A Network Analytic Approach to Dissociation: New Insights from Clinical Data.

Dissociation—a fragmentation of consciousness, memory, identity, perception, body representation, or behavior—lacks a unified definition and its dimensionality is debated. Using Exploratory Graph Analysis (EGA) on the Dissociative Experiences Scale (DES) responses from 668 day-hospital psychotherapy patients with diverse mental disorders, a four-dimensional structure was initially found but proved unstable. After removing unstable items, a final network of 16 items mapped onto three stable dimensions: segregated processes, derealization/depersonalization, and absorption. This three-factor solution aligns with a bipartite model distinguishing altered states of consciousness (detachment) from non-integrated mental modules (compartmentalization), replicating and extending prior findings on dissociation's structure.

Study at a glance

Abstract

The transdiagnostic construct of dissociation, characterized by a disintegration of specific psychological functions such as consciousness, memory, identity, perception, body representation, and behavior, remains elusive to a unified conceptualization. Specifically, its dimensionality is a matter of ongoing controversy. Empirical approaches applying factor analyses to the Dissociative Experiences Scale (DES) have yielded inconsistent findings. This study adopts a novel methodological approach, utilizing Exploratory Graph Analysis (EGA) to address this issue. In a sample of 668 day-hospital patients undergoing psychotherapy for a variety of mental disorders, a Gaussian graphical model was estimated for the 28 items of the DES. Additionally, the stability of the results was ensured by bootstrap procedures. While both the original EGA and the bootstrap EGA suggested four dimensions, the structural consistency of this solution was low due to an instability of 12 items. After excluding 10 of these unstable items, re-analyses again revealed a four-factor structure, but boot EGA indicated that one factor had unsatisfactory structural consistency due to the multidimensionality of its two items. Upon removing these, our final network consisted of 16 items mapping onto 3 dimensions. Our study, using data from a diagnostically heterogeneous sample, replicates and extends previous findings on the dimensionality of dissociation as captured by the DES. The three dimensions identified correspond to segregated processes, derealization/depersonalization, and absorption. This solution aligns with a bipartite model of dissociation with two broader categories referring to either altered states of consciousness (often named detachment) or to non-integrated mental modules (labeled as compartmentalization).