Exploring strategies to cope with dissociation and its determinants through functional analysis in patients suffering from PTSD: a qualitative study

Introduction Dissociation is a contraindication for cognitive behavior therapy (CBT) for PTSD and has been observed to impair CBT efficacy. Therefore, there is a need to identify the determinants of dissociation through functional analysis, as well as strategies to cope with dissociation. Identifying such determinants would allow clinicians to treat dissociation and would therefore increase CBT efficacy for patients suffering from dissociation and PTSD. Method We recruited 15 patients suffering from dissociative subtype of PTSD. We used self-report scales to measure post-traumatic symptoms, dissociative symptoms and emotion regulation abilities. We used a visual analog scale to measure the ability to control dissociation. A trained clinician then carried out semi-structured interviews to explore the determinants of dissociation. Results We identified different manifestations, positive and negative beliefs, and triggers of dissociation, and strategies to block it. A functional analysis of dissociation was developed based on these data. Conclusion Cognitive restructuring techniques could be used to change beliefs about dissociation. Different strategies to block dissociation has been identified in this study, such as concentration, emotion regulation, and reality anchor techniques.