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      The dissociative subtype of PTSD in trauma-exposed individuals: a latent class analysis and examination of clinical covariates Translated title: El subtipo disociativo del TEPT en individuos expuestos al trauma: Un análisis de clase latente y un examen de las covariables clínicas Translated title: 创伤暴露个体PTSD 的解离亚型:一项潜在类别分析和对临床协变量的考查


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          A dissociative subtype of posttraumatic stress disorder (D-PTSD) was introduced into the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) but latent profiles and clinical correlates of D-PTSD remain controversial.


          The aims of our study were to identify subgroups of individuals with distinct patterns of PTSD symptoms, including dissociative symptoms, by means of latent class analyses (LCA), to compare these results with the categorization of D-PTSD vs. PTSD without dissociative features according to the CAPS-5 interview, and to explore whether D-PTSD is associated with higher PTSD severity, difficulties in emotion regulation, and depressive symptoms.


          A German sample of treatment-seeking individuals was investigated ( N = 352). We conducted an LCA on the basis of symptoms of PTSD and dissociation as assessed by the CAPS-5. Moreover, severity of PTSD (PCL-5), difficulties in emotion regulation (DERS), and depressive symptoms (BDI-II) were compared between patients with D-PTSD according to the CAPS-5 interview and patients without dissociative symptoms.


          LCA results suggested a 5-class model with one subgroup showing the highest probability to fulfill criteria for the dissociative subtype and high scores on both BDI and DERS. Significantly higher scores on the DERS, BDI and PCL-5 were found in the D-PTSD group diagnosed with the CAPS-5 ( n = 75; 35.7%). Sexual trauma was also reported more often by this subgroup. When comparing the dissociative subtype to the LCA results, only a partial overlap could be found.


          Our findings suggest that patients with D-PTSD have significantly more problems with emotion regulation, more depressive symptoms, and more severe PTSD-symptoms. Given the results of our LCA, we conclude that the dissociative subtype seems to be more complex than D-PTSD as diagnosed by means of the CAPS-5.


          • First study to examine overlap of LCA results on dissociative symptoms in patients with PTSD and dissociative subtype according to CAPS-5, relationships between dissociative subtype and sexual assault, higher levels of depression, more emotion regulation difficulties confirmed.

          Translated abstract

          Antecedentes: Un subtipo disociativo del trastorno de estrés postraumático (TEPT-D) fue introducido en la 5ª edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5), pero los perfiles latentes y los correlatos clínicos del TEPT-D siguen siendo controversiales. Objetivo Los objetivos de nuestro estudio fueron identificar subgrupos de individuos con distintos patrones de síntomas de TEPT, incluyendo síntomas disociativos, mediante análisis de clases latentes (LCA, por sus siglas en inglés), comparar estos resultados con la categorización de TEPT-D vs. TEPT sin rasgos disociativos según la entrevista CAPS-5, y explorar si el TEPT-D se asocia con una mayor gravedad del TEPT, dificultades en la regulación de las emociones y síntomas depresivos.

          Método: Se investigó una muestra alemana de individuos que buscaban tratamiento ( N = 352). Se realizó un LCA sobre la base de los síntomas de TEPT y disociación evaluados por el CAPS-5. Además, se comparó la gravedad del TEPT (PCL-5), las dificultades en la regulación de las emociones (DERS) y los síntomas depresivos (BDI-II) entre los pacientes con TEPT según la entrevista CAPS-5 y los pacientes sin síntomas disociativos.

          Resultados: Los resultados del LCA sugirieron un modelo de 5 clases con un subgrupo que mostraba la mayor probabilidad de cumplir los criterios del subtipo disociativo y altas puntuaciones tanto en el BDI como en el DERS. Se encontraron puntuaciones significativamente más altas en el DERS, el BDI y el PCL-5 en el grupo de TEPT-D diagnosticado con el CAPS-5 ( n = 75; 35,7%). Este subgrupo también informó con más frecuencia de traumas sexuales. Al comparar el subtipo disociativo con los resultados del LCA, sólo se pudo encontrar una superposición parcial. Conclusiones Nuestros resultados sugieren que los pacientes con TEPT-D tienen significativamente más problemas con la regulación emocional, más síntomas depresivos y síntomas de TEPT más graves. Dados los resultados de nuestro LCA, concluimos que el subtipo disociativo parece ser más complejo que el TEPT-D diagnosticado mediante el CAPS-5.

          Translated abstract

          背景: 第 5 版《精神疾病诊断和统计手册》 (DSM-5) 中引入了一种创伤后应激障碍 (D-PTSD) 解离亚型, 但 D-PTSD 的潜在特征和临床相关变量仍然存在争议。

          目的: 我们的研究旨在通过潜在类别分析 (LCA) 识别具有不同 PTSD 症状模式 (包括解离症状) 的个体亚组, 以将这些结果与 D-PTSD 与根据 CAPS-5 访谈无解离特征的 PTSD 分类进行比较, 并探讨 D-PTSD 是否与更高的 PTSD 严重程度, 情绪调节困难和抑郁症状相关。

          方法: 考查了一个德国寻求治疗的个体样本 ( N= 352) 。我们根据 CAPS-5 评估的 PTSD 和解离症状进行了 LCA。此外, 比较了根据 CAPS-5 访谈的 D-PTSD 患者和没有解离症状的患者的 PTSD 严重程度 (PCL-5), 情绪调节困难 (DERS) 和抑郁症状 (BDI-II)。

          结果: LCA 结果表明一个 5 类模型, 其中一个亚组显示满足解离亚型标准的最高概率以及 BDI 和 DERS 的高分。在用CAPS-5 诊断为 D-PTSD 的组中发现 DERS, BDI 和 PCL-5 的得分显著更高 ( n= 75; 35.7%) 。该亚组也更频繁地报告性创伤。将解离亚型与 LCA 结果进行比较时, 只能发现部分重叠。

          结论: 我们的研究结果表明, D-PTSD 患者的情绪调节问题显著更多, 抑郁症状更严重, PTSD 症状更严重。鉴于我们 LCA 的结果, 我们得出结论, 解离亚型似乎比通过 CAPS-5 诊断的 D-PTSD 更复杂。

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                Author and article information

                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                3 March 2022
                3 March 2022
                : 13
                : 1
                [a ]Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf; , Hamburg, Germany
                [b ]Institute of Psychology, University of Münster; , Münster, Germany
                [c ]Department of Psychology, School of Social Sciences, University of Mannheim; , Mannheim, Germany
                [d ]Department of Clinical Psychology and Psychotherapy, Free University Berlin; , Berlin, Germany
                [e ]Psychotrauma Centre, German Armed Forces Hospital Berlin; , Germany
                [f ]Department of Psychotherapy and Psychosomatic Medicine, Technical University Dresden; , Dresden, Germany
                [g ]Department of Psychology, LMU Munich; , Germany
                [h ]Centre for Interdisciplinary Addiction Research, University of Hamburg; , Hamburg, Germany
                Author notes
                CONTACT Aljosha Deen a.deen@ 123456uke.de Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf; , Martinistrasse 52, Hamburg 20246, Germany

                These authors contributed equally to this work.

                © 2022 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-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 1, Tables: 5, References: 68, Pages: 1
                Research Article
                Clinical Research Article

                Clinical Psychology & Psychiatry
                ptsd,dissociative subtype,dissociation,depression,emotion regulation,derealization,depersonalization,latent class analysis,tept,subtipo disociativo,disociación,depresión,regulación emocional,desrealización,despersonalización,análisis de clases latentes,解离亚型,解离,抑郁,情绪调节,现实解体,人格解体,潜在类别分析


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