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Am J Psychiatry 1994; 151:902-907
Copyright © 1994 by American Psychiatric Association
Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans
CR Marmar, DS Weiss, WE Schlenger, JA Fairbank, BK Jordan, RA Kulka and RL Hough
Department of Psychiatry, University of California, San Francisco.
OBJECTIVE: The aim of this study was to determine the reliability and
validity of a proposed measure of peritraumatic dissociation and, as part
of that effort, to determine the relationship between dissociative
experiences during disturbing combat trauma and the subsequent development
of posttraumatic stress disorder (PTSD). METHOD: A total of 251 male
Vietnam theater veterans from the Clinical Examination Component of the
National Vietnam Veterans Readjustment Study were examined to determine the
relationship of war zone stress exposure, retrospective reports of
dissociation during the most disturbing combat trauma events, and general
dissociative tendencies with PTSD case determination. RESULTS: The total
score on the Peritraumatic Dissociation Experiences Questionnaire--Rater
Version was strongly associated with level of posttraumatic stress
symptoms, level of stress exposure, and general dissociative tendencies and
weakly associated with general psychopathology scales from the MMPI-2.
Logistic regression analyses supported the incremental value of
dissociation during trauma, over and above the contributions of level of
war zone stress exposure and general dissociative tendencies, in accounting
for PTSD case determination. CONCLUSIONS: These results provide support for
the reliability and validity of the Peritraumatic Dissociation Experiences
Questionnaire--Rater Version and for a trauma-dissociation linkage
hypothesis: the greater the dissociation during traumatic stress exposure,
the greater the likelihood of meeting criteria for current PTSD.
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