title: Are there two qualitatively distinct forms of dissociation? A review and some clinical implications.
abstract: This review aims to clarify the use of the term 'dissociation' in theory, research and clinical practice. Current psychiatric definitions of dissociation are contrasted with recent conceptualizations that have converged on a dichotomy between two qualitatively different phenomena: 'detachment' and 'compartmentalization'. We review some evidence for this distinction within the domains of phenomenology, factor analysis of self-report scales and experimental research. Available evidence supports the distinction but more controlled evaluations are needed. We conclude with recommendations for future research and clinical practice, proposing that using this dichotomy can lead to clearer case formulation and an improved choice of treatment strategy. Examples are provided within Depersonalization Disorder, Conversion Disorder and Posttraumatic Stress Disorder (PTSD).
authors.affiliation: MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, CB2 2EF, UK. emely.holmes@mrc-cbu.cam.ac.uk
authors.forename: Emily A
authors.initials: EA
authors.lastname: Holmes
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Brown
authors.forename: Warren
authors.initials: W
authors.lastname: Mansell
authors.forename: R Pasco
authors.initials: RP
authors.lastname: Fearon
authors.forename: Elaine C M
authors.initials: EC
authors.lastname: Hunter
authors.forename: Frank
authors.initials: F
authors.lastname: Frasquilho
authors.forename: David A
authors.initials: DA
authors.lastname: Oakley
mesh_terms: D003243:Consciousness / Q000502:physiology; D003291:Conversion Disorder / Q000523:psychology / Q000628:therapy; D003861:Depersonalization / Q000209:etiology / Q000523:psychology / Q000628:therapy; D004213:Dissociative Disorders / Q000145:classification* / Q000175:diagnosis / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005239:Fear / Q000523:psychology; D006801:Humans; D007389:Internal-External Control; D012094:Repression, Psychology; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy