Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study

Background Research suggests that individuals exposed to (childhood) trauma are not only unable to experience pleasure, known as hedonic deficit (HD), but also experience ‘negative affective responses to positive events’, known as negative affective interference (NAI). The clinical relevance and pro...

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Autores principales:	Kaja Kaspersen, Gorm Hol, Ellen K. K. Jepsen
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	anhedonia negative affective interference dissociative disorders childhood trauma Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/9745cbaefe8649beb569154bb504cb09
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spelling	oai:doaj.org-article:9745cbaefe8649beb569154bb504cb092021-11-11T14:23:42ZNegative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study2000-806610.1080/20008198.2021.1976954https://doaj.org/article/9745cbaefe8649beb569154bb504cb092021-01-01T00:00:00Zhttp://dx.doi.org/10.1080/20008198.2021.1976954https://doaj.org/toc/2000-8066Background Research suggests that individuals exposed to (childhood) trauma are not only unable to experience pleasure, known as hedonic deficit (HD), but also experience ‘negative affective responses to positive events’, known as negative affective interference (NAI). The clinical relevance and prognostic features of NAI have increasingly been recognized. To date, no studies have focused on NAI in patients with complex dissociative disorders (CDDs) who were abused early in life. Objective In this pilot study, we quantitatively and qualitatively investigated how NAI is related to trauma-related symptoms and how this phenomenon can be understood in a selected group of adult CDD patients. Method CDD patients (N = 25) referred to an inpatient dissociation-focused treatment programme completed the Hedonic Deficit & Interference Scale (HDIS), and measures of trauma-related symptoms and interpersonal functioning, as well as a qualitative questionnaire addressing possible inner conflicts and phobias with respect to the experience of positive events. A convergent mixed-methods design was used to obtain different but complementary data on NAI to gain a more complete understanding of the phenomenon. Results The quantitative analyses showed a significant relationship between NAI and trauma-related symptoms and interpersonal functioning. NAI seems to be more strongly associated with these symptoms than HD. The qualitative analysis revealed three themes – fear, shame, and aggressive ‘parts’ – preventing positive emotions, which provided a possible interpretation of the quantitative results. The integrated findings were discussed in light of theories of structural dissociation of the personality and attachment. Conclusions These findings indicate that NAI is related to a spectrum of trauma-related symptoms and interpersonal functioning in patients with a CDD to a larger degree than HD and that different dissociative identities are involved. Studies of the relationship between changes in HDIS (particularly the NAI subscale) and changes in trauma-related symptoms and interpersonal functioning following treatment are warranted.Kaja KaspersenGorm HolEllen K. K. JepsenTaylor & Francis Grouparticleanhedonianegative affective interferencedissociative disorderschildhood traumaPsychiatryRC435-571ENEuropean Journal of Psychotraumatology, Vol 12, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anhedonia negative affective interference dissociative disorders childhood trauma Psychiatry RC435-571
spellingShingle	anhedonia negative affective interference dissociative disorders childhood trauma Psychiatry RC435-571 Kaja Kaspersen Gorm Hol Ellen K. K. Jepsen Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study
description	Background Research suggests that individuals exposed to (childhood) trauma are not only unable to experience pleasure, known as hedonic deficit (HD), but also experience ‘negative affective responses to positive events’, known as negative affective interference (NAI). The clinical relevance and prognostic features of NAI have increasingly been recognized. To date, no studies have focused on NAI in patients with complex dissociative disorders (CDDs) who were abused early in life. Objective In this pilot study, we quantitatively and qualitatively investigated how NAI is related to trauma-related symptoms and how this phenomenon can be understood in a selected group of adult CDD patients. Method CDD patients (N = 25) referred to an inpatient dissociation-focused treatment programme completed the Hedonic Deficit & Interference Scale (HDIS), and measures of trauma-related symptoms and interpersonal functioning, as well as a qualitative questionnaire addressing possible inner conflicts and phobias with respect to the experience of positive events. A convergent mixed-methods design was used to obtain different but complementary data on NAI to gain a more complete understanding of the phenomenon. Results The quantitative analyses showed a significant relationship between NAI and trauma-related symptoms and interpersonal functioning. NAI seems to be more strongly associated with these symptoms than HD. The qualitative analysis revealed three themes – fear, shame, and aggressive ‘parts’ – preventing positive emotions, which provided a possible interpretation of the quantitative results. The integrated findings were discussed in light of theories of structural dissociation of the personality and attachment. Conclusions These findings indicate that NAI is related to a spectrum of trauma-related symptoms and interpersonal functioning in patients with a CDD to a larger degree than HD and that different dissociative identities are involved. Studies of the relationship between changes in HDIS (particularly the NAI subscale) and changes in trauma-related symptoms and interpersonal functioning following treatment are warranted.
format	article
author	Kaja Kaspersen Gorm Hol Ellen K. K. Jepsen
author_facet	Kaja Kaspersen Gorm Hol Ellen K. K. Jepsen
author_sort	Kaja Kaspersen
title	Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study
title_short	Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study
title_full	Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study
title_fullStr	Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study
title_full_unstemmed	Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study
title_sort	negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/9745cbaefe8649beb569154bb504cb09
work_keys_str_mv	AT kajakaspersen negativeaffectiveresponsestopositiveeventsandstimuliinpatientswithcomplexdissociativedisordersamixedmethodspilotstudy AT gormhol negativeaffectiveresponsestopositiveeventsandstimuliinpatientswithcomplexdissociativedisordersamixedmethodspilotstudy AT ellenkkjepsen negativeaffectiveresponsestopositiveeventsandstimuliinpatientswithcomplexdissociativedisordersamixedmethodspilotstudy
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Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study

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