Dissociation from a Perspective of Developmental Psychopathology

Abstract

Dissociation is defined as a disruption in the functions of consciousness, memory, identity, and perceptions of one's environment, functions that are usually integrated. (American Psychiatric Association, 1994). Dissociation, in general, is addressed under dissociative disorders in clinical applications although the phenomenon represents a more complex notion from a developmental perspective. Researchers and clinicians put more emphasize on developmental factors in order to understand etiological courses lying under disorders since the onset of psychiatric disorders pursuit a developmental process and disorders as result variables could be defined as poor psychological responses to process. In this context developmental psychopathology presents a multidimensional notion for understanding psychopathology combining miscellaneous disciplines such as neurobiology, psychiatry, genetics, developmental psychology and cultural studies. In the review, intersection and distinction points of pathological and nonpathological dissociation, continuities and discontinuities, possible mechanisms underlying psychopathology in developmental process would be in our main interest from a perspective of developmental psychopathology

Keywords

• Dissociative disorders, dissociation, development, psychopathology, attachment

Gelişimsel psikopatolojinin bakış açısıyla disosiyasyon

Öz

Disosiyasyon bütünlük halindeki bilinç, bellek ve çevrenin algılanması süreçlerinde ayrışma olarak tanımlanmaktadır (APA 1994). Disosiyasyon olgusu klinik uygulamalarda disosiyatif bozukluklar başlığı altında ele alınmasına karşın gelişimsel açıdan çok daha geniş bir nosyonu temsil etmektedir. Psikiyatrik bozuklukların gelişimsel bir süreç izlemesi ve psikiyatrik tanının gelişimsel sürece ilişkin sonuç değişkeni olması nedeniyle, ruhsal rahatsızlıkların altında yatan etiolojik süreçlerin yeterince anlaşılabilmesi adına, araştırmacı ve klinisyenlerin ilgilerini gelişimsel süreç üzerinde yoğunlaştırmalarına sebep olmuştur. Bu anlamda gelişimsel psikopatoloji nörobiyoloji, psikiyatri, genetik, gelişim psikolojisi ve antropoloji gibi pek çok disiplinden elde edilen bulguları bütünleştirerek psikopatolojiye ilişkin çok boyutlu bir nosyon sunmaktadır. Bu derlemede patolojik ve patolojik olmayan disosiyasyonun gelişimsel süreçte izlediği değişim çizgisinin keşişim ve ayrım noktaları, gelişimdeki süreklilik ve süreksizlikler, ve psikopatolojinin altında yatan temel etkenler gelişimsel psikopatolojnin bakış açısıyla irdelenecektir.

Anahtar Kelimeler

• Disosiyatif bozukluk, disosiyasyon, gelişim, psikopatoloji, bağlanma

Kaynakça

1. Amaya-Jackson L, March JS (1995) Post Traumatic Stress Disorder in Adolescents: Risk Factors, Diagnosis, and Intervention. Adolesc Med 6(3): 251-269.
2. Amerikan Psikiyatri Birliği (1994) Mental Bozuklukların Tanısal ve Sayımsal Elkitabı Köroğlu E (Çev.), Amerikan Psikiyatri Birliği, Washington. Hekimler Yayın Birliği, Ankara.
3. Anderson CL, Alexander PC (1996) The relationship between attachment and dissociation in adult survivors of incest. Psychiatry, 59(3): 240-246.
4. Armsworth MW, Stronck K (1999) Intergenerational effects of incest on parenting: skills, abilities, and attitudes, J Couns Dev, 77, (3): 303-325.
5. Bowlby J (1988). A Secure Base. Basic Books, London.
6. Boysan M, Goldsmith RE, Cavus H, Kayri M, Keskin S (2009) Relations among anxiety, depression, and dissociative symptoms: The Influence of Abuse Subtype. J Trauma Dissociation, 10:83-101.
7. Burk LR, Burkhart BR (2003) Disorganized attachment as a diathesis for sexual deviance:developmental experience and the motivation for sexual offending. Aggress Violent Behav, 8 (5): 487-511.
8. Butler LD, Duran REF, Jasiukaitis P, Kopman C, Spiegel D (1996). Hypnotizability and traumatic experience: a diathesis-stress model of dissociative symtomatology. Am J Psychiatry, 153 (7): 42-63.

9. Cassidy J, Mohr JJ (2001) Unsolvable fear, trauma, and psychopathology: theory, research, and clinical considerations related to disorganized attachment across the life span. Clinical Psychology: Science And Practice, 8(3): 275-298.
10. Cicchetti D, Manly JT (2001) Editorial: Operationalizing child maltreatment: Developmental processes and outcomes. Dev Psychopathol, 13: 755–757.
11. Cicchetti D, Cohen DJ (1995) Perspectives on developmental psychopathology. Developmental Psychopathology: Theory and Methods Cicchetti D, Cohen DJ (Ed) New York, John Wiley &Sons, Inc. syf. 3-21.
12. Cicchetti D, Rogosh FA (2002) A Developmental Psychopathology Perspective on Adolescence. J Consult Clin Psychol, 70(1): 6–20.
13. Darves-Bornoz J-M (1997) Rape-related psychotraumatic syndromes. Eur J Obstet Gynecol Reprod Biol, 71(1): 59-65.
14. Demitreack MA, Putnam FW, Brewerton TD, Brandt HA, Gold PW (1990) Relation of clinical variables to dissociative phenomena in eating disorders, Am J Psychiatry, 147(9): 1184-1188.
15. Eisen ML, Lynn SJ (2001) Dissociation, memory and suggestibility in adults and children. Appl Cogn Psychol, 15: 49-73.
16. Eisen ML,Carlson EB (1998) Individual differences in suggestibility: Examining the effects of dissociation, absorption and a history of child abuse. Appl Cogn Psychol, 12: 47-61.
17. Ellason WJ, Ross CA, Fuchs DL (1996) Lifetime axis I and axis II comorbidity and childhood trauma history in dissociative personality disorders. Psychiatry, 59(3): 255-266.
18. Erikson E H (1950/1963). Child And Society.W.W. Norton Company Inc., New York.
19. Everill JT, Waller G, Macdonald W (1995) Dissociation in bulimic and non-eating-disordered women. International Journal Of Eating Disorders, 17: 127–134.
20. Fairbrother N, Rachman S (2006) PTSD in victims of sexual assault: Test of a major component of the Ehlers–Clark theory. J Behav Ther Exp Psychiatry. 37(2):74-93.
21. Famularo R, Fenton T, Kinscherff R, Augustyn M (1996) Psychiatric comorbidity in childhood post traumatic stress disorder. Child Abuse Negl, 20(10): 953-961.
22. Famularo R, Kinscherff R, Fenton T (1991) Posttraumatic Stress Disorder among Children Clinically diagnosed as Borderline Personality Disorder. J Nerv Ment Dis, 179: 428-431.
23. George C, West M (1999) Developmental vs. Social personality models of adult attachment and mental ill health. Br J Med Psychol, 72: 285-303.
24. Goodman M, Mitropoulou V, New AS, Sprung L, Siever LJ (2000) Pathological dissociation in borderline personality disorder-the role of childhood trauma and serotonergic genes. Biol Psychiatry, 47(8): 133-134.
25. Gottlieb G (1991) Experimental canalization of behavioral development: theory. Dev Psychol, 21(1): 4-13.
26. Grossman AW, Churchill J D, McKinney B C,. Kodish IM, Otte SL, Greenough WT (2003) Experience effects on brain development: Possible contributions to psychopathology. J Child Psychol Psychiatry, 44(1): 33–63.
27. Guz H, Doganay Z, Ozkan A, Colak E, Tomac A, Sarısoy G (2004) Conversion and somatization disorders. Dissociative symptoms and other characteristics, J Psychosom Res, 56(3): 287-291.
28. Horstein N (1996) Dissociative disorders in children and adolescence. Handbook of Dissociation: Theorical, Empirical And Clinical Perspectives, L K Michelson, WJ Ray (Eds.), Plenum Press, New York, syf. 139-161.
29. ICD-10 (1992) Ruhsal ve Davranışsal Bozukluklar Sınıflaması: Klinik Tanımlamalar ve Tanı Kılavuzu, Öztürk M O, Uluğ B (Ed.) Dünya Sağlık Örgütü, Cenevre. Türkiye Sinir Ve Ruh Sağlığı Derneği Yayınları, Ankara.
30. Irwin HJ (1999) Pathological and nonpathological dissociation: the relevance of childhood trauma. J Psychol, 133(2): 157-164.
31. Kilpatrick DG, Ruggiero KJ, Acierno R, Saunders BE, Resnick HS, Best CL (2003) Violence and Risk of PTSD, Major Depression, Substance Abuse/Dependence, and Comorbidity: Results From the National Survey of Adolescents. J Consult Clin Psychol, 71(4): 692-700.
32. Kluft RP (1984) An introduction to multiple personality disorder. Psychiatric Annals, 14, 19–24.
33. Kluft RP (1996) Dissociative identity disorder. Handbook of Dissociation: Theoretical, Empirical, and Clinical Perspectives LK Michelson, WJ Ray (Eds.) New York, Plenum Press, syf. 337- 366.
34. Lansford JE, Dodge KA, Pettit GS, Bates JE, Crozier J, Kaplow J (2002) A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academical problems in adolescence. Arch Pediatr Adolesc Med, 156 (8): 824-831.
35. Liotti G (1992) Disorganised/disoriented attachment in the etiology of dissociative disorders. Dissociation, 4: 196-204.
36. Macfie J, Cicchetti D, Toth SL (2001) The development of dissociation in maltreated preschool-aged children. Dev Psychopathol, 13: 233–254.
37. Main M, Solomon J (1986) Discovery of an insecure disorganized / disoriented attachment pattern: procedures, findings and implications for classification of behaviour. Affective development in infancy, M.W. Yogman, T.B. Brazelton, Norwood, NJ: Ablex, syf. 95-124.
38. Mair K (1999) Multiple personality and child abuse. Psychologist, 12 (2): 76-80.
39. Manly JT, Kim JE, Rogosch FA, Cicchetti D (2001) Dimensions of child maltreatment and children’s adjustment: Contributions of developmental timing and subtype. Dev Psychopathol, 13, 759–782.
40. Mccallum KE, Lock J, Kulla M, Rorty M, Wetzel RD (1992) Dissociative symptoms and disorders in patients with eating disorders. Dissociation, 5: 227– 235.
41. Merkelbach H, Peter M (2001) The causal link between self-reported trauma and dissociation: a critical review. Behav Res Ther, 39: 245-254.
42. Nijenhuis ERS (2000) Somatoform dissociation: major symptoms of dissociative disorders, J Trauma Dissociation, 1(4): 7-32.
43. Nijenhuis ERS (2004) Somatoform dissociation: phenomena, measurement and theoretical issues, New York, WW Norton & Company.
44. Nijenhuis ERS, Van Dyck R, Kuile MM, Mourits MJE (2003) Evidence for associations among somatoform dissociation, psychological dissociation and reported trauma in patients with chronic pelvic pain. J Psychosom Obstet Gynaecol, 24(2): 87-99.
45. Ogawa JR, Sroufe LA, Weinfield NS, Carlson EA, Egeland B (1997) Development and the fragmented self: Longitudinal study of dissociative symptomatology in a nonclinical sample. Dev Psychopathol, 9: 855–879.
46. Öztürk MO (2001) Ruh Sağlığı ve Bozuklukları (8. Basım), Ankara, Nobel Tıp Kitabevleri.
47. Paris J, Zweig-Frank H (1997) Dissociation in patients with borderline personality disorder. Am J Psychiatry, 154: 137-139.
48. Peterson G. (1990) Diagnosis of childhood multiple personality disorder. Dissociation, 3: 3-9.
49. Piaget J (1951). The Child' s Conception Of The World. Maryland: Humanities Press.
50. Putnam F.W. (1993). Dissociative disorders in children: Behavioral profiles and problems. Child Abuse Negl, 17, 39-45.
51. Putnam FW (1995). Development of dissociative disorders. Developmental Psychopathology: Vol. 2: Risk, Disorders, and Adaptation, D Cicchetti, DJ Cohen (Eds.). New York: John Wiley & Sons. syf. 581-608.
52. Putnam FW (1997). Dissociation in Children and Adolescents: A Developmental Perspective, The Guilford Press, New York.
53. Putnam FW, Carlson EB, Ross CA ve ark (1996). Patterns of dissociation in clinical and nonclinical samples. J Nerv Ment Dis, 184(11): 673– 679.
54. Pynoos RS, Steinberg AM, Wraith R (1995). A developmental model of childhood traumatic stress. Developmental Psychopathology Vol. 2, Cicchetti D. & Cohen D.J. (Ed.) John Wiley &Sons, Inc.
55. Ray W. J. (1996). Dissociation in Normal Population. Handbook of Dissociation: Theorical, Empirical and Clinical Perspectives, L K Michelson, W J Ray (Eds.), New York: Plenum Press, syf. 51- 68.
56. Rogosch F A., Cicchetti D (2004).Child maltreatment and emergent personality organization: Perspectives from the five-factor model. J Abnorm Child Psychol, 32(2): 123–145.
57. Rusch MD (1998) Psychological response to trauma. Plast Surg Nurs, 18(3): 147-157.
58. Rutter M, Sroufe LA (2000) Developmental psychopathology: Concepts and challenges. Dev Psychopathol, 12, 265–296.
59. Scheeringa MS, Peebles CD, Cook CA, Zeanah CH (2001), Toward establishing procedural, criterion and discriminant validity for PTSD in early childhood. J Am Acad Child Adolesc Psychiatry, 40:52–60.
60. Scheeringa, MS, Zeanah CH, Drell MJ, Larrieu JA (1995) Two approaches to diagnosing posttraumatic stress disorder in infancy and early childhood. J Am Acad Child Adolesc Psychiatry, 34: 191-200.
61. Schuengel C, Van Ijzendoorn MH, Bakermans- Kranenburg MJ, Blom M (1998) Frightening maternal behaviour, unresolved loss, and disorganized infant attachment: a pilot study. J Reprod Infant Psychol, 16(4): 277-284.
62. Silbergl JL, Nemzer ED (1998) Dissociative Symptoms in Children. Am J Psychiatry; 155(5): 708-709.
63. Spiegel H, Greenleaf M, Spiegel D (1995) Hypnosis. In “Comprehensive Textbook Of Psychiatry” Editors, RM Kaplan, B Sadock, (7th Edition), Lippincott William And Witkins, New York.
64. Spitzer C, Klauer T, Grabe H, Lucht M, Stieglitz R, Schneider W, Freyberger H (2003). Gender differences in dissociation a dimensional approach. Psychopathology; 36(2): 65-70.
65. Sroufe LA, Rutter M (1984) The domain of developmental psychopathology. Child Development, 55: 17-29.
66. Svanberg POG (1998) Attachment, resilience and prevention. J Ment Health, 7(6): 543-579.
67. Terr LC (1991) Childhood traumas: An outline and overview. Am Jour Psych,148(1): 10-20.
68. Tezcan E, Atmaca M, Kuloglu M, Gecici O, Buyukbayram A, Tutkun H (2003) Dissociative disorders in Turkish inpatients with conversion disorder. Compr Psychiatry. 44(4): 324-330.
69. Van Der Kolk BA (1998) Trauma and memory. J Psychiatry Neurosci, 52, 5, 97-109.
70. Van Der Kolk BA, van Der Hart O (1998) Pierre janet and the breakdown of adaptation in psychological trauma. Am J Psychiatry, 146(12): 1530-1540.
71. Van Ijzendoorn MH, Schuengel C, Bakermans–Kranenburg MJ (1999) Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Dev Psychopathol, 11: 225–249.
72. Whalen JE, Nash MR (1996) Hypnosis and dissociation: Theorical, empirical and clinical perspectives. Handbook of Dissociation: Theorical, Empirical And Clinical Perspectives, L. K. Michelson ve W. J. Ray (Eds.), Plenum Press, New York.
73. Whiffen VE, Macintosh HB (2005) Mediators of the link between childhood sexual abuse and emotional distress: a critical review. Trauma Violence Abuse. 6(1): 24-39.
74. Yates TM (2004) The developmental psychopathology of self-injurious behavior: compensatory regulation in posttraumatic adaptation. Clin Psychol Rev, 24(1): 35-74.