Experimental induction of peritraumatic dissociation: The role of negative affect and pain and their psychophysiological and neural correlates

• Published in: Behaviour research and therapy Vol. 164; p. 104289
• Main Authors: Danböck, Sarah K., Franke, Laila K., Miedl, Stephan F., Liedlgruber, Michael, Bürkner, Paul-Christian, Wilhelm, Frank H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2023
• Subjects: Affect; Bayes Theorem; Dissociation; Dissociative Disorders; Female; fMRI; Humans; Negative-affect; Pain; Psychophysiology; Stress Disorders, Post-Traumatic - diagnosis; Trauma film; Trauma film; fMRI; Pain; Dissociation; Negative-affect; Psychophysiology
• ISSN: 0005-7967; 1873-622X; 1873-622X
• DOI: 10.1016/j.brat.2023.104289

While research has elucidated processes underlying dissociative symptoms in patients with posttraumatic stress disorder, little is known about the circumstances under which trauma-related dissociation initially arises. To experimentally investigate causes and concomitants of peritraumatic dissociation, we subjected sixty-nine healthy women to aversive-audiovisual and painful-electrical stimulation in a 2(aversive/neutral film) x 2(pain/no pain) within-subject design while recording psychophysiological and fMRI-BOLD responses. Afterwards, participants rated negative-affect, pain, and dissociation for each condition. Using Bayesian multilevel regression models, we examined (1) whether aversive-audiovisual and painful-electrical stimulation elicit higher dissociation-levels than control conditions and (2) whether stronger negative-affect and pain responses (operationalized via self-report, psychophysiological, and neural markers) correlate with higher dissociation-levels. Several key findings emerged: Both aversive-audiovisual and painful-electrical stimulation elicited dissociation. Dissociation was linked to higher self-reported negative-affect, but we did not find enough evidence linking it to psychophysiological and neural negative-affect markers. However, dissociation was associated with higher levels of self-reported pain, a skin-conductance-response-based pain marker, and the fMRI-BOLD-based Neurologic-Pain-Signature. Results indicate that both aversive-audiovisual and painful stimuli can independently cause dissociation. Critically, pain responses captured via self-report, psychophysiological, and neural markers were consistently linked to higher dissociation-levels suggesting a specific, evolutionary meaningful, contribution of pain to the rise of dissociation. •Both aversive-audiovisual and painful-electrical stimulation elicit dissociation.•Self-reported negative-affect is associated with dissociation.•Self-reported, physiological, and neural pain responses are linked to dissociation.•Pain might have a specific, evolutionarily meaningful, connection to dissociation.