Posttraumatic Stress Disorder and Dissociation in a Clinical Sample of Refugees in the Netherlands: Evidence for a Dissociative Subtype

Abstract

An increasing number of studies have been investigating the co-occurrence of posttraumatic symptoms and dissociation in trauma-exposed samples. As traumatized refugees are particularly susceptible to developing posttraumatic stress disorder (PTSD), the aim of this study was to investigate the relationship between PTSD and dissociation in a traumatized refugee sample. Cross-sectional data from a clinical refugee sample (N = 526) were collected. Latent class analysis (LCA) examined different classes of PTSD, based on the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) items. Subsequently, it was examined whether cumulative trauma, sexual trauma and general psychopathology predicted class membership. The LCA identified five classes. The classes were summarized as (1) “High PTSD,” (2) “Moderate PTSD,” (3) “High PTSD with high loss of interest,” (4) “High PTSD with moderate loss of interest,” and (5) “PTSD-DS.” PTSD DS (10% of the sample) was characterized by high PTSD symptoms, as well as high depersonalization and derealization symptoms. The majority (61.4%) of this group has been exposed to sexual trauma. Overall endorsement of PTSD symptoms was extremely high in this clinical sample of refugees. A group evidencing the PTSD dissociative subtype was identified.