Dissociation among patients diagnosed with addictive disorders: A comparative and follow-up study

Christopher Ralph Penta (1999)

Individuals with addictive disorders are exposed to traumatic experiences with greater frequency than the general population. A number of studies have found high levels of dissociation, a common defensive response to overwhelming experience, in this population. The effect of intoxicants is a confounding effect in these investigations. Dissociative symptoms in newly abstinent addicts are often dismissed as an artifact of substance abuse. Follow-up measurements are commonly suggested as a remedy. The investigation explored whether dissociation would remain elevated despite remission of the addictive disorder. Subjects were hospitalized addictive disorder patients at the UCONN Health Center (n = 70) and geographically matched control subjects with no history of addiction (n = 90). Measures included the Dissociative Experiences Scale (DES), Structured Clinical Interview for DSM-III-R Axis I Disorders, Addiction Severity Index, and toxicology screening. Mean scores for the addictive disorders group as inpatients and control groups were 22.78 ± 18.0 and 6.66 ± 6.87 respectively. The difference was statistically significant, F (1, 158) = 60.547, p < .001. The level of dissociation within the addictive disorders group did not change significantly at a follow-up assessment one year later. The mean score at that time was 18.49 ± 18.09, F (52, 17) = 1.717, p = .110. This was also significantly higher than the control group, F (1, 158) = 35.542, p < .001. The mean DES score for patients who achieved full remission of their addictive disorder (n = 34) was 16.17 ± 16.90. The mean score for continued users was 20.69 ± 19.12. The difference between these groups was nonsignificant, F (1, 68) = 1.097, p = .299. Elevated levels of dissociation compared to controls was observed in the subgroup of abstainers, F (1, 122) = 19.972, p < .001 and continued users, F (1, 124) = 36.959, p < .001. The results obtained are inconsistent with a simple biochemical model of dissociation in this population. Dissociation was consistently elevated compared to control subjects acted as a stable trait, surviving remission in the addictive disorder. Future investigations would benefit from the addition of measures of traumatic experiences, a diagnostic test for dissociative disorders and improved control of the effect of time on the control group.