Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study

• Published in: European journal of psychotraumatology Vol. 12; no. 1; p. 1976954
• Main Authors: Kaspersen, Kaja, Hol, Gorm, Jepsen, Ellen K. K.
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01-01-2021; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Adult; Adult Survivors of Child Abuse; anhedonia; Child; childhood trauma; Clinical; Dissociative disorders; Dissociative Disorders - therapy; Fear & phobias; Fear - psychology; Female; Humans; interferencia afectiva negativa; Life Change Events; Male; Mixed methods research; negative affective interference; Personality; Phobic Disorders - complications; Pilot Projects; Post traumatic stress disorder; Shame; Surveys and Questionnaires; trastornos disociativos; Trauma care; trauma infantil; 分离性障碍; 快感缺失; 消极情感干扰; 童年创伤; childhood trauma; dissociative disorders; negative affective interference; anhedonia
• ISSN: 2000-8066; 2000-8198; 2000-8066
• DOI: 10.1080/20008198.2021.1976954

Background: Research suggests that individuals exposed to (childhood) trauma are not only unable to experience pleasure, known as hedonic deficit (HD), but also experience 'negative affective responses to positive events', known as negative affective interference (NAI). The clinical relevance and prognostic features of NAI have increasingly been recognized. To date, no studies have focused on NAI in patients with complex dissociative disorders (CDDs) who were abused early in life.
Objective: In this pilot study, we quantitatively and qualitatively investigated how NAI is related to trauma-related symptoms and how this phenomenon can be understood in a selected group of adult CDD patients.
Method: CDD patients (N = 25) referred to an inpatient dissociation-focused treatment programme completed the Hedonic Deficit & Interference Scale (HDIS), and measures of trauma-related symptoms and interpersonal functioning, as well as a qualitative questionnaire addressing possible inner conflicts and phobias with respect to the experience of positive events. A convergent mixed-methods design was used to obtain different but complementary data on NAI to gain a more complete understanding of the phenomenon.
Results: The quantitative analyses showed a significant relationship between NAI and trauma-related symptoms and interpersonal functioning. NAI seems to be more strongly associated with these symptoms than HD. The qualitative analysis revealed three themes - fear, shame, and aggressive 'parts' - preventing positive emotions, which provided a possible interpretation of the quantitative results. The integrated findings were discussed in light of theories of structural dissociation of the personality and attachment.
Conclusions: These findings indicate that NAI is related to a spectrum of trauma-related symptoms and interpersonal functioning in patients with a CDD to a larger degree than HD and that different dissociative identities are involved. Studies of the relationship between changes in HDIS (particularly the NAI subscale) and changes in trauma-related symptoms and interpersonal functioning following treatment are warranted.
Dissociative disorder patients (DDs) experience negative affective responses to positive events (NAI) in addition to hedonic deficits.
NAI is related to trauma-related symptoms and interpersonal functioning in DDs and may involve dissociative personality parts or 'identities'.