Dissociation and PTSD in women with a history of childhood sexual abuse: a pilot examination of a specialized inpatient unit.

BACKGROUND

Worldwide, there are relatively few specialized inpatient units dedicated to women with histories of childhood sexual abuse (CSA) and comorbid psychiatric disorders. This pilot study examined dissociation and PTSD among women admitted to such a specialized integrative inpatient unit in Israel. We conduct an in-depth analysis of the role of dissociation in these women's clinical picture, as well as in their treatment response.

METHODS

The study included two phases. Phase 1 used a cross-sectional design to assess the complex inter-relationships between PTSD and various facets of dissociation in women with CSA histories admitted to a specialized inpatient unit (N = 108). Phase 2 focused on a sub-sample of participants (N = 28) who completed the inpatient program and completed admission and discharge assessments. Measures included the PTSD Checklist for DSM-5 (PCL-5) and the Dissociative Experiences Scale (DES-II).

RESULTS

In Phase 1, dissociative symptoms were positively correlated with overall PTSD severity and all PTSD symptom clusters, with the dissociative sub-measure of Absorption showing the strongest associations. In Phase 2, PTSD symptoms significantly decreased following treatment. In line with phase 1, reductions in Absorption were associated with improvements in overall PTSD severity and specifically in Hyperarousal symptoms.

CONCLUSIONS

Findings from this pilot study indicate the therapeutic potential of a specialized integrated inpatient unit for women with CSA histories. Importantly, our results indicate that dissociation should be regarded as a major therapeutic target, most notably patients' tendency for maladaptive absorption. These preliminary results should be expanded upon in larger, controlled clinical trials, further elucidating the role of dissociation and other mechanisms of change in similar units.