The Relevance of Dissociation in PTSD: Subtype, Comorbidity, or Component?
Webinar with Ruth Lanius, MD, PhD, & Bethany Brand, PhD, and Paul Frewen, PhD, C. Psych., which took place on June 18th 2021
Paul Frewen: Dissociation and Complex PTSD
The field of chronic trauma and dissociation is in continuous development. With the diagnoses of the ICD-11 Complex PTSD and the DSM-5 PTSD, dissociative subtype, the relevance of discussing the role of dissociation in these disorders and their overlap with dissociative disorders is at forefront.
There is evidence for a link between dissociation and trauma, in particular chronic (childhood) trauma. An increasing body of research point to the importance of dissociation's role in PTSD. In particular, PTSD related to chronic traumatization is associated with high levels of dissociation and major treatment challenges. Consequently, the DSM-5 included a PTSD dissociative subtype (PTSD-dd), i.e., PTSD with persistent and recurring symptoms of depersonalization and derealization. The ICD-11 has included the diagnosis of complex PTSD (C-PTSD), a diagnosis that communicates disturbances in self-organization in addition to core symptoms of PTSD. Like dissociative disorders, PTSD-dd and C-PTSD are associated with higher levels of childhood trauma than simple PTSD, and there is much overlap between these conditions. This workshop aims at bringing focus on the relevance of dissociation and dissociative processes for the maintenance of symptoms in PTSD, including, respectively, the DSM-5 PTSD dissociative subtype and the ICD-11 complex PTSD. The overlap between the different PTSD-diagnoses and dissociative disorders are discussed, as are clinical implications.
We are priveleged having three outstanding experts presenting and joining a panel discussion on this webinar's important focus. More specifically, Ruth Lanius presents an overview of the four-dimensional model of dissociation and its diagnostic and clinical relevance transdiagnostically. Paul Frewen discusses recent research data relating to the four-dimensional model of dissociation, the dissociative subtype, and complex PTSD. Bethany Brand discusses the practical clinical implications for assessing and treating highly dissociative, traumatized individuals that extend beyond the DSM and ICD.
Ruth Lanius, MD, PhD, Professor of Psychiatry is the director of the posttraumatic stress disorder (PTSD) research unit at the University of Western Ontario. She established the Traumatic Stress Service and the Traumatic Stress Service Workplace Program, services that specialized in the treatment and research of Posttraumatic Stress Disorder (PTSD) and related comorbid disorders. She currently holds the Harris-Woodman Chair in Mind-Body Medicine at the Schulich School of Medicine & Dentistry at the University of Western Ontario. Her research interests focus on studying the neurobiology of PTSD and treatment outcome research examining various pharmacological and psychotherapeutic methods. She has authored more than 150 published papers and chapters in the field of traumatic stress and is currently funded by several federal funding agencies. She is the recipient of the 2019 Banting Award for Military Health Research. She regularly lectures on the topic of PTSD nationally and internationally. She has recently published a book 'Healing the traumatized self: consciousness, neuroscience, treatment' with Paul Frewen.
Paul Frewen, PhD, joined the departments of psychiatry and psychology at the University of Western Ontario in London, Ontario, Canada in September 2008. He completed his doctorate in clinical psychology at Western and his post-doctoral residency at the Royal Ottawa Mental Health Centre. He has chaired the Traumatic Stress Section of the Canadian Psychological Association (CPA) and is current chair of the practice committee of the American Psychological Association (APA) Psychological Trauma Division. He received the President's Early Research Award from the CPA in 2010, Early Career Awards from the Traumatic Stress sections of the American and Canadian Psychological Associations in 2013 and 2014, and the Scientist-Practitioner Early Career Award from the CPA in 2014. He has authored over 100 peer-reviewed articles on the subjects of trauma, affect regulation, mindfulness, dissociation, and the self, primarily utilizing functional neuroimaging and psychometrics approaches. His text, "Healing the Traumatized Self: Consciousness, Neuroscience & Treatment", co-authored with Dr. R. Lanius, was published within the Norton Series in Interpersonal Neurobiology in 2015. He currently has a clinical psychology practice in London, Ontario where he primarily sees adults with trauma- and stressor-related disorders using integrative and experiential psychotherapy. He has also been researching the augmentation of psychotherapy outcome by innovative technologies including virtual reality, EEG neurobiofeedback, non-invasive brain stimulation, and psychoactive medicines.
Bethany Brand, PhD, is a Psychology Professor at Towson University and she specialises in the assessment and treatment of trauma-related disorders. She has over 30 years of clinical and research experience. Dr. Brand has been honoured with numerous research, teaching and clinical awards and served on several national task forces that developed guidelines for the assessment and treatment of trauma-related disorders. Dr. Brand is the Principal Investigator on a series of international treatment studies of patients with dissociative disorders (TOP DD studies) as well as studies distinguishing dissociative disorders from other conditions including malingering. She has served as an expert witness on trauma in forensic cases at the state, federal, and international level.