Nader, Karim; Glenn
E. Schafe, Joseph Le Doux (2000) Fear memories
require protein synthesis in the amygdala for reconsolidation
after retrieval Nature 406, 722 - 726
(2000)
ABSTRACT 'New' memories are initially labile
and sensitive to disruption before being consolidated
into stable long-term memories. Much evidence indicates
that this consolidation involves the synthesis of
new proteins in neurons. The lateral and basal nuclei
of the amygdala (LBA) are believed to be a site of
memory storage in fear learning. Infusion of the protein
synthesis inhibitor anisomycin into the LBA shortly
after training prevents consolidation of fear memories.
Here we show that consolidated fear memories, when
reactivated during retrieval, return to a labile state
in which infusion of anisomycin shortly after memory
reactivation produces amnesia on later tests, regardless
of whether reactivation was performed 1 or 14 days
after conditioning. The same treatment with anisomycin,
in the absence of memory reactivation, left memory
intact. Consistent with a time-limited role for protein
synthesis production in consolidation, delay of the
infusion until six hours after memory reactivation
produced no amnesia. Our data show that consolidated
fear memories, when reactivated, return to a labile
state that requires de novo protein synthesis for
reconsolidation. These findings are not predicted
by traditional theories of memory consolidation.
Nagata T, Kiriike
N, Iketani T, Kawarada Y, Tanaka H (1999) Department
of Neuropsychiatry, Osaka City University Medical School,
Osaka, Japan. History of childhood sexual
or physical abuse in Japanese patients with eating disorders:
relationship with dissociation and impulsive behaviours.
Psychol Med 1999 Jul;29(4):935-42
ABSTRACT BACKGROUND: Empirical data regarding
prevalence of sexual and physical abuse histories
in Japanese patients with eating disorders is lacking,
in contrast to Western countries. This study investigated
the prevalence of traumatic events in Japanese patients
with eating disorders, and examined the relationship
between such traumatic events and clinical features.
METHODS: Subjects consisted of 33 patients with anorexia
nervosa restricting type (RAN), 40 patients with anorexia
nervosa binge eating/purging type (AN-BP), 63 patients
with bulimia nervosa purging type (BN) and 99 healthy
controls. All were female and diagnoses were based
on DSM-IV. The Physical and Sexual Abuse Questionnaire
(PSA), Eating Disorder Inventory (EDI) and Dissociation
Experience Scale (DES) were administered to all of
the subjects. RESULTS: Paradoxically, victims of minor
sexual abuse committed by Chikan (a Japanese word
indicating a person who commits minor sexual crimes)
were more prevalent among controls than among patients
with RAN, AN-BP or BN. However, physical punishment
histories tended to be more prevalent among patients
with AN-BP or BN than among RAN or controls. Only
AN-BP and BN patients with physical punishment histories
had twofold higher scores for DES and significantly
more frequent histories of self-mutilation (67% v.
33%) compared with patients without such histories.
CONCLUSION: An abuse history is not essential or a
prerequisite to developing an eating disorder in Japan
Nebout-Lenes,
Marie-Claude .
(2001) Service de Psychiatrie B, CHRU
Saint Jacques, Clermont-Ferrand, France. La trace sensorielle du trauma dans les dessins d*enfants
victimes = Sensorial mark of trauma in children*s drawings.
Revue Francophone du Stress et du Trauma (ISSN:
v. 1, no. 2, pp. 103-108 (February 2001).
ABSTRACT Drawing, the privileged style in
children's expression, usually reveals the sensorial
mark of psychic trauma. We intend to start from a
three-case-study to show that this assertion can be
easily proved. We rely on the concept of "Image Inconsciente
du Corps" through M. Sapir and F. Dolto*s research
to fully understand the way this sensorial mark expresses
itself in drawing. The existence of this sensorial
mark, here discovered in drawings, raises the question
about the implication of sensorial ingraving in committing
trauma to memory and in setting up the repetition
syndrome process. We propose an hypothesis about this
process. Then, from case studies we derive to the
usefulness and limits of using drawing in diagnosis
and therapy of psychic trauma.
Nicolai,
N.J. (2001) Attachment and psychopathology: An overview Tijdschrift voor psychotherapie 43 (2001) 5
ABSTRACT BACKGROUND: In John Bowlby's work
a relation was proposed between early attachment experiences
and psychpathology in adulthood. Attachment experiences
in childhood become internalised as mental representations
or internal working models. These can be evaluated
with the Adult Attachment Overview. In recent developmental
research a relation has been found between attachment,
described as an internal working model of the mind
and psychopathology. Attachment status is a state
of mind with respect to attachment. It is evolved
from attachment behaviour in childhood and is classified
according discourse and attachment, not on (retrospective)
life history. AIMS: This review describes the results
of a recent research on attachment style and psychopathology.
METHODS: Recent handbooks and overviews on internet
and attachment related sites were selected. PsycLit
has been consulted to search for references and also
special sites on attachment in research centres (Berkeley
London). RESULTS: Individuals with psychiatric problems
as anxiety disorders, conduct disorders, eating disorders
and some personality disorders have nearly all insecure
attachment, measured with the Adult Attachment Interview
(AAI). However, a clear-cut relation between attachment
style and psychopathology does not exist. More than
insecurity, disorganisation of attachment by loss
or trauma seems to be a decisive factor in the enhancement
of vulnerability. CONCLUSIONS: Disorganisation of
attachment by loss or trauma is correlated with coercive
behaviour in childhood and the development of dissociative
disorders. In this article an overview of recent research
in the area of psychopathology and attachment is given.
Nicolai,
N.J. (1999) Over de betekenis van hervonden herinneringen en
de standard of care Tijdschrift voor psychotherapie = ISSN 0165-1188:
Vol. 25 (1999), no. 6 (nov), pag. 434-440.
Nijenhuis,
E.R.S.
; Van Der, Hart O., Kruger, K., & Steele, K. (2004) Somatoform dissociation, reported abuse and animal defence-like reactions. Australian and New Zealand Journal of Psychiatry, 38, 678-686.
ABSTRACTObjective: To test the hypotheses that among general psychiatric
outpatients, somatoform dissociation is associated with posttraumatic stress
symptoms and with reported potentially traumatizing events, especially with
events that involve bodily threat from a person, also when reported age at
onset, duration and subjectively rated impact of potentially traumatizing
events are considered. Method: Administration of self-report questionnaires
evaluating the severity of somatoform and psychoform dissociation,
posttraumatic stress-symptoms, and reported traumatizing events, using
samples of consecutive and unselected psychiatric outpatients (n = 153).
Results: Somatoform dissociation was strongly correlated with posttraumatic
stress symptoms and with reported cumulative traumatization as assessed with
two different self-report trauma questionnaires. Among a wide range of
trauma types, bodily threat from a person best predicted somatoform
dissociation. Emotional neglect and age further improved the prediction, but
emotional neglect and abuse did not predict somatoform dissociation when
interpersonal threat to the body was not reported. Somatoform dissociation
was also best predicted by bodily threat when reported age at onset,
duration and subjective impact of reported traumatization were included in
the analyses. Conclusion: This retrospective study suggests that recurrent
interpersonal bodily threat may evoke animal defence-like psychobiological
systems manifesting as somatoform dissociation and that this type of threat
is often accompanied by emotional neglect. These hypotheses should now be
tested in prospective studies.
Nijenhuis,
E.R.S.
; van Dyck R, ter Kuile MM, Mourits MJ, Spinhoven
P, van der Hart O. (2003) Evidence for associations among somatoform dissociation,
psychological dissociation and reported trauma in patients
with chronic pelvic pain. Psychosom Obstet Gynaecol. 2003 Jun;24(2):87-98.
ABSTRACT This study investigates somatoform
as well as psychological dissociation, somatization
and reported trauma among patients with chronic pelvic
pain (CPP). Women with CPP (n = 52) who were newly
referred to a gynecology department, or whose pain
had resisted treatment, completed standardized self-report
questionnaires and received a structured interview
for DSM-IV dissociative disorders. The prevalence
of dissociative disorders in the sample was very low.
As hypothesized, self-reported somatoform dissociation
was positively correlated with self-reported psychological
dissociation and features of DSM-IV dissociative disorders;
women who reported more serious psychic trauma, in
particular sexual and physical abuse, experienced
more somatoform and psychological dissociation than
women reporting less trauma, or no trauma at all;
and the association of somatoform dissociation and
reported trauma was stronger than the association
of psychological dissociation and trauma. Physical
abuse/life threat posed by a person predicted somatoform
dissociation best. The results are consistent with
findings among psychiatric patients, and, therefore,
strengthen the thesis that somatoform dissociation,
(features of) dissociative disorder, and reported
trauma are strongly intercorrelated phenomena.
Nijenhuis,
E.R.S.
; Van der Hart, & Steele, K. (2002)
The emerging psychobiology of trauma-related dissociation
and dissociative disorders. In: H. D’Haenen, J.A. Den Boer, H. Westenberg,
& P. Willner (Eds.), Textbook of Biological Psychiatry,
pp. 1079-1098. London: Wiley.(book)
ABSTRACT Traumatic experiences may hamper
the integrative functions of the mind. This chapter
discusses several key neuroendocrine systems and brain
structures that seem to be involved in trauma-related
dissociation. Clinical, empirical, and experimental
evidence suggests that this dissociation, described
in this chapter as structural dissociation of the
personality, reflects a lack of integration among
psychobiological emotional systems, e.g., reproduction,
attachment, defense. The primary form of this structural
dissociation involves failed integration between systems
dedicated to daily life and systems dedicated to defense
in the face of severe threat. Most research has largely
overlooked the fact that psychobiological reactivity
to threat cues may depend on the type of dissociative
psychobiological system that dominates the functioning
of the patient at the time of measurement. As predicted
by the theory of structural dissociation, pioneering
studies have found such differences between dissociative
systems dedicated to daily life and to defense.
Nijenhuis,
E.R.S. Van der Hart, O., & Kruger, K.
(2002) The psychometric characteristics of the Traumatic
Experiences Questionnaire (TEC): First findings among
psychiatric outpatients. Clinical Psychology and Psychotherapy, 9(3),
200-210.
ABSTRACT The objective of the study was to
assess the reliability and validity of a retrospective
self-report measure of potential traumatic experiences
among psychiatric outpatients. The range of evaluated
experiences includes emotional neglect and abuse.
Participants completed the Traumatic Experiences Checklist
(TEC) (N = 153), a self-report trauma questionnaire
of known psychometric qualities, i.e. the Stressful
Life Experiences Questionnaire (SLESQ), and self-report
measures of somatoform dissociation (SDQ-20), psychoform
dissociation (DES). A majority (N = 115) completed
the TEC twice, and also completed a measure of posttraumatic
stress symptoms (PTSD-ss). The TEC's internal consistency
and test-retest reliability were good, and the TEC
strongly correlated with the SLESQ. Associations between
the TEC and the PTSD-ss, DES, and SDQ-20 supported
the criterion-related validity of the TEC. The internal
consistency, test-retest reliability and criterion-related
validity of TEC trauma area presence and severity
scores were also satisfactory. Preliminary findings
suggest that the psychometric characteristics of the
TEC are good. Future study of the TEC should include
larger samples of psychiatric patients, as well as
non-clinical groups
Nijenhuis,
Ellert R S
; Van Engen, Annegien; Kusters, Ine; Van der Hart, Onno(2001)
Peritraumatic somatoform and psychological dissociation
in relation to recall of childhood sexual abuse. Journal of Trauma and Dissociation (ISSN: 1529-9732),
v. 2, no. 3, pp. 49-68 (2001).
ABSTRACT OBJECTIVE: Overwhelming experience
can evoke psychological dissociation during or immediately
after the event, including dissociative amnesia. Whereas
some data suggest that such peritraumatic dissociation
can also find expression in somatoform symptoms, only
a limited range of such symptoms has been systematically
studied. The present study hypothesized that peritraumatic
psychological and somatoform dissociation are associated
with each other, with delayed recall of childhood
sexual abuse (CSA), and with CSA severity. Because
current somatoform dissociation is most strongly associated
with recalled childhood physical abuse (CPA), we also
hypothesized that peritraumatic somatoform dissociation
is associated with reported CPA over and above CSA.
METHOD: 34 Dutch women who reported CSA were interviewed
using a modified version of the Traumatic Memory Inventory
(TMI) which assesses the characteristics of traumatic
memories. The participants also completed the Traumatic
Experiences Checklist, the Peritraumatic Dissociation
Experiences Questionnaire, and the Peritraumatic Somatoform
Dissociation Questionnaire. RESULTS: Peritraumatic
psychological and somatoform dissociation were associated
with each other, with delayed recall of trauma, and
with severity of reported CSA. Reported CPA predicted
peritraumatic somatoform dissociation over and above
the severity of CSA in terms of the acts involved.
Approximately 44 percent of the women reported independent
corroboration of the abuse. Similar proportions of
delayed, partial, and continuous CSA memories were
corroborated. CONCLUSIONS: This retrospective study
suggested that delayed recall of CSA is associated
with peritraumatic dissociation and CSA severity.
It also suggested that trauma -- especially that which
involves serious threat to the integrity of the body
-- may evoke somatoform dissociation. Based on patient
report, delayed recall of some CSA memories was as
accurate as continuous recall of CSA. KEYWORDS. Peritraumatic
psychological dissociation, peritraumatic somatoform
dissociation, child sexual abuse, continuous recall,
partial recall, delayed recall
Nijenhuis,
E.R.S. PhD (2000) Vrije Universiteit at Amsterdam,
The Netherlands. Somatoform Dissociation: Major Symptoms of Dissociative
Disorders. Journal of Trauma & Dissociation, Vol. 1(4)
2000
ABSTRACT In most of the recent scientific
and clinical literature, dissociation has been equated
with dissociative amnesia, depersonaliza-tion, derealization,
and fragmentation of identity. However, according
to Pierre Janet and several World War I psychiatrists,
dissociation also pertains to a lack of integration
of somatoform components of experi-ence, reactions,
and functions. Some clinical observations and contem-porary
studies have supported this view. Somatoform dissociation,
which can be measured with the Somatoform Dissociation
Questionnaire (SDQ-20), is highly characteristic of
dissociative disorder patients, and a core feature
in many patients with somatoform disorders and in
a subgroup of patients with eating disorders. It is
strongly associated with reported trauma among psychiatric
patients and patients with chronic pelvic pain presenting
in medical healthcare settings. Motor inhibitions
and anesthesia/analgesia are somatoform dissociative
symptoms that are similar to animal defensive reactions
to major threat and injury. Among a wider range of
somatoform dissociative symptoms, these particular
symptoms are highly characteristic of patients with
dissocia-tive disorders. The empirical findings reviewed
in this article should have implications for the contemporary
conceptualization and defini-tion of dissociation,
as well as the categorization of somatoform disor-ders
in a future version of the DSM..
Nijenhuis
E.R.S. ,
van Dyck R, Spinhoven P, van der Hart O, Chatrou M,
Vanderlinden J, Moene F (1999) Vrije Universiteit at Amsterdam,
The Netherlands. Somatoform dissociation discriminates among diagnostic
categories over and above general psychopathology. Aust N Z J Psychiatry 1999 Aug;33(4):511-20
ABSTRACT OBJECTIVE: The primary aim of this
study was to investigate the hypothesis that somatoform
dissociation would differentiate among specific diagnostic
categories after controlling for general psychopathology.
METHOD: The Somatoform Dissociation Questionnaire
(SDQ-20), the Dissociative Experiences Scale, and
the Symptom Checklist-90-R were completed by patients
with DSM-IV diagnoses of dissociative disorders (n
= 44), somatoform disorders (n = 47), eating disorders
(n = 50), bipolar mood disorder (n = 23), and a group
of consecutive psychiatric outpatients with other
psychiatric disorders (n = 45), mainly including anxiety
disorders, depression, and adjustment disorder. RESULTS:
The SDQ-20 significantly differentiated among diagnostic
groups in the hypothesised order of increasing somatoform
dissociation, both before and after statistically
controlling for general psychopathology. Somatoform
dissociation was extreme in dissociative identity
disorder, high in dissociative disorder, not otherwise
specified, and increased in somatoform disorders,
as well as in a subgroup of patients with eating disorders.
In contrast with somatoform dissociation, psychological
dissociation did not discriminate between bipolar
mood disorder and somatoform disorders. CONCLUSIONS:
Somatoform dissociation is a unique construct that
discriminates among diagnostic categories. It is highly
characteristic of dissociative disorder patients,
a core feature in many patients with somatoform disorders,
and an important symptom cluster in a subgroup of
patients with eating disorders.
Nijenhuis,
E.R.S. (1999) Hoe kunnen therapeuten en patiënten het beste
omgaan met herinneringen aan misbruik in de kindertijd?
PsychoPraxis= ISSN 1566-6166: Vol. 1 (1999), no.
2 (okt), pag. 53-55.
ABSTRACT In het eerste nummer van PsychoPraxis
beschreef Walter Vandereycken hoe therapeuten en patiënten
het beste omgaan met herinneringen aan misbruik in
de kindertijd. Sommige richtlijnen zijn verstandig,
maar andere missen nuancering of berusten op misvattingen
en behoeven daarom aanpassing
Nijenhuis
E.R.S. ,
Spinhoven P, van Dyck R, van der Hart O, Vanderlinden
J. (1998) Department of Psychiatry Vrije
Universiteit at Amsterdam, The Netherlands. Psychometric characteristics of the somatoform dissociation
questionnaire: a replication study. Psychother Psychosom 1998;67(1):17-23
ABSTRACT Aimed to replicate the results of
previous studies (e.g., J. Vanderlinden et al, 1993)
concerning the development of 2 versions of the Somatoform
Dissociation Questionnaire (SDQ). The SDQ-20 evaluates
the severity of somatoform dissociative phenomena,
and the SDQ-5 is a dissociative disorders screening
instrument. 31 patients (aged 18-53 yrs) with dissociative
disorders and 45 consecutive psychiatric outpatients
(aged 19-53 yrs) with other Diagnostic and Statistical
Manual of Mental Disorders-IV (DSM-IV) diagnoses completed
the SDQ-20 and SDQ-5 as well as the Dissociation Questionnaire
(DIS-Q). Mokken scale analysis showed that the items
of the SDQ-20 are strongly scalable on a latent unidimensional
scale. Internal consistency was high. The SDQ-20 convergent
validity was supported by high intercorrelations with
the DIS-Q. Ss with dissociative identity disorder
scored significantly higher than Ss with dissociative
disorder nos. Sensitivity (94%) and specificity (98%)
of the SDQ-5 were very satisfactory, as were positive
(84%) and negative predictive value (99%). Results
corroborate the conclusion that the SDQ-20 and SDQ-5
are instruments of sound psychometric quality, and
that somatoform dissociative phenomena are core symptoms
of complex dissociative disorders.
Nijenhuis
E.R.S. ,
Spinhoven, Philip; Vanderlinden, Johan; van Dyck, Richard;
van der Hart, Onno (1998) Somatoform dissociative symptoms as related
to animal defensive reactions to predatory imminence
and injury. Journal of Abnormal Psychology. 1998 Feb Vol 107(1)
63-73
ABSTRACT The authors hypothesized that there
would be a similarity between animal defensive responses
to variable predatory imminence and injury and certain
somatoform dissociative symptoms of trauma-reporting
patients who have dissociative disorder. As a first
test of this hypothesis, 12 somatoform symptom clusters
consisting of clinically observed somatoform dissociative
phenomena were constructed. All clusters discriminated
between patients with dissociative disorders (n =
50) and patients with other psychiatric diagnoses
(n = 50). Those expressive of the hypothesized similarity--freezing,
anesthesia-analgesia, and disturbed eating--belonged
to the 5 most characteristic symptoms of dissociative
disorder patients. Anesthesia-analgesia, urogenital
pain, and freezing symptom clusters independently
contributed to predicted presence of dissociative
disorder. Using an independent sample, it appeared
that anesthesia-analgesia best predicted presence
of dissociative disorder after controlling for symptom
severity. The results were largely consistent with
the hypothesized similarity.
Nijenhuis E.R.S.,
Spinhoven P, van Dyck R, van der Hart O, Vanderlinden
J (1998) Department of Psychiatry,
Vrije Universiteit, Amsterdam, The Netherlands. Degree of somatoform and psychological dissociation
in dissociative disorder is correlated with reported trauma.
. J Trauma Stress 1998 Oct;11(4):711-30
ABSTRACT In this study, the prevalence and
severity of traumatic experiences as reported by patients
with dissociative disorders and with other DSM-IV
psychiatric diagnoses were compared. Furthermore,
the predictive value of emotional, physical, and sexual
trauma with respect to somatoform and psychological
dissociation was analyzed. In contrast with comparison
patients, dissociative disorder patients reported
severe and multifaceted traumatization. Physical and
sexual trauma predicted somatoform dissociation, sexual
trauma predicted psychological dissociation as well.
According to the memories of the dissociative disorder
patients, this abuse occurred in an emotionally neglectful
and abusive social context. Pathological dissociation
was best predicted by early onset of reported intense,
chronic and multiple traumatization. Methodological
limitations restricting causal inferences between
reported trauma and dissociation are discussed.
Nijenhuis E.R.S.,
Vanderlinden J, Spinhoven P. (1998) Department of Psychiatry, Vrije Universiteit,
Amsterdam, The Netherlands. Animal defensive
reactions as a model for trauma-induced dissociative reactions. J Trauma Stress 1998 Apr;11(2):243-260
ABSTRACT Patients with complex dissociative
disorders remain in alternating psychophysiological
states which are discrete, discontinuous, and resistant
against integrative tendencies. In this chapter, a
parallel is drawn between animal defensive and recuperative
states that are evoked in the face of severe threat
and the characteristic responses of dissociative disorder
patients as displayed in major dissociative states.
Empirical data and clinical observations seem to be
supportive of the idea that there are similarities
between freezing, concomitant development of analgesia
and anesthesia, and acute pain in threatened animals
and severely traumatized human beings.
Nishith,
Pallavi; Mindy B. Mechanic, and Patricia A. Resick (2000) Prior Interpersonal Trauma: The Contribution to Current
PTSD Symptoms in Female Rape Victims Journal of Abnormal Psychology, 2000, Vol. 109,
No. 1, 2025,
ABSTRACT The purpose of the current study
was to disentangle the relationship of childhood sexual
abuse and childhood physical abuse from prior adult
sexual and physical victimization in predicting current
posttraumatic stress disorder (PTSD) symptoms in recent
rape victims. The participants were a community sample
of 117 adult rape victims assessed within 1 month
of a recent index rape for a history of child sexual
abuse, child physical abuse, other adult sexual and
physical victimization, and current PTSD symptoms.
Results from path analyses showed that a history of
child sexual abuse seems to increase vulnerability
for adult sexual and physical victimization and appears
to contribute to current PTSD symptoms within the
cumulative context of other adult trauma.
Nixon, Reginald D. V; Nishith, Pallavi; Resick, Patricia A. (2003) The
Accumulative Effect of Trauma Exposure on Short-Term and Delayed Verbal
Memory in a Treatment-Seeking Sample of Female Rape Victims. Journal of
Traumatic Stress. Vol 17(1) Feb 2004, 31-35.
ABSTRACTThe accumulative effect of prior high-magnitude trauma exposure on memory
was examined in 73 rape victims, 92% of whom had current posttraumatic
stress disorder (PTSD). Participants were administered the Logical Memory
component of the Wechsler Memory Scale, the Quick Test to obtain an
estimate of intelligence, and were assessed for prior traumatic
experiences. Prior exposure to high-magnitude stressors (e.g., child rape,
being kidnapped) was significantly correlated with poorer performance on
the memory tasks. Regression analyses controlling for estimated IQ and
psychopathology severity demonstrated that magnitude of prior trauma
exposure predicted performance on the memory task, suggesting that in the
current sample, deficits in verbal memory may be related (in part) to the
degree of accumulative stress experienced over the lifetime.