Differences in Dissociative Experiences Between Survivors of Childhood Incest and Survivors of Assault in Adulthood

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In the last decade, there has been a rekindling of interest in dissociative processes and disorders. In part, this interest is due to the increased awareness that 5% to 10% of the general population may have a dissociative disorder (Ross et al., 1990) and that 27% of psychiatric patients across diverse diagnostic categories report dissociative experiences (Putnam and Trickett, 1993). In addition, with the development of a valid and reliable index of dissociative experiences, the Dissociative Experiences Scale (Bernstein and Putnam, 1986), researchers have been able to quantify the construct.Dissociation has long been conceptualized as a reaction to trauma. The early writings of Freud (1896/1962) and work by Pierre Janet (1865/1907) have underscored the importance of dissociation as a primary psychological process in response to overwhelming experiences. Contemporary theorists have postulated that dissociative symptomatology represents an extreme response to trauma, especially childhood trauma (Herman, 1992; Putnam and Trickett, 1993). Recently, several studies have provided empirical evidence for a strong relationship between dissociation and a history of childhood sexual and physical abuse (Chu and Dill, 1990; Coons et al., 1988; Sanders and Giolas, 1991). Other childhood stressors, such as neglect, familial loss, and witnessing abuse, have also been associated with adult dissociative symptomatology (Irwin, 1994; Zlotnick et al., 1995).Many theorists regard dissociation as an age-related vulnerability, with young children susceptible to dissociative states because of their capacity for self-hypnosis (Spiegel, 1986; Terr, 1991). Empirical support for this view is found in studies that have demonstrated that hypnotizability is greatest in the years preceding adolescence (Berstein and Putnam, 1986; Hilgard, 1965; Morgan and Hilgard, 1973). Further, research has shown that among survivors of sexual abuse, there is a markedly higher level of dissociative symptoms for subjects abused before age 13 (Kirby et al., 1993).Recently, another body of literature has emerged suggesting that traumatic events in adulthood can precipitate dissociative pathology. Studies have found that Vietnam veterans with posttraumatic stress disorder and Cambodian refugees display high levels of dissociative symptoms (Bremner et al., 1992; Carlson and Rosser-Hogan, 1991). Other studies have reported that adults who have experienced disasters, such as loss of home after a firestorm, witnessing a shootout, or witnessing an execution, show elevations in symptoms of dissociation (Claasen et al., 1994; Freinkel et al., 1994). Unfortunately, these studies did not assess whether those individuals who exhibited high levels of dissociation had histories of childhood trauma that may have placed them at greater risk for dissociative pathology. A study that examined the relationship of prior childhood sexual abuse and dissociative symptomatology in recent rape victims found that those rape victims who reported histories of sexual abuse obtained higher scores on a dissociative symptom scale than rape victims without such a history (Hearst et al., 1994). To further examine the notion that there may be a critical period for the development of dissociative pathology, the present study attempted to investigate whether women with histories of incest before 13 years of age were likely to report more dissociative symptomatology than women with their first experience of interpersonal violence in adulthood (i.e., histories of physical or sexual assault after the age of 17). We also included a measure of general psychopathology in an attempt to examine the specificity of outcome, that is, whether childhood incest is related to a particular psychopathology, dissociation, or whether these childhood experiences had a more global impact on well-being in general.

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