ABSTRACT The article reviews the current knowledge regarding altered states of consciousness (ASC) (a) occurring spontaneously, (b) evoked by physical and physiological stimulation, (c) induced by psychological means, and (d) caused by diseases. The emphasis is laid on psychological and neurobiological approaches. The phenomenological analysis of the multiple ASC resulted in 4 dimensions by which they can be characterized: activation, awareness span, self-awareness, and sensory dynamics. The neurophysiological approach revealed that the different states of consciousness are mainly brought about by a compromised brain structure, transient changes in brain dynamics (disconnectivity), and neurochemical and metabolic processes. Besides these severe alterations, environmental stimuli, mental practices, and techniques of self-control can also temporarily alter brain functioning and conscious experience.

ABSTRACT Studied the relationship between acute daily stress over 3 months and dissociative phenomena. Human Ss: 52 male and female Belgian adults (aged 25-53 yrs). Stress was measured at the beginning of naturally occurring acute crisis situations and 3 mo later. Tests used: The Daily Problem List, the Dissociation Questionnaire (J. Vanderlinden et al, 1992), and the General Health Questionnaire.

ABSTRACT Research has suggested the existence of a pathological dissociative taxon. However, relatively little is known about this taxon. This study examined the 2-month retest stability of this taxon--together with other measures of dissociation and the Big Five--in a sample of 465 undergraduates. Contrary to expectation, taxon scores were only modestly stable and were substantially less stable than the other measures, including continuous indicators of dissociation. Furthermore, most individuals who were identified as taxon members at one assessment were classified as nonmembers at the other. These results challenge the existence of a pathological dissociative taxon. More generally, these data demonstrate that statistically identified taxa need to be explicated through the normal process of construct validation.

ABSTRACT Symptoms of Acute Stress Disorder and Posttraumatic Stress Disorder Follow ing Exposure to Disastrous Flooding flood related threat and losses; 74 of these persons completed a one-year follow- up assessing PTSD symptoms. Results showed that threat and loss were both significantly related to ASD symptoms. Exposure to losses and ASD symptoms, but not threat, predicted the development of PTSD symptoms. These results suggest that stressor characteristics, such as loss and threat, may be differentially related to shorter and longer-term trauma responses. These results extend previous research by showing that ASD symptoms predict those of PTSD among disaster survivors and that stressor characteristics together with acute symptoms predict longterm distress.

ABSTRACT Objective: The purpose of this study was to evaluate the relative efficacy of a number of psychological tests and interviews in discriminating dissociative identity disorder (DID) from feigned dissociation and schizophrenia. Method: Three measures of dissociation (SCID-D, DES, SDQ-5) two personality measures (MMPI-2, Millon-III) and a brief measure of hypnotic susceptibility (Spiegel & Spiegel’s Eye-Roll Sign) were assessed for their ability to differentiate these diagnostic groups. Results: Results indicate that the SCID-D was clearly the most efficacious instrument in discriminating DID from schizophrenia and from feigned dissociation. The DES-Taxon and the SDQ-5 were adequate in screening pathological dissociation from schizophrenia but were less discriminative of feigned dissociation. The commonly used personality inventories were unable to detect feigned dissociation and the DID group tended to have higher elevations on scales measuring psychotic symptoms than did the schizophrenic group. The eye-roll sign discriminated feigned dissociation from those with dissociative disorders. Conclusions: Structured interviews such as the SCID-D, although resource consuming, are essential in comprehensive assessment of dissociative disorders. Comprehensive assessment of psychotic disorders should include some measure of dissociation.

Wilkeson A, Lambert MT, Petty F. (2000)
Posttraumatic stress disorder, dissociation, and trauma exposure in depressed and nondepressed veterans.
J Nerv Ment Dis 2000 Aug;188(8):505-9

ABSTRACT Increasing evidence indicates that exposure to traumatic events predisposes individuals to depressive symptoms as well as to emotional and psychophysiological symptoms covered under the diagnostic criteria of posttraumatic stress disorder (PTSD). Trauma exposure history and PTSD symptoms would, therefore, be expected to be more common in a depressed population than in a nondepressed group. To examine the association between trauma exposure (trauma load), dissociation, and depression, we administered clinical interviews and an assessment package derived from existing instruments (including the Dissociative Experiences Scale; DES) to 101 veteran patients with histories of clinically significant depression and a comparison group of 49 medical patients with no history of depression. The depression group had experienced significantly higher numbers of traumatic incidents, had higher average DES scores, and more frequently met diagnostic criteria for PTSD. The findings support the argument for a causal or predisposing effect of trauma in the expression of clinically significant depression.

Williams LM. (1995)
Recovered memories of abuse in women with documented child sexual victimization histories.
J Trauma Stress. 1995 Oct;8(4):649-73.

ABSTRACT This study provides evidence that some adults who claim to have recovered memories of sexual abuse recall actual events that occurred in childhood. One hundred twenty-nine women with documented histories of sexual victimization in childhood were interviewed and asked about abuse history. Seventeen years following the initial report of the abuse, 80 of the women recalled the victimization. One in 10 women (16% of those who recalled the abuse) reported that at some time in the past they had forgotten about the abuse. Those with a prior period of forgetting--the women with "recovered memories"--were younger at the time of abuse and were less likely to have received support from their mothers than the women who reported that they had always remembered their victimization. The women who had recovered memories and those who had always remembered had the same number of discrepancies when their accounts of the abuse were compared to the reports from the early 1970s.

Williams, Christopher L; Haines, Janet; Sale, Ian M. (2003)
Psychophysiological and psychological correlates of dissociation in a case of dissociative identity disorder.
Journal of Trauma and Dissociation (ISSN: 1529-9732), v. 4, no. 1, pp. 101-118 (2003).

ABSTRACT The aim of this study was to examine the psychological and psychophysiological mechanisms that underlie dissociative experiences in dissociative disorders. A four-stage, personalized guided imagery methodology was used to recreate the psychological and psychophysiological responses associated with two dissociative episodes experienced by a 25 year old, single female diagnosed with Dissociative Identity Disorder. The responses to these two dissociative episodes were compared with a stressful experience and an emotionally neutral event. The results demonstrated a reduction in psychophysiological arousal associated with the experience of dissociation during times of intense distress accompanied by relevant alterations in psychological response. It was concluded that the experience of dissociation served to protect this individual from extreme distress and, therefore, functioned as a protective mechanism. [Author Abstract] KEY WORDS: Dissociation, dissociative identity disorder, imagery, psychophysiology

Witztum, Eliezer; Margalit, Chaim (Haim); Van der Hart, Onno. (2002)
Combat-induced dissociative amnesia: review and case example of generalized dissociative amnesia.
Journal of Trauma and Dissociation (ISSN: 1529-9732), v. 3, no. 2, pp. 35-55 (2002).

ABSTRACTDissociative amnesia following combat trauma in various wars has been extensively documented. In this article, we describe theoretical constructs related to dissociative amnesia, and integrate them with clinical practice through the presentation of a case. Although there is ample documentation of this condition in combat soldiers, in actual clinical practice such dissociative amnesia is probably underdiagnosed and undertreated. This may be detrimental to therapeutic progress, given the fact that ongoing memory deficits constitute one of the core symptoms of chronic PTSD in combat veterans. As illustrated in our case example of combat-induced generalized dissociative amnesia, combat-induced amnesia may also reflect previously existing dissociated traumatic memories that become reactivated during trauma. In this case, intensive treatment using hypnosis within a larger therapeutic milieu involved both the uncovering and processing of recent dissociated traumatic experiences, and, by necessity, other traumas of the past.

Wilson, Scott N; Van der Kolk, Bessel A; Burbridge, Jennifer A; Fisler, Rita E; Kradin, Richard. (1999)
Phenotype of blood lymphocytes in PTSD suggests chronic immune activation.
Psychosomatics (ISSN: 0033-3182), v. 40, no. 3, pp. 222-225 (May-June 1999).

ABSTRACT Patients with PTSD have a past history of extremely stressful experience and often present with somatic complaints. Peripheral blood lymphocytes (PBL) of patients with PTSD associated with a history of childhood sexual abuse were examined for changes in immune phenotype. The ratio of CD45RO-positive to CD45RA-positive lymphocytes (CD45RO/CD45RA), an index of lymphocyte activation, was higher (P = 0.04) in the PTSD subjects than in the normal subjects. No differences were observed for the number of PBL or the representation of major T, B, or NK lymphocyte subsets. These findings suggest the presence of increased lymphocyte activation in the PBL of patients with PTSD.

Woller W, Kruse J. (2003)
Klinik Wersbach, Klinik fur Psychosomatische Medizin und Psychotherapie, woeller@klinikwersbach.de
Nervenarzt. 2003 Nov;74(11):972-6.

ABSTRACT Pervasive personality disorders have been shown to be long-term sequelae of cumulative childhood physical and sexual traumatization. This finding is not reflected in DSM-IV and ICD-10 classifications where post-traumatic stress disorder is confined to intrusions, avoidance, numbing, and hyperarousal. However, there is growing evidence that trauma etiology should be taken into account in planning treatment for personality disorders. It is not yet clear whether childhood traumatization is more strongly associated with borderline personality disorder than with other personality disorders. The finding of a substantial overlap between borderline personality disorder and dissociative identity disorder gives rise to discussions concerning the relationship of these two pathologies.

Wood JM , Lilienfeld SO, Garb HN, Nezworski MT (2000)
Department of Psychology, University of Texas at El Paso, 79968, USA.
The Rorschach test in clinical diagnosis: a critical review, with a backward look at Garfield (1947)
J Clin Psychol 2000 Mar;56(3):441-8

ABSTRACT The present article comments on a classic study by Garfield (1947) then reviews research on the Rorschach and psychiatric diagnoses. Despite a few positive findings, the Rorschach has demonstrated little validity as a diagnostic tool. Deviant verbalizations and bad form on the Rorschach, and indices based on these variables, are related to Schizophrenia and perhaps to Bipolar Disorder and Schizotypal Personality Disorder. Patients with Borderline Personality Disorder also seem to give an above-average number of deviant verbalizations. Otherwise the Rorschach has not shown a well-demonstrated relationship to these disorders or to Major Depressive Disorder, Posttraumatic Stress Disorder (PTSD), anxiety disorders other than PTSD, Dissociative Identity Disorder, Dependent, Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or psychopathy.