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Dissociation in Posttraumatic Stress Disorder: Evidence from the World Mental Health Surveys
Open accessAbstract
Background Although the proposal for a dissociative subtype of posttraumatic stress disorder (PTSD) in DSM-5 is supported by considerable clinical and neurobiological evidence, this evidence comes mostly from referred samples in Western countries. Cross-national population epidemiologic surveys were analyzed to evaluate generalizability of the subtype in more diverse samples. Methods Interviews were administered to 25,018 respondents in 16 countries in the World Health Organization World Mental Health Surveys. The Composite International Diagnostic Interview was used to assess 12-month DSM-IV PTSD and other common DSM-IV disorders. Items from a checklist of past-month nonspecific psychological distress were used to assess dissociative symptoms of depersonalization and derealization. Differences between PTSD with and without these dissociative symptoms were examined across a variety of domains, including index trauma characteristics, prior trauma history, childhood adversity, sociodemographic characteristics, psychiatric comorbidity, functional impairment, and treatment seeking. Results Dissociative symptoms were present in 14.4% of respondents with 12-month DSM-IV/Composite International Diagnostic Interview PTSD and did not differ between high and low/middle income countries. Symptoms of dissociation in PTSD were associated with high counts of re-experiencing symptoms and net of these symptom counts with male sex, childhood onset of PTSD, high exposure to prior (to the onset of PTSD) traumatic events and childhood adversities, prior histories of separation anxiety disorder and specific phobia, severe role impairment, and suicidality. Conclusion These results provide community epidemiologic data documenting the value of the dissociative subtype in distinguishing a meaningful proportion of severe and impairing cases of PTSD that have distinct correlates across a diverse set of countries.
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“poor functional outcomes (Stein et al., 2013)”
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 Stein et al., 2013
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“Transdiagnostically, heighted dissociative symptoms are associated with increased disease severity (Belli et al., 2012;Rufer et al., 2006a;Stein et al., 2013)”
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 Stein et al., 2013
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“elevated risk of suicidality (Stein et al., 2013)”
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“Critically, increased disease severity (e.g., elevated risk of 12-month suicidality), earlier age of onset, and poorer functional outcomes have been reported in this subtype (Stein et al., 2013).”
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 Stein et al., 2013
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Cites
The Measurement of Observer Agreement for Categorical Data
Landis, J. R., & Koch, G. G. (1977) · Biometrics · doi:10.2307/2529310 · Cited by 81,148
(1990) · Choice Reviews Online · doi:10.5860/choice.27-3338 · Cited by 35,305
Hosmer, D. W., & Lemeshow, S. (2000) · doi:10.1002/0471722146 · Cited by 20,302
Measuring Intrafamily Conflict and Violence: The Conflict Tactics (CT) Scales
Straus, M. A. (1979) · Journal of Marriage and the Family · doi:10.2307/351733 · Cited by 6,187
Kessler, R. C., & Üstün, T. B. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.168 · Cited by 4,771
Self-citationDevelopment, reliability, and validity of a dissociation scale
BERNSTEIN, E. M., & PUTNAM, F. W. (1986) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198612000-00004 · Cited by 3,793 · cited 2×
“47. van Ijzendoorn MH, Schuengel C (1996): The measurement of dissociation in normal and clinical populations: Meta-analytic validation of the Dissociative Experiences Scale (DES).”
BackgroundComplex PTSD: A syndrome in survivors of prolonged and repeated trauma
Herman, J. L. (1992) · Journal of Traumatic Stress · doi:10.1002/jts.2490050305 · Cited by 2,609 · cited 1×
“This pattern is consistent with discussions in clinical studies about complex PTSD and Disorders of Stress Not Otherwise Specified (56,57).”
ResultGreen, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.186 · Cited by 2,323
Self-citationCloitre, M., Stolbach, B. C., Herman, J. L., Kolk, B. V. D., Pynoos, R., Wang, J., & Petkova, E. (2009) · Journal of Traumatic Stress · doi:10.1002/jts.20444 · Cited by 1,473
Introduction to Variance Estimation.
King, B. F., & Wolter, K. M. (1987) · Journal of the American Statistical Association · doi:10.2307/2289497 · Cited by 1,377
Flagged first, then by citations
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Sorted by citations
Items 301–328 of 328
White, W. F., Burgess, A., Dalgleish, T., Dixon, C., Halligan, S. L., Hiller, R. M., McKinnon, A., Smith, P. A., & Meiser‐Stedman, R. (2024) · British Journal of Clinical Psychology · doi:10.1111/bjc.12461
Maldonado, J. R., & Spiegel, D. (2024) · Springer eBooks · doi:10.1007/978-3-030-51366-5_80
Self-citationThe “Square of Deception”: How some borrowers boxed themselves in to access funds
Ivanaj, S., & Mesly, O. (2024) · Management & Prospective · doi:10.3917/g2000.406.0088
Trauma and Mental Health: Individual and Collective Traumas
Carmassi, C., Fantasia, S., Pedrinelli, V., Mammarella, S., Giusti, L., & Roncone, R. (2024) · Sustainable development goals series · doi:10.1007/978-3-031-70165-8_17 · Cited by 1
(2025) · Discussions · doi:10.28953/2997-2582.1203
Fung, H. W., Huang, C. H. O., Cheung, C. T. Y., Chou, P., & Ito, M. (2025) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2025.104394
Southall, A. E. (2025) · Springer briefs in education · doi:10.1007/978-981-96-0409-8_1
Traumatic events and sense-making: mobilization of meta-emotional processes
Julien, C., Binaut, L., Dubois, M., & Bréjard, V. (2025) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2025.100557
Harmelech, T., Hendler, T., Gurevitch, G., Fine, N. B., Fruchter, E., Amital, D., Goldental, N., Gross, R., Robinson, M. A., Lebois, L. A. M., et al. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116752
Narikuzhy, S., Harricharan, S., Rabellino, D., Densmore, M., Théberge, J., Lieberman, J. M., McKinnon, M. C., Nicholson, A. A., & Lanius, R. A. (2025) · NeuroImage Clinical · doi:10.1016/j.nicl.2025.103920 · Cited by 1
Thompson, J. N., Salazar, A. M., & Taussig, H. N. (2026) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2026.107883 · Cited by 3
Pan, X., Palermo, C. A., Bair, Z. A., Hill, S. B., Kaplan, C. S., Marr, M. C., Modell, R. L., Purcell, J. B., Shanahan, M. E., Swee, M. B., et al. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.03.003
Eroğlu, M., Güllü, B. Ü., Uytun, M. Ç., & Öztop, D. B. (2026) · Early Intervention in Psychiatry · doi:10.1111/eip.70150
Rueger, M. S., Nehler, K. J., Lechner‐Meichsner, F., Ehring, T. W., Preiß, H., Nexhmedin Morina, B., Kip, A., Mewes, R., Giesebrecht, J., Weise, C., et al. (2026) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2026.2641642
Kurapov, A., Vlasenko, I., Hettegger, S. E., Liedlgruber, M., Wilhelm, F. H., & Danböck, S. K. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2635315
Vancappel, A. (2021) · theses.fr (ABES) · doi:10.70675/dea8e3d7zeecaz44d6za3e9z95ed7c42b45e
ICD-11 PTSD and CPTSD in Serbia: clinical validation of the International Trauma Questionnaire
Pejušković, B., Lero, M., Pavlović, V., Arsenijević, M., Ilić, M., & Pešić, D. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2646128
Boisselier, N. (2025) · theses.fr (ABES) · doi:10.70675/801d548cz4105z46cfz95fcz749e7eb17f46
Spezifisch Belastungs-assoziierte Störungen
Kapfhammer, H., Eberle, D. J., & Maercker, A. (2026) · Springer Reference Medizin · doi:10.1007/978-3-642-45028-0_71-2
Bengizi, A., Qureshi, A. R., Incze, T., Ashur, A., Abdul-Rahman, Z., Ali, Y., Dhillon, S., Ali, M., Elmoursi, O., Couban, R., et al. (2026) · BMJ Military Health · doi:10.1136/military-2025-003186
Clinicians’ experience with trauma-related dissociation in CAMHS: A reflexive thematic analysis
Pandzic, I., Milkins, D. B., Boutrus, M., Ohan, J. L., & Milroy, H. (2026) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2026.100700
Mélanie, M., Hirschelmann, A., & Geoffrion, S. (2026) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2026.108119
Teaching psychiatry through movies: the PTSD in Brothers: film analysis
Crokaert, J., Bouayed, Y. H., Daher, C., & Calzada, G. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1841640
Taujanskaitė, U., & Kamboj, S. K. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2678662
Molina-Coloma, V., Reyes-Sosa, H., Lara-Machado, J. R., & Álvarez-Montero, F. J. (2026) · International Journal of Forensic Mental Health · doi:10.1177/14999013261464269
Deutsch, S. I., Elikan, J., Spiegel, D. R., Cockerham, M.-C., & Burket, J. A. (2026) · Clinical neuropharmacology · doi:10.1097/wnf.0000000000000700
Self-citationMessina, A. (2026) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2026.100773
Metadata
- Authors
- Stein, D. J., Koenen, K. C., Friedman, M. J., Hill, E., McLaughlin, K. A., Petukhova, M., Ruscio, A. M., Shahly, V., Spiegel, D., Borges, G., Bunting, B., Caldas-de-Almeida, J. M., de Girolamo, G., Demyttenaere, K., Florescu, S., Haro, J. M., Karam, E. G., Kovess-Masfety, V., Lee, S., Matschinger, H., Mladenova, M., Posada-Villa, J., Tachimori, H., Viana, M. C., & Kessler, R. C.
- Affiliations
- University of Cape Town (ZA)
- Columbia University (US)
- United States Department of Veterans Affairs (US)
- Harvard University (US)
- Boston Children's Hospital (US)
- University of Pennsylvania (US)
- Stanford Medicine (US)
- Universidad Autónoma Metropolitana (MX)
- University of Ulster (GB)
- Universitair Ziekenhuis Leuven (BE)
- National School of Public Health, Management and Professional Development (RO)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- University of Balamand (LB)
- Chinese University of Hong Kong (HK)
- Leipzig University (DE)
- New Bulgarian University (BG)
- National Center of Neurology and Psychiatry (JP)
- Corresponding author
- Kessler, Ronald C.
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 73
- Issue
- 4
- Pages
- 302-312
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC3589990
- OpenAlex
- W2133036344
- Semantic Scholar
- 8601d919bf5250f9bfb8f93096a6cecaa3d5db7a
- Cited by
- 328
- References
- 61
- Citations by year
- 2026: 19 · 2025: 19 · 2024: 19 · 2023: 19 · 2022: 22 · 2021: 29 · 2020: 31 · 2019: 20 · 2018: 24 · 2017: 30 · 2016: 17 · 2015: 29 · 2014: 34 · 2013: 15
- FWCI
- 28.24
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Public Health Agency (COM/4411/10, COM/4437/11)
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05, 5r01mh093612-03)
- Medical Research Council (MR/K023241/1)
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, U01-MH-60220, R01-MH092526, R01-MH093612, K01MH092526, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558)
- Fogarty International Center (R03TW006481)
- 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 › Migration, Health and Trauma
- Keywords
- post-traumatic stress disorder, dissociation, depersonalization, derealization, DSM-5, childhood adversity, re-experiencing symptoms, psychiatric comorbidity, suicidality, functional disability, treatment seeking, World Mental Health Surveys
- MeSH terms
- Adolescent, Adult, Dissociative Disorders, Female, Health Surveys, Humans, Interview, Psychological, Life Change Events, Male, Mental Health, Stress Disorders, Post-Traumatic, Suicide, Comorbidity, Prevalence, Diagnostic and Statistical Manual of Mental Disorders
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