title: Dissociation: An insufficiently recognized major feature of complex posttraumatic stress disorder.
abstract: The role of dissociation in (complex) posttraumatic stress disorder (PTSD) has been insufficiently recognized for at least two reasons: the view that dissociation is a peripheral, not a central feature of PTSD, and existing confusion regarding the nature of dissociation. In this conceptual article, the authors address both issues by postulating that traumatization essentially involves some degree of division or dissociation of psychobiological systems that constitute personality. One or more dissociative parts of the personality avoid traumatic memories and perform functions in daily life, while one or more other parts remain fixated in traumatic experiences and defensive actions. Dissociative parts manifest in negative and positive dissociative symptoms that should be distinguished from alterations of consciousness. Complex PTSD involves a more complex structural dissociation than simple PTSD.
authors.affiliation: Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands. o.vanderhart@fss.uu.nl
authors.forename: Onno
authors.initials: O
authors.lastname: van der Hart
authors.forename: Ellert R S
authors.initials: ER
authors.lastname: Nijenhuis
authors.forename: Kathy
authors.initials: K
authors.lastname: Steele
mesh_terms: D003243:Consciousness; D003937:Diagnosis, Differential; D004213:Dissociative Disorders / Q000453:epidemiology*; D006801:Humans; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology; D012649:Self Concept; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology