Evaluation of the Evidence for the Trauma and Fantasy Models of Dissociation

• Published in: Psychological bulletin Vol. 138; no. 3; pp. 550 - 588
• Main Authors: Dalenberg, Constance J., Brand, Bethany L., Gleaves, David H., Dorahy, Martin J., Loewenstein, Richard J., Cardeña, Etzel, Frewen, Paul A., Carlson, Eve B., Spiegel, David
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychological Association 01-05-2012
• Subjects: Adult and adolescent clinical studies; Amnesia - etiology; Amnesia - psychology; Anxiety; Biological and medical sciences; Child; Child Abuse; Child Abuse - psychology; Correlation; Correlation analysis; Data Analysis; Dissociation; dissociative disorder; Dissociative Disorders; Dissociative Disorders - etiology; Dissociative Disorders - physiopathology; Dissociative Disorders - psychology; Evidence; False Positive Reactions; Fantasies; Fantasy; Fantasy proneness; Foreign Countries; High School Students; Human; Humans; Hypotheses; Imagination; Life Change Events; Measures (Individuals); Medical sciences; Memories; Memory; Mental Recall; Mental stress; Miscellaneous; Models, Psychological; Narratives; Posttraumatic Stress Disorder; Prediction; Prone; Psychiatric Status Rating Scales; Psychological trauma; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Psykologi; Repression, Psychology; Samhällsvetenskap; Social Sciences; Stress Disorders, Post-Traumatic - complications; Stress Disorders, Post-Traumatic - psychology; Suggestibility; Suggestion; Symptoms (Individual Disorders); Theories; Time Factors; Trauma; Turkey; Turkey; trauma; dissociative disorder; suggestibility; fantasy; dissociation; Human; Evaluation; Imagination; Suggestibility; Dissociative disorder; Models; Review; Dissociation; Trauma
• ISSN: 0033-2909; 1939-1455; 1939-1455
• DOI: 10.1037/a0027447

The relationship between a reported history of trauma and dissociative symptoms has been explained in 2 conflicting ways. Pathological dissociation has been conceptualized as a response to antecedent traumatic stress and/or severe psychological adversity. Others have proposed that dissociation makes individuals prone to fantasy, thereby engendering confabulated memories of trauma. We examine data related to a series of 8 contrasting predictions based on the trauma model and the fantasy model of dissociation. In keeping with the trauma model, the relationship between trauma and dissociation was consistent and moderate in strength, and remained significant when objective measures of trauma were used. Dissociation was temporally related to trauma and trauma treatment, and was predictive of trauma history when fantasy proneness was controlled. Dissociation was not reliably associated with suggestibility, nor was there evidence for the fantasy model prediction of greater inaccuracy of recovered memory. Instead, dissociation was positively related to a history of trauma memory recovery and negatively related to the more general measures of narrative cohesion. Research also supports the trauma theory of dissociation as a regulatory response to fear or other extreme emotion with measurable biological correlates. We conclude, on the basis of evidence related to these 8 predictions, that there is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled. We find little support for the hypothesis that the dissociation-trauma relationship is due to fantasy proneness or confabulated memories of trauma.