Research Information System
11th INTERNATIONAL USBILIM SOCIAL SCIENCES CONGRESS April 27-30, 2026 Çankırı/TÜRKİYE, Çankırı, Turkey, 27 - 30 April 2026, pp.1-2, (Summary Text)
Abstract
Objective: Although the strong association between childhood trauma and psychotic disorders is well established, the underlying mechanisms of this relationship, particularly the role of dissociation, remain unclear. This study aimed to investigate whether psychotic patients with chronic childhood trauma and pathological dissociation can be conceptualized as representing a dissociative subtype of schizophrenia within the framework of the trauma model.
Method: The study was conducted with 51 inpatients diagnosed with psychotic disorders according to DSM-5-TR criteria who were in partial or full remission. Participants were assessed using the Childhood Trauma Questionnaire (CTQ), Adverse Childhood Experiences Scale (ACE), Dissociation Questionnaire (DISQ), Somatoform Dissociation Questionnaire (SDQ), Positive and Negative Syndrome Scale (PANSS), Symptom Checklist-90-R (SCL-90-R), Borderline Personality Inventory (BPI), and the Dissociative Disorders Interview Schedule (DDIS). Patients were divided into two groups according to the presence of pathological dissociation, and the groups were compared. Group comparisons, correlation analyses, logistic regression, and partial least squares structural equation modeling (PLS-SEM) were used in the analyses.
Results: Pathological dissociation was identified in 13.7% of the sample. This group had significantly higher childhood trauma and ACE scores (p=0.006). Emotional abuse (p=0.001), physical abuse (p=0.011), and sexual abuse (p=0.002) scores were significantly higher, whereas no significant differences were found in neglect dimensions. The pathological dissociation group also showed significantly higher borderline personality features (p<0.001) and greater overall psychopathology (p<0.001). In addition, positive psychotic symptoms were significantly higher (p<0.001), whereas negative symptoms were significantly lower (p=0.006) in this group. A history of previous diagnoses, suicide attempts, widespread comorbidity, polypharmacy, and treatment resistance were also significantly more frequent in the pathological dissociation group (p<0.001). Logistic regression analysis identified CTQ (OR=1.076, p=0.004), BPI (OR=1.252, p=0.005), and SCL-90 (OR=16.272, p=0.004) scores as significant predictors of pathological dissociation. Correlation analyses revealed significant associations between dissociation and childhood trauma (r=0.444, p=0.001), as well as borderline features (r=0.803, p<0.001). All 7 patients who underwent DDIS assessment were found to fall within the dissociative disorder spectrum and met Ross’s (2004) criteria for dissociative schizophrenia. PLS-SEM analysis further demonstrated that dissociation played a significant mediating role in the relationship between childhood trauma and positive psychotic symptoms.
Conclusion: The findings suggest the presence of a clinically more severe subgroup among psychotic patients characterized by high trauma burden, prominent dissociative symptoms, and dominant positive psychotic features. This subgroup appears to be consistent with the conceptualization of a dissociative subtype of schizophrenia and indicates that pathological dissociation should not be overlooked in the clinical assessment of psychotic disorders.
Keywords: Psychosis, dissociation, childhood trauma, dissociative schizophrenia, trauma model