Peritraumatic dissociation and chronic posttraumatic symptomatology : Thirty years and counting

Three decades ago, systematic research on possible acute and long-term aftereffects of peritraumatic dissociation (PD) was partly spurred by the proposal of a Brief Reactive Dissociative Disorder (BRDD) and the associated literature reviews and analyses of datasets (Cardeña, Lewis-Fernández, Beahr, Pakianathan & Spiegel, 1996; Cardeña et al., 1998; Spiegel & Cardeña, 1991). The goal was to “encourage greater clinical and research attention to the substantial number of people who may have severe and acute dissociative and anxiety reactions to trauma and bring the DSM nosology into greater accord with the ICD-10 diagnosis of acute stress reaction” (Cardeña et al., 1996, p. 994). That proposal was discussed by the DSM-IV Anxiety Disorders Work Force within the frame of what became the Acute Stress Disorder diagnosis. This chapter provides an introduction to the concepts of dissociation and peritraumatic dissociation (henceforth PD), and reviews measures of peritraumatic dissociation and related biological research. It then discusses PD within the context of Acute Stress Disorder (ASD) and its role as a predictor of PTSD or, more generally, of posttraumatic stress symptoms (PTSS), including research on potential mediators and moderators, before providing conclusions and recommendations for future research