Somatoform dissociation, reported abuse and animal defence-like reactions.
OBJECTIVE
To test the hypotheses that among general psychiatric outpatients, somatoform dissociation is associated with posttraumatic stress symptoms and with reported potentially traumatizing events, especially with events that involve bodily threat from a person, also when reported age at onset, duration and subjectively rated impact of potentially traumatizing events are considered.


METHODS
Administration of self-report questionnaires evaluating the severity of somatoform and psychoform dissociation, posttraumatic stress-symptoms, and reported traumatizing events, using samples of consecutive and unselected psychiatric outpatients (n = 153).


RESULTS
Somatoform dissociation was strongly correlated with posttraumatic stress symptoms and with reported cumulative traumatization as assessed with two different self-report trauma questionnaires. Among a wide range of trauma types, bodily threat from a person best predicted somatoform dissociation. Emotional neglect and age further improved the prediction, but emotional neglect and abuse did not predict somatoform dissociation when interpersonal threat to the body was not reported. Somatoform dissociation was also best predicted by bodily threat when reported age at onset, duration and subjective impact of reported traumatization were included in the analyses.


CONCLUSIONS
This retrospective study suggests that recurrent interpersonal bodily threat may evoke animal defence-like psychobiological systems manifesting as somatoform dissociation and that this type of threat is often accompanied by emotional neglect. These hypotheses should now be tested in prospective studies.
Nijenhuis
Ellert R S
ER
Outpatient Department, Mental Health Care Drenthe, PO Box 30007, 9400 RA Assen, The Netherlands. e.nijenhuis@home.nl
van der Hart
Onno
O
Kruger
Karlien
K
Steele
Kathy
K
D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012647:Self-Assessment; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D011795:Surveys and Questionnaires