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Dissociation and Dissociative Mechanisms in Panic Disorder, Obsessive–

Compulsive Disorder, and Depression: A Review and Heuristic Framework

Article in Psychology of Consciousness: Theory, Research, and Practice · November 2014

DOI: 10.1037/cns0000023

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Nirit Soffer-Dudek
Ben-Gurion University of the Negev
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 Dissociation and Dissociative Mechanisms in Panic Disorder, Obsessive-

Compulsive Disorder, and Depression: A review and heuristic framework

Nirit Soffer-Dudek, Ph.D.a

The full-text of the post-print (author’s personal copy) may be found

on the first author’s personal website at:
http://soffern.wixsite.com/soffer-dudek-lab-bgu/papers
However, that version may not exactly replicate the final version
published in the APA journal. It is not the copy of record. The copy of
record may be found at:
http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2014-32924-
001
and should be cited as:
Soffer-Dudek, N. (2014). Dissociation and Dissociative Mechanisms in
Panic Disorder, Obsessive–Compulsive Disorder, and
Depression: A Review and Heuristic Framework. Psychology of
Consciousness: Theory, Research, and Practice, 1, 243-270.
http://dx.doi.org/10.1037/cns0000023

Copyright for the definitive version belongs to the publisher: American

Psychological Association

a Dr. Nirit Soffer-Dudek is the head of the Consciousness States and Psychopathology

laboratory, at the Department of Psychology, Ben-Gurion University of the Negev.

Correspondence: P.O.B. 653 Beer-Sheva 8410501 Israel. Tel.: +972-8-642-8505. Fax:

+972-8-642-8348. Email: soffern@bgu.ac.il.

Dissociation and Dissociative Mechanisms in Panic Disorder, Obsessive-Compulsive

Disorder, and Depression: A review and heuristic framework

Abstract

Dissociative experiences predict increased symptoms, poor adherence to treatment, and

poor prognosis in several psychiatric conditions, including panic disorder (PD),

obsessive-compulsive disorder (OCD), and depression. Nevertheless, dissociative

experiences have been extensively studied and reviewed primarily in relation to the

dissociative disorders and post-traumatic stress disorder (PTSD), and often neglected in

other disorders. The purpose of this review was to (a) summarize existing research on

dissociative symptoms in psychopathologies other than the dissociative disorders and

PTSD; specifically, anxiety, OCD, and depression, and (b) to suggest specific

mechanisms through which these symptoms interact. A thorough search of the literature

revealed that dissociation is related to panic and other anxiety symptoms, obsessive-

compulsive symptoms, and depressive symptoms. Nevertheless, most extant research is

cross-sectional and precludes the determination of causality. In addition, many studies

report only general dissociation scores, despite the fact that dissociation is multifaceted.

Three models are proposed. Specifically, it is postulated that absorption is the

dissociative factor especially relevant to obsessive-compulsive disorder (OCD) due to

poor confidence in reality monitoring and that depersonalization and derealization are

the dissociative factors particularly relevant to both depression, due to sleep alterations,

and to panic, due to a combination of physiological and cognitive factors. Dissociative

amnesia is hypothesized to interact with OCD and depressive symptoms in different

ways. Practical suggestions for clinicians and researchers are offered.

 Keywords: Dissociation; Depression; Anxiety; Obsessive-Compulsive Disorder; Panic

Disorder.

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