The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD
Open accessAbstract
Purpose A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD.Methods The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD.Results The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group.Conclusions In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.
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Approximately 15-30% of individuals with PTSD experience symptoms of depersonalization and derealization that are consistent with the dissociative subtype.
“Subsequent latent class and confirmatory factor analyses have indicated that approximately 15-30% of individuals with PTSD experience symptoms of depersonalization and derealization that are consistent with the dissociative subtype (Armour et al., 2014;Bennett et al., 2015;Blevins et al., 2014;Frewen et al., 2015;Spiegel et al., 2013;Steuwe et al., 2012;Tsai et al., 2015;Wolf et al., 2012aWolf et”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Armour et al., 2014
The Introduction identifies depersonalization and derealization as the defining symptoms and reports a prior study in which the dissociative subtype comprised 25% of the sample. But the Discussion reports a broader range of 6–30% across prior studies and 13.9% of this study’s total sample; it does not establish 15–30% as the proportion among individuals with PTSD generally. Page numbers were not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredApproximately 15-30% of individuals with PTSD can be classified as belonging to a dissociative subtype featuring symptoms of depersonalization and derealization.
“approximately 15-30% of individuals with PTSD can be classified as belonging to a dissociative subtype featuring symptoms of depersonalization and derealization (Armour et al., 2014;Blevins et al., 2014;Frewen et al., 2015;Spiegel et al., 2013;Steuwe et al., 2012;Tsai et al., 2015;Wolf et al., 2012aWolf et al., , 2012b)).”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Armour et al., 2014
The Introduction identifies depersonalization and derealization as the symptoms defining the dissociative-PTSD subtype. The Discussion reports that the subtype comprised 13.9% of this study’s total sample and that previous studies found proportions of 6–30%; it does not report a 15–30% range specifically among individuals with PTSD. (LLM, conf=0.84)
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- Authors
- Armour, C., Karstoft, K.-I., & Richardson, J. D.
- Affiliations
- University of Southern Denmark (DK)
- ORCID
- Karstoft, Karen-Inge
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2014-01-21
- Volume
- 49
- Issue
- 8
- Pages
- 1297-1306
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- OpenAlex
- W2087924445
- Semantic Scholar
- d9111ed5a196b5111dd2f79a4abafc44c4e0442a
- Cited by
- 90
- References
- 42
- Citations by year
- 2026: 2 · 2025: 8 · 2023: 2 · 2022: 11 · 2021: 5 · 2020: 6 · 2019: 8 · 2018: 11 · 2017: 13 · 2016: 8 · 2015: 10 · 2014: 6
- FWCI
- 14.55
- Type
- journal article
- Language
- en
- Open access
- green
- pure.ulster.ac.uk
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Ulster University Research Portal (Ulster University) (submittedVersion, other-oa)
- Scholarship@Western (Western University) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, dissociation, PTSD symptom severity, PTSD subtypes, military veterans, trauma exposure, depression, anxiety, DSM-5, latent profile analysis
- MeSH terms
- Adult, Canada, Depression, Dissociative Disorders, Female, Humans, Male, Military Personnel, Severity of Illness Index, Stress Disorders, Post-Traumatic, Veterans, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders
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