Trauma and dissociation in conversion disorder and chronic pelvic pain.
OBJECTIVE
The purpose of this study was to: a) assess the link between sexual and/or physical abuse and dissociation in conversion disorder and chronic pelvic pain patients; and b) assess whether this effect is independent of level of general psychopathology.


METHODS
This report examines data from four separate samples. Fifty-two patients with chronic pelvic pain, 61 patients with non-epileptic seizures, and two samples of patients (102 and 54) with predominantly motor or sensory types of conversion disorder were studied.


RESULTS
Using point-biserial correlations no compelling evidence for a consistent and positive association of sexual and/or physical abuse with dissociation was found. After statistically controlling for level of psychopathology using multiple regression analyses, in most of the cases the association of abuse with dissociation was no longer statistically significant. Only physical abuse predicted level of somatoform dissociation over and above level of psychopathology.


CONCLUSIONS
In future clinical studies of dissociation in patients with conversion disorder and chronic pelvic pain more complex models may be needed with less exclusive reliance on historical antecedents such as childhood abuse and more emphasis on recent potentially traumatizing experiences or co-morbid psychiatric disorders.
Spinhoven
Philip
P
Faculty of Social and Behavioral Sciences, Section of Clinical and Health Psychology, Leiden University, The Netherlands. Spinhoven@fsw.leidenuniv.nl
Roelofs
Karin
K
Moene
Franny
F
Kuyk
Jarl
J
Nijenhuis
Ellert
E
Hoogduin
Kees
K
Van Dyck
Richard
R
D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D002908:Chronic Disease; D015897:Comorbidity; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology*; D004213:Dissociative Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000175:diagnosis / Q000453:epidemiology*; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires