Reality versus fantasy: reply to Lynn et al. (2014).
We respond to Lynn et al.'s (2014) comments on our review (Dalenberg et al., 2012) demonstrating the superiority of the trauma model (TM) over the fantasy model (FM) in explaining the trauma-dissociation relationship. Lynn et al. conceded that our meta-analytic results support the TM hypothesis that trauma exposure is a causal risk factor for the development of dissociation. Although Lynn et al. suggested that our meta-analyses were selective, we respond that each omitted study failed to meet inclusion criteria; our meta-analyses thus reflect a balanced view of the predominant trauma-dissociation findings. In contrast, Lynn et al. were hypercritical of studies that supported the TM while ignoring methodological problems in studies presented as supportive of the FM. We clarify Lynn et al.'s misunderstandings of the TM and demonstrate consistent superiority in prediction of time course of dissociative symptoms, response to psychotherapy of dissociative patients, and pattern of relationships of trauma to dissociation. We defend our decision not to include studies using the Dissociative Experiences Scale-Comparison, a rarely used revision of the Dissociative Experiences Scale that shares less than 10% of the variance with the original scale. We highlight several areas of agreement: (a) Trauma plays a complex role in dissociation, involving indirect and direct paths; (b) dissociation-suggestibility relationships are small; and (c) controls and measurement issues should be addressed in future suggestibility and dissociation research. Considering the lack of evidence that dissociative individuals simply fantasize trauma, future researchers should examine more complex models of trauma and valid measures of dissociation.
Trauma Research Institute, California School of Professional Psychology, Alliant International University.
Constance J
CJ
Dalenberg
Department of Psychology, Towson University.
Bethany L
BL
Brand
Sheppard Pratt Health System.
Richard J
RJ
Loewenstein
School of Psychology, University of South Australia.
David H
DH
Gleaves
Department of Psychology, University of Canterbury.
Martin J
MJ
Dorahy
Department of Psychology, Lund University.
Etzel
E
Cardeña
Department of Psychology, University of Western Ontario.
Paul A
PA
Frewen
National Center for PTSD.
Eve B
EB
Carlson
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine.
David
D
Spiegel
D000647:Amnesia / Q000209:etiology*; D002649:Child Abuse / Q000523:psychology*; D004213:Dissociative Disorders / Q000209:etiology*; D005201:Fantasy; D006801:Humans; D008960:Models, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000150:complications*