This study had methodological limitations. First, group assignment for statistical comparison was carried out by applying a median split on script-related reexpe- riencing and dissociation scores, but there was no separate control group. In purely methodological terms, it might have been preferable to induce both dissociation and reexperiencing subsequently during different ex- perimental conditions, so that participants could serve as their own controls. However, results from previous research (Lanius et al., 2001) show that it is relatively difficult to provoke discrete reactions of either reexpe- riencing or dissociation, since script-driven imagery is typically associated with a range of individually different reactions that may include both dissociation and reexpe- riencing. Second, since the sample employed in our study was characterized by a broad spectrum of trauma-related symptoms and diagnoses, it remains open whether our results are valid also for specific diagnoses such as PTSD or dissociative disorders. Third, as it has recently been pointed out by Berntson et al. (2005), the use of RMSSD to index parasympathetic tone might have led to an underestimation of possible between-group differences in basal parasympathetic activity. For our study, RMSSD was chosen since it is especially suitable for measur- ing relatively short-term changes in parasympathetic activity and displaying time course data. Also, estimates of parasympathetic activity generated from frequency domain methods generally require cautious interpreta- tion because setting factors such as breathing rate or physical activation are known to interfere significantly (Grossman, Wilhelm & Spoerle, 2004). To limit possible influences of such factors in our study, RMSSD analyses were adjusted for influences of baseline breathing rate and the experimental setting was standardized as much as possible.
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Sixty patients 2 with ICD-10 diagnoses of dissociative dis- order (DD; ICD-10 codes F44.4, F44.6, F44.7), 39 pa- tients with an ICD-10 diagnosis of posttraumatic stress disorder (PTSD; ICD-10 code F43.1), and 40 healthy comparison participants (HC) participated in the study. DD patients were recruited at the local neurological re- habilitation centre (Kliniken Schmieder Konstanz and Gailingen). Following neurological routine, inclusion cri- teria were at least one core negative somatoform dis- sociative symptom. Exclusion criteria were central nervous lesions and positive somatoform dissociative symptoms (e.g. seizures). Similar subtypes of dissociative disorders, characterized by negative somatoform dis- sociative symptoms were selected in order to assure homogeneity of the study sample. Diagnoses were given by at least two experienced psychiatrics and neurolo- gists. Patients diagnosed with PTSD were recruited at the Department of Psychosomatic Medicine and Psycho- therapy of the Central Institute for Mental Health (CIMH, Mannheim). Diagnoses were based on DSM-IV criteria (Structured clinical interview for DSM-IV and International Personality Disorder Examination [34, 35]). Comorbid conditions are summarized in Table 5. HC were recruited from the local community by flyer and oral advertisement and selected to be comparable to the patient samples with respect to age and gender distribu- tion. HC were screened for DSM-axis I and II diagnoses using the German version of the MINI international
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embodiment, and in the sense of presence. The aberrant conscious experiences that result from this breakdown in multisensory integration nearly always lead to a state of dissociation and associated positive symptoms (i.e., perceptual distortions, hallucinations, delusions). Typically these aberrations have been associated with neurological conditions and/or psychiatric disorders such as: schizophrenia, psychosis, schizotypy, depersonalization, anxiety, and depression. Importantly such instances are now also known to occur in non- clinical groups in the apparent absence of all these factors.
is recognized as a multidimensional construct . In a study of exposure therapy conducted with adults who had experienced complex trauma, 45% of whom were in the range of dissociation suggestive of a DD, patients showed a worsening of symptoms, including a trend level worsening of a physiological marker of emotion regulation (respiratory sinus arrythmia; ). Despite exposure therapy being considered a first-line treatment for PTSD , this severely dissociative sample did not benefit from exposure therapy; rather, they showed more improvement in response to psychodynamic treat- ment and stress inoculation therapy. The participants in the Hagenaars et al. study had comparably less severe levels of dissociation and less severe traumas than those in D’Andrea & Pole’s study (e.g., 24% vs. 67% sexual as- sault). Given that state dissociation has been shown to interfere with emotional learning  and that dissoci- ation during treatment sessions has been shown to be the only predictor of treatment outcome, it is crucial that future studies examine the effects of state dissoci- ation during treatment sessions on treatment outcome rather than only examining the effects of trait dissoci- ation on psychotherapeutic processes in general, as most studies have done to date. It will also be critical that future studies utilize measures of dissociation that fully assess the range and severity of dissociative phenomena.
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so suggested that childhood sexual abuse is very com- mon, childhood physical abuse often present and both sexual and physical abuse/maltreatment (performed by multiple perpetrators) present in a percentage vari- able between 77% to 100% in patients with dissocia- tive identity disorder. Overall, 5-12 years are needed for patients with dissociative disorders in order to reach the correct diagnosis while during this period at least 3-4 incorrect diagnoses were usually carried out by clini- cians with important negative consequences in terms of clinical management and treatment.
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The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) defines dissociative disorders as a “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behaviour” (American Psychiatric Association, 2013, p. 291). It is thought to exist along a continuum of severity with, at one end, non-pathological everyday experiences of dissociation (such as daydreaming or doing things on ‘automatic pilot’). At the other end lie more chronic, complex and pathological forms of dissociation such as dissociative amnesia, depersonalisation/derealisation or dissociative identity disorder which can affect the individual’s ability to function (Mulder, Beautrais, Joyce, & Fergusson, 1998). It is thought that everybody dissociates for approximately ten percent of the day, which involves the individual losing conscious awareness of their surroundings (Diseth, 2005). Studies have also estimated that 3-5% of the population suffer from high levels of dissociation; dissociative experiences which occur frequently and impact on their daily functioning (Maaranen et al., 2005; Putnam et al., 1996).
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The PsS (psychoeducation about sexual matters) extracts show the range across which I recorded giving Kayleigh „real-world‟ information. A few relate to her own experience of sexual abuse directly, how usual or unusual this might be (K 1:7), or whether an eight year should know what sex is or not (K 2:8, K 8:6). However the vast majority involve myself responding to Kayleigh‟s active attempts to learn „what is normal‟ - what she should expect and how she should behave - much of which she is naively surprised by. We talk about the nature of teenage girls having „safe‟ crushes on celebrities or teachers, people that are actually out of reach (K 1:4), what is age appropriate and legal (K 6:10, K 9:11), and what it might be „ordinary‟ to do or not do on a first date (K 11:12). With a less dissociative un-abused young woman this last conversation about what is „ordinary‟ might centre on her own internal needs, desires, fears and prohibitions, how to understand, listen to and balance these, but in Kayleigh these aspects were segregated. Dissociative personality Priti had charge of the needs and desires and was unafraid to metaphorically „take the bull by the horns‟ to get what she wanted, but this left Kayleigh naive and with no awareness of her libido, despite craving intimate male relationship. In psychoanalytic terms, we might take the view that Kayleigh‟s dissociation cut off her id impulses, projecting these into the vehicle of Priti, leaving her to manage a critical superego with a weakened (split) ego. In the context of her telling about consensual sexual activity I ask Kayleigh directly if her body enjoys the contact (K 2:9), I challenge her telling of a clearly flirtatious encounter as though she has no active desire, asserting the normality of this (K 8:6) following which she admits to some limited enjoyment (K 8:7), and in the face of her disquiet that she finds some acts with some boys „disgusting‟ I assert the normality of being repulsed by sexual intimacy with people she is not actually attracted to (K 11:24). This work went hand in hand with the more usual analytic fare of exploring her present day passions and anxieties in relation to her history, particularly her delight in the attention of older men in the light of how little she had received from her father, but the deficit in her understanding was never far away:
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The reason for this is that the cerium centers are better able to activate the phenolic ring for nucleophilic attack by dissociated H 2 because they pull more electron density away from the ring than simple hydrogen bonds with hydroxyls/water on the ceria surface. Thus, the higher activity observed in hexane should be due to the dissociative phenol adsorption and its direct binding to coordinatively unsaturated Ce cations, which is enabled by the lack of competition between substrate and solvent (Scheme 2). However, upon phenoxy formation and subsequent reduction to the ketone or alcohol, the phenoxy-forming sites were seemingly not regenerated, as indicated by the decreased activity observed in the recycling experiments. In order for the active site to be retained, a hydroxyl near a coordinatively unsaturated cerium cation should be present, which is not the case after one phenol molecule adsorbs dissociatively and is reduced (Scheme 2). The proposed deactivation mechanism is supported by the red shift of the C − O band for phenol adsorbed on the fresh (1273 cm −1 ) and recycled (1263 cm −1 ) catalyst (Figure S8 in the Supporting Information). In addition, the C − O band red shift on the recycled catalyst indicates that phenol is no longer able to bind dissociatively to ceria (Figure 9). The proposed solvent-dependent adsorption mechanism is consistent with the greater amounts of phenoxy species formed in hexane relative to those in water, the higher catalytic activity in hexane in comparison to that in water, the sharp decrease in activity after the ﬁ rst catalytic run in hexane, and the stability of catalyst activity after cycling experiments in both solvents. Furthermore, after oxidation and reduction treatment of the cycled catalyst, the DRIFT spectrum shows the reemergence of the hydroxyl peak at 3699 cm −1 (Figure S9 in the Supporting Information) and the activity is restored (Figure 8), further supporting the adsorption mechanism.
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Our sample fits well with other studies on juvenile disso- ciative disorder. A high rate of our patients was adolescent (mean age of 12.7 years). In line with this age pattern there were more females than males in our sample. Most of our patients had a favourable treatment response at the end of treatment at our department. The finding that con- version disorders affecting motor control and sensation as well as pseudoseizures were in the foreground is well in line with other studies on child psychiatric and paediatric samples. This holds for the proportion of patients with mixed symptomatology as well [13,44,7]. It should be noted that most of our former patients had symptoms of conversion and would have been classified as having somatoform disorder according to DSM-IV's terminology (in DSM-IV the term "dissociative" only refers to mental and cognitive symptoms and does not include pseudo- neurological symptoms of conversion). In our sample the most frequent co-existing features were somatoform symptoms, anxiety and aggressive behaviour. Other stud- ies also reported on internalizing co-morbidity, pain and externalizing symptoms [11,47,7].
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A non-thermal plasma is usually generated by a dis- charge. In non-thermal discharge plasmas, it is thought that electron impact dissociative reactions dominate the PFC decomposition processes . High-current electron beams (e-beams) may possibly be employed to generate a non- thermal plasma. E-beams are frequently used in excimer lasers and radiation chemical reactions. An e-beam gener- ated plasma has also been used for the decomposition of carbon tetrachloride . Ions and metastable atoms are ef- ficiently generated using an e-beam. The ion reaction for any PFC will be the dominant decomposition process [3,4], because the energy of secondary electrons produced by the e-beam rapidly decreases to room temperature.
There has been much separate research into both grief and trauma, but few studies have investigated the traumatic aspects of grief. One condition that is known to be associated with traumatic stress responses is dissociation (Horowitz, 1997; Merckelbach & Muris, 2001; Putnam, 1997). This thesis seeks to establish if those suffering from a traumatic form of grief also report a higher incidence of dissociation and general psychological distress, in
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It is important to bear in mind that the abuse described above occurs within a setting to which one belongs (willingly or otherwise). Freyd (1996) talks about the devastating impact of betrayal on the incestually abused child, and how amnesia to (that is, dissociation of) the incest serves as protection. For the person with DID, this usually means that some of their alters are aware of the abuse and want to avoid it, while other alters are only aware of the ‘sense of belonging’ or even love. The latter alters have nothing to prevent them from continued involvement with the abusers (Sachs 2011; Sinason 2011). Moreover, some alters are identified with the abusers and admire their strength, cruelty or high standing within the group (for example, boy soldiers admire their commanders) or family. Such alters may feel nothing but loathing and contempt for the suffering of the abused whether the abused is an external person or one of their own alters. They, too, have no reason to change or stop a relationship in which abuse never stops.
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& Colombo, 2002; Craparo, 2011), and other dissociative experiences such as absorption and psychogenic amnesia (Kihlstrom, 2005). Dissociative Amnesia (DA) is characterized by one or more episodes of the inability to remember important personal information, usually too excessive to be explained by ordinary forgetfulness. Absorption and Imaginative Involvement (AbII) concerns being immersed in a certain activity to the point of becoming completely unaware of the surrounding environment. The Depersonalization-Derealization (DD) disorder occurs when there is persistently or recurrent experiences of feeling detached from, as if one were an outside observer of, one’s mental processes or body experiences and experience of unreality of surroundings. Instead, the Passive Influence (PI) is the tendency to consider that one's own feelings, thoughts and behavior are involuntarily imposed by an external source (American Psychiatric Association, 2013).
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tion, probably due to small sample size, in an otherwise interesting study in which different mediators were test- ed, including separated PTSD dimensions, emotional dysregulation and dissociation. In this work only hyper- arousal and emotional dysregulation partially mediated the TE-NSSI relationship. The authors hypothesize that dissociation failed to mediate the TE-NSSI relationship in their sample because TE were assessed in an exces- sively broad way, while previous report that the effect of CSA in particular is mediated in the TE-NSSI rela- tionship. This interpretation is interesting, as it warrants further systematic studies to assess the differential role of different types of TE on NSSI and on dissociation. In a sample of over 400 female college students 64 different
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H allucinogens are a class of drugs that cause hallucinations—profound distortions in a person’s perceptions of reality. Hallucinogens can be found in some plants and mushrooms (or their extracts) or can be man-made, and they are commonly divided into two broad categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). When under the influence of either type of drug, people often report rapid, intense emotional swings and seeing images, hearing sounds, and feeling sensations that seem real but are not.
A second experimental study of the DE of HeH + was performed by C. Strömholm et al. . In this work the DR and DE processes for HeH were studied and the absolute cross sections were determined for energies below 40 eV. The experiments were performed using CRYRING ion storage ring at the Manne Siegbahn Laboratory at Stockholm University. Contrary to the results of the cross section obtained by Yousif and Mitchell, it was found here that the absolute cross section for the direct DE process was basically constant in the 21 − 37 eV energy region. Furthermore, it was found that there was an alternate DE pathway with an energy threshold already at 10 eV. In the reaction the electron is captured into a neutral doubly excited state which auto-ionizes into He + H + . This reaction is resonant dissociative excitation which competes with the DR process.
As previously mentioned, using the Adult Attachment Interview (AAI; George, Kaplan & Main, 1985), Cole-Detke and Kobak (1996) compared older adolescents (college women) who reported depressive symptoms with those who reported elevated levels of eating disorder symptoms, on attachment style. Eating disorder tendencies were identified as one standard deviation above the mean on three scales of the Eating Disorders Inventory (EDI; Gamer et al., 1983), and participants scoring over one standard deviation above the mean on the Beck Depression Inventory (EDI; Beck et al, 1979) were considered to have depressive tendencies. Those participants who met depressive criteria but scored below the mean on the eating disorder scales were selected for the depression group, and those who met eating disorder criteria but were below the mean on the BDI were selected for the eating disorder group. They found those reporting only eating disorder symptoms were predominantly dismissing (67%), whereas those reporting depressive symptoms showed a tendency toward preoccupation (43%). Those reporting high levels of both eating disorder and depressive symptoms were predominantly preoccupied (53%). This suggests that AAI classification did differ according to symptoms. Cole-Detke and Kobak (1996) found that eating disorder symptoms was uniquely associated with denial or minimisation of anger toward parents and a tendency toward a restricted processing of attachment information, as well as a lack of co-operation and insight in the interview.
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The generalisation of our findings is restricted on account of various limitations. The sample size is too small owing to restricted time limits. Also, it is gender-specific. Also, where there are patients suffering from higher degree of dissociation, some problems with memory may arise, which, in turn, may affect the results. Reports dealing with abuse in childhood were not verified because the respective family could not be approached.
electron mass and ǫ the electron energy. In low-temperature plasmas, the shape and effective temperature of the electron energy distribution function is highly variable, depending on parameters such as the nature of the plasma source, the operating pressure [31, 32, 33], the voltage/current [34, 35] the driving frequency [36, 37, 38] and the gas or gas mixture [39, 40]. The shape and temperature of the distribution function can also vary strongly in space and time within the same plasma source [41, 42, 43, 44, 45, 46]. To understand how the cross-sections calculated in this work affect the corresponding rate coefficients for electron impact dissociation we follow the approach of Gudmundsson  and Toneli et al  and define a general expression for the electron energy distribution function:
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We describe a case of a 54-year-old Caucasian woman with a complex phenotype for sui- cidal behavior after traumatic brain injury. At the admission patient had Bipolar Disorder, Post Traumatic Stress Disorder, Dissociative Identity Disorder, Conversion Disorder (with Psychogenic Non Epileptic Seizures) and a drug treatment for a post-traumatic epilepsy. Dur- ing a follow up period of 30 months, despite the symptomatological improvements due to psychopharmachological treatments (including also lithium) and psychoeducation treatment, the patient showed yet high risk of suicide and high levels of dissociation.