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

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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

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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.

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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: Nijenhuis, Ellert
Steele, Kathy
Brown, Daniel
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

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Trauma-Related Dissociation: Conceptual Clarity Lost and Found

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