Examining the 4-D Model in Persons Enrolled in the Top DD Internet Intervention.
Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD) January 1, 2022 Paul Frewen, Bethany L Brand, Hugo J Schielke et al.
Trauma-related dissociation can be understood through a 4-dimensional model that distinguishes altered states of consciousness from distress symptoms across time, thought, body, and emotions. In 111 people with trauma-related dissociative disorders receiving in-person psychotherapy plus an online psychoeducational program, intrusive memories were more common than flashbacks, and emotional numbing was more common than other forms of affect dysregulation. Negative thoughts and emotion dysregulation correlated more strongly than did voice hearing and emotional numbing. Distress symptoms were more tied to PTSD symptoms and emotion regulation difficulties, while depersonalization was more linked to dissociative self-states. Distress symptoms also reduced more than altered states during treatment. Results support distinguishing distress from dissociation, though findings varied across dimensions.