Pre-amputation assessment using Roy''s Adaptation Model

Depersonalization disorder comprises one of the four major dissociative disorders and yet remains poorly studied. There are no reports describing the application of dissociation scales to this population. Our goal was to investigate the applicability of four such scales to depersonalization disorder and to establish screening criteria for the disorder. Two general dissociation scales and two depersonalization scales were administered to 50 subjects with DSM-III-R depersonalization disorder and 20 healthy control subjects. The depersonalization disorder group scored significantly higher than the normal control group in all scales and subscales. Factor analysis of the Dissociative Experiences Scale (DES) yielded three factors as proposed previously, absorption, amnesia, and depersonalization/derealization. A DES cutoff score of 12, markedly lower than those previously proposed for the screening of other dissociative disorders, is required for the sensitive detection of depersonalization disorder. Alternatively, the DES pathological dissociation taxon (DES-taxon) score recently generated in the literature appears more sensitive to the detection of depersonalization disorder and is better recommended for screening purposes. The other three scales were fairly strongly correlated to the DES, suggesting that they may measure similar but not identical concepts, and cutoff scores are proposed for these scales also. General implications for the screening and quantification of depersonalization pathology are discussed.     

Dissociation in the laboratory: a comparison of strategies

Several methods for inducing dissociation in the laboratory were examined in a sample of 78 undergraduate students. Participants scoring high or low on the Dissociative Experiences Scale participated in three dissociation challenge conditions: (a) dot-staring task, (b) administration of pulsed photic and audio stimulation and (c) stimulus deprivation. Participants recorded their dissociative experiences both before and after each of the three challenge conditions. Across conditions, high DES participants reported significantly more dissociative sensations than low DES participants, even after controlling for pre-challenge dissociation. Moreover, regardless of DES status, pulsed photo and audio stimulation produced the greatest level of dissociative symptoms. The findings suggest that the induction of dissociative symptoms in a nonclinical sample is easily accomplished in the laboratory and that those who report more dissociative symptoms in their day-to-day life exhibit more pronounced dissociative symptoms when undergoing dissociative challenge in the laboratory. Implications for the study and treatment of dissociative symptoms are discussed.     

Types of dissociation and dissociative types: A taxometric analysis of dissociative experiences.

This article examined evidence for dimensional and typological models of dissociation. The authors reviewed previous research with the Dissociative Experiences Scale (DES; E. B. Bernstein-Carlson & F. W. Putnam; see record 1987-14407-001) and note that this scale, like other dissociation questionnaires, was developed to measure that so called dissociative continuum. Next, recently developed taxometric methods for distinguishing typological from dimensional constructs are described and applied to DES item-response data from 228 adults with diagnosed multiple personality disorder and 228 normal controls. The taxometric findings empirically justify the distinction between two types of dissociative experiences. Nonpathological dissociative experiences are manifestations of a dissociative trait, whereas pathological dissociative experiences are manifestations of a latent class variable. The taxometric findings also indicate that there are two types of dissociators. Individuals in the pathological dissociative class (taxon) can be identified with a brief, 8-item questionnaire called the DES-T. Scores on the DES-T and DES are compared in 11 clinical and nonclinical samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dissociative experiences, psychopathology and adjustment, and child and adolescent maltreatment in female college students.

33 female college students who scored in the upper 15% on the Dissociative Experiences Scale (DES) were compared with 33 female students who scored below the mean on the DES on measures of psychopathology (SCL-90), college adjustment (Student Adpatation to College Questionnaire), and child and adolescent maltreatment. Compared with controls, high-DES Ss reported more psychopathology, poorer college adjustment, and a greater extent of psychological, physical, and sexual maltreatment. On the basis of the Dissociative Disorders Interview Schedule, 2 high-DES Ss but none of the control Ss met criteria for a dissociative disorder (i.e., multiple personality and psychogenic amnesia). Despite the sensitivity of the DES, 8 Ss who scored in the upper 2% of the population on the DES failed to meet criteria for a dissociative disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans

OBJECTIVE: The aim of this study was to determine the reliability and validity of a proposed measure of peritraumatic dissociation and, as part of that effort, to determine the relationship between dissociative experiences during disturbing combat trauma and the subsequent development of posttraumatic stress disorder (PTSD). METHOD: A total of 251 male Vietnam theater veterans from the Clinical Examination Component of the National Vietnam Veterans Readjustment Study were examined to determine the relationship of war zone stress exposure, retrospective reports of dissociation during the most disturbing combat trauma events, and general dissociative tendencies with PTSD case determination. RESULTS: The total score on the Peritraumatic Dissociation Experiences Questionnaire--Rater Version was strongly associated with level of posttraumatic stress symptoms, level of stress exposure, and general dissociative tendencies and weakly associated with general psychopathology scales from the MMPI-2. Logistic regression analyses supported the incremental value of dissociation during trauma, over and above the contributions of level of war zone stress exposure and general dissociative tendencies, in accounting for PTSD case determination. CONCLUSIONS: These results provide support for the reliability and validity of the Peritraumatic Dissociation Experiences Questionnaire--Rater Version and for a trauma-dissociation linkage hypothesis: the greater the dissociation during traumatic stress exposure, the greater the likelihood of meeting criteria for current PTSD.     

Adaptation and psychometric properties of the German version of the Dissociative Experience Scale

We introduce the 'Fragebogen zu Dissoziativen Symptomen' (FDS), a German adaptation of the Dissociative Experience Scale (DES) which was developed to screen for dissociation within an ICD-10 framework. In addition to the original 28 DES items, the FDS contains 16 items covering dissociative phenomena included in the ICD-10, particularly pseudoneurological conversion symptoms. The psychometric properties of the FDS were studied in 927 clinical and nonclinical subjects from different diagnostic groups and compared to results of American studies. The scale had good test-retest reliability of .88, high internal consistency (split-half = .90, Cronbach's alpha = .94) and good construct validity. These results indicate that the FDS may be a valuable screen for dissociative psychopathology in German-speaking countries.     

Investigating the construct validity of the dissociative taxon: Stability analyses of normal and pathological dissociation.

Research has suggested the existence of a pathological dissociative taxon. However, relatively little is known about this taxon. This study examined the 2-month retest stability of this taxon--together with other measures of dissociation and the Big Five--in a sample of 465 undergraduates. Contrary to expectation, taxon scores were only modestly stable and were substantially less stable than the other measures, including continuous indicators of dissociation. Furthermore, most individuals who were identified as taxon members at one assessment were classified as nonmembers at the other. These results challenge the existence of a pathological dissociative taxon. More generally, these data demonstrate that statistically identified taxa need to be explicated through the normal process of construct validation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dissociative states in eating disorders: An empirical Rorschach study.

The study explores the DSM-IV-TR classification of eating disorders that is constituted of four subtypes, two of them defined as anorexia (restricting and binge eating/purging) and two as bulimia (purging and non-purging). This classification is based on body weight as the distinguishing criterion. However, psychoanalytic thinking substantially distinguishes between restricting anorexia and the other three subtypes, all of them involving binge eating. Accordingly, binge eating patients are assumed to present different personality characteristics and different dynamics including dissociation proneness as a core component of the disturbance. The dissociative component of binge eating is examined by using the Rorschach Reality-Fantasy Scale (RFS; Tibon, Handelzalts, & Weinberger, 2005) and other Rorschach measures in a sample of 61 female adolescent inpatients diagnosed with eating disorders. This sample was divided into two groups by using the criterion of whether or not the symptoms involve binge eating behavior. The results support the view that dissociation between reality and fantasy is an important facet of binge eating disorders. A case study that demonstrates the utility of the RFS is presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Narrowed focus and dissociative experiences in a community sample of experienced video lottery gamblers.

Problem (20 Ss) and occasional (22 Ss) video lottery terminal (VLT) gamblers were compared on speed of reaction to irrelevant light stimuli on a nongambling baseline measure and while playing on a VLT, on feelings of dissociation when gambling, and on general dissociative experiences. Measures included the Dissociative Experiences Scale (DES), the Brief Symptom Inventory, and the Dissociative Experiences Scale. The groups did not differ on DES scores. Problem gamblers reported more dissociative-like experiences when gambling than occasional gamblers. For the problem gamblers only the speed of response to irrelevant light stimuli when playing on the VLT was dependent on the order of task presentation. These findings suggest problem VLT gamblers focus intensely on VLT play but are capable of changing their focus if the task requires it. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of peritraumatic dissociation and posttraumatic stress: Findings in female Vietnam theater veterans.

This study examined the relationship of dissociation at the time of trauma, as assessed by the Peritraumatic Dissociation Experiences Questionnaire, Rater Version (PDEQ-RV; C. R. Marmar, D. S. Weiss, & T. J. Metzler, in press), and posttraumatic stress symptoms in a group of 77 female Vietnam theater veterans. PDEQ-RV ratings were found to be associated strongly with posttraumatic stress symptomatology, as measured by the Impact of Event Scale (M. J. Horowitz, N. Wilner, & W. Alvarez; see record 1980-26834-001), and also positively associated with level of stress exposure and general dissociative tendencies, measured by the Dissociative Experiences Scale. The PDEQ-RV was unassociated with general psychiatric symptomatology, as assessed by the clinical scales of the Minnesota Multiphasic Personality Inventory-2 (J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989). The PDEQ-RV was predictive of posttraumatic stress symptoms beyond the contributions of level of stress exposure and general dissociative tendencies. The findings provide further support for the reliability and validity of the PDEQ-RV as a measure of peritraumatic dissociation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Uncharged S4 residues and cooperativity in voltage-dependent potassium channel activation

The purpose of this study was to investigate psychological testing features of children and adolescents with dissociative disorder diagnoses to provide diagnostic information that might facilitate early intervention. The psychological testing protocols of 30 children diagnosed with dissociative disorders were compared with the testing protocols of 30 consecutive admissions to the Sheppard Pratt Hospital who did not receive a dissociative identity disorder (DID; formerly termed multiple personality disorder) or dissociative disorder not otherwise specified (DDNOS) diagnosis. A rater, blind to the diagnosis, scored these protocols for the presence or absence of behavioral and testing response variables hypothesized to discriminate between the dissociative patients and the mixed group of other diagnoses. Behavioral features significantly more common in the dissociative group included forgetting, staring, unusual motor behaviors, dramatic fluctuations, fearful and angry reactions to stimuli, physical complaints during testing, and expressions of internal conflict. Significant indications of dissociation in the test responses included images of multiplicity, malevolent religiosity, dissociative coping, depersonalized imagery, emotional confusion, extreme dichotomization, images of mutilation and torture, and magical transformation. A combination of these behavioral and response variables was able to select 93% of the dissociative sample. These results add support to the discriminant validity of DID and DDNOS as diagnostic categories in childhood and provide clinical information that may be useful for early diagnosis of traumatized children with dissociative pathology.     

Personality characteristics of mental health professionals who have engaged in sexualized dual relationships: a Rorschach investigation

This study is the first to empirically investigate the psychological characteristics of mental health professionals who have engaged in sexualized dual relationships. Twenty mental health professionals were administered the Rorschach as part of a comprehensive evaluation to assess rehabilitation potential during or after a disciplinary hearing. The Rorschach protocols were scored according to Exner's (1993) Comprehensive System. Results included a total of seven scores that differed by more than 3 standard deviations from the normative mean. These included measures of distress (especially interpersonal longing, helplessness, and generalized dysphoria), primitive sexualization, and idiosyncratic reality contact. Other indicators differing by 2 standard deviations from the normative mean included measures of vulnerable self-boundaries and long-standing, characterological dysphoria. These characteristics and vulnerabilities are consistent with previous observations emphasizing long-standing conflicts involving interpersonal longing and deprivation, anxiety regarding body integrity or self-boundaries, primitive sexualization of anxiety-provoking issues, and depression (Celenza, 1995b). Awareness of such vulnerabilities may represent useful guidelines to supervisors and educators as a focus of concern in an individual's training and personal development.     

"The Rorschach and Holtzman as Measures of Pathognomic Verbalization": Erratum.

Reports an error in the article, "The Rorschach and Holtzman as Measures of Pathognomic Verbalization" by Leighton Whitaker in the April 1965 issue of the Journal of Consulting Psychology. A corrected version of the sentence on page 182, 15 lines from the bottom of the right-hand column is given. (The following abstract of this article originally appeared in record 1965-10275-001). This study was planned to obtain information about the reliability of Rorschach and Holtzman pathognomic verbalization scores (V). The Rorschach and Holtzman protocols of 45 psychiatric patients were scored by scorer A and 19 of the Holtzman protocols were scored "blind" by scorer B. Holtzman interscorer reliability was .81 (p     

"Rorschach and TAT indices of homosexuality in overt homosexuals, neurotics, and normal males": Erratum.

Reports an error in the original article by Anthony Davids, Mark Joelson, and Charles McArthur (Journal of Abnormal & Social Psychology, 1956[Sept], 53, 161-172). In the section on TAT results, under the heading of Signs suggested for further confirmation (p. 168), it states incorrectly (line 15) that the sign of a strong unresolved attachment to a father or father figure was scored in stories composed for Card 8. The sign was in fact scored in stories composed for TAT Card 7. (The following abstract of this article originally appeared in record 1958-02891-001). Rorschach and TAT protocols of 20 male overt homosexuals, 20 male neurotics, and 20 normal male students were compared in order to determine whether proposed homosexual signs were discriminative. The homosexual group gave a significantly greater mean number of the Rorschach and TAT signs than did either nonhomosexual group. "Within the homosexual group, correlation between the number of Rorschach signs and number of TAT signs produced by each S proved significant, serving as a check on the validity of both schemes and indicating the consistency of these 2 diverse measures of homosexuality." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Object relations development and psychotherapy dropout in borderline outpatients.

Used Rorschach object relations measures to identify patterns of object representations in borderline outpatients that would distinguish those at risk for premature termination from those likely to continue in expressive psychodynamic psychotherapy. Existing data from the Borderline Psychotherapy Research Project (O. Kernberg et al, 1989) were used. Ss were 12 women, aged 21–39 yrs, with borderline personality disorder. Ss who dropped out showed a predominance of narcissistic themes in their Rorschach responses at the outset of treatment, as scored by the Rorschach Separation-Individuation Scale (S-I Scale), and produced almost 4 times as many narcissism as rapprochement themes on the S-I Scale as Ss who continued treatment. Overall findings lend support to the salience of developmental themes related to separation-individuation within the population of borderline patients. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Rorschach assessment of annihilation anxiety and ego functioning.

This work illustrates the development, validation, and application of the Rorschach Content Scale (RCS; M. Hurvich et al; see record 1994-15961-001) for annihilation anxiety. Annihilation anxiety is defined here as the fear of one's impending psychic or physical destruction. Results reflected adequate RCS interrater reliability, content validity, construct validity, criterion validity, and divergent validity. Patient groups scored significantly higher on annihilation anxiety measures than did controls. Findings also demonstrated that certain aspects of RCS annihilation anxiety appeared more frequently than did others and may be more central to the construct. Results supported the contention that annihilation anxiety is associated with compromised ego functioning, when both are measured on the Rorschach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obesity, level of aspiration, and Rorschach and TAT measures of oral dependence.

Obese Israelis and controls were administered the Rorschach, TAT, and a level-of-aspiration task. The obese Ss scored higher on oral dependence than the control Ss on both the Rorschach (p = .01) and TAT (p = .02). There were no differences on either test for oral sadism, although the Rorschach subcategories of overwhelming figures and burdens and TAT themes of deprivation discriminated significantly between the groups. The most sensitive oral dependence subcategories were nurturers, supplicants and food organs (Rorschach), and themes of passivity, optimism, and helplessness (TAT). When only those Ss who scored above or below the median on both tests were considered, predictions regarding obesity were 90% accurate. Contrary to expectation, the obese Ss set level-of-aspiration goals more realistically than the controls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Rorschach and Holtzman as measures of pathognomic verbalization.

This study was planned to obtain information about the reliability of Rorschach and Holtzman pathognomic verbalization scores (V). The Rorschach and Holtzman protocols of 45 psychiatric patients were scored by scorer A and 19 of the Holtzman protocols were scored "blind" by scorer B. Holtzman interscorer reliability was .81 (p     

Two methods for studying the incremental validity of a Rorschach variable.

The MMPI can be scored by a clerk. Also, both the number and form level of Rorschach responses can be easily assessed. Other Rorschach variables should be examined for their incremental validity beyond number of responses and form level, or from these variables plus simple MMPI variables. This study applied multiple regression analyses to 2 data sets with reasonable criteria of pathology that were predicted by W. Perry and D. J. Viglione's (see record 1991-26233-001) Ego Impairment Index considered alone. The index had only slight incremental validity over and above the number of responses and form quality, and even less when the average MMPI elevation and L. R. Goldberg's (see record 2011-19214-001) formula for predicting psychosis versus neurosis were entered before these Rorschach variables. Another way of assessing incremental validity is through the use of unit weights, that is, adding standardized variables weighted equally rather than optimally. The unit-weighted incremental validity analysis resulted in the same conclusions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Personality profiles, dissociations, and absorption in women reporting repressed, recovered, or continuous memories of childhood sexual abuse.

Women reporting either repressed, recovered, or continuous memories of childhood sexual abuse or no abuse history completed questionnaires tapping personality traits, absorption (fantasy proneness), dissociation, depression, and posttraumatic stress. Planned contrasts indicated that recovered memory participants scored higher on absorption and dissociation than did those reporting either continuous memories or no abuse history; repressed memory participants scored nonsignificantly higher than did recovered memory participants. On measures of distress, continuous memory participants were indistinguishable from nonabused participants, repressed memory participants scored highest, and recovered memory participants scored midway between continuous and repressed memory participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)