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      Six-year follow-up of the treatment of patients with dissociative disorders study*

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          ABSTRACT

          Objective: Literature on the treatment of dissociative disorders (DDs) suggests that these individuals require long-term and specialized treatment to achieve stabilization and functionality. There is considerable empirical support for specialized phasic, dissociation-focused treatment in reducing a myriad of psychological symptoms and self-harm in this population. However, until recently, there has been a paucity of longitudinal treatment research on DD patients.

          Method: In the present six-year follow-up study, 61 therapists who participated in the initial phase of the Treatment of Patients with Dissociative Disorders (TOP DD) study answered questionnaires about their study patient’s stressors, quality of life, global functioning, victimization, and safety. These results provided a view of patients’ progress six years since the beginning of the TOP DD study.

          Results: Longitudinal analyses demonstrated patients had significantly fewer stressors ( Χ 2 (6) = 18.76, < .01, canonical = .48, N = 76), instances of sexual revictimization ( X 2(1) = 107.05, p < .001) and psychiatric hospitalizations ( t(54) = 2.57, p < .05, Cohen’s d = .43), as well as higher global functioning ( Χ 2 (2) = 59.27, < .001, canonical = .65, N = 111).

          Conclusions: These findings continue to support the initial results of the TOP DD study that, despite marked initial difficulties and functional impairment, DD patients benefit from specialized treatment.

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          Most cited references26

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          Guidelines for treating dissociative identity disorder in adults, third revision.

          (2010)
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            A review of dissociative disorders treatment studies.

            This review examines empirical reports of treatment for Dissociative Disorders (DD), including 16 DD treatment outcome studies and 4 case studies that used standardized measures. Collectively, these reports suggest that treatment for DD is associated with decreased symptoms of dissociation, depression, posttraumatic stress disorder, distress, and suicidality. Effect sizes, based on pre/post measures, are in the medium to large range across studies. Patients with dissociative disorder who integrated their dissociated self states were found to have reduced symptomatology compared with those who did not integrate. The magnitude of pre/post effect sizes for these DD studies are comparable to pre/post effect sizes in treatment studies of complex PTSD. There are significant methodological limitations in the current DD treatment outcome literature that reduce internal and external validity including regression towards the mean, limited sample sizes, and nonrandomized research designs. Implications for future research and treatment planning for patients suffering from DD are discussed.
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              Trauma and recovery

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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                ZEPT
                zept20
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8066
                2017
                28 June 2017
                : 8
                : 1
                : 1344080
                Affiliations
                [ a ]Family & Children’s Services , Bel Air, MD, USA
                [ b ]University of Maryland, Baltimore County , Catonsville, MD, USA
                [ c ]Sheppard Pratt Health Systems , Towson, MD, USA
                [ d ]University of Western Ontario , London, ON, Canada
                [ e ]University of North Carolina , Chapel Hill, NC, USA
                [ f ]Towson University , Towson, MD, USA
                Author notes
                CONTACT Amie C. Myrick amie.myrick@ 123456gmail.com Family & Children’s Services , Bel Air, MD, USA

                *Portions of these data were presented at the annual conference of the International Society for the Study of Trauma and Dissociation, Orlando, Florida, April 2015.

                Article
                1344080
                10.1080/20008198.2017.1344080
                5492082
                28680542
                107e8bb7-9ca7-4f1e-a6f2-9ff98dca4289
                © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 February 2017
                : 11 June 2017
                Page count
                Tables: 3, References: 32, Pages: 8
                Categories
                Research Article
                Basic Research Article

                Clinical Psychology & Psychiatry
                dissociative disorders,long-term treatment,treatment,revictimization

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