The Prevalence of Dissociative Disorders and Spirit Possession in the General Population: A Systematic Review and Meta-Analysis With the Moderating Effect of Individualism–Collectivism on Prevalence Rates

In a meta-analysis pooling data from multiple studies, individualism at the national level was positively associated with the prevalence of dissociative disorders. Women had higher odds than men of experiencing pathological dissociation (odds ratio 2.43) and spirit possession (odds ratio 4.31). A reliable 1-month prevalence estimate was obtained only for depersonalization disorder, at 1.12%. The findings are discussed within a framework that attempts to bridge trauma-based and sociocultural models of dissociation.

Study at a glance

Abstract

Drawing on culturally sensitive approaches to the study of dissociation, in the present meta-analysis, we aimed to obtain pooled prevalence estimates for dissociative disorders and spirit possession and to test for the effect of nation-level individualism scores on the occurrence of pathological dissociation. Pooled odds ratios ( OR s) for the probability of women presenting with a dissociative disorder or with spirit possession relative to men were also computed. Individualism was positively associated with the prevalence of dissociative disorders: b = 0.712, 95% confidence interval [CI] = [0.274, 1.538], p = .015, n = 11. Women showed higher odds of having pathological dissociation, OR = 2.43, 95% CI = [1.18, 5.01], p = .03, n = 7, and spirit possession, OR = 4.31, 95% CI = [1.55, 11.99], p = .02, n = 5. A reliable prevalence estimate could be computed only for depersonalization disorder, for which, a predicted 1-month prevalence of 1.12% was obtained (95% CI = [0.61, 2.05], n = 6). These findings are discussed within a transtheoretical framework in an attempt to bridge the gap between the trauma and sociocultural models of dissociation.