The dissociative subtype of PTSD: a replication and extension

Depress Anxiety. 2012 Aug;29(8):679-88. doi: 10.1002/da.21946. Epub 2012 May 25.


Background: The nature of the relationship between dissociation and posttraumatic stress disorder (PTSD) has clinical and nosological importance. The aim of this study was to evaluate the evidence for a dissociative subtype of PTSD in two independent samples and to examine the pattern of personality disorder (PD) comorbidity associated with the dissociative subtype of PTSD.

Methods: Latent profile analyses were conducted on PTSD and dissociation items reflecting derealization and depersonalization in two samples of archived data: Study 1 included 360 male Vietnam War Veterans with combat-related PTSD; Study 2 included 284 female Veterans and active duty service personnel with PTSD and a high base rate of exposure to sexual trauma.

Results: The latent profile analysis yielded evidence for a three-class solution in both samples: the model was defined by moderate and high PTSD classes and a class marked by high PTSD severity coupled with high levels of dissociation. Approximately 15% of the male sample and 30% of the female sample were classified into the dissociative class. Women (but not men) in the dissociative group exhibited higher levels of comorbid avoidant and borderline PD diagnoses.

Conclusions: Results provide support for a dissociative subtype of PTSD and also suggest that dissociation may play a role in the frequent co-occurrence of PTSD and borderline PD among women. These results are pertinent to the on-going revisions to the DSM and suggest that consideration should be given to incorporating a dissociative subtype into the revised PTSD criteria.

Trial registration: NCT00032617.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Borderline Personality Disorder / epidemiology*
  • Combat Disorders / epidemiology
  • Comorbidity
  • Depersonalization / epidemiology
  • Dissociative Disorders / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Reproducibility of Results
  • Sex Offenses / statistics & numerical data
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Veterans / psychology
  • Veterans / statistics & numerical data

Associated data