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ForwardDissociation and the Intersection with Autism, Anxiety, and Depression
Abstract
The current research explores the intersection with dissociation and the most commonly treated mental health presentations: depression and anxiety. It also addresses the research gap about the relationship between dissociation and autism.
The research employs the Multidimensional Inventory of Dissociation (MID-60; Kate, Jamieson, Dorahy, & Middleton, 2020), a screening tool based on Paul Dell’s diagnostic MID. The MID-60 has the same factor structure and internal reliability as its parent. The MID-60 assesses symptoms and experiences consistent with DID, OSDD-1, dissociative amnesia and depersonalization and derealization disorder, conversion disorder and PTSD. Unlike the DES, the MID-60 has a robust relationship with childhood trauma and negative parent-child dynamics with moderate to large effect sizes (Kate et al., 2021; 2023).
The study participants comprised individuals receiving mental health care, primarily in Australia, who had completed the relevant psychometric assessments as part of routine assessment and treatment. Secondary data was provided by NovoPsych, Australia's largest provider of online psychometric tools designed to help mental health practitioners assess and monitor their clients' mental health. Participants included those who had completed the MID-60 and at least one of the following measures:
- For depression, 1164 clients who had completed the Depression, Anxiety, Stress Scale short form (DASS-21; Lovibond & Lovibond, 1995).
- For anxiety, 518 clients who had completed the DASS-21 (including 72 individuals who had completed anxiety measure at 9-12 months apart) and 223 individuals who had completed the Generalised Anxiety Disorder assessment (GAD-7; Spitzer et al., 2006).
- For autism, 201 clients who had completed the Ritvo Autism Asperger Diagnostic Scale Revised (RAADS-R; Ritvo et al, 2008).
Dissociation was found to have a robust relationship with depression, anxiety, and autism, which was evident across the majority of the 12 MID-60 subscales. Odds ratios for clinical dissociation were 6-fold risk if the individual had autism or moderate to severe anxiety, and 4.4 for individuals who had moderate to severe depression as compared to those who did not meet these clinical cut-offs. On average, those with moderate or severe anxiety that persisted for 9 to 12 months had severe dissociation consistent with DID or OSDD-1. These findings highlight the importance of screening for dissociation in people with depression and anxiety (particularly so where this is chronic) and autism.
Potential to Distress: No
This presentation was originally presented as a live webinar in December 2023.
Target Audience
Beginning/Introductory
Learning Objectives
At the conclusion of this presentation, participants will be able to:
- Explain the Multidimensional Inventory of Dissociation - 60 item version and its 12 subscales
- Describe the bi-directional relationship between anxiety and dissociation, and identify the additional risk for people with treatment-refractory anxiety
- Describe the bi-directional relationship between depression and dissociation
- Discuss dissociative symptoms people with autism may experience and how these can overlap with symptoms and experiences related to autism
- Explain the importance of screening for dissociation in people presenting with depression, anxiety and individuals with autism
Presenter: Mary-Anne Kate, PhD
Presenter Bio: Dr Mary-Anne Kate is an award-winning researcher specialising in dissociation and interpersonal trauma, and mental health. She is a Scientific Committee member of ISSTD. Mary-Anne currently lectures on the Master of Professional Psychology and Bachelor of Psychological Science programs at Southern Cross University and has previously taught on the Master of Mental Health. She recently developed the master’s unit on psychological assessment and psychopatholog, and the undergraduate unit Understanding Psychological Diagnoses.
In 2021 Mary-Anne was awarded the Morton Prince award for Scientific Research. In 2018 she was awarded the Chancellor's Doctoral Research Medal from the University of New England and in 2019 the David Caul Award from the ISSTD for her PhD on childhood maltreatment, parent-child dynamics, and dissociation. Mary-Anne developed the Multidimensional Inventory of Dissociation - 60 item version (MID-60) to screen for dissociative symptoms, DSM-5-TR dissociative disorders and PTSD.
Mary-Anne also has extensive experience improving the quality of life and mental health of refugees, migrants, and other vulnerable groups, including in a diplomatic role in Cairo, as a policy advisor in an influential EU think tank, and strategic policy development in Canberra. Mary-Anne is passionate about creating a mentally healthy and equitable society.
Presenter: Pete Sykes
Presenter Bio: Peter Sykes is the Clinical Director of a private occupational therapy practice. He has 14 years of experience working with individuals who have complex and dual diagnoses disabilities. Peter is a scientist-practitioner for neurodevelopmental and psychosocial needs. Pete specialises in conducting functional assessments for people with autism and intellectual disabilities, collaborates with community organisations on quality improvement projects and serves as an independent assessor and expert witness for individuals living with intellectual disability. Peter is passionate about enabling meaningful and purposeful occupation for his clients and empowering them to achieve their goals of independent living.
In addition to holding a Master of Occupational Therapy, Peter is completing his Bachelor of Psychological Science with Honours at Southern Cross University and has recently submitted his thesis: Understanding Dissociative Symptoms and Experiences in Treatment-Seeking Adults with Autistic Traits: An Exploratory Study.
Presenter: Stephanie Hill
Presenter Bio: Stephanie is a Neurophysiology Scientist. She completed her technical training at the Royal Melbourne Hospital, where she autonomously performed an array of diagnostic neurological tests (EEG, VEP, sleep studies) and assisted neurologists with nerve conduction studies. Stephanie currently works as an EEG scientist at John Flynn Hospital Neuro Care Centre with people with a variety of neurological conditions. Stephanie is also a disability support worker assisting clients with daily tasks and help them engage with the community.
Stephanie is completing her Bachelor of Psychological Science with Honours at Southern Cross University and has recently submitted er thesis: Exploring the Complex Relationship Between Anxiety and Dissociation in a Clinical Population.
Presenter: Benjamin Dixon
Presenter Bio: Benjamin is a honours student at Southern Cross University. He recently submitted his thesis Unravelling the Ties: An Explorational Study of the Complex Interplay Between Dissociation and Depression.
Ben is a Student Ambassador for Southern Cross University, works in client services assisting students with enquiries or issues regarding their studies, and is a a Crisis Supporter at Lifeline.
Participants who attend the webinar live and wish to claim CE credits must do so within 30 days of the live webinar by completing the webinar evaluation. After this time, participants will be required to watch the webinar recording and take a quiz in addition to the evaluation in order to claim CE credits.
Available Credit
- 1.50 APAThe International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
- 1.50 ASWB ACEThe International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/20/2024 – 08/20/2027. Social workers completing this course receive 1.50 continuing education credits.
- 1.50 ISSTD Certificate ProgramThis program is eligible for 1.50 credits in the ISSTD Certificate Program. No certificate of completion is generated for this type of credit.
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ISSTD defines a student as those enrolled in a program of study leading to a degree or certification in the mental health field and who have an interest in trauma and dissociation.
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