Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders

The four-dimensional (4-D) model proposes that trauma-related dissociation involves altered states of consciousness (TRASC) and normal waking consciousness (NWC) across time, thought, body, and emotion. In 142 patients with PTSD, 46 of whom also had a dissociative disorder, TRASC experiences were less frequent and more specifically linked to other dissociation measures, dissociative disorder comorbidity, and childhood sexual abuse than NWC experiences. However, the prediction that TRASC items would show lower intercorrelation was not supported. The model offers a promising way to understand dissociation in trauma-related disorders.

Study at a glance

Abstract

ABSTRACT Background: The four-dimensional (‘4-D’) model has been proposed as a theoretical framework to understand and delineate trauma-related dissociative experiences, categorizing symptoms into trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC), which occur along four dimensions: time, thought, body and emotion. Objective: The main aim of the present study was to evaluate the validity of this model in patients with post-traumatic stress disorder (PTSD), with and without comorbid dissociative disorders. Method: The predictions of the 4-D model were tested in 142 patients with PTSD, with (N = 46) and without (N = 96) comorbid dissociative disorders. Results: As predicted by the 4-D model, experiences of TRASC were less frequent and more specifically related to other measures of dissociation, dissociative disorder comorbidity and a history of childhood sexual abuse compared to experiences of NWC. The predicted lower intercorrelation of TRASC was not supported. Conclusion: The 4-D model represents a promising framework for understanding dissociation across trauma-related disorders.