Mindfulness and pathological dissociation fully mediate the association of childhood abuse and PTSD symptomatology - 21/02/18

Doi : 10.1016/j.ejtd.2017.06.004

L. Kratzer ^a,^⁎ , P. Heinz ^a , F. Pfitzer ^b , F. Padberg ^c , A. Jobst ^c , R. Schennach ^c,^d
^a Department of Psychotraumatology, Clinic St. Irmingard, Osternacher Strasse 103, 83209 Prien am Chiemsee, Germany
^b Department of Psychosomatics, Clinic St. Irmingard, Osternacher Strasse 103, 83209 Prien am Chiemsee, Germany
^c Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstrasse 7, 80336 Munich, Germany
^d Schoen Clinic Roseneck, Am Roseneck 6, 83209 Prien am Chiemsee, Germany

^⁎Corresponding author.

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Abstract

Introduction

The role of dissociation and mindfulness deficits in posttraumatic stress disorder (PTSD) is not yet fully clear.

Objective

We examined how mindfulness deficits and pathological dissociation might explain the association of childhood sexual and childhood physical abuse and PTSD.

Method

Using data from 218 severely traumatized inpatients with PTSD, we fit a multiple mediation model in a structural equation-modeling (SEM) framework.

Results

We found significant indirect effects of childhood physical and childhood sexual abuse on PTSD symptomatology via pathological dissociation and mindfulness. After accounting for these indirect effects, the direct effect of childhood abuse on PTSD symptoms disappeared, indicating full mediation.

Conclusion

Our results suggest that pathological dissociation and mindfulness deficits may be important mechanisms underlying the association of childhood abuse and chronic PTSD. We discuss implications of this finding for the effective treatment of survivors of childhood abuse with PTSD, highlighting the importance of focusing on dissociative symptoms and mindfulness deficits.

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Keywords : Post-traumatic stress disorder, Childhood sexual abuse, Childhood physical abuse, Mindfulness, Dissociation