Yale University School of Medicine, New Haven, Connecticut, USA.
J Trauma Stress. 2013 Aug;26(4):492-7. doi: 10.1002/jts.21834. Epub 2013 Jul 25.
This study explored distinctions between spontaneous and deliberate dissociative states in 335 military personnel exposed to stressful survival training. Participants completed the Clinician-Administered Dissociative States Scale (CADSS) after a stressful mock-captivity event. They were also asked to indicate whether the dissociative experiences just happened (i.e., spontaneous), or whether they chose to have them happen (i.e., deliberate); and whether they appraised the dissociative experience as helpful (i.e., facilitative) or hurtful (i.e., debilitative) to their ability to cope with the stressful event. A majority (95.4%) endorsed dissociative states during stress. More than half (57.4%) described dissociative experiences as spontaneous, 13.0% as deliberate, and 29.5% endorsed neither. In Special Forces soldiers only, those who endorsed facilitative dissociation exhibited higher total CADSS scores than those who endorsed debilitative dissociation. Seventy-three percent of spontaneous dissociators described the experience as debilitative to coping with stress; conversely, 76% of deliberate dissociators said these experiences facilitated coping with stress. Individuals with prior trauma exposure tended to appraise dissociative states as more debilitative to coping. This research may enhance the fidelity of studies of dissociation constructs and may offer pivot points for prevention and treatment of stress-related disorders.
本研究探讨了在 335 名经历过应激生存训练的军事人员中，自发性和故意性分离状态之间的区别。参与者在经历了一场有压力的模拟囚禁事件后，完成了临床医生管理的分离状态量表 (CADSS)。他们还被要求指出分离体验是刚刚发生的（即自发性），还是他们选择让其发生（即故意性）；以及他们是否认为分离体验对他们应对应激事件的能力有帮助（即促进性）或有伤害（即削弱性）。大多数（95.4%）参与者在压力下表现出分离状态。超过一半（57.4%）的人描述分离体验是自发性的，13.0%是故意性的，29.5%的人则没有。在特种部队士兵中，那些支持促进性分离的人表现出更高的 CADSS 总分，而那些支持削弱性分离的人则得分较低。73%的自发性分离者描述这种体验对应对压力有削弱作用；相反，76%的故意性分离者表示这些体验有助于应对压力。有先前创伤经历的个体倾向于将分离状态评估为对应对更具削弱性。这项研究可能会提高对分离结构研究的保真度，并为预防和治疗与应激相关的障碍提供关键切入点。
