Trial reportPsychological medicine2025
Is dissociation predicting the efficacy of psychological therapies for PTSD? Results from a randomized controlled trial comparing Dialectical Behavior Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT).
Trial report in Psychological medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed.
- Do subjective and objective baseline sleep disturbances predict post-traumatic stress disorder treatment response? A secondary analysis of a randomized controlled trial.European journal of psychotraumatology · 2026Trial
- The experience of professionals receiving patients with manifestations of traumatic dissociation: a qualitative study.European journal of psychotraumatology · 2026Article
- The relationship between complex PTSD and dissociation: longitudinal findings across Western and South Asian female samples.Social psychiatry and psychiatric epidemiology · 2026Article
- Dissociative Identity Disorder and Partial Dissociative Identity Disorder.Deutsches Arzteblatt international · 2026Review
- Emotion dysregulation and dissociation mediate the association between alexithymia and depressive symptoms in individuals with alcohol use disorder.Alcohol and alcoholism (Oxford, Oxfordshire) · 2026Article
- Fluctuations of dissociation and inner tension during inpatient dialectical behavior therapy: associations with self-injury and suicidal ideation.Borderline personality disorder and emotion dysregulation · 2026Article
- PTSD, complex PTSD and the dissociative subtype of PTSD in patients with eating disorders.Journal of eating disorders · 2025Article
- Psychometric Properties of the Arabic Dissociative Symptoms Scale-Brief Across Five Arab Countries.Public health challenges · 2025Article
- Toward an Experimental Model to Study Dissociation in the Laboratory: Current Challenges and a Path Forward.Biological psychiatry global open science · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeuropsychological evidence suggests that dissociation might disturb emotional learning, which is a fundamental mechanism of psychotherapy. However, a recent meta-analysis on the impact of dissociation on treatment outcomes in psychotherapy trials for posttraumatic stress disorder (PTSD) reported inconsistent results and concluded that further high-quality clinical trials are needed to test whether dissociation affects the efficacy of psychotherapies. We had two main aims: First, to test whether the efficacy of two evidence-based psychotherapies for individuals with trauma-related PTSD is affected by the level of pretreatment dissociation. Second, we investigated whether a significant reduction in dissociation at an early stage of treatment is beneficial for subsequent efficacy.
methodsThe potential impact of dissociation on efficacy was studied in 193 women with PTSD related to childhood abuse who were randomized to dialectical behavior therapy for PTSD (DBT-PTSD) or cognitive processing therapy (CPT). Efficacy was operationalized as a change in the Clinician-Administered PTSD Scale (CAPS). Dissociation was assessed with the Dissociation Tension Scale (DSS). The analyses accounted for major confounders (in particular initial PTSD severity).
resultsTwo main findings emerged from this study. First, baseline dissociation was a negative predictor for treatment efficacy. Second, a significant drop in dissociation at the initial stages of treatment was beneficial for subsequent efficacy.
conclusionsDissociation likely reduces the efficacy of trauma-focused therapies. Accordingly, successful reduction of dissociation at an early stage of treatment assists the efficacy of trauma-focused psychotherapies.
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