According to the findings of the largest prospective study of its kind, the presence of dissociation, or a profound sense of detachment from one’s sense of self or surroundings, may indicate a high risk of developing severe post-traumatic stress disorder, anxiety, physical pain, depression, and social impairment in people who have experienced trauma.
The study was done under the supervision of McLean Hospital experts, and the results were published in the journal ‘American Journal of Psychiatry.’
“Detachment may help someone deal in the aftermath of trauma by offering some psychological distance from the experience,” stated main author Lauren A. M. Lebois, PhD, head of the Dissociative Disorders and Trauma Research Center.
“Detachment may help someone cope in the aftermath of trauma by providing some psychological distance from the experience,” said lead author Lauren A. M. Lebois, PhD, director of the Dissociative Disorders and Trauma Research Program at McLean Hospital and an assistant professor of psychiatry at Harvard Medical School. ”
Detachment symptoms
However, because to a relative lack of understanding in medical and clinical practise, detachment symptoms remain under-studied and under-diagnosed.”
Lebois and her colleagues evaluated data from the Advancing Understanding of RecOvery after TraumA (AURORA) Study to give insights.
The study included 1,464 persons treated at 22 different emergency rooms across the United States who reported whether or not they suffered a severe form of dissociation known as detachment. In addition, 145 individuals received brain imaging while doing an emotional activity.
Researchers gathered follow-up reports of post-traumatic stress disorder, sadness, pain, anxiety symptoms, and functional impairment three months later.
At the 3-month follow-up, patients who reported feeling detachment had greater levels of post-traumatic stress, anxiety, despair, pain, and functional impairment, according to the research team.
Furthermore, detachment was predicted by both self-reported survey responses and brain imaging data, even after accounting for post-traumatic stress symptoms at the start of the trial and histories of childhood trauma.
The findings emphasise the necessity of screening patients for dissociation-related symptoms after trauma in order to identify at-risk people who might benefit from early treatments.
The researchers observed that detachment was associated with altered activity in certain brain areas as assessed by brain imaging.
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“As a result, chronic detachment is both an early psychological indication and a biological marker of worse mental outcomes later,” said senior author Kerry J. Ressler, MD, PhD, chief scientific officer at McLean Hospital and a professor of psychiatry at Harvard Medical School.
The researchers hope that their results will raise awareness about these symptoms and their possible consequences.
“Hopefully, this will allow more physicians to empathically engage with patients and talk intelligently with them to help them comprehend their symptoms and potential therapies,” Lebois added.
“Unfortunately, excluding dissociation from the dialogue makes patients more vulnerable to more serious mental disorders following trauma.”
The study is an example of how data from the AURORA Study—a major national initiative headquartered at the University of North Carolina that seeks to inform the development and testing of preventive and treatment interventions for individuals who have experienced traumatic events—might impact patient care.
“These new findings add to the growing list of AURORA discoveries that will help improve understanding about how to better prevent and treat adverse mental health outcomes after trauma,” said Samuel McLean, MD, the AURORA Study’s organising principal investigator and a professor of anesthesiology, emergency medicine, and psychiatry at the University of North Carolina School of Medicine.
“Studies like AURORA are crucial because unfavourable post-traumatic mental health consequences entail a great worldwide burden of suffering,” he noted.
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