Neuropsychological impairment in dissociative and non-dissociative posttraumatic stress disorder (PTSD)

The long-standing debate between trauma theorists and fantasy theorists has led to great discussion about the etiology or true origins of dissociative symptomatology. The current study investigates the possibility that there are two distinct groups of dissociative individuals --- one group characterized by trauma history and trauma-related symptomatology and the other by deficits in attention/concentration, executive functioning, memory and/or speed of information processing. This research aims to bring clarity to the long-standing debate that exists between Trauma Model and Fantasy Model theorists. One hundred participants from an intensive outpatient program were recruited to take part in a number of cognitive and neuropsychological measures, a clinical interview, and a questionnaire process. Results of this study revealed high correlations between dissociation and psychological symptom variables, with more mixed findings regarding correlations between dissociation and neuropsychological factors. Cluster analysis results presented three different clusters (Psychological Symptoms cluster, Low Severity cluster, and Neuropsychological Impairment cluster). Interestingly, the Low Severity cluster included the largest n, as compared to both the Psychological Symptoms and Neuropsychological Impairment clusters. Comparing the Neuropsychological Impairment and Psychological Symptoms clusters, more severe trauma history was found for those showing severe psychological symptoms. Further, the Creative Experiences Questionnaire was a strong marker for poor executive functioning in the high dissociation group, but not the low dissociation group. This subgroup, showing a combination of high dissociation, high fantasy proneness, and low executive functioning, would be interesting to evaluate further in future studies.