The relationship between pathological dissociation, self-injury and childhood trauma in patients with personality disorders using taxometric analyses

Objective: Dissociative phenomena exist on a spectrum ranging from psychological absorption to highly symptomatic disruptions of identity and memory. A statistical methodology called taxometric analysis has established a set of indicators that identify patients who have pathological dissociation, a qualitatively different form of dissociative phenomena. Using taxometric methodology, this study examines the relationship of pathological dissociation to personality diagnosis and self-directed injury, including suicide and history of childhood abuse, in a sample of outpatients with personality disorders. Method: Patients were recruited from advertisements or referred from local clinicians. Participants completed a diagnostic interview and rating scales for dissociation, self-injury and childhood trauma. Pathological dissociation was identified using the Dissociative Experiences Scale-Taxon (DES-T; Waller, Putnam, & Carlson, 1996). Membership in the pathological dissociation taxon was established by calculating Bayesian posterior taxon membership probabilities; the method advocated by Waller, and compared to an approximation, used widely in the literature, based simply on the unweighted mean of the DES-T items. Results: Overlapping, but not identical groups ofpatients were identified, indicating that the two methods are not interchangeable in this sample of personality disordered individuals. Surprisingly, no associations were detected between indices of childhood trauma and membership in the pathological dissociation taxon nor for the high dissociators identified through the approximation method. Conclusions: This study serves as a replication of the ability to detect pathological dissociation as measured by the DES-T. Nonetheless, the failure to confirm our hypotheses regarding an association between pathological dissociation, childhood trauma, and personality diagnosis raise a challenge to some parts of existing etiologic theories.