Three of the highest risk factors for clinical dissociation were as follows:

This Australian study examined 310 respondents’ retrospective reports about the quality of their relationship with their caregivers during their childhood to identify the dynamics that predict clinical levels of dissociation in adulthood. The sample comprised 277 university participants and 32 inpatients and outpatients receiving treatment for a dissociative disorder. The authors developed the 32-item parent-child dynamics questionnaire (PCD-Q) to understand and identify aspects of the relational dynamics and home environment that give rise to dissociation. The PCD-Q demonstrated excellent internal reliability and effectively differentiated between groups with different levels of dissociation. For females in the university sample, parent-child dynamics were clearly positive for 186 non-dissociative controls, mildly positive for the 27 individuals with elevated levels of dissociation consistent with a dissociative disorder or PTSD, and mildly negative for the 26 with clinical levels of dissociation, whereas the 30 females in the clinical group experienced clearly negative dynamics. The PCD-Q demonstrated protective factors from dissociation as parental care, being able to seek comfort, and developing self-esteem and self-worth; experiences of safety (absence of unpredictable parental behaviour, powerlessness and control, unfairness, secrecy, isolation, and dysfunction), and feeling seen and being supported on the road to independence. Nineteen items (59%) had large effect sizes, and 11 items (34%) had medium effect sizes. In males, despite the small sample, significant differences were found between the 34 controls and 12 dissociators for half the PCD-Q items. The findings suggest parent-child dynamics may be equally as influential as trauma in the aetiology of dissociation.