TY - JOUR
T1 - Childhood experiences and dissociation among high school students in China
T2 - Theoretical reexamination and clinical implications
AU - Fung, Hong Wang
AU - Geng, Fulei
AU - Yuan, Danyan
AU - Zhan, Nalan
AU - Lee, Vincent Wan Ping
N1 - Funding Information:
The first author received The RGC Postdoctoral Fellowship Scheme 2022/2023 from the Research Grants Council (RGC) of Hong Kong.
Publisher Copyright:
© The Author(s) 2023.
PY - 2023/6/23
Y1 - 2023/6/23
N2 - Background: Dissociation remains a controversial topic in terms of its prevalence, cross-cultural validity, and relationship with childhood trauma and adversities.Aims: This study investigated the prevalence of dissociative symptoms and probable dissociative disorders among Chinese high school students and tested the trauma model of dissociation.Methods: A total of N = 1,720 high school students completed standardized measures of positive and adverse childhood experiences (PCEs and ACEs), dissociation, depression, and anxiety.Results: The prevalence rates of dissociative symptoms and (probable) DSM-5 dissociative disorders (DDs) were 11.2% and 6.9%, respectively. Dissociation was a reliable construct (ICC =.682 to .752, p <.001) and was moderately correlated with general psychopathology (r =.424 with depressive symptoms, r =.423 with anxiety symptoms). Participants with a probable DD reported more ACEs, fewer PCEs, and more mental health symptoms than those without a probable DD. ACEs were significantly associated with dissociative symptoms (β =.107, p <.001) even after controlling for age, depressive, and anxiety symptoms. PCEs moderated the relationship between ACEs and dissociative symptoms.Conclusions: This is the first report of the prevalence of dissociative symptoms and probable DSM-5 DDs among nonclinical children. We provide cross-cultural evidence that dissociation is a reliable and valid clinical phenomenon associated with psychopathology in children across cultures. The findings partly support the trauma model of dissociation. This study contributes to the limited literature on dissociation in children. It also offers empirical data to facilitate the ongoing controversy about (childhood) trauma and dissociation. Our findings imply that dissociation is cross-culturally associated with childhood adversities, but trauma is not the only, sufficient cause. Theoretical and clinical implications are discussed.
AB - Background: Dissociation remains a controversial topic in terms of its prevalence, cross-cultural validity, and relationship with childhood trauma and adversities.Aims: This study investigated the prevalence of dissociative symptoms and probable dissociative disorders among Chinese high school students and tested the trauma model of dissociation.Methods: A total of N = 1,720 high school students completed standardized measures of positive and adverse childhood experiences (PCEs and ACEs), dissociation, depression, and anxiety.Results: The prevalence rates of dissociative symptoms and (probable) DSM-5 dissociative disorders (DDs) were 11.2% and 6.9%, respectively. Dissociation was a reliable construct (ICC =.682 to .752, p <.001) and was moderately correlated with general psychopathology (r =.424 with depressive symptoms, r =.423 with anxiety symptoms). Participants with a probable DD reported more ACEs, fewer PCEs, and more mental health symptoms than those without a probable DD. ACEs were significantly associated with dissociative symptoms (β =.107, p <.001) even after controlling for age, depressive, and anxiety symptoms. PCEs moderated the relationship between ACEs and dissociative symptoms.Conclusions: This is the first report of the prevalence of dissociative symptoms and probable DSM-5 DDs among nonclinical children. We provide cross-cultural evidence that dissociation is a reliable and valid clinical phenomenon associated with psychopathology in children across cultures. The findings partly support the trauma model of dissociation. This study contributes to the limited literature on dissociation in children. It also offers empirical data to facilitate the ongoing controversy about (childhood) trauma and dissociation. Our findings imply that dissociation is cross-culturally associated with childhood adversities, but trauma is not the only, sufficient cause. Theoretical and clinical implications are discussed.
KW - childhood trauma
KW - cross-cultural psychiatry
KW - Dissociation
KW - dissociative disorders
KW - mental health
UR - http://www.scopus.com/inward/record.url?scp=85162673410&partnerID=8YFLogxK
U2 - 10.1177/00207640231181528
DO - 10.1177/00207640231181528
M3 - Journal article
AN - SCOPUS:85162673410
SN - 0020-7640
JO - International Journal of Social Psychiatry
JF - International Journal of Social Psychiatry
ER -
