McGuinness Roberta, Herring Daniel, Wu Xinyi, Almandi Maryam, Bhangu Daveena, Collinson Lucia, Shang Xiaocheng, Černis Emma
School of Psychology, University of Birmingham, Birmingham, UK.
School of Mathematics, University of Birmingham, Birmingham, UK.
Early Interv Psychiatry. 2025 Feb;19(2):e70015. doi: 10.1111/eip.70015.
Dissociation is associated with clinical severity, increased risk of suicide and self-harm, and disproportionately affects adolescents and young adults. Whilst evidence indicates multiple factors contribute to dissociative experiences, a multi-factorial explanation of increased risk for dissociation has yet to be achieved.
We used multiple regression to investigate the relative influence of five plausible risk factors (childhood trauma, loneliness, marginalisation, socio-economic status, and everyday stress), and machine learning to generate tentative high-risk profiles for 'felt sense of anomaly' dissociation (FSA-dissociation) using cross-sectional online survey data from 2384 UK-based 16- to 25-year-olds.
Multiple regression indicated that four risk factors significantly contributed to FSA-dissociation, with relative order of contribution: everyday stress, childhood trauma, loneliness and marginalisation. Exploratory analysis using machine learning suggested dissociation results from a complex interplay between interpersonal, contextual, and intrapersonal pressures: alongside marginalisation and childhood trauma, negative self-concept and depression were important in younger (16-20 years), and anxiety and maladaptive emotion regulation in older (21-25 years) respondents.
Validation of these findings could inform clinical assessment, and prevention and outreach efforts, improving the under-recognition of dissociation in mainstream services.
分离与临床严重程度、自杀和自我伤害风险增加相关,且对青少年和年轻人的影响尤为严重。虽然有证据表明多种因素会导致分离体验,但尚未实现对分离风险增加的多因素解释。
我们使用多元回归来研究五个合理风险因素(童年创伤、孤独感、边缘化、社会经济地位和日常压力)的相对影响,并使用机器学习,利用来自2384名16至25岁英国在线横断面调查数据,生成“异常感觉”分离(FSA-分离)的初步高风险特征。
多元回归表明,四个风险因素对FSA-分离有显著影响,影响程度的相对顺序为:日常压力、童年创伤、孤独感和边缘化。使用机器学习的探索性分析表明,分离源于人际、情境和个人内部压力之间的复杂相互作用:除了边缘化和童年创伤外,消极的自我概念和抑郁在较年轻(16至20岁)的受访者中很重要,而焦虑和适应不良的情绪调节在较年长(21至25岁)的受访者中很重要。
对这些发现的验证可为临床评估、预防和宣传工作提供参考,改善主流服务中对分离认识不足的情况。