Trauma-Related Altered States of Consciousness: Exploring the 4-D Model

A 4-D model classifies posttraumatic stress symptoms into those occurring in normal waking consciousness versus those representing dissociative altered states of consciousness. Across four dimensions—time-memory, thought, body, and emotion—the model predicts that dissociative symptoms are less frequent, less intercorrelated as momentary states, more common in people with high dissociative symptoms, and more frequent after repeated trauma, especially early developmental trauma. In a sample of 74 women with PTSD primarily from childhood trauma and 504 undergraduates, the first two predictions were supported; the third held in the PTSD sample. However, childhood trauma severity was not strongly linked to dissociative symptoms, indicating further research is needed.

Study at a glance

Abstract

Frewen and Lanius (in press) recently articulated a 4-D model as a framework for classifying symptoms of posttraumatic stress into those that potentially occur within normal waking consciousness (NWC) versus those that intrinsically represent dissociative experiences of trauma-related altered states of consciousness (TRASC). Four dimensions were specified: time-memory, thought, body, and emotion. The 4-D model further hypothesizes that in traumatized persons, symptoms of TRASC, compared with NWC forms of distress, will be (a) observed less frequently; (b) less intercorrelated, especially as measured as moment-to-moment states; (c) observed more frequently in people with high dissociative symptomatology as measured independently; and (d) observed more often in people who have experienced repeated traumatization, particularly early developmental trauma. The aim of the present research was to begin to evaluate these 4 predictions of the 4-D model. Within a sample of 74 women with posttraumatic stress disorder (PTSD) primarily due to histories of childhood trauma, as well as within a 2nd sample of 504 undergraduates (384 females), the 1st 2 hypotheses of the 4-D model were supported. In addition, within the PTSD sample, the 3rd hypothesis was supported. However, inconsistent with the 4th hypothesis, severity of childhood trauma history was not strongly associated with TRASC. We conclude that the hypotheses articulated by the 4-D model were generally supported, although further research in different trauma-related disorders is needed, and the role of childhood trauma history in the etiology of TRASC requires further research.