The co-occurrence of depression and dissociation: The relevance of childhood trauma

Abstract

Recent studies showed that dissociation may be common and persistent in people with depression. Dissociation also predicts subsequent depressive symptoms. Both conditions have been linked with trauma exposure. Yet, little is known about the co-occurrence of depression and dissociation. This multi-sample study investigated the co-occurrence of depressive and dissociative symptoms and its relationship with different types of childhood trauma. We analyzed available data from five samples of Chinese adults (N = 2737 in total). Participants completed the same set of measures of depressive and dissociative symptoms and childhood betrayal and non-betrayal trauma. Across samples, between 22.0% and 50.6% of participants with depression exhibited co-occurring dissociation; the majority of participants with dissociation (67.0%–90.2%) presented with depression too. One-way ANCOVA showed that participants who presented with both depression and dissociation reported a statistically significantly higher number of childhood betrayal and non-betrayal trauma types compared to those who had only one or none of these conditions. Exploratory mediation analysis also revealed that dissociative symptoms partly mediated the relationship between childhood trauma and depressive symptoms, regardless of the type of trauma. Findings suggest that the co-occurrence of depressive and dissociative symptoms is associated with childhood trauma. Individuals who report depressive symptoms or seek treatments for a depressive disorder should be screened for dissociation. Further studies on the reliability, validity, clinical features, and intervention needs of the possible dissociative subtype of depression are required.