title: Dissociation, shame, complex PTSD, child maltreatment and intimate relationship self-concept in dissociative disorder, chronic PTSD and mixed psychiatric groups.
abstract: BACKGROUND
  Whilst a growing body of research has examined dissociation and other psychiatric symptoms in severe dissociative disorders (DDs), there has been no systematic examination of shame and sense of self in relationships in DDs. Chronic child abuse often associated with severe DDs, like dissociative identity disorder, is likely to heighten shame and relationship concerns. This study investigated complex posttraumatic stress disorder (PTSD), borderline and Schneiderian symptoms, dissociation, shame, child abuse, and various markers of self in relationships (e.g., relationship esteem, relationship depression, fear of relationships).
  
  
  METHODS
  Participants were assessed via clinical interview with psychometrically sound questionnaires. They fell into three diagnostic groups, dissociative disorder (n=39; primarily dissociative identity disorder), chronic PTSD (Chr-PTSD; n=13) or mixed psychiatric presentations (MP; n=21; primarily mood and anxiety disorders). All participants had a history of child abuse and/or neglect, and the groups did not differ on age and gender.
  
  
  RESULTS
  The DD group was higher on nearly all measured variables than the MP group, and had more severe dissociative, borderline and Schneiderian symptoms than the Chr-PTSD sample. Shame and complex PTSD symptoms fell marginally short of predicting reductions in relationship esteem, pathological dissociative symptoms predicted increased relationship depression, and complex PTSD symptoms predicted fear of relationships.
  
  
  CONCLUSIONS
  The representativeness of the samples was unknown.
  
  
  CONCLUSIONS
  Severe psychiatric symptoms differentiate DDs from chronic PTSD, while dissociation and shame have a meaningful impact on specific markers of relationship functioning in psychiatric patients with a history of child abuse and neglect.
authors.affiliation: Department of Psychology, University of Canterbury, Christchurch, New Zealand; The Cannan Institute, Belmont Private Hospital, Brisbane, Australia. Electronic address: martin.dorahy@canterbury.ac.nz.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Dorahy
authors.affiliation: Department of Psychology, University of Canterbury, Christchurch, New Zealand; The Cannan Institute, Belmont Private Hospital, Brisbane, Australia.
authors.forename: Warwick
authors.initials: W
authors.lastname: Middleton
authors.affiliation: The Cannan Institute, Belmont Private Hospital, Brisbane, Australia.
authors.forename: Lenaire
authors.initials: L
authors.lastname: Seager
authors.affiliation: The Cannan Institute, Belmont Private Hospital, Brisbane, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McGurrin
authors.affiliation: The Cannan Institute, Belmont Private Hospital, Brisbane, Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Williams
authors.affiliation: Anxiety Disorders Service, Canterbury District Health Board, Christchurch, New Zealand.
authors.forename: Ron
authors.initials: R
authors.lastname: Chambers
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D004213:Dissociative Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D012752:Shame; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Complex PTSD; Dissociation; Relationships self-concept; Shame