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Psychol Med. 2018 Nov;48(15):2467-2476. doi: 10.1017/S0033291718000740. Epub 2018 Apr 10.

Dissociation in victims of childhood abuse or neglect: a meta-analytic review.

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Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg University,Mannheim J5, D-68159,Germany.
Department of Psychology,School of Social Sciences, University of Mannheim,Mannheim,Germany.
Department of Psychosomatic Medicine and Psychotherapy,Medical Faculty Mannheim/Heidelberg University,Mannheim,Germany.


Childhood abuse and neglect are associated with dissociative symptoms in adulthood. However, empirical studies show heterogeneous results depending on the type of childhood abuse or neglect and other maltreatment characteristics. In this meta-analysis, we systematically investigated the relationship between childhood interpersonal maltreatment and dissociation in 65 studies with 7352 abused or neglected individuals using the Dissociative Experience Scale (DES). We extracted DES-scores for abused and non-abused populations as well as information about type of abuse/neglect, age of onset, duration of abuse, and relationship to the perpetrator. Random-effects models were used for data synthesis, and meta-regression was used to predict DES-scores in abused populations from maltreatment characteristics. The results revealed higher dissociation in victims of childhood abuse and neglect compared with non-abused or neglected subsamples sharing relevant population features (MAbuse = 23.5, MNeglect = 18.8, MControl = 13.8) with highest scores for sexual and physical abuse. An earlier age of onset, a longer duration of abuse, and parental abuse significantly predicted higher dissociation scores. This meta-analysis underlines the importance of childhood abuse/neglect in the etiology of dissociation. The identified moderators may inform risk assessment and early intervention to prevent the development of dissociative symptoms.


Childhood abuse; childhood neglect; childhood trauma; dissociation; meta-analysis


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