Acute stress-related dissociation and impulsivity are core symptoms of borderline personality disorder (BPD). Both symptoms are linked to emotional distress and non-suicidal self-injury. However,...Show moreAcute stress-related dissociation and impulsivity are core symptoms of borderline personality disorder (BPD). Both symptoms are linked to emotional distress and non-suicidal self-injury. However, it is unclear how stress-related dissociation and impulsivity are associated in BPD and whether this association is specific to BPD. This study aimed to examine whether dissociation influences impulsivity after experimental stress induction in BPD (29 patients) compared to ADHD (29 patients) and HC (30 patients). Dissociation was measured through self-reports (DES and DSS-4), while impulsivity was assessed through self-reports (STIMP) as well as experimental response inhibition and delay discounting behavioral tasks. Stress was induced with the Mannheim Multicomponent Stress Test. The BPD group reported significantly higher trait and state dissociation, before stress induction, than both the ADHD and HC groups. All groups reported significantly higher state dissociation after stress induction. Nonetheless, patients with BPD reported significantly higher state dissociation after stress induction, than the ADHD and HC groups. In general, significant correlations were found between state dissociation and all three state impulsivity measures. After adjusting for multiple comparisons, however, only the correlation within the BPD group between dissociation and self-reported impulsivity remained significant. The present study, thus, underlines the considerable role stress can have in increasing acute symptoms of dissociation specifically in patients with BPD. Moreover, it supports the idea that stress-related dissociation is associated with impulsivity, as measured by how participants view themselves in self-report questionnaires. The relation between dissociation and behavioral aspects of impulsivity remains unclear.Show less
Depersonalisation /Derealisation (DP/DR) has been an object of interest in clinical psychology for many years, with its exact causes still uncertain and debated. As part of a pilot study for a...Show moreDepersonalisation /Derealisation (DP/DR) has been an object of interest in clinical psychology for many years, with its exact causes still uncertain and debated. As part of a pilot study for a larger study, this paper attempts to integrate information from previous studies to link DP/DR to disrupted interoceptive processes, indicated through a disruption in the sense of presence in the real world and decreased heart rate variability (HRV). By using a virtual reality (VR) experience to induce an altered state of consciousness, data from questionnaires and electrocardiogram (ECG) measures were used to determine the relations between the sense of presence and HRV, depending on whether attention was directed, or the participant was allowed to fully immerse themselves in the experience. While no significant results were found, the limitation of a small sample size does not necessarily imply the rejection of the theoretical assumptions shaping the proposed hypothesis, and trends in the data may reflect the theoretical background.Show less
Background: Dissociation is a prevalent symptom of borderline personality disorder (BPD) that has been associated with impaired psychological functions, such as working memory (WM) deficits. While...Show moreBackground: Dissociation is a prevalent symptom of borderline personality disorder (BPD) that has been associated with impaired psychological functions, such as working memory (WM) deficits. While previous studies have shown a link between dissociation and WM deficits, the influence of (mal)adaptive skills on this relationship remains unexplored. A core component of BPD treatment is practicing emotional regulation, which has been found to be associated with dissociation and WM capacity. Exploring these associations may be of clinical importance since practicing emotional regulation during treatment may additionally improve WM capacity in people with dissociation. This cross-sectional study examined how adaptive coping skills and maladaptive coping (self-harm) impact the relationship between dissociation and WM in 57 female BPD patients. Methods: An emotional working memory task (EWMT, adapted Sternberg recognition task), assessed WM in terms of accuracy and reaction time (RT) during distraction. Participants self-reported dissociation (Dissociation Stress Scale acute), self-harming behavior (Borderline Symptom List Supplement) and the use of (mal)adaptive skills (Dialectical Behavior Therapy-Revised Ways of Coping Checklist). Baseline characteristics were compared to a healthy control group (HC, n = 28) using a one-way Multivariate Analysis of Variance (MANOVA). Within the BPD group, simple and hierarchical linear regression analyses and correlation analyses were conducted to assess associations between clinical variables and WM. Results: BPD patients reported increased dissociation and self-harm, and less adaptive coping skills compared to HC, while they did not differ regarding WM. Within the BPD group, both pre-task dissociation and adaptive skills significantly predicted accuracy but not RT on the EWMT. Self-harm and adaptive skills were found to influence the association between dissociation and WM performance. These findings emphasize the importance of assessing dissociative symptoms prior to and during treatment. Strengthening adaptive skills and reducing self-harm remains an important treatment avenue that may enhance WM through better emotional regulation capacities.Show less
Research master thesis | Psychology (research) (MSc)
closed access
Posttraumatic stress disorder (PTSD) and dissociative symptoms often co-occur. Yet, the symptom interrelations between PTSD and dissociation have not been disentangled. The timing and type of...Show morePosttraumatic stress disorder (PTSD) and dissociative symptoms often co-occur. Yet, the symptom interrelations between PTSD and dissociation have not been disentangled. The timing and type of traumatic events have been suggested to play crucial roles in the comorbidity between PTSD and dissociative symptoms. Therefore, partial correlations between PTSD, dissociative symptoms, and adverse childhood maltreatment (ACE) were investigated in two regularized partial correlation networks. Online self-report responses from participants (N = 495) of an overarching study on domestic violence were used. Symptoms and maltreatment types were assessed with the Post-Traumatic Stress Disorder Checklist DSM-5, the Dissociation Experience Scale-II, and the Childhood Trauma Questionnaire-Short Form. The first network analysis included nine nodes (four PTSD symptoms, three dissociation symptoms, two assumed confounders). The second analysis additionally considered five ACE types. The network exploration revealed few and weak connections between PTSD and dissociation. Regardless of the bridge strength, absorption/imagination and hyperarousal showed to be hubs linking PTSD and dissociative symptoms. Adding ACE barely changed the bridges between PTSD and dissociative symptoms. Amnesia appeared to be a hub for connecting dissociative symptoms to ACE. Emotional abuse was the only maltreatment type connected to the PTSD symptoms. These preliminary findings suggest that PTSD and dissociation are largely independent constructs and hint towards separate diagnostic entities. The study was limited by the sample’s subclinical symptoms and maltreatment scores. This limitation may also be partly responsible for the poorly connected network. Prospective studies with clinical samples are needed to further investigate the interplay between PTSD, dissociation, and ACE.Show less
Research master thesis | Psychology (research) (MSc)
under embargo until 2025-01-31
2025-01-31T00:00:00Z
Dissociation is a complex trans-diagnostic phenomenon, which ranges from normative to pathological. There are multiple ways of measuring and categorising dissociation, and different theories as to...Show moreDissociation is a complex trans-diagnostic phenomenon, which ranges from normative to pathological. There are multiple ways of measuring and categorising dissociation, and different theories as to the aetiology and function of dissociation in psychological disorders. People with Borderline Personality Disorder (BPD) experience more dissociation than healthy controls and other personality disorders, and dissociation is associated with other key features of BPD. Despite this, dissociation in BPD is poorly understood. It is unclear which types of dissociation manifest in BPD, in which situations, and the function that dissociation achieves. The aim of this study was to investigate the form and function of dissociation in BPD, by identifying themes across personal narratives. A thematic analysis was performed on narratives of dissociative experiences assessed within a script-driven imagery approach. The predominant forms of dissociation were depersonalisation and derealisation. Dissociation occurred in interpersonal and threatening situations, tended to follow negative affect, and was accompanied by physical reactions consistent with sympathetic nervous system activation. Dissociation functioned as psychological escape from internal experiences or external situations. These themes are discussed within the context of prominent theories of BPD and dissociation. These findings are in line with the idea that dissociation in BPD acts as a protective mechanism against high sensitivity and reactivity to affective and interpersonal experiences in the place of normative regulation skills. This paper concludes that dissociation in BPD offers psychological escape from intolerable experiences, and is related to a low threshold for threat perception and threat response mobilisation.Show less
Introduction: Childhood maltreatment (CM) is a highly prevalent issue in our society that includes physical, emotional and sexual abuse, as well as physical and emotional neglect. CM can lead to...Show moreIntroduction: Childhood maltreatment (CM) is a highly prevalent issue in our society that includes physical, emotional and sexual abuse, as well as physical and emotional neglect. CM can lead to various negative consequences, such as dissociation. Known subtypes are amnestic dissociation, absorption and depersonalization/derealization. There is ample empirical evidence supporting sexual and physical abuse leading to dissociation, but rarely do studies focus on all facets of the variables. This study aims to investigate the relationship between the different types of CM and dissociation taking post-traumatic stress disorder (PTSD) as a mediator into account. Methods: Using an online self-report survey, CM, dissociation and PTSD were assessed cross-sectionally among a sample recruited on online platforms for domestic violence via Leiden University (N=432). Obtained data were analyzed by performing a multivariate analysis of covariance (MANCOVA) and mediation analysis (PROCESS macro). Results: The results support the notion to use all subscales of both variables, as sexual abuse and physical neglect were significantly associated with amnestic dissociation, while sexual abuse, physical neglect and emotional abuse were significant predictors of derealization/depersonalization; physical neglect had a significant relationship with absorption. PTSD was a significant mediator but it did not fully explain the link between CM and dissociation. Discussion: Future studies should focus on using clinical samples and longitudinal designs to gain deeper knowledge into therapeutic implications. Integrating the findings of our paper is an important step to better understand the types of CM, dissociation and the importance of PTSD.Show less
Introduction: Traumatic experiences may lead to pathological dissociation. Three components of dissociation can be distinguished: absorption, depersonalization, and amnesia. Especially maltreated...Show moreIntroduction: Traumatic experiences may lead to pathological dissociation. Three components of dissociation can be distinguished: absorption, depersonalization, and amnesia. Especially maltreated children are at risk for developing dissociative symptoms. Several studies support a relationship between childhood maltreatment (CM) and dissociation, but previous research often does not differentiate between different types of CM in relation to the different types of dissociation. Hence, this study explored whether different types of CM could predict different types of dissociation. Method: using an online survey, self-reported experiences of CM and dissociation were cross-sectionally assessed among a sample from the general population (N = 549). Multiple regressions were performed in order to investigate whether the different types of CM were predictors for the different types of dissociation. Results: the regression for CM and dissociation, with gender as a covariate, was significant. Emotional abuse and emotional neglect significantly predicted any type of dissociation, and specifically depersonalization; emotional abuse and sexual abuse significantly predicted absorption, with gender as a covariate; physical neglect and sexual abuse significantly predicted amnesia. Discussion: the findings fit previous research concerning the relationship between CM and dissociation, although more research is needed to investigate the specific role of emotional maltreatment in regard to other types of CM and how it is related to dissociation.Show less
The literary phenomena of segmentation in La vie mode d'emploi makes the reader purposely suffer in a way similar to Perec, in relation to his traumatic and problematic past. With the help of...Show moreThe literary phenomena of segmentation in La vie mode d'emploi makes the reader purposely suffer in a way similar to Perec, in relation to his traumatic and problematic past. With the help of psychoanalytical notions such as "defense mechanisms", "transference", "counter-transference", "trauma"; and terms from contemporary cognitive behavioural sources, I corroborate this assertion. As memories are necessary according to Freud for a bereavement process, Perec lacks them, and therefore this process would not be possible. Nevertheless, I show that contemporary ideas about "dissociation", bereavement and auto-narrative, supports my claim that La vie mode d'emploi can be seen as a literary representation of a bereavement process.Show less
