Symptoms of dissociation in humans experiencing acute, uncontrollable stress: A prospective investigation

Objective: Peritraumatic dissociation has been associated with subsequent d evelopment of posttraumatic stress disorder, but supporting data have been largely retrospective, The current study was designed to assess the nature and prevalence of dissociative symptoms in healthy humans experiencing acut e, uncontrollable stress during U.S. Army survival training. Method: In study 1, 94 subjects completed the Clinician-Administered Dissoc iative States Scale after exposure to the stress of survival training. In s tudy 2, 59 subjects completed the Brief Trauma Questionnaire before acute s tress and the dissociative states scale before and after acute stress. A ra ndomly selected group of subjects in study 2 completed a health problems qu estionnaire after acute stress. Results: In study 1, 96% of subjects reported dissociative symptoms in resp onse to acute stress, Total scores, as well as individual item scores, on t he dissociation scale were significantly lower in Special Forces soldiers c ompared to general infantry troops. In study 2, 42% of subjects reported di ssociative symptoms before stress and 96% reported them after acute stress. Dissociative symptoms before and after stress were significantly higher in individuals who reported a perceived threat to life in the past. Forty-one percent of the variance in reported health problems was accounted for by p oststress dissociation scores. Discussion: Symptoms of dissociation were prevalent in healthy subjects exp osed to high stress. Stress-hardy individuals (Special Forces soldiers) exp erienced fewer symptoms of dissociation, compared to individuals who were l ess hardy. These data support the idea that the nature of response to previ ously experienced threatening events significantly determines the nature of psychological and somatic response to subsequent stress.