The bidirectional relationship between depression and dissociation: A longitudinal investigation

Depression is a major public health concern. Recent studies suggest that dissociative symptoms are associated with depressive symptoms, and the concept of "dissociative depression" has been proposed. Yet, only cross-sectional evidence is available in the literature. This study examined the bidirectional relationship between dissociative and depressive symptoms through the use of screening tools in a sample of Chinese young adults (N = 340) over four months. Baseline dissociative symptoms predicted depressive symptoms at follow-up (β = .262, p < .001), but not the other way around (β = .065, p = .121). Among different dissociative symptom clusters, identity dissociation was the only significant predictor of subsequent depressive symptoms (β = .177, p < .001). Furthermore, identity dissociation symptoms partially mediated the relationship between childhood trauma and subsequent depressive symptoms. This preliminary study is the first to test the bidirectional relationship between dissociative and depressive symptoms. The results highlight the importance of taking dissociative symptoms into account when preventing and treating depressive symptoms, especially among childhood trauma survivors.