Relations among psychological trauma, dissociative phenomena, and trauma-related distress: a review and integration

Clin Psychol Rev. 1999 Aug;19(5):631-57. doi: 10.1016/s0272-7358(98)00103-2.


Recently, there has been a resurgence of interest in relations among psychological trauma, dissociative phenomena, and various forms of trauma-related distress that has spawned a prolific amount of research. To date, a relatively comprehensive review of this recent research is lacking. Thus, this paper provides such a review to help summarize and synthesize recent findings, illuminate study limitations, and offer suggestions for future research. In general, findings have revealed fairly strong and consistent relations among the constructs of trauma, dissociation, and trauma-related distress (e.g., posttraumatic stress disorder, borderline personality disorder, bulimia); individuals who have experienced a traumatic event are more likely to dissociate than individuals who have not, and individuals who experience more dissociative phenomena are more likely to also experience higher levels of trauma-related distress. It is theorized here that dissociative phenomena and subsequent trauma-related distress may relate to fears about death and fears about loss or lack of control above and beyond the occurrence of the traumatic event itself. Such fears about death and loss/lack of control may also help differentiate traumatized individuals who psychologically suffer to varying degrees. Possible functions of dissociation in response to trauma and in relation to forms of trauma-related distress are considered and discussed.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adaptation, Psychological*
  • Borderline Personality Disorder / complications
  • Bulimia / complications
  • Dissociative Disorders / etiology
  • Dissociative Disorders / psychology*
  • Humans
  • Stress Disorders, Post-Traumatic / etiology*
  • Stress, Psychological / psychology*