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Am J Psychiatry 1992; 149:328-332
Copyright © 1992 by American Psychiatric Association
Dissociation and posttraumatic stress disorder in Vietnam combat veterans
JD Bremner, S Southwick, E Brett, A Fontana, R Rosenheck and DS Charney
National Center for Post-Traumatic Stress Disorder, West Haven VA Medical Center, CT 06516.
OBJECTIVE: This study compared current dissociative symptoms and
dissociation at the time of specific traumatic events in Vietnam combat
veterans with posttraumatic stress disorder (PTSD) and Vietnam combat
veterans without PTSD. METHOD: Vietnam combat veterans who sought treatment
for PTSD (N = 53) were compared to Vietnam combat veterans without PTSD (N
= 32) who sought treatment for medical problems. Dissociative symptoms were
evaluated with the Dissociative Experiences Scale. Dissociation at the time
of a combat-related traumatic event was evaluated retrospectively with the
modified Dissociative Experiences Questionnaire. The Combat Exposure Scale
was used to measure level of combat exposure. RESULTS: There was a
significantly higher level of dissociative symptoms, as measured by the
Dissociative Experiences Scale, in patients with PTSD (mean = 27.0, SD =
18.0) than in patients without PTSD (mean = 13.7, SD = 16.0). This
difference persisted when the difference in level of combat exposure was
controlled with analysis of covariance. PTSD patients also reported more
dissociative symptoms at the time of combat trauma, as measured
retrospectively by the Dissociative Experiences Questionnaire (mean = 11.5,
SD = 1.6) than non- PTSD patients (mean = 1.8, SD = 2.1). CONCLUSIONS:
Dissociative symptoms are an important element of the long-term
psychopathological response to trauma.
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