Dissociative Symptoms in Adolescent Girls: Contextual Determinants and Behavioral Outcomes

Publication Year:
2014
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Repository URL:
https://opencommons.uconn.edu/dissertations/482
Author(s):
Zona, Kate P.
artifact description
Dissociative symptoms in adolescents have not been widely studied. Existing research suggests that dissociation is important in understanding vulnerability for psychopathology and high-risk behavior during adolescence, especially among girls exposed to potentially traumatic events. Using a diverse, low-income sample of 13- to 17-year-old girls (N=194), this study examined: 1) psychometric properties of the Adolescent Dissociative Experiences Scale (A-DES; Armstrong et al., 1997); 2) associations between dissociative symptoms and exposure to traumatic events, relational factors,and racial/ethnic/cultural factors, including potential moderating effects of contextual variables on the relationship between trauma exposure and dissociation; and 3) whether dissociation predicted risky behavior, above and beyond more common and frequently comorbid symptoms, and uniquely mediated associations between trauma exposure and destructive behaviors. Results showed that adolescent and mother A-DES scores were moderately correlated, and both were highly stable at eight-week follow-up. In EFA, there was a good fit for a two-factor A-DES structure that reflected response scale differences across items, with all items loading onto one factor and a second-order factor emerging consisting of items treated as dichotomous due to low endorsement. A significant relationship was found between dissociation and past year (but not lifetime) traumatic events, controlling for PTSD. Dissociative symptoms did not differ by race and were not uniquely associated with relational or cultural variables, other than relational style with mothers. Preoccupied and dismissing styles were significantly related to dissociation, controlling for traumatic events and PTSD. None of the relational or racial/ethnic/cultural factors moderated the relationship between trauma exposure and dissociation. However, age had both a main and interactive effect with trauma on dissociation; younger participants reported greater dissociation, in general and in response to trauma. Finally, dissociation was related to most risk behaviors (suicidal ideation, self-harm, disturbed eating, alcohol use), but not after controlling for PTSD and depression, with the exception of suicidality. Suicidal ideation significantly predicted dissociation above and beyond PTSD and depression, and dissociation mediated the relationship between trauma exposure and suicidal ideation. These findings highlight the importance of assessing and treating dissociation in adolescent girls, particularly younger girls with trauma histories.