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Quality of Early Care and Childhood Trauma: A Prospective Study of Developmental Pathways to Dissociation

Lissa Dutra, Ph.D.,1 Jean-Francois Bureau, Ph.D.,2 Bjarne Holmes, Ph.D. 2 Amy Lyubchik, Ph.D. 2 & Karlen Lyons-Ruth, Ph.D.2

Correspondence should be addressed to Dr. Lissa Dutra,Boston University, Department of Psychology, 64 Cummington Street, Boston, MA, 02215. Email: syriana_777@yahoo.com

1 2

Boston University, Department of Psychology, 64 Cummington Street, Boston, MA 02215 Harvard Medical School, Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA, 02139

Acknowledgements: This research was supported by NIH grants MH#035122 and MH#062030. We would like tothank the participating families for their continued investment in the study over many years and our research coordinators and staff, Nancy Hall Brooks, Anne Bellows, Susan Hileman, Joanna Jenei, and Nadia Manzoor for their dedicated work on the project.

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Quality of Early Care and Childhood Trauma: AProspective Study of Developmental Pathways to Dissociation

Abstract Kihlstrom (2005) has recently called attention to the need for prospective longitudinal studies of dissociation. The present study assesses quality of early care and childhood trauma as predictors of dissociation in a sample of fifty-six low income young adults followed from infancy to age 19. Dissociation was assessed withthe Dissociative Experiences Scale; quality of early care was assessed by observer ratings of mother-infant interaction at home and in the lab; and childhood trauma was indexed by state-documented maltreatment, self-report, and interviewer ratings of participants’ narratives. Regression analysis indicated that dissociation in young adulthood was significantly predicted by observed lack of parentalresponsiveness in infancy, while childhood verbal abuse was the only type of trauma that added to the prediction of dissociation. Implications are discussed in the context of previous prospective work also pointing to the important contribution of parental emotional unresponsiveness in the development of dissociation.

Keywords: Dissociation; Abuse; Trauma; Attachment; Longitudinal

EARLYCARE, TRAUMA AND DISSOCIATION Dissociation refers to a wide range of alterations in the normally integrative functions of identity, memory, or consciousness, including trance states, depersonalization, derealization,


amnesia, and dissociative identity disorder (Waller et al., l996). Dissociative symptoms are most commonly assessed using the Dissociative Experiences Scale (DES; Bernstein &Putnam, l986), with DES cut-off scores identifying approximately 5% to 15% of individuals in the general population as being “at risk” for a dissociative disorder (Kihlstrom, 2005). A taxometric analysis of the DES (Waller et al. 1996) indicated that approximately 3.3% of the general population report frequent and profound experiences of amnesia and/or depersonalization and belong to a pathologicaldissociative taxon, as measured by the DES-T (Waller & Ross, 1997). While several studies have concurred that the dissociative taxon membership appears to capture more extreme forms of dissociative experiences (Waelde et al., 2005; Waller et al., 2001; Waller & Ross, 1997), some researchers have questioned the clinical utility of the taxon in identifying Dissociative Disorders. The DES-T, forexample, has demonstrated low test-rest reliability (Watson, 2003), poor sensitivity compared to the DES (Leavitt, 1999), and unimpressive concordance rates with dissociative disorders (Simeon et al., 2003). While the nature of pathological and non-pathological dissociation has been debated in the field for decades, researchers and clinicians have recently turned their attention to factors associated...
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