{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:37:40Z","timestamp":1791214660469,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T00:00:00Z","timestamp":1548806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"ANS Research, Towson University, and numerous generous donors including Anne Bartoletto and family, Michael Hemmer, and Brad Foote"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Individuals with dissociative disorders (DDs) are underrecognized, underserved, and often severely psychiatrically ill, characterized by marked dissociative and posttraumatic stress disorder (PTSD) symptoms with significant disability. Patients with DD have high rates of nonsuicidal self\u2010injury (NSSI) and suicide attempts. Despite this, there is a dearth of training about DDs. We report the outcome of a web\u2010based psychoeducational intervention for an international sample of 111 patients diagnosed with dissociative identity disorder (DID) or other complex DDs. The Treatment of Patients with Dissociative Disorders Network (TOP DD Network) program was designed to investigate whether, over the course of a web\u2010based psychoeducational program, DD patients would exhibit improved functioning and decreased symptoms, including among patients typically excluded from treatment studies for safety reasons. Using video, written, and behavioral practice exercises, the TOP DD Network program provided therapists and patients with education about DDs as well as skills for improving emotion regulation, managing safety issues, and decreasing symptoms. Participation was associated with reductions in dissociation and PTSD symptoms, improved emotion regulation, and higher adaptive capacities, with overall sample |\n                    <jats:italic>d<\/jats:italic>\n                    |s = 0.44\u20130.90, as well as reduced NSSI. The improvements in NSSI among the most self\u2010injurious patients were particularly striking. Although all patient groups showed significant improvements, individuals with higher levels of dissociation demonstrated greater and faster improvement compared to those lower in dissociation |\n                    <jats:italic>d<\/jats:italic>\n                    |s = 0.54\u20131.04 vs. |\n                    <jats:italic>d|<\/jats:italic>\n                    s\u00a0\n                    <jats:italic>=<\/jats:italic>\n                    0.24\u20130.75, respectively.\u00a0These findings support dissemination of DD treatment training and initiation of treatment studies with randomized controlled designs.\n                  <\/jats:p>","DOI":"10.1002\/jts.22370","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T10:29:08Z","timestamp":1548844148000},"page":"156-166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["An Online Educational Program for Individuals With Dissociative Disorders and Their Clinicians: 1\u2010Year and 2\u2010Year Follow\u2010Up"],"prefix":"10.1002","volume":"32","author":[{"given":"Bethany L.","family":"Brand","sequence":"first","affiliation":[{"name":"Department of Psychology Towson University  Towson Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo J.","family":"Schielke","sequence":"additional","affiliation":[{"name":"California Department of State Hospitals Napa  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen T.","family":"Putnam","sequence":"additional","affiliation":[{"name":"The Department of Psychiatry University of North Carolina School of Medicine at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank W.","family":"Putnam","sequence":"additional","affiliation":[{"name":"The Department of Psychiatry University of North Carolina School of Medicine at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Loewenstein","sequence":"additional","affiliation":[{"name":"Sheppard Pratt Health System and University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amie","family":"Myrick","sequence":"additional","affiliation":[{"name":"Family and Children's Services  Bel Air Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen K. K.","family":"Jepsen","sequence":"additional","affiliation":[{"name":"Modum Bad Psychiatric Center  Vikersund Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willemien","family":"Langeland","sequence":"additional","affiliation":[{"name":"Bascous  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Steele","sequence":"additional","affiliation":[{"name":"Atlanta  Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine C.","family":"Classen","sequence":"additional","affiliation":[{"name":"University of California San Francisco and Zuckerberg San Francisco General Hospital  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth A.","family":"Lanius","sequence":"additional","affiliation":[{"name":"Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890423349"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_5_4_1","first-page":"1","article-title":"Dissociation predicts treatment response in eye\u2010movement desensitization and reprocessing for posttraumatic stress disorder","volume":"9732","author":"Bae H.","year":"2016","journal-title":"Journal of Trauma and Dissociation"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(96)00033-2"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X15571996"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0016210"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e3181b3afaa"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1300\/J229v02n04_07"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/2051-6673-1-13"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0027654"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0026487"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000100"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20578"},{"key":"e_1_2_5_15_1","first-page":"16","article-title":"An update on the Dissociative Experience Scale","volume":"6","author":"Carlson E. 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