Multidimensional measures of dissociation enable detailed characterization of dissociative phenomena, yet their clinical use is limited by the lack of validated cutoff scores. The Italian version of the Multiscale Dissociation Inventory (MDI-ITA) has demonstrated solid psychometric properties, but its diagnostic accuracy in identifying clinically significant dissociation has not been investigated. This study reports a secondary analysis of data from the Italian validation of the MDI-ITA, including 439 adults from the general population. Clinically significant dissociation was operationalized using the Dissociative Experiences Scale-II cutoff score (>= 30). Receiver Operating Characteristic (ROC) analyses were conducted to evaluate the discriminative accuracy of the MDI-ITA total score and its five subscales (Disengagement [DIS]; Depersonalization-Derealization [DP/DR]; Emotional Constriction [EC]; Memory Disturbances [MD]; Identity Dissociation [ID]). The cutoff for the total score was identified using the Youden Index. The MDI-ITA total score showed good discriminative accuracy (AUC = 0.885). The optimal cutoff value of 52 yielded a sensitivity of 70.6% and a specificity of 90.9%, favoring exclusion of non-cases. Subscale analyses revealed heterogeneous but overall fair discriminative performance, with DP/DR and DIS demonstrating the highest accuracy. Thresholds derived for subscales were interpreted dimensionally and not as independent diagnostic cutoffs. The findings support the use of the MDI-ITA total score as a screening index for potentially clinically significant dissociation. While the multidimensional structure of the MDI-ITA remains essential for dimensional characterization, the availability of the total-score cutoff enhances its applicability in assessment and research contexts requiring both classification and dissociation profiling.
Research has previously suggested an association between childhood maltreatment and narcissism. However, this research has primarily focused on the grandiose dimension of narcissism. This contrasts with a multi-dimensional approach to understanding narcissistic pathology, which emphasizes both grandiosity and vulnerability. Research suggests that one factor associated with narcissistic grandiosity is childhood maltreatment, although the association between child maltreatment and narcissistic vulnerability is unclear. In this study, we examine the association between different forms of childhood maltreatment and dimensions of narcissism in a sample of men and women recruited online (N = 306) using a Bayesian approach to structural equation modeling. Results suggest that for women, physical abuse was positively associated with grandiose narcissism, and that physical neglect was positively associated with vulnerable narcissism over and above other traumatic experiences. For men, there were no positive associations between maltreatment or other traumatic experiences and narcissism. Study findings clarify the role of childhood maltreatment on narcissism and have potential implications for the treatment of narcissistic pathology.
Trauma-related sexual symptoms are common following interpersonal trauma yet are rarely systematically addressed in trauma-focused treatment. This multicenter pilot study aimed to evaluate the safety, applicability, and preliminary efficacy of a novel manualized group intervention integrating trauma-specific and sex therapy techniques (TrusT). In a multicenter pilot study, 54 individuals assigned female at birth (51 female, 3 non-binary, mean age = 33.8) with a history of interpersonal trauma and persistent sexual symptoms participated in a 12-week group therapy program with weekly sessions. Baseline, post-treatment, and three-month follow-up data were analyzed. The intervention led to significant improvements in trauma-related sexual symptoms (p < .001), posttraumatic stress disorder (PTSD) severity (p < .001), and dissociative symptoms during sexual situations (all p < .05) after treatment, with sustained effects at follow-up and large effect sizes. Additionally, participants reported enhanced self-determined sexuality (all p < .05), while reported side effects remained minimal. TrusT appears to be a safe and well-tolerated intervention with encouraging preliminary effects on trauma-related sexual symptoms in a clinically underserved population. Further research, including randomized controlled trials, is necessary to confirm efficacy and inform integration into trauma-focused treatment frameworks.
Autism spectrum disorder (ASD) is associated with a variety of mental health conditions, including dissociation. In addition to high rates of trauma exposure, vulnerability for dissociation in autism may be heightened by social differences, cognitive inflexibility, and sensory sensitivities. This study examined dissociative symptoms across levels of autistic traits using existing clinical data from 716 individuals receiving mental health care ("clients") in Australia. Clients completed the Multidimensional Inventory of Dissociation-60 (MID-60), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), and the Adverse Childhood Experiences Questionnaire (ACE-Q) or Life Events Checklist for DSM-5 (LEC-5). Clients were grouped according to their RAADS-R scores, measuring autistic traits. Analyses first compared those with high autistic traits (HA; ≥120; n = 338) to below-threshold autistic traits (BA; <120; n = 378). The latter group was then subdivided into those with moderate autistic traits (MA; 65-119; n = 214) and low autistic traits (LA; <65; n = 164) for more comprehensive analysis. HA clients had the highest scores on all trauma and dissociation measures and subscales, and clinically elevated dissociation was significantly more prevalent among HA clients (68%) than BA clients (33%; OR = 4.42) and LA clients (15%; OR = 12.59). MA clients also scored higher than LA clients in almost all domains. Autistic traits and dissociation severity were significantly correlated overall and for all subscales, with the strongest correlations found for the RAADS-R Sensory-Motor domain. All relationships remained significant after controlling for ACEs. This highlights the need for routine screening and tailored interventions addressing both autistic traits and dissociation.
The link between traumatic events, such as sexual abuse, and dissociation is well-documented, but the mechanisms underlying these symptoms remain unclear. The aim of this study was to investigate the relationship between sexually abused individuals' dissociative experiences and emotion dysregulation and mindfulness; and to examine whether mindfulness and emotion dysregulation play a role in the relationship between sexual abuse and dissociative symptoms. The sample consisted of 52 female adolescents who were victims of sexual abuse and 52 female adolescents without a history of sexual abuse who attended the child psychiatry clinic. All participants were asked to fill out the Adolescent Dissociative Experiences Scale (ADES), the Mindful Attention Awareness Scale (MAAS) and the Difficulty in Emotion Regulation Scale Brief Form (DERS-16). Findings revealed that dissociative symptoms and emotion dysregulation were significantly higher, and mindfulness was lower in the abused group. Both mindfulness and emotion dysregulation were found to mediate the relationship between sexual abuse and dissociative symptoms. In a literature review conducted by the researchers, no study in a clinical setting was found in which the role of mindfulness and emotion regulation in the relationship between sexual abuse and dissociation in adolescents exposed to sexual abuse was examined together. We believe that our results are unique and furthermore it is believed that considering and developing mindfulness and emotion regulation in the treatment process of sexual abuse victims will be beneficial for patients.
