CoChat
Sign Up
Cited by 308Psychosomatic Disorders and Their TreatmentsPsychoanalysis and Psychopathology ResearchPosttraumatic Stress Disorder Research

Trauma-Related Dissociation: Conceptual Clarity Lost and Found

Van Der Hart, Onno, Nijenhuis, Ellert, Steele, Kathy, Brown, Daniel·2004·Australian & New Zealand Journal of Psychiatry
DOI 10.1080/j.1440-1614.2004.01480.x
Open this paper in CoChat — free account

Abstract

Objective: Imprecise conceptualizations of dissociation hinder understanding of traumarelated dissociation. An heuristic resolution for research and clinical practice is proposed. Method: Current conceptualizations of dissociation are critically examined. They are compared with a new theory that incorporates classical views on dissociation with other contemporary theories related to traumatization, viewing dissociation as a lack of integration among psychobiological systems that constitute personality, that is, as a structural dissociation of the personality. Results: Most current views of dissociation are overinclusive and underinclusive. They embrace non-dissociative phenomena – rigid alterations in the level and field of consciousness – prevalent in non-traumatized populations, and which do not require structural dissociation. These views also largely disregard somatoform and positive symptoms of dissociation and underestimate integrative deficiencies, while emphasizing the psychological defensive function of dissociation. They do not offer a common psychobiological pathway for the spectrum of trauma-related disorders. Structural dissociation of the personality likely involves divisions among at least two psychobiological systems, each including a more or less distinct apperceptive centre, that is, a dissociative part of the personality. Three prototypical levels of structural dissociation are postulated to correlate with particular traumarelated disorders. Conclusions: Limitation of the concept of dissociation to structural dividedness of the personality sets it apart from related but non-dissociative phenomena and provides a taxonomy of dissociative symptoms. It postulates a common psychobiological pathway for all trauma-related disorders. Trauma-related dissociation is maintained by integrative deficits and phobic avoidance. This conceptualization advances diagnosis, classification, treatment and research of trauma-related disorders.

Integrity signals

Registry

Crossref · 10.1080/j.1440-1614.2004.01480.x

Cites

104 of 104 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

3 of the 107 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Van Der Hart, O., Nijenhuis, E., Steele, K., & Brown, D.
Affiliations
  • Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
  • GGZ Drenthe (NL)
  • Metropolitan Psychotherapy Associates, Atlanta, Georgia, US
  • Harvard University (US)
ORCID
Venue
Australian & New Zealand Journal of Psychiatry
Publisher
SAGE Publications
Published
2004-11
Volume
38
Issue
11-12
Pages
906-914
ISSN
  • 0004-8674 (ISSN-L)
  • 1440-1614
DOI
10.1080/j.1440-1614.2004.01480.x
OpenAlex
W2147365600
Cited by
308
References
107
Citations by year
2026: 10 · 2025: 16 · 2024: 14 · 2023: 33 · 2022: 8 · 2021: 11 · 2020: 18 · 2019: 21 · 2018: 23 · 2017: 14 · 2016: 21 · 2015: 13 · 2014: 10 · 2013: 6 · 2012: 16
FWCI
5.60
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Australian & New Zealand Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
trauma-related dissociation, structural dissociation, personality integration, dissociative symptoms, trauma-related disorders, phobic avoidance
MeSH terms
Brain Injuries, Dissociative Disorders, Humans

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review