http://dailynews.yahoo.com/h/nm/20010717/hl/dissociation_1.html

Tuesday July 17 1:37 PM ET

Dissociation May Worsen Effects of Sexual Abuse

NEW YORK (Reuters Health) - Although it is considered a protective response to traumatic stress, dissociation may actually increase the risk of psychiatric disturbances in sexually abused children and adolescents, researchers suggest.

Dissociation occurs when a person wipes out the memory of an event, usually a traumatic one, in a kind of selective amnesia.

``A natural, protective response to overwhelming traumatic experiences, dissociation can become an automatic response to stress,'' Drs. Cassandra L. Kisiel and John S. Lyons write in the July issue of the American Journal of Psychiatry. ``This can impair functioning and increase susceptibility to serious psychopathology.''

The investigators, of Wellesley College in Massachusetts, and Northwestern University Medical School in Chicago, respectively, say dissociation is uniquely associated with sexual abuse. And while they point out that it is protective in the short term, their findings suggest that in the long term it can actually worsen the psychological consequences of sexual abuse.

The researchers examined levels of dissociation and psychiatric disturbance in 114 children who were wards of the Illinois Department of Children and Families. The investigators found significantly higher levels of dissociation in children who had been sexually abused than in those classified as physically abused.

Moreover, both dissociation and sexual abuse were independently associated with a range of psychiatric disturbances, including suicidality, self-mutilation and sexual aggression. ``Dissociation was associated with more symptoms, more frequent risk-taking behaviors and less competent functioning,'' Kisiel and Lyons report.

The finding could have implications for physicians and other healthcare and mental health professionals caring for sexually abused children, the authors propose. In particular, ''assessing dissociation may be an important aspect of clinical care among traumatized children,'' they write. Further study of the link may also provide important clues about ways to reduce the impact of dissociation in this population.

SOURCE: American Journal of Psychiatry 2001;158:1034-1039

-- (in@health.news), July 18, 2001