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

The DOI matches its Crossref record; 103 of the 107 references it cites were found in a registry or an index.

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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Crossref · 10.1080/j.1440-1614.2004.01480.x

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Citations

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Research works printed but not linked: 18

  1. Brett E A, 1996, Traumatic stress, 117
  2. Janet P, 1889, L'automatisme psychologique
  3. Spiegel D, 1993, Review of psychiatry, 10, 261
  4. Van der Hart O, Dissociation and the dissociative disorders: DSM-V and beyond
  5. Myers C S, 1940, Shell shock in France, 1914–1918
  6. Steinberg M, 1994, Interviewer's guide to the Structured Interview for DSM-IV Dissociative Disorders (SCID-D), revised
  7. Noyes R, 1977, Psychiatry, 18, 375
  8. Van der Hart O, 1989, Dissociation, 2, 3
  9. Nijenhuis E R.S, 1999, Splintered reflections: images of the body in trauma, 39
  10. Nemiah J C, 1991, Review of psychiatry, 10, 248
  11. World Health Organization, 1992, The ICD-10 classification of mental and behavioural disorders
  12. Wolff P H, 1987, The development of behavioral states and the expression of emotions in early infancy
  13. Nemiah J C, 1998, Tauma, memory, and dissociation, 1
  14. Van der Hart O, 1993, Dissociation, 6, 162
  15. Herman J L, 1987, Psychological trauma, 111
  16. Freyd J J, 1996, Betrayal trauma: the logic of forgetting abuse
  17. Vanderlinden J, 1993, Hospital and Community Psychiatry, 44, 786
  18. Ciorciari J, 2003, Paper delivered at the International Conference on Trauma, Attachment, and Dissociation, Delphi Centre

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Metadata

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

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