Am J Psychiatry 1996; 153:935-940
Copyright © 1996 by American Psychiatric Association
Dissociation in aging Holocaust survivors
R Yehuda, A Elkin, K Binder-Brynes, B Kahana, SM Southwick, J Schmeidler and EL Giller Jr
Department of Psychiatry, Mount Sinai School of Medicine, New York, USA.
OBJECTIVE: This study explored relationships among dissociation, trauma,
and posttraumatic stress disorder (PTSD) in elderly Holocaust survivors
with and without PTSD and in a demographically comparable group of
nontraumatized subjects. METHOD: Holocaust survivors with PTSD (N = 35) and
without PTSD (N = 25) who had been recruited from the community and a
comparison group (N = 16) were studied. Dissociation was evaluated with the
Dissociative Experiences Scale. Past cumulative trauma and recent stress
were evaluated with the Antonovsky Life Crises Scale and the Elderly Care
Research Center Recent Life Events Scale, respectively. PTSD symptoms were
assessed with the Clinician- Administered PTSD Scale. RESULTS: The
Holocaust survivors with PTSD showed significantly higher levels of current
dissociative experiences than did the other groups. However, the extent of
dissociation was substantially less than that which has been observed in
other trauma survivors with PTSD. Dissociative Experiences Scale scores
were significantly associated with PTSD symptom severity, but the relation
between Dissociative Experiences Scale scores and exposure to trauma was
not significant. CONCLUSIONS: Possible explanations for this finding
include the age of the survivors, the length of time since the traumatic
event, and possible unique features of the Holocaust survivor population.
Nevertheless, the findings call into question the current notion that PTSD
and dissociative experiences represent the same phenomenon. The findings
suggest that the relationships among dissociation, trauma, and PTSD can be
further clarified by longitudinal studies of trauma survivors.
