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J Trauma Dissociation. 2015;16(5):500-19. doi: 10.1080/15299732.2015.1022925. Epub 2015 Sep 17.

Trauma-Related Altered States of Consciousness (TRASC) and Functional Impairment I: Prospective Study in Acutely Traumatized Persons.

Author information

1
a Departments of Psychiatry and Psychology and Graduate Program in Neuroscience , Western University , London , Ontario , Canada.
2
b Faculty of Nursing , The University of Alberta , Edmonton , Alberta , Canada.
3
c Department of Psychiatry , The University of Alberta , Edmonton , Alberta , Canada.
4
d Department of Emergency Medicine and School of Public Health , University of Alberta , Edmonton , Alberta , Canada.
5
e Alberta Health Services , Edmonton , Alberta , Canada.
6
f Department of Psychiatry and Graduate Program in Neuroscience , Western University , London , Ontario , Canada.

Abstract

A theoretical framework referred to as a 4-D model has been described for classifying posttraumatic stress symptoms into those potentially occurring within normal waking consciousness (NWC) versus those thought to intrinsically exemplify dissociative experiences, specifically, trauma-related altered states of consciousness (TRASC). As a further test of this theoretical distinction, this prospective study evaluated whether TRASC and NWC forms of distress incrementally and prospectively predicted functional impairment at 6 and 12 weeks following presentation at hospital emergency departments in the acute aftermath of traumatic events in 180 persons. Establishing the clinical significance of both TRASC and NWC-distress symptoms, we found that 6-week markers of TRASC and NWC-distress independently predicted 12-week self-reported levels of social and occupational impairment. We also observed broad support for various predictions of the 4-D model except that, in contrast with hypotheses, childhood trauma history was generally more strongly correlated with symptoms of NWC-distress than with TRASC. Future research directions are discussed.

KEYWORDS:

4-D model; childhood abuse and neglect; dissociation; posttraumatic stress disorder; trauma-related altered states of consciousness

PMID:
26378486
DOI:
10.1080/15299732.2015.1022925
[Indexed for MEDLINE]

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