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Behaviour Research and Therapy 39 (2001) 245–254 www.elsevier.

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The causal link between self-reported trauma and dissociation: a critical review
Harald Merckelbach *, Peter Muris
Department of Psychology, Maastricht University, Maastricht, The Netherlands Received in revised form 2 December 1999

Abstract The idea that traumatic experiences cause dissociative symptoms is a recurrent theme in clinical literature. The present article summarizes evidence that cast doubts on the commonly voiced view that the connection between self-reported trauma and dissociation is a simple and robust one. It is argued that: (1) the correlations between self-reported traumatic experiences and dissociative symptoms reported in the literature are, at best, modest; (2) other factors may act as a third variable in the relationship between trauma and dissociation; and (3) high scores on the Dissociative Experiences Scale are accompanied by fantasy proneness, heightened suggestibility, and susceptibility to pseudomemories. These correlates of dissociation may promote a positive response bias to retrospective self-report instruments of traumatic experiences. Thus, the possibility that dissociation encourages self-reported traumatic experiences rather than vice versa merits investigation. While attractive, simple models in which trauma directly causes dissociation are unlikely to be true. © 2001 Elsevier Science Ltd. All rights reserved.
Keywords: Dissociative experiences; Trauma; Fantasy proneness; Memory

1. Introduction According to Bernstein and Putnam (1986, p. 727), “dissociation is the lack of normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory”. A similar definition of dissociation can be found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, American Psychiatric Association, 1994). DSM-IV considers phenomena like derealization, depersonalization, and psychogenic amnesia as examples of dissociation. One widely used measure for assessing such symptoms is the Dissociative Experiences Scale (DES;
* Corresponding author Tel.: +31-43-3881945; fax: +31-43-3615735. E-mail address: h.merckelbach@psychology.unimaas.nl (H. Merckelbach).

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. Anderson. Chu. Loewenstein. It is structured as follows. our knowledge of these correlates has increased considerably. Roth. The third and final section concludes that the link between trauma and dissociation may be more complex than many clinicians have proposed. p. a chronic reliance on dissociative defenses as a way of coping with stressful events would contribute to psychopathology (e. Dill. McFarlane. Mark the line to show what percentage of the time this happens to you”. Scores are then averaged across items to obtain a mean DES score. Coons. 1995). The authors cited above also provide a clear rationale for why trauma generates dissociation. dissociation would promote the compartmentalization of traumatic experiences and. Ross. The first section briefly summarizes studies that have looked at the associations between trauma and dissociation as well as studies that have identified factors that may modulate these associations. Berkowitz. Van der Kolk.. Carlson. In particular. A recurrent theme in clinical literature is that traumatic experiences cause dissociative symptomatology. 1989. and Herman (1996.246 H. It is important. and Schwartz (1993). Chinman. P. Likewise. Over the past few years. & Spiegel. Even a quick literature search shows that since 1980. fantasy proneness) are especially relevant because they may undermine the accuracy of retrospective measures of self-reported trauma. we focus on individual studies that we believe to be exemplary for this domain of research. Referring to the work of Chu and Dill (1990) and Saxe. thus. Instead. As Frankel (1996) pointed out. the commonly voiced view that there exists a robust and direct link between trauma and dissociation is attractive because of its elegant simplicity. 673) claim that “numerous clinical studies have established that elevated levels of dissociation are significantly associated with histories of antecedent trauma”. Lieberg. Koopman. The present article critically evaluates this type of study. Bowman. Illustrative examples of DES items are: “Some people have the experience of finding themselves in a place and having no idea how they got there. We do not attempt to provide an exhaustive review of this burgeoning literature. a self-report scale that asks respondents to what extent they experience 28 dissociative phenomena. Merckelbach.g. Mark the line to show what percentage of the time this happens to you“ and “Some people have the experience of not being sure whether things that they remembering happening really did happen or whether they just dreamed them. and Braun (1996. 85) conclude that “numerous studies have demonstrated a strong relation between trauma and dissociative symptoms”. The second section reviews studies that explored the psychological correlates of dissociation. Hall. By this view. reduce their impact.g. Pelcovitz. . Torem. Putnam. Van der Kolk. 1993). though. Respondents indicate on 100-mm visual analog scales the frequency with which they experience the phenomena described by the items. Mandel. hundreds of articles about trauma and dissociation have been published.. Putnam. More specifically. 1986).g. Classen. Clark. these authors then go on to argue that “two studies examining the psychological profiles of patients with high scores on the Dissociative Experiences Scale found that the scale scores were highly correlated with reported childhood histories of trauma”. Some of these correlates (e. Van der Kolk & Fisler. p. Muris / Behaviour Research and Therapy 39 (2001) 245–254 Bernstein & Putnam. For example. They conceptualize dissociation as an initially adaptive response to traumatic events (e. the possibility that dissociation acts as an antecedent of self-reported trauma warrants serious attention. to emphasize that the primary source of evidence for this view comes from cross-sectional studies that obtained both self-reports of traumatic experiences and DES scores in clinical or nonclinical samples.

g. 809).21. Mulder. Chaves. Ganaway. 1998. p. Walker. Zlotnick.. 1996. A similar conclusion can be drawn from a recent community study by Mulder et al. Joyce. Tromovitch. Shea. have not been uniformly found. these correlations attained significance. P. Merckelbach. Due to the large sample size. Simpson. (1998) findings call into question the simple trauma–dissociation model that is often advocated in clinical literature. small. Accordingly. as several authors (e. It may well be the case that individuals with dissociative symptoms and a history of childhood abuse are more likely to enter treatment programs than people who display dissociative symptoms. Costello. However. A case in point is a study by DiTomasso and Routh (1993) that relied on a large sample of undergraduate students (N=312). these authors also observed that the connection between self-reported sexual abuse and dissociation disappears when a measure of family pathology (i. The correlation between sexual abuse and the DES was 0. This suggests that the connection between trauma and dissociation may be modulated by family pathology and is more complex than has previously been assumed.. 1998) have pointed out. 1999). Engel. respondents’ perceptions of their parents) is entered as a covariate in the analyses. and Powell (1999) .40 between a self-reported history of childhood sexual abuse and scores on the DES in a sample of 148 female psychiatric inpatients.g. Hulsey. 1996). correlations of the magnitude reported by Zlotnick et al.H. For example. (1993) and the Mulder et al. Students were asked to complete self-report scales of sexual and physical abuse as well as the DES. A similar point was raised in a recent review by Lilienfeld. Schmeidler. Sarbin. Chu. Nash. & Fergusson. This co-occurrence of dissociation and trauma self-reports has been documented for various patients groups (e. both the Nash et al.e. 1996. Pope & Hudson. That study was based on a randomly selected sample of over 1000 individuals. The link between trauma and dissociation A number of clinical studies noted significant correlations between self-reported traumatic events and dissociation as indexed by the DES. Yet. Harralson. Elkin. and Begin (1996) reported a correlation of 0. & Matthews.. p. & Katon. dissociation in Holocaust survivors is not simply a consequence of having experienced severe trauma” (Yehuda et al. 1995. Kahana. and Lambert (1993) noted in a mixed sample of women with and without psychiatric complaints (N=105) that women with a self-reported history of sexual abuse scored significantly higher on dissociation measures than women without such a history. the meta-analysis conducted by Rind. Ganzel. Lynn. of course. Indeed. Binder-Brynes. a low (and this time non-significant) correlation between exposure to traumatic experiences and dissociation was even observed in a study concerned with dissociative symptoms of Holocaust survivors (Yehuda. (1998). Muris / Behaviour Research and Therapy 39 (2001) 245–254 247 2. but their magnitude is. such clinical findings should be interpreted with caution. Pearlstein. Thus. 938). DES as well as data about psychiatric symptoms and childhood abuse were obtained and subjected to logistic regression modeling. & Giller. Beautrais. However. This finding nicely fits with the idea that trauma is an important antecedent of dissociation. the authors concluded that “in contrast to current dogma. The authors found that “any causal influence of childhood sexual abuse on dissociation is likely to be indirect and mediated by more general linkages between childhood sexual abuse and risks of mental disorder” (Mulder et al. Sexton. Frey.18. Kirsch. while that between physical abuse and the DES was 0. Furthermore.. and Bauserman (1998) indicates that such a modest assocation between self-reported abuse and dissociative symptoms is typical for college samples. Southwick. but have no history of childhood abuse..

g.10). 3. An expert blind as to the patients’ scores on the self-report trauma questionnaire and the DES evaluated these patients records in terms of indications for trauma. One distinct possibility that should be considered is that high DES individuals display a positive response bias on retrospective self-report indices of trauma. More specifically. 1999)..50). An interesting aspect of the Sanders and Giolas (1991) study is that these authors had access to the hospital records of the patients (including therapy notes and information concerning family background and history). Fantasy proneness refers to a deep and profound involvement in fantasy and imagination (e. 1995. Joshi. 1988). Lynn & Rhue. Silva & Kirsch.g. but modest (r=0. the correlation between sexual abuse and DES was significant. 1992. Rauschenberg & Lynn. The considerable overlap between dissociation and fantasy proneness has important ramifications.63 (Merckelbach et al. Fantasy proneness may compromise the veridicality of retrospective reports of traumatic events (e. 1995. fantasy proneness could either lead to a tendency to confuse memories that derive from real autobiographical episodes with those that derive from fantasies or it could lead to the adoption of a liberal criterion . Rauschenberg & Lynn. a negative correlation emerged between sexual abuse ratings based on hospital records and DES scores (r= 0. (1993) results. 1988. Dissociation. Horselenberg. the correlation between negative family atmosphere and DES was considerably higher (r=0... Research shows that most fantasy prone individuals are well adjusted persons without overt psychopathology (Lynn & Rhue. Evidence consistent with this possibility comes from three separate research lines. the studies cited in this section demonstrate that the connection between trauma and DES is not that robust and uncomplicated as has often been suggested in clinical literature. In line with the DiTomasso and Routh (1993) study.. Merckelbach. 1992) to 0. depersonalization–derealization and activities of dissociated states.248 H. Meanwhile.e. Wilson and Barber. Muris. Bryant.21. & Currie. Sanders and Giolas (1991) had a group of adolescent psychiatric patients (N=47) complete the DES and retrospective self-report measures of abuse and family atmosphere. a finding that accords well with the Nash et al. but also for those DES factors that are thought to be powerful predictors of dissociative psychopathology (i. 1995). correlations between DES total scores and fantasy proneness range from 0. Curiously enough.42 (Silva & Kirsch. 1983).26). Ross. Muris. 1999). One clearly established individual difference correlate of dissociation is fantasy proneness (e. Muris / Behaviour Research and Therapy 39 (2001) 245–254 who concluded that the evidence for a straightforward connection between childhood abuse and dissociative disorders is less compelling than previously believed. Merckelbach. & Rassin. and Stougie (2000a) noted that the significant association between fantasy proneness and DES is not only evident for the particular DES factor that taps relative benign experiences of absorption and imaginative involvement. P. p=0.. The first research line pertains to individual difference correlates of dissociation. For college students’ samples. then.g. 1991). Merckelbach. To sum up. confabulation and suggestibility It is worth asking why Sanders and Giolas (1991) found a positive and significant correlation between self-reported sexual abuse and DES and a negative correlation reaching borderline significance between abuse ratings based on hospital records and DES.

Muris. two types of errors could occur during the recognition test: source monitoring errors (confusing photographs with paragraphs and vice versa) and false positive response errors (identifying an item as part of the previously seen slide series when it was not). whether items had been presented as photograph or paragraphs. high scores on DES and fantasy proneness were accompanied by a raised frequency of false recognition errors. The second possibility refers to a confabulatory tendency or. & van Koppen. in other words. Garry. P. The first possibility refers to source monitoring problems of the sort described by Johnson. undergraduate subjects completed a so-called Life Events Inventory (LEI. controlling for fantasy proneness reduced the correlation between DES and positive responses on the LEI to practically zero. suggests that high DES scores are accompanied by an inclination to report negative events. These studies relied on the Gudjonsson Suggestibility Scale (GSS. respectively). a null finding that replicates the negative results of Van den Hout. A similar conclusion can be drawn from the work of Johnson. a positive response bias of the type described by Roediger. Positive correlations were found between DES and scores on the Bad Things Scale (r’s 0. These authors had subjects complete a Bad Things Scale that contained items describing mildly aversive events like “I have been short changed in stores” and “I have helped friends and not been helped in return”. During a post-experimental recognition task.40 and r=0. Thus.. Briefly. partialling out the contribution of fantasy proneness attenuated the correlation between DES and false positive responses.53. Manning. Merckelbach. Neither DES scores nor fantasy proneness scores were found to be related to source monitoring errors. In this study. Merckelbach. Wessel. Both DES and fantasy proneness were associated with a positive answer tendency on the LEI (r=0. Wheeler. Fellows. However. these findings suggest that high DES individuals exhibit a positive response bias that is strongly linked to their heightened levels of fantasy proneness. Merckelbach. Subjects indicated how certain they were that the LEI items had happened to them before the age of 10. Merckelbach and colleagues (2000a) sought to determine whether the positive response bias of high DES individuals also extends to autobiographical memory. Next. both DES and fantasy proneness were significantly correlated with false positive response errors (r=0. 2000b). Merckelbach and colleagues (2000a. 1996).H. “I went with my school to Disneyland”). but highly specific events (e. Rassin. Muris / Behaviour Research and Therapy 39 (2001) 245–254 249 for reporting past events. 1998. subjects had to indicate whether or not they had seen particular items and if so. respectively). That is. Loftus. and Pool (1996). & Bull. Hashtroudi. Thus. & Sherman. and Danko (1995) and Irwin (1998). Muris. A second research line that bears relevance to the idea that high levels of dissociation might be conducive to memory or report biases consists of studies that looked at the relationship between interrogative suggestibility and DES (Ost. To examine these alternatives. Gudjonsson. 1998. Yet. an inventory that consists of a large number of relatively neutral. and Lindsay (1993). again. the subject has to answer a set of questions about the narrative. and Rajaram (1993). & Horselenberg. Some of the slides were photographs of common objects. Edman. Following this. All in all. 1997. which.g. Wolfradt & Meyer.26. the GSS consists of a short narrative that is read out to the subject. 1992) which measures subjects’ susceptibility to memory or report biases under conditions of post-hoc misinformation and social pressure. the subject is told that he/she made many mistakes and that the questions should be answered once again.39 and r=0. some of which are misleading and contain misinformation about the narrative. In a second experiment. Interestingly. Study 1) exposed undergraduates to a series of slides. two measures can be derived from the GSS: the tendency to give in to misleading questions . while others consisted of paragraphs describing an object. Merckelbach.40).

. To begin with. 4. Burgess.. DiTomasso & Routh. Almost 25% of the subjects created a pseudomemory in response to the fictitious retrieval prompts. Merckelbach. Thus. DES has been found to correlate with GSS scores. Joseph. 2000b) and 0. Chan.53 (Wolfradt & Meyer. and Lerner (1994. In this review. simple trauma–dissociation models assume that there exists a robust linkage between measures of trauma and dissociation. Burgess.36 and r=0. Conclusion A burgeoning literature on dissociation and trauma has appeared over the past decade. 405) summarized the implication of this as follows: “dissociation confounds the accuracy of reports of early trauma. family pathology) may operate in the connection between trauma and dis- . on the one hand. most studies in this domain support the idea that dissociative subjects tend to adopt a low criterion for accepting a memory as authentic. Putnam et al. and high levels of dissociation as indexed by the DES. Spanos. but some studies have found evidence to suggest that a third variable (i. these studies have found that imagining low probability childhood events inflates subjects’ confidence that these events actually had occurred. simple trauma–dissociation models assume that the causal link between antecedent trauma and dissociation is fairly direct. Terranova. 1996). and Glover (1998) demonstrated that DES scores predict the tendency to falsely recognize distracters in a traditional word list memory task. 1993).48. Subjects were led to believe that the fictitious event had also been supplied by their parents and were encouraged to recall that event. One recurrent theme in this literature is the idea that traumatic childhood experiences constitute a direct pathway to dissociative symptoms (e. 1999. Manning.e. indicating that high scores on fantasy proneness and dissociation reflect a heightened receptivity to pseudomemories. 1999). Secondly. we made an attempt to explain why this evidence is ambiguous. In general.. p. notably with the Yield subscale of the GSS. However. This point is further underlined by studies examining the phenomenon of imagination inflation (Heaps & Nash. both fantasy proneness and DES were linked to pseudomemory creation (r=0. but not all studies have come up with substantial correlations between such measures (e. Ross. dream.. Tillman. 1998).. Peluso. serve as the major source of evidence for this view. Hyman and Billings (1998) asked students to recall autobiographical events that had been reported by their parents to the researchers. In summary.g.g. an effect that is more pronounced in subjects with high DES scores. although exceptions have been reported (e. and mnemonic experience”. the studies cited in this section converge on the notion that dissociation is associated with an array of features that may compromise the veridicality of autobiographical accounts. P. Using a somewhat different approach. 1993. Classen et al. Nash.30 (Merckelbach et al. Most interestingly. & Blois. Pearson product–moment correlations between DES and the Yield subscale range between 0. This indicates that high DES individuals are susceptible to misleading post-hoc information.. dissociative symptomatology may predispose some patients to confound fantasy. Paddock. 1998). Studies that found a connection between self-reported traumatic childhood experiences. Winograd. 1997. on the other hand.250 H. retrieval cues referring to a fictitious event that subjects had never experienced were embedded in the series of true retrieval cues. Muris / Behaviour Research and Therapy 39 (2001) 245–254 (termed Yield) and the tendency to alter accounts as a result of social pressure (termed Shift). & Loftus.. that is. Samuels. respectively).g. A third research line that should be considered has to do with the experimental analysis of pseudomemories.

superstition and spiritualism) and DES.g. suggestibility. state anxiety (r=0. 2000a). For example. Merckelbach. On the basis of studies reviewed above. Ross & Joshi. 1996. dissociative identity disorder). it seems self-evident that due to certain personality traits. a rigorous test of the idea that childhood trauma is responsible for a whole spectrum involving dissociation. One could argue. trait anxiety (r=0. Irwin. Still.g. Andrews. with the latter manifesting itself in paranormal experiences and beliefs (e. some people are less accurate in their self-reports of autobiographical childhood events than are other people.g.g. see also Irwin. More specifically. 1997) have recommended the DES as a screening instrument for severe dissociative pathology (e. 1995. precognition etc. is likely to yield a large number of false positives for dissociative disorders” (Sandberg & Lynn. The by now well-established fact that the DES strongly correlates with these traits has important ramifications for our understanding of the causal links between trauma and dissociation. these correlates of the DES suggest the possibility that high dissociation may lead to an overreporting of traumatic incidents. the fact remains that both suggestibility and fantasy proneness may undermine the accuracy of self-reported childhood traumas...75. it is fair to conclude that the DES taps a wide diversity of traits that do not necessarily possess a pathological quality (e. but also to reports of supernatural experiences (e. Muris / Behaviour Research and Therapy 39 (2001) 245–254 251 sociation (Nash et al.. De Silva & Ward. 1993. 1998). P. one possible exception being the study of Sanders and Giolas (1991) who reported results that are difficult to accommodate by a simple trauma–dissociation model (cf. 1995. of course. Wolfradt (1997) found strong associations between certain forms of paranormal belief (e. These authors concluded that “the DES. Hacking. an interpretation for that matter that awaits further empirical testing (e. studies that are cited as evidence for the idea that trauma causes dissociation often relied on the DES.. 1995). 722). and fantasy proneness would require studies that seek independent verification of childhood trauma. 1998). neuroticism (r=0.g. & Hetherington. First.. Aside from its association with fantasy proneness. the DES has been found to be linked to cognitive failures (r=0.. Merckelbach et al. 1996. Consistent with this is the finding that high DES scores are not only related to self-reports of childhood trauma.53. and schizotypy (r=0. suggestibility. In their scholarly review. Lawrence. 1992.g. However.g. some authors (e. fantasy proneness) that may compromise the accuracy of retrospective self-reports of trauma (Merckelbach et al. that a history of childhood trauma may give rise to dissociative symptoms. This may be especially true for traits like fantasy proneness and suggestibility. Frankel. Yet. 1995). and Gotlib (1993) argued that the unreliability of retrospective self-report instruments should not be exaggerated. Barraclough. Ross. Hacking. To the present authors’ knowledge such studies have not yet been undertaken. Three final comments are in order. 1992. in the final analysis. it is easy to see why this is the case: the overlap between the DES and relatively benign traits such as fantasy proneness is considerable.H. Edwards. 1999).. a study of Sandberg and Lynn (1992) demonstrated that only a small minority (6%) of individuals scoring in the upper 15% of the DES meet the criteria for a dissociative disorder. Thus.g. telepathy. 1993). see also Holtgraves & Stockdale. Brewin. Thus. Thirdly and most importantly.. Wolfradt & Meyer. 1992). Ross & Joshi. this point raises fundamental questions about . Frankel. and fantasy proneness. 1998).66.. Church. 1997. 1990.57. Apart from its ramifications for clinical decision making.48. but this measure overlaps with personality features (e. The hypothesis that trauma causes dissociation provides only one interpretation. 1998). Bauer & Power. Van IJzendoorn & Schuengel.. Wolfradt & Meyer. 1996).. p. Thus. 1990. the connection between self-reported trauma and dissociation is open to multiple interpretations. supra). when used with nonclinical samples..

. Vandereycken.252 H. & Putnam. (1996).. for an analysis of this type of problem. Vanderlinden. amnesia. E. Bauer. (4th ed. Manning. J. 109–117). Weiss. To the extent that the new dissociation measures do correlate with these traits. (1990). American Journal of Psychiatry. & Dill.g. Bernstein. & Sherman. Metzler. 40. Garry. Engel. Development. Chu. 749–755.. Memories of childhood abuse: Dissociation. Over the past few years. H. & Katon. Journal of Nervous and Mental Disease. & Spiegel. . F. One of them is that established correlates of dissociation (e. Vanderlinden. A. Bryant. Frankel. Dissociative experiences and psychopathological symptomatology in a Scottish sample. Bulletin of the Menninger Clinic. L.. Stanley. 113.. P. 156. (1996). their results are open to alternative interpretations. 1991. & Van der Hart.). L. B. M. K. and schizotypy. A. 8. DC: APA. C. E. J. 82–98. & Gotlib. W. E... A. (1993). K. Nijenhuis. & Vertommen. M.g. & Pearl. (1995). & Ward. D. DiTomasso. J. F. 147. O. However. 477–485. New York: Wiley. & R.. and validity of a dissociation scale.. new dissociation measures have been developed and published (e. Dissociative symptoms in relation to childhood physical and sexual abuse. & Matthews. (1986). peritraumatic dissociation) are predictive of the subsequent development of Post Traumatic Stress Disorder (PTSD) symptomatology. Psychonomic Bulletin & Review. & Power. C. G. 209–219. Personality and Individual Differences. Trauma and dissociation. Chu. 147. Titchenor. H. It is difficult to evaluate whether these new measures have any additional value over and above the DES until studies have explored their intercorrelations with fantasy proneness. 857–859. 1998). Merckelbach. B. 17. Psychological Bulletin.e. C. A. Dissociation: The clinical realities. (1995). Contemporary International Hypnosis (pp. J. Factors related to dissociation among patients with gastrointestinal complaints. D. I. Walker. fantasy proneness) contribute to the connection between peritraumatic dissociation and self-reported PTSD symptoms. Frey. M. (1999). (1990). and corroboration. 153. In G. D. A.. L. 823–829. 3. J. J. 174. (1996).. C. Washington. C.. Frankel. Personality correlates of dissociative experiences. M. Hypnotizability and dissociation. Spinhoven. Licht. Nicholls.. Dissociation. they also suffer from the problematic features that were addressed in the current article. M. cognitive failures. Van Dyck. W. R... Imagination inflation: Imagining a childhood event inflates confidence that it occurs. neuroticism. Burrows. A. (1993). Andrews. 178–194. as these studies heavily relied on retrospective reports of dissociation and PTSD symptomatology. 727–735. Child Abuse & Neglect. Brewin. American Journal of Psychiatry (Festschrift Supplement). Ganzel. D. 887–892. (1993). Secondly. 14. Marmar. Muris / Behaviour Research and Therapy 39 (2001) 245–254 the manner in which the DES operationalizes the construct of pathological dissociation (see. 64–70. Psychopathology and early experience: A reappraisal of retrospective reports. M. References American Psychiatric Association (1994). 1982).g. 1996) found that dissociative reactions at the time of trauma (i. 27. R.. American Journal of Psychiatry. (1993). 208–214... A third and final remark has to do with concurrent measures of dissociation. Koopman. G. Van Dijck. a number of recent studies (e. & Routh. American Journal of Psychiatry. J. S. Recall of abuse in childhood and three measures of dissociation. H. Journal of Psychosomatic Research. De Silva P. F. reliability. C. A. & Ronfeldt. Diagnostic and Statistical Manual of Mental Disorders. Fantasy-proneness and recall of childhood abuse. Loftus. F.. Classen.. anxiety. 643–653.

18.. (1996)... (1998). P.. 1–20.. Muris. Manning. A. Journal of Traumatic Stress... Dissociative tendencies and the sitting duck: Are self-reports of dissociation and victimization symptomatic of neuroticism? Journal of Clinical Psychology. (1995).. C. & Rhue.. P. Dill. 1005–1015. J. P. When guided visualization may backfire: Imagination inflation and predicting individual differences in suggestibility. 363–381. 806–811. A. Contemporary Hypnosis. & van Koppen.. R. Sarbin. (1998). C. Clark.. 43. Spinhoven. E. D. & Lindsay. H. M. Vanderlinden. Terranova. Personality and Individual Differences. (1995). E. R. P. 114. Journal of Psychiatry & Law. Hacking. D. Wessel. 155. K. Psychonomic Bulletin & Review. P. J. Johnson.. childhood sexual abuse. F. J. Psychological Bulletin. 184. J. 61. B... Coons. The psychology of interrogations. P.. Putnam. Johnson. T. Sexton. Journal of Consulting and Clinical Psychology. 125. R.. Does childhood sexual abuse cause adult psychiatric disorders? Essentials of methodology.. S. G. O.. Lilienfeld. (1988). Individual differences and the creation of false memories. Dissociative identity disorder and the sociocognitive model: Recalling the lessons of the past. psychopathology. & Powell. Barraclough. Merckelbach. Memory. Applied Cognitive Psychology (Supplement).. 3–28.. (1998). R. P.. 203–210. F. 673–679. New Jersey: Princeton. Relationship between dissociation. 132–137. American Journal of Psychiatry. R.. S. R. Mulder. Putnam. and mental illness in a general population sample. Source monitoring. (1999). M. developmental antecedents. Merckelbach. Muris / Behaviour Research and Therapy 39 (2001) 245–254 253 Gudjonsson. I. Ost. G.. E. 14. (1989).. & Van der Hart. B. Kirsch. The Gudjonsson Suggestibility Scale (GSS): Further data on its reliability. 107. Psychological Bulletin.. and metacognition correlates. Edwards. (1993). H. & Fergusson. Chan. 2. F. Joyce. C.. Ganaway. reality monitoring. J. S. Torem. (2000a). L. M. Lynn. W. A. L. . Patterns of dissociation in clinical and nonclinical samples. S. (1998).. Individual differences in imagination inflation. Personality and Individual Differences.. I.. Some dangers of using personality questionnaires to study personality. (1998). S. validity. (2000b). S. & Hudson. J. Somatoform dissociative symptoms as related to animal defensive reactions to predatory imminence and injury. L. Dissociation. & Lambert. Irwin. Chu. (1992). Paddock. J.. T. Nicholls. D. 12. Pope. & Billings. 350–444. L. & Stougie. C. and dissociation. J. Loewenstein. S.. B. Bowman. Harralson... R. F. & Danko. T. I.H. J. & Pearl. Pierre Janet and modern views of dissociation. 793–795. F. R. H. Individual differences and the suggestibility of human memory. validity. Personality and Individual Differences. Anderson. M. G. Personality and Individual Differences. T. J. C. F. (1982). Merckelbach. Hashtroudi. Chaves. E. Beautrais. and testimony. H. Social Behavior and Personality.. R. 6. P. T. O. W. G. G. 413–429. E. F. Fantasy proneness and cognitive failures as correlates of dissociative experiences. I. J.. and psychopathology. (1993).. Lawrence.. 507–523. Journal of Abnormal Psychology. 313–318.. G. & Hetherington.. P. 63–73. T. N. L. E. R... 63–75. Carlson.. Hulsey. Heaps. & Nash. (1997). & Horselenberg. I. Modelling childhood causes of paranormal belief and experience: Childhood trauma and childhood fantasy. Edman. & Braun.. A. 26. Personality and Individual Differences (in press) Merckelbach. H. W. 23.. & Bull. J. and factor structure of the dissociative experiences scale. 961–967.. (1998). (1995). Muris. Chichester: Wiley. The assessment of dissociative experiences in a non-clinical population: Reliability. W. 572–580. & Loftus. 699–706.. M.. S. S. G. Hyman. L. confessions. J. Nijenhuis. Personality and Individual Differences. 22. childhood physical abuse. & Stockdale.. Fantasy proneness: Hypnosis. Horselenberg. Lynn. Nash. Ross. 92. H. S.. and response bias. American Psychologist.. Psychological Bulletin. P. Merckelbach.. Dissociative experiences and interrogative suggestibility in college students. Muris. Holtgraves. 26. B. R. (1997).. (1995). K. J. Fellows. A... (1999). A. M. Rewriting the soul: Multiple personality and the sciences of memory. Self reported negative experiences and dissociation. Rassin. Muris. P. G. 49–58. Church. 28. M... Journal of Nervous and Mental Disease. Long-term sequela of childhood sexual abuse: perceived family environment. H.... 54. C. Licht. Van Dijck. 19. G. E. (1999). H.. J.. R. & Rassin. 209–215. R. 276–283. R. 6. Joseph.

Dissociative experiences. 101... somatization. (1991). Hospital and Community Psychiatry. (1996).. Applied Cognitive Psychology.. Remembering. New York: Academic Press. III. Dissociation. (1992). D. C.. J. Dissociative identity disorder: Diagnosis. P. A. Ross.. and thought suppression. knowing and reconstructing the past. & Lerner. (1996). Dissociation in aging Holocaust survivors.254 H. R. American Journal of Psychiatry. The Psychology of learning and motivation: Advances in theory and research (pp. Saxe. Dissociation: Clinical and Theoretical Perspectives (pp... W.. New York: Guilford. A. H. E. E. 395–413). A meta-analytic examination of assumed properties of child sexual abuse using college samples. impulsivity. Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study. Individual differences in susceptibility to memory illusions. L. Ross... (1994). M. Mandel. D. Vandereycken. and self-mutilation. Samuels... T. 425–432. 365–382. (1998). Fantasy proneness. Vanderlinden. Shea. Journal of Consulting and Clinical Psychology. M. Rhue. X. R. 124. H. Winograd. (1996). Journal of Personality and Social Psychology. J... The relationship between dissociative symptoms. DSM-III-r axis I psychopathology. Rind. Dissociation. sexual abuse.. 297–301. H.. Tillman. & Meyer. Costello. 505–525. Simpson.. E. (1991). R. L. & Giller. & Pool. S. Van der Kolk. M. A.. Merckelbach. S.. B. 153. & Bauserman. (1992). Psychological Bulletin. Wheeler. 357–361. 847–856.. and dissociation among anxious patients and normal controls. Journal of Abnormal Psychology.. M.. 8. R. Van Dyck. P. Journal of Abnormal Psychology. Elkin. 153. Wolfradt. 12. Silva. H. C. Titchenor. .. Van der Kolk. The relationship of peritraumatic dissociation and posttraumatic stress: Findings in female Vietnam theater veterans. and parapsychological phenomena. J. J. Dissociative disorders in psychiatric inpatients. B. & Lynn. C. W. Burgess. Paranormal experiences in the general population. Roth. 1037–1042. Imagery: Current Theory. N. (1983).. Clinical Psychology Review. Personality and Individual Differences. Interpretive sets.. Chinman. E. and Application (pp... Van der Kolk. L. trauma. R. New York: Wiley. American Journal of Psychiatry. B. Nash.. J. clinical features... A. trait anxiety. 50–54. S. C. Fantasy-prone personality: Implications for understanding imagery. Journal of Nervous and Mental Disease. (1997). Dissociation and childhood trauma in psychologically disturbed adolescents. Pelcovitz. Schmeidler. 5–27. & Fisler. 97–108. J. The measurement of dissociation in normal and clinical populations: Meta-analytic validation of the Dissociative Experiences Scale (DES). New York: Wiley. 180–184. 935–940.. & Glover. M. & Barber. Marmar. Dissociative experiences in the general population in the Netherlands and Belgium. Roediger. (1996). B. Kahana. (1998). G. Berkowitz. H.. Wilson. L. K.. 23. American Journal of Psychiatry. 15–19. A.. 37. Behavioural and Cognitive Psychotherapy. A. E. W. psychopathology and adjustment. and dissociation.. Applied Cognitive Psychology (Supplement). U. 1054–1059. 717–723. & Joshi. S.. Metzler. B. & Begin. A. Zlotnick. J. A. & Ronfeldt.. T. Sanders. (1992). McFarlane. Pearlstein.. D. Wolfradt. M. and treatment of multiple personality. & J.. and child and adolescent maltreatment in female college students. J. & Blois.. 201–218. G. In D.... S. Burgess. alexithymia. 25. 180. F. & Currie. P. A. Weiss. B. S. R. hypnosis. T. 340– 387). 373–380. 104.. (1991). A. Creating false memories of infancy with hypnotic and non-hypnotic procedures. & Lynn. S. A. (1995). & Giolas. In A. O. Sandberg. American Journal of Psychiatry. Interrogative suggestibility. 83–93. S. N. anxiety. C. & Vertommen.. 63. (1995). & Herman. P. S. Sheikh. Van Ijzendoorn. (1996). G. (1998). 64. & Schwartz. T. reality monitoring. & Rajaram. P. & Schuengel. Does trauma cause dissociative psychopathology? In S. R.. (1993). I. Southwick. A.. 22–53. (1997). 150.. Dissociative experiences. (1999). and affect dysregulation: The complexity of adaptation to trauma. 148. 97–103).. C. L. Joshi. V. D. K. Yehuda. Muris / Behaviour Research and Therapy 39 (2001) 245–254 Rauschenberg. A. M. M. C. Research. and dissociation as predictors of hypnotic response. K. U. 16. C. (1996). J. fantasy proneness. Comprehensive Psychiatry. Spanos. A. F.. T. 42. Dissociative experiences in the general population: A factor analysis.. 4. Hall. S.. 12–16. 24. Lynn. C. C. 13. expectancy. A. Dissociation. Lieberg. H. G. Binder-Brynes. M. Medin. Journal of Traumatic Stress. S. and paranormal beliefs. (1993). T. Ross. Tromovitch. Merckelbach. Van den Hout. Personality and Individual Differences. & Kirsch. J. M. Peluso.