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Traumatic Dissociation

Neurobiology and Treatment

Edited by Eric Vermetten, M.D., Ph.D., Martin J. Dorahy, Ph.D., and David Spiegel, M.D.

  • ISBN 978-1-58562-196-5
  • Item #62196

Description

Traumatic Dissociation: Neurobiology and Treatment offers an advanced introduction to this symptom, process, and pattern of personality organization seen in several trauma-related disorders, including acute stress disorder, posttraumatic stress disorder (PTSD), and the dissociative disorders. Our understanding of traumatic dissociation has recently been advanced by neuroimaging technology, empirically-based investigation, and an acknowledgment of its importance in psychopathology. The authors of this volume tie these findings together, tracking the condition from its earliest historical conceptualization to its most recent neurobiological understanding to provide even greater insight into traumatic dissociation and its treatment.

Bringing together for the first time theoretical, cognitive, and neurobiological perspectives on traumatic dissociation, this volume is designed to provide both empirical and therapeutic insights by drawing on the work of many of the main contributors to the field. Opening chapters examine historical, conceptual, and theoretical issues and how other fields, such as cognitive psychology, have been applied to the study of traumatic dissociation. The following section focuses specifically on how neurobiological investigations have deepened our understanding of dissociation and concluding chapters explore issues pertinent to the assessment and treatment of traumatic dissociation. The interacting effects of traumatic experience, developmental history, neurobiological function, and specific vulnerabilities to dissociative processes that underlie the occurrence of traumatic dissociation are among some of the key issues covered. The book's significant contributions include

  • A review of cognitive experimental findings on attention and memory functioning in dissociative identity disorder
  • An appreciation of how the literature on hypnosis provides a greater understanding of perceptual processing and traumatic stress
  • Ascertaining symptoms of dissociation in a military setting and in other situations of extreme stress
  • An outline of key issues for planning assessment of traumatic dissociation, including a critique of its primary empirically supported standardized measures
  • An examination of the association between child abuse or neglect and the development of eating disorders, suggesting ways to therapeutically deal with negative body experience to reduce events that trigger dissociation
  • A description of neuroendocrine alterations associated with stress, pointing toward a better understanding of the developmental effects of deprivation and trauma on PTSD and dissociation
  • A review of the relation of attachment and dissociation
  • A discussion of new research findings in the neuroimaging of dissociation and a link between cerebellar functioning and specific peritraumatic experiences

Useful as a clinical reference or as ancillary textbook, Traumatic Dissociation reorganizes phenomenological observations that have been overlooked, misunderstood, or neglected in traditional training. The research and clinical experience described here will provide the basis for further clinical and theoretical formulations of traumatic dissociation and will advance empirical examination and treatment of the phenomenon.

Contents

Contributors
Preface
Introduction
Part 1: Conceptual Domain of Dissociation
Chapter 1. Relationship Between Trauma and Dissociation: A Historical Analysis
Chapter 2. Attachment, Disorganization, and Dissociation
Chapter 3. Memory and Attentional Processes in Dissociative Identity Disorder: A Review of the Empirical Literature
Chapter 4. Relationships Between Dissociation and Posttraumatic Stress Disorder
Chapter 5. Perceptual Processing and Traumatic Stress: Contributions From Hypnosis
Part II: Neurobiology of Traumaand Dissociation
Chapter 6. Translational Research Issues in Dissociation
Chapter 7. Neuroendocrine Markers of Early Trauma: Implications for Posttraumatic Stress Disorders
Chapter 8. Symptoms of Dissociation in Healthy Military Populations: Why and How Do War Fighters Differ in Responses to Intense Stress?
Chapter 9. Peritraumatic Dissociation: Time Perception and Cerebellar Regulation of Psychological, Interpersonal, and Biological Processes
Chapter 10. Posttraumatic Stress Disorder Symptom Provocation and Neuroimaging: Heterogeneity of Response
Chapter 11. Psychobiology of Traumatization and Trauma-Related Structural Dissociation of the Personality
Part III: Contemporary Implications for Assessment and Treatment
Chapter 12. Psychiatric Approaches to Dissociation: Integrating History, Biology, and Clinical Assessment
Chapter 13. Psychological Assessment of Posttraumatic Dissociation
Chapter 14. Dissociative Identity Disorder: Issues in the Iatrogenesis Controversy
Chapter 15. Applications of Innate Affect Theory to the Understanding and Treatment of Dissociative Identity Disorder
Chapter 16. Trauma, Dissociation, and Impulse Dyscontrol: Lessons From the Eating Disorders Field
Chapter 17. Treatment of Traumatic Dissociation
Afterword
Index

Contributors

Judith Armstrong, Ph.D.
David M. Benedek, M.D.
Marian J. Bakermans-Kranenburg, Ph.D.
Robyn Bluhm, M.A.
Martin Bohus, M.D., Ph.D.
J. Douglas Bremner, M.D.
John Briere, Ph.D.
James A. Chu, M.D.
Laurence Claes, Ph.D.
E. Ronald de Kloet, Ph.D.
Johan A. den Boer, M.D., Ph.D.
Martin J. Dorahy, Ph.D.
Carol S. Fullerton, Ph.D.
Dorith Harari, M.D.
Gary Hazlett, Psy.D.
Rafaele J. C. Huntjens, Ph.D.
Richard P. Kluft, M.D.
Ruth A. Lanius, M.D., Ph.D.
Ulrich Lanius, Ph.D.
Richard J. Loewenstein, M.D.
Charles R. Marmar, M.D.
C. Andrew Morgan III, M.D., M.A.
Ellert R.S. Nijenhuis, Ph.D.
Thomas Rinne, M.D., Ph.D.
Christian Schmahl, M.D., Ph.D.
Daphne Simeon, M.D.
Steven M. Southwick, M.D.
David Spiegel, M.D.
George Steffian, Ph.D.
Robert J. Ursano, M.D.
Walter Vandereycken, M.D., Ph.D.
Onno van der Hart, Ph.D.
Johan Vanderlinden, Ph.D.
Marinus J. van IJzendoorn, Ph.D.
Eric Vermetten, M.D., Ph.D.

About the Authors

Eric Vermetten, M.D., Ph.D., is Head of Research for Military Mental Health at Central Military Hospital and Associate Professor of Psychiatry at the University Medical Center Utrecht in Utrecht, the Netherlands.

Martin J. Dorahy, Ph.D., is Clinical and Research Psychologist at the Trauma Resource Centre, North & West Belfast Health and Social Services Trust, and Research Tutor in the School of Psychology at The Queen's University of Belfast in Northern Ireland.

David Spiegel, M.D., is Jack, Lulu, and Sam Wilson Professor at the School of Medicine, Associate Chair of Psychiatry and Behavioral Sciences, and Medical Director at the Center for Integrative Medicine at Stanford University in Stanford, California.

This is a stimulating and thought-provoking collection of chapters that illustrate how far the study of dissociation has advanced in recent years. These scholarly contributions place dissociation at the heart of understanding people's response to traumatic events, and integrate dissociative phenomena with developmental, psychological, and neurobiological processes. The editors are to be congratulated on bringing together a large quantity of diverse empirical findings that bear on one of the most important intellectual challenges facing the trauma field.—Chris Brewin, Ph.D., Professor of Clinical Psychology, University College London, London, United Kingdom


This book is an excellent collection of chapters that provide a good review of the existing literature in the field. It is also provides fertile ground for new research ideas. I am very familiar with the literature in this area, yet many of the chapters had me jotting down new references and new ideas to consider. The three well-known editors have collected a stellar lineup of the most important researchers in the field of traumatic dissociation. Chapters are mostly well written and are always intriguing. This book makes a voluble overall contribution to the literature in this area.—PsycCRITIQUES, 1/2/2008


In all, this book succeeds in drawing together different historical, research, and clinical strands into a largely cohesive text. It acknowledges the considerable controversy regarding dissociation in psychiatry and takes a realistic attitude toward limitation in the current body of knowledge. Traumatic Dissociation: Neurobiology and Treatment will be of interest to practitioners likely to encounter patients with a history of traumatic exposure and to researchers in the filed of dissociation, since it offers insights from a multitude of perspective.—AMJ Psychiatry, 1/2/2008

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