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http://ajp.psychiatr...rticleID=174876

The Role of Childhood Interpersonal Trauma in Depersonalization Disorder

Daphne Simeon, M.D.; Orna Guralnik, Psy.D.; James Schmeidler, Ph.D.; Beth Sirof, M.A.; Margaret Knutelska, M.A.

"The main findings of this study can be summarized as follows: childhood interpersonal trauma as a whole was highly predictive of both a diagnosis of depersonalization disorder and of scores denoting dissociation, pathological dissociation, and depersonalization. When we examined the role of the various types of trauma with conservative statistical methods, emotional abuse alone, both total score and maximum severity, emerged as the most significant predictor of both depersonalization disorder diagnosis and depersonalization severity. The large majority of perpetrators in the category of emotional abuse were either or both parents. It appears, then, that the ongoing chronicity and frequency of abuse, which presumably reflect the predominant affective coloring of the underlying attachment between parent and child and are captured by the total score, the worst form that the emotional abuse ever took as encoded by its maximum severity, and its earlier age at onset, may all play an important role in the pathogenesis of depersonalization disorder. It is of interest that separation or loss appeared protective; one might speculate that their greater occurrence in healthy subjects yielded them protection from otherwise potentially abusive individuals. It is also intriguing that emotional abuse significantly predicted depersonalization disorder but not general scores denoting dissociation, which were better predicted by the combined severity of emotional and sexual abuse. This suggests a unique relationship between emotional abuse and depersonalization disorder, while other more severe types or combinations of abuse may contribute to more severe dissociative symptoms, such as amnesia or identity disturbances."
 
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