HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in BJP Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by MURRAY, J. Articles by MAYOU, R. A. Search for Related Content PubMed PubMed Citation Articles by MURRAY, J. Articles by MAYOU, R. A.

Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors

Department of Psychology, University of Surrey, Guildford

ANKE EHLERS, PhD

Department of Psychology, Institute of Psychiatry, London

RICHARD A. MAYOU, MD

Department of Psychiatry, University of Oxford, UK

Correspondence: Professor Anke Ehlers, Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Tel: 020 7848 5033; fax: 020 7848 0591; e-mail: a.ehlers{at}iop.kcl.ac.uk

Declaration of interest None.

Background Dissociative symptoms during trauma predict post-traumatic stress disorder (PTSD), but they are often transient. It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms.

Aims To investigate prospectively the relationship between dissociative symptoms before, during and after a trauma and other psychological predictors, and chronic PTSD.

Method Two samples of 27 and 176 road traffic accident survivors were recruited. Patients were assessed shortly after the accident and followed at intervals over the next 6 months. Assessments included measures of dissociation, memory fragmentation, data-driven processing, rumination and PTSD symptoms.

Results All measures of dissociation, particularly persistent dissociation 4 weeks after the accident, predicted chronic PTSD severity at 6 months. Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters. Memory fragmentation and data-driven processing also predicted PTSD. Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms.

Conclusions Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop chronic PTSD than initial reactions.

Related articles in BJP:

Highlights of this issue

ELIZABETH WALSH
BJP 2002 180: 0. [Full Text]  

This article has been cited by other articles:

				A. EHLERS More Evidence for the Role of Persistent Dissociation in PTSD Am J Psychiatry, June 1, 2006; 163(6): 1112 - 1112. [Full Text] [PDF]

				K. Jordan The Scripto-Trauma Genogram: An Innovative Technique for Working with Trauma Survivors' Intrusive Memories Brief. Treat. Crisis Interven., February 1, 2006; 6(1): 36 - 51. [Abstract] [Full Text] [PDF]

				N. Esposito Manifestations of Enduring During Interviews With Sexual Assault Victims Qual Health Res, September 1, 2005; 15(7): 912 - 927. [Abstract] [PDF]

				M. L. O'DONNELL and M. CREAMER Drs. O'Donnell and Creamer Reply Am J Psychiatry, March 1, 2005; 162(3): 630 - 631. [Full Text] [PDF]

				M. L. O'Donnell, M. Creamer, P. Pattison, and C. Atkin Psychiatric Morbidity Following Injury Am J Psychiatry, March 1, 2004; 161(3): 507 - 514. [Abstract] [Full Text] [PDF]

				M. B. Stein A 46-Year-Old Man With Anxiety and Nightmares After a Motor Vehicle Collision JAMA, September 25, 2002; 288(12): 1513 - 1521. [Full Text] [PDF]