or controls were administered a range of psychopathology measures within one month of their trauma.Method.Fifty-one civilian trauma survivors with either acute stress disorder or no acute stress disorder were administered the acute stress disorder interview, the Impact of Event Scale, the Beck Anxiety Inventory, the Peritraumatic Dissociative Experiences Questionnaire, and the Physical Reactions Scale to index panic reactions during the trauma.Results.Hierarchical regression analysis found that panic reactions during the trauma accounted for nearly half of the variance (47%) of peritraumatic dissociation, and subsequent stress reactions accounted for an additional 3% of the variance.Conclusions.These findings are consistent with proposals that acute dissociation is associated with panic symptoms that occur during the traumatic experience. Possible mechanisms for the association of panic and dissociation are discussed.

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