The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review
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Objective: Several studies have observed that dissociative experiences are frequently reported by individuals with severe mental illness (SMI), especially amongst patients that report a history of adverse/traumatic life experiences. This review examined the magnitude and consistency of the relationship between childhood adversity (sexual abuse, physical abuse, emotional abuse, neglect, bullying, natural disasters and mass violence) and dissociation across three SMI diagnostic groups: schizophrenia, bipolar disorder and personality disorders. Method: A database search (EMBASE, PubMed and PsycINFO) identified 30 eligible empirical studies, comprising of 2199 clinical participants. Effect sizes representing the relationship between exposure to childhood adversity and dissociation were examined and integrated using a random‐effects meta‐analysis. Results: The results indicated that exposure to childhood trauma was associated with heightened dissociation across SMIs. Positive significant associations were also found between specific childhood adversities and dissociation, with aggregated effect sizes in the small‐to‐moderate range. Conclusion: These findings support calls for the routine assessment of traumatic experiences in clients with SMIs presenting with dissociative symptoms and the provision of adequate therapeutic support (e.g. trauma‐focused therapies) to manage and resolve these difficulties.
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Previous metanalyses demonstrate a robust link between dissociative experiencing and exposure to trauma.
“Previous metanalyses demonstrate a robust link between dissociative experiencing and exposure to trauma (Rafiq et al., 2018; Vonderlin et al., 2018).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Rafiq et al., 2018
The available copy identifies the work as a meta-analytic review of childhood adversities and dissociation in severe mental illness, but provides only title and bibliographic information, not its findings. Searches for an association, effect size, and results found no passage establishing the claimed robust link. (LLM, conf=0.72)
Experimental — accuracy not yet measuredThe DD effect size (g=1.25) exceeds the association in non-dissociative clinical samples (r=0.33 [d=0.70]).
“and in non-dissociative clinical samples (r = 0.33 [d = 0.70]) (Rafiq et al., 2018)”
From Hypnotic suggestibility in dissociative and related disorders: A meta-analysis (2022) · cites this paper as Rafiq et al., 2018
The available indexed passages are bibliographic metadata and keywords, not the review’s findings. Searches for non-dissociative clinical samples, r = 0.33, d = 0.70, and the effect-size comparison found no passage reporting those results, so the attribution cannot be checked from our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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- Authors
- Rafiq, S., Campodonico, C., & Varese, F.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- Greater Manchester Mental Health NHS Foundation Trust (GB)
- Corresponding author
- Rafiq, S.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2018-10-18
- Volume
- 138
- Issue
- 6
- Pages
- 509-525
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2888892556
- Cited by
- 108
- References
- 119
- Citations by year
- 2026: 15 · 2025: 15 · 2024: 17 · 2023: 12 · 2022: 15 · 2021: 19 · 2020: 12 · 2019: 3
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- childhood adversity, childhood trauma, dissociation, severe mental illness, schizophrenia, bipolar disorder, personality disorders, sexual abuse, physical abuse, emotional abuse, neglect, bullying, natural disasters, mass violence, trauma-focused psychotherapy
- MeSH terms
- Psychological Trauma, Adverse Childhood Experiences, Adult, Bipolar Disorder, Child, Child Abuse, Dissociative Disorders, Humans, Personality Disorders, Schizophrenia
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