Trauma and dissociation in psychiatric outpatients

We investigated the prevalence of exposure to traumatic events, the prevalence of post-traumatic suffering and dissociative symptoms, and the relationship between type of trauma and dissociation in a large sample of outpatient adults (ages 18-65) seeking treatment at an urban ambulatory mental health clinic in Jerusalem (N = 298).

Study participants completed self-report measures regarding trauma history, post-traumatic symptoms of intrusion and avoidance phenomena, and both psychological and somatic dissociative phenomena.

98% of our sample reported experiencing at least one lifetime traumatic event, 83% of subjects who completed the Impact of Events Scale reported high levels of intrusion and avoidance symptoms, and 15% of the sample reported high levels of dissociative phenomena. Elevated dissociation was associated with physical and sexual abuse, particularly early childhood abuse, as well as increased prevalence of lifetime traumatic events. Diagnoses did not reflect the high levels of post-traumatic and dissociative symptoms.

Our findings indicate the need for increased awareness and improved screening of traumatic exposure and its psychological impact upon psychiatric outpatients.