What Causes Dissociation?

Mary-Anne discusses the findings from her meta-analysis of 31,905 college students, in-depth interviews with 13 in-patients with a severe Dissociative Disorder (DD), and questionnaires completed by 313 participants from an Australian university and 30 individuals in treatment for a DD that explored dissociation (a 60 question version of Dell’s Multidimensional Inventory of Dissociation), adult attachment style (Holmes & Lyons-Ruth’s Relationship Questionnaire), experiences of childhood maltreatment (a revised version of Freyd, Deprince, & Zurbriggen’s Betrayal Trauma Index), and the dynamics between themselves and their parents during their childhood (Kate’s Parent-Child Dynamics Questionnaire). The meta-analysis finds 11.4% of students sampled meet criteria for DD, which is consistent with the prevalence of experiencing multiple traumas during childhood (12%). Scores on the Dissociative Scale varied significantly across the 16 countries and were highest in countries that were comparatively unsafe. There was no evidence that DES scores had decreased over recent decades. Three of the five hypotheses tested provided clear support for the trauma model of dissociation and a fourth hypothesis provided partial support for it. None of the five hypotheses tested supported the fantasy model of dissociation. In her own primary research, she was able to predict half of a person’s dissociative symptomology based on specific childhood experiences of abuse, negative parentchild dynamics, an insecure attachment style, and the parents’ role in, or reaction to, any abuse experienced. Mary-Anne quantified DD odds ratios, e.g. in females an insecure attachment style was 72 : 1, and if the mother’s role in, or response to, maltreatment was negative it was 45 : 1. In light of her statistical analysis, Mary-Anne uses vignettes from in-patients to describe the pathogenic family environment in which dissociation occurs, as well as to illustrate how the fantasy model of dissociation could not account for the dissociative symptoms in the in-patient sample.

Timed Outline
5 minutes - Introduction
10 minutes - Overview of dissociation and the dissociative disorders 10 minutes - The prevalence of dissociation and dissociative disorders 10 minutes - The two models of dissociation: trauma and fantasy
20 minutes - Meta-analysis critiquing the plausibility of each model
20 minutes - Attachment style and dissociation
30 minutes - Parent-child dynamics and dissociation
15 minutes – Parental role in (or reaction to) trauma
10 minutes - Physical abuse
10 minutes - Emotional abuse
10 minutes - Sexual Abuse
10 minutes - Key findings: what causes dissociation
20 minutes - Question and Answer (with original live audience)

This session was originally presented as a live conference session in October 2020.

Target Audience


Learning Objectives


At the conclusion of this presentation, participants will be able to:

  • Appraise the validity of the Trauma Model and Fantasy Model in light of the findings of the metaanalysis on the prevalence of DDs and dissociation in college populations
  • Recognize the specific types of childhood maltreatment that are predictive of dissociation
  • Identity the types of parent-child dynamics, attachment style and parents’ role and/or response in relation to the maltreatment experienced, that are predictive of dissociation
  • Assess the validity of the Trauma Model and Fantasy Model in light of the findings from questionnaires and interviews with in-patients
  • Recognize the risk factors for dissociation and a DD, which may assist participants in identifying children at risk of developing a DD, and children and adults with a DD
Course summary
Available credit: 
  • 3.00 ISSTD Certificate Program
    This program is eligible for 3.00 credits in the ISSTD Certificate Program.
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Presenter: Mary-Anne Kate, PhD
Presenter Bio: 

Dr Mary-Anne Kate has a professional background is in the development of national and EU policies and practices to improve quality of life outcomes for vulnerable client groups. Mary-Anne is a Scientific Committee member of the International Society for the Study of Trauma and Dissociation and has recently been awarded the Chancellor's Doctoral Research Medal for her PhD on childhood maltreatment, parent-child dynamics and dissociation. Mary-Anne teaches therapists internationally and locally about trauma and dissociation. She is the lead author of the Dissociative disorders and somatic symptom-related disorders in Wiley's Australasian edition of Abnormal Psychology. Her previous roles have included a diplomatic posting to Cairo to manage Australia’s refugee and migration programmes for North Africa; policy development to improve the regulation, education and training of Allied Health Professionals in Scotland; coordinating Australia’s National Integrated Settlement Strategy for migrants and refugees; and policy development for Europe’s most influential thinktank on immigration and equality issues to improve the socio-economic situation of migrants and refugees in Europe.

Available Credit

  • 3.00 ISSTD Certificate Program
    This program is eligible for 3.00 credits in the ISSTD Certificate Program.


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"Your Price" above reflects your final price based on your membership status and career level. 

  • 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. 
  • ISSTD defines an emerging professional as mental health professionals who have completed an advanced degree and are in the first three years of their career (or first three years after graduation for researchers).
  • If you do not fall into one of the above categories please register as Professional/Retired. 

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