Dissociative symptoms in alcohol-dependent patients: associations with childhood trauma and substance abuse characteristics.

OBJECTIVE Inconsistent findings have been reported concerning the level of dissociative symptoms and their relationship with childhood trauma in alcohol-dependent patients. The present study aimed to further examine the level of dissociation and the trauma-dissociation relationship in a sample of alcohol-dependent patients, taking potential mediating factors into account. METHOD A sample of 100 consecutively admitted inpatients with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were administered the Dissociative Experiences Scale, the Childhood Trauma Questionnaire, the International Diagnostic Checklist for posttraumatic stress disorder, the European Addiction Severity Index, and an additional questionnaire assessing the age at onset of different symptoms of alcohol dependence. RESULTS Substantial rates of childhood trauma were found. However, the mean Dissociative Experiences Scale score was low (9.0). Dissociative symptoms were significantly related to childhood emotional abuse; however, other forms of childhood trauma and posttraumatic stress disorder status were not. Younger age at onset of alcohol dependence was related to both childhood trauma and a higher level of dissociative symptoms. In a hierarchical linear regression model, emotional abuse was found to contribute to dissociation independent of potential chronic residual effects resulting from early onset of alcohol abuse as well as its chronicity or severity. CONCLUSION The findings support the idea that (clinically significant) dissociation is relatively uncommon in alcohol-dependent patients. Yet, when it occurs, dissociation is associated with childhood emotional abuse independent of chronic alcohol abuse. In addition, patients with an earlier onset of alcohol dependence could be more similar to patients with other substance-related disorders with regard to levels of dissociation.