Childhood trauma and dissociation in schizophrenia.
BACKGROUND
This study is concerned with relationships between childhood trauma history, dissociative experiences, and the clinical phenomenology of chronic schizophrenia.


METHODS
Seventy patients with a schizophrenic disorder were evaluated using the Structured Clinical Interview for DSM-IV, Dissociative Experiences Scale, Dissociative Disorders Interview Schedule, Positive and Negative Symptoms Scales, and Childhood Trauma Questionnaire.


RESULTS
Childhood trauma scores were correlated with dissociation scale scores and dissociative symptom clusters, but not with core symptoms of the schizophrenic disorder. Cluster analysis identified a subgroup of patients with high dissociation and childhood trauma history. The dissociative subgroup was characterized by higher numbers of general psychiatric comorbidities, secondary features of dissociative identity disorder, Schneiderian symptoms, somatic complaints, and extrasensory perceptions. A significant majority of the dissociative subgroup fit the diagnostic criteria of DSM-IV borderline personality disorder concurrently. Among childhood trauma types, only physical abuse and physical neglect predicted dissociation.


CONCLUSIONS
A trauma-related dissociative subtype of schizophrenia is supported. Childhood trauma is related to concurrent dissociation among patients with schizophrenic disorder. A duality model based on the interaction of 2 qualitatively distinct psychopathologies and a dimensional approach are proposed as possible explanations for the complex relationship between these 2 psychopathologies and childhood trauma.
Sar
Vedat
V
Clinical Psychotherapy Unit and Dissociative Disorders Program, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. vsar@istanbul.edu.tr
Taycan
Okan
O
Bolat
Nurullah
N
Ozmen
Mine
M
Duran
Alaattin
A
Oztürk
Erdinç
E
Ertem-Vehid
Hayriye
H
D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology*; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology; D002908:Chronic Disease; D015897:Comorbidity; D004213:Dissociative Disorders / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010268:Parapsychology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D055815:Young Adult