Psychological mechanisms connected to dissociation: generating hypotheses using network analyses

Emma Černis*, Anke Ehlers, Daniel Freeman

*Corresponding author for this work

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Abstract

A large number of mechanisms, many relating to the processing of affect, have been proposed to cause dissociation. The aim of this study was to use network analyses to identify psychological processes most closely connected with ‘felt sense of anomaly’ dissociative experiences. Both an undirected model and a partially directed network model were estimated using data from 6161 general population respondents collected online. The networks were used to identify relationships between dissociation and ten candidate mechanisms: cognitive appraisals, behavioural responses to dissociation, affect intolerance, alexithymia, attentional control, body vigilance, anxiety sensitivity, general self-efficacy, perseverative thinking, and beliefs regarding stress. Both models indicated a highly connected network in which dissociation had direct connections with six psychological processes: cognitive appraisals, behavioural responses, perseverative thinking, alexithymia, general self-efficacy, and beliefs about being overwhelmed. The strongest connection in both networks was between dissociation and cognitive appraisals (causal effect 0.73). The causal direction of connections could not be statistically determined with confidence, apart from the strong probability that dissociation causes meta-cognitions about being overwhelmed (98.54% of 50,000 sampled directed acyclic graphs). Both networks suggest that cognitive appraisals and factors relating to heightened (negative) sensitivity to affect are closely connected to dissociation. Dissociative experiences may arise from a high sensitivity to affect leading to threat-based appraisals that are ruminated upon and maintained by unhelpful behaviours such as avoidance. Investigation of these relationships in clinical groups, and direct causal tests, are required.

Original languageEnglish
Pages (from-to)165-173
Number of pages9
JournalJournal of Psychiatric Research
Volume148
Early online date29 Jan 2022
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Funding Information:
The work was supported by the Wellcome Trust via a Clinical Doctoral Fellowship to EČ (grant number 102176/B/13/Z ). DF was supported during this work by an NIHR Research Professorship ( NIHR-RP-2014-05-003 ) and is an NIHR Senior Investigator . AE is funded by the Wellcome Trust ( 200796 ) and supported by the Oxford Health NIHR Biomedical Research Centre and a NIHR Senior Investigator Award . The views expressed are those of the authors and not necessarily those of the National Health Service, NIHR, or Department of Health.

Publisher Copyright:
© 2022 The Authors

Keywords

  • Dissociation
  • Network analysis
  • Perseverative thinking
  • Psychological mechanisms
  • Self-efficacy

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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