Soffer-Dudek Nirit
Psychiatry. 2017 Fall;80(3):265-278. doi: 10.1080/00332747.2016.1247622.
Dissociative experiences are associated with several psychopathological symptoms and are a hindrance to therapeutic gain. Depersonalization-derealization (DEP-DER) is positively associated with stress and anxiety, while absorption and imaginative involvement (ABS), a tendency for total, immersed attention, is commonly referred to as nonpathological dissociation, although it is positively associated with obsessive-compulsive (OC) symptoms. Previous studies in the field have been mainly cross-sectional. The present study aimed to examine these associations rigorously and attempted to determine directionality between dissociation and distress.
The current study employed both variable-centered (cross-sectional) and person-centered (longitudinal, within-subjects) analyses of the associations of DEP-DER and ABS with distress. Undergraduate students (N = 184) completed trait questionnaires on dissociation, stress, anxiety, depression, and OC symptoms, and n = 78 also completed questionnaires assessing the same constructs daily for 14 days. Multiple regression and multilevel modeling analyses were conducted.
In the cross-sectional phase, DEP-DER was uniquely positively related to anxiety and OC symptoms, and ABS was uniquely positively related to OC symptoms. In the daily diary phase, increases in DEP-DER were related to increases in anxiety, depression, OC symptoms, and stress, while increases in ABS were related to increases in OC symptoms and stress. In addition, time-lag analysis showed that ABS tended to temporally precede OC.
ABS foretold increases in OC symptoms, at least in this nonclinical sample. Future studies on clinical samples should explore whether ABS should be referred to as "nonpathological" and its possible role in the development or maintenance of clinical-level OCD.
分离体验与多种精神病理症状相关,并且是治疗进展的一个阻碍。人格解体-现实解体(DEP-DER)与压力和焦虑呈正相关,而专注与想象投入(ABS),即一种完全沉浸式注意力的倾向,通常被称为非病理性分离,尽管它与强迫症状呈正相关。该领域之前的研究主要是横断面研究。本研究旨在严格检验这些关联,并试图确定分离与痛苦之间的方向性。
本研究对DEP-DER和ABS与痛苦之间的关联采用了以变量为中心(横断面)和以人为中心(纵向,个体内)的分析方法。本科生(N = 184)完成了关于分离、压力、焦虑、抑郁和强迫症状的特质问卷,78名学生还连续14天每天完成评估相同构念的问卷。进行了多元回归和多层次建模分析。
在横断面阶段,DEP-DER与焦虑和强迫症状呈独特的正相关,ABS与强迫症状呈独特的正相关。在每日日记阶段,DEP-DER的增加与焦虑、抑郁、强迫症状和压力的增加相关,而ABS的增加与强迫症状和压力的增加相关。此外,时间滞后分析表明ABS在时间上倾向于先于强迫症状出现。
至少在这个非临床样本中,ABS预示着强迫症状的增加。未来对临床样本的研究应探讨ABS是否应被称为“非病理性的”,以及它在临床水平强迫症的发展或维持中可能扮演的角色。