{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:25:56Z","timestamp":1792121156457,"version":"4.4.0"},"reference-count":98,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria (<jats:italic>N<\/jats:italic>= 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5\u201345.0%) across all samples, 45.5% (95% CI 37.7\u201353.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8\u201332.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0\u201361.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.<\/jats:p>","DOI":"10.1017\/s0033291722001647","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T06:22:45Z","timestamp":1655965365000},"page":"1629-1644","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":82,"title":["Prevalence of the dissociative subtype of post-traumatic stress disorder: a systematic review and meta-analysis"],"prefix":"10.1017","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4642-0564","authenticated-orcid":false,"given":"William F.","family":"White","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-5219","authenticated-orcid":false,"given":"Aaron","family":"Burgess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7304-2231","authenticated-orcid":false,"given":"Tim","family":"Dalgleish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3436-3358","authenticated-orcid":false,"given":"Sarah","family":"Halligan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4180-8941","authenticated-orcid":false,"given":"Rachel","family":"Hiller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Oxley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0743-7972","authenticated-orcid":false,"given":"Patrick","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0262-623X","authenticated-orcid":false,"given":"Richard","family":"Meiser-Stedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"S0033291722001647_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21933"},{"key":"S0033291722001647_ref11","doi-asserted-by":"publisher","DOI":"10.1080\/24750573.2017.1326746"},{"key":"S0033291722001647_ref90","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20034"},{"key":"S0033291722001647_ref64","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2014.71"},{"key":"S0033291722001647_ref57","doi-asserted-by":"publisher","DOI":"10.1037\/0033-3204.41.4.472"},{"key":"S0033291722001647_ref84","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000474"},{"key":"S0033291722001647_ref31","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"S0033291722001647_ref27","doi-asserted-by":"publisher","DOI":"10.1037\/a0027900"},{"key":"S0033291722001647_ref15","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000297"},{"key":"S0033291722001647_ref3","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1698223"},{"key":"S0033291722001647_ref2","first-page":"201","article-title":"Associations between circadian preferences, sleep quality, dissociation, post-traumatic cognitions, and post-traumatic stress disorder (PTSD) among incarcerated offenders","volume":"21","author":"Acar","year":"2019","journal-title":"Sleep and Hypnosis"},{"key":"S0033291722001647_ref66","doi-asserted-by":"publisher","DOI":"10.1037\/a0019783"},{"key":"S0033291722001647_ref78","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-017-1445-2"},{"key":"S0033291722001647_ref92","volume-title":"Clinician-administered PTSD scale:(CAPS)","author":"Weathers","year":"2004"},{"key":"S0033291722001647_ref89","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"S0033291722001647_ref80","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.1986.tb03174.x"},{"key":"S0033291722001647_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.02.004"},{"key":"S0033291722001647_ref36","doi-asserted-by":"publisher","DOI":"10.1177\/1745691613504115"},{"key":"S0033291722001647_ref5","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"S0033291722001647_ref54","first-page":"234","volume-title":"Handbook of PTSD: Science and practice","author":"Lanius","year":"2014"},{"key":"S0033291722001647_ref9","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000057"},{"key":"S0033291722001647_ref69","first-page":"318","article-title":"Dissociative disorders and dissociative symptoms among veterans of the Iraq-Iran war suffering from chronic post-traumatic disorder","volume":"12","author":"Nejad","year":"2007","journal-title":"Neurosciences Journal"},{"key":"S0033291722001647_ref29","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22339"},{"key":"S0033291722001647_ref24","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-0310-5_14"},{"key":"S0033291722001647_ref17","doi-asserted-by":"publisher","DOI":"10.1037\/a0027748"},{"key":"S0033291722001647_ref38","doi-asserted-by":"publisher","DOI":"10.1300\/J229v07n02_02"},{"key":"S0033291722001647_ref67","unstructured":"Naish, B. L. (2021). Relative efficacy of the Clinician-Administered PTSD Scale-5, the Dissociative Subtype of PTSD Scale, and the Dissociative Experiences Scales to identify the PTSD dissociative subtype [Doctoral dissertation, Alliant International University]."},{"key":"S0033291722001647_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2019.02.003"},{"key":"S0033291722001647_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852920001248"},{"key":"S0033291722001647_ref41","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2018.1451805"},{"key":"S0033291722001647_ref22","doi-asserted-by":"publisher","DOI":"10.1002\/da.21920"},{"key":"S0033291722001647_ref85","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2015.04.017"},{"key":"S0033291722001647_ref70","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-26633-6_12"},{"key":"S0033291722001647_ref86","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1176\/ajp.153.7.83","article-title":"Dissociation, somatization, and affect dysregulation: The complexity of adaptation to trauma","volume":"153","author":"van der Kolk","year":"1996","journal-title":"American Journal of Psychiatry"},{"key":"S0033291722001647_ref76","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejtd.2018.08.005"},{"key":"S0033291722001647_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2016.04.008"},{"key":"S0033291722001647_ref49","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12771"},{"key":"S0033291722001647_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.11.010"},{"key":"S0033291722001647_ref62","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1176\/ajp.155.6.806","article-title":"Relationship between dissociation, childhood sexual abuse, childhood physical abuse, and mental illness in a general population sample","volume":"155","author":"Mulder","year":"1998","journal-title":"American Journal of Psychiatry"},{"key":"S0033291722001647_ref30","first-page":"1","article-title":"Latent profile analysis of PTSD and dissociation, and relations with anger","volume":"41","author":"Durham","year":"2020","journal-title":"Current Psychology"},{"key":"S0033291722001647_ref58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.01.016"},{"key":"S0033291722001647_ref94","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.1574"},{"key":"S0033291722001647_ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s12207-019-09371-9"},{"key":"S0033291722001647_ref23","doi-asserted-by":"publisher","DOI":"10.2307\/3001666"},{"key":"S0033291722001647_ref32","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2019.1597806"},{"key":"S0033291722001647_ref60","first-page":"208","article-title":"Posttraumatic stress disorder in DSM-5: New criteria and controversies","volume":"21","author":"Miller","year":"2014","journal-title":"Clinical Psychology: Science and Practice"},{"key":"S0033291722001647_ref93","doi-asserted-by":"publisher","DOI":"10.1002\/da.21946"},{"key":"S0033291722001647_ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1235-2"},{"key":"S0033291722001647_ref73","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199611000-00004"},{"key":"S0033291722001647_ref87","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.116.185579"},{"key":"S0033291722001647_ref74","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2019.11.904"},{"key":"S0033291722001647_ref91","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.106.4.499"},{"key":"S0033291722001647_ref65","first-page":"345","volume-title":"Handbook of quantitative methodology for the social sciences","author":"Muth\u00e9n","year":"2004"},{"key":"S0033291722001647_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2019.104040"},{"key":"S0033291722001647_ref97","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2018.1468707"},{"key":"S0033291722001647_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2013.12.008"},{"key":"S0033291722001647_ref83","doi-asserted-by":"publisher","DOI":"10.1002\/da.21944"},{"key":"S0033291722001647_ref81","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-020-00274-x"},{"key":"S0033291722001647_ref56","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2018.11.008"},{"key":"S0033291722001647_ref95","doi-asserted-by":"publisher","DOI":"10.1177\/1073191115615212"},{"key":"S0033291722001647_ref34","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1606625"},{"key":"S0033291722001647_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2017.09.425"},{"key":"S0033291722001647_ref52","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000140"},{"key":"S0033291722001647_ref75","doi-asserted-by":"publisher","DOI":"10.3109\/00048670903393597"},{"key":"S0033291722001647_ref25","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/17-207"},{"key":"S0033291722001647_ref26","first-page":"128","article-title":"Prevalence and risk factors of post-traumatic stress disorders among survivors of the 2015 Nepal earthquake, in Dhading, Nepal","volume":"20","author":"Dahal","year":"2018","journal-title":"Sleep and Hypnosis"},{"key":"S0033291722001647_ref88","unstructured":"Verbeck, E. G. (2015). Examining the evidence for a dissociative subtype of posttraumatic stress disorder. [Doctoral dissertation, Alliant International University]."},{"key":"S0033291722001647_ref72","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2017.1338914"},{"key":"S0033291722001647_ref79","first-page":"1","article-title":"The dissociative subtype of PTSD: An update of the literature","volume":"29","author":"Schiavone","year":"2018","journal-title":"PTSD Research Quarterly"},{"key":"S0033291722001647_ref33","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.10135"},{"key":"S0033291722001647_ref82","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2012.08.022"},{"key":"S0033291722001647_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-014-0819-y"},{"key":"S0033291722001647_ref20","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2019.1572043"},{"key":"S0033291722001647_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.01.004"},{"key":"S0033291722001647_ref46","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"S0033291722001647_ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.11.014"},{"key":"S0033291722001647_ref18","first-page":"39","volume-title":"Dissociation and the dissociative disorders: DSM-V and beyond","author":"Carlson","year":"2009"},{"key":"S0033291722001647_ref45","doi-asserted-by":"publisher","DOI":"10.1002\/9780470712184.ch7"},{"key":"S0033291722001647_ref55","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2020.19060647"},{"key":"S0033291722001647_ref59","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2017.1296209"},{"key":"S0033291722001647_ref8","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-203104"},{"key":"S0033291722001647_ref50","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2019.1675113"},{"key":"S0033291722001647_ref53","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1657372"},{"key":"S0033291722001647_ref71","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v6.26657"},{"key":"S0033291722001647_ref35","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v6.26406"},{"key":"S0033291722001647_ref44a","doi-asserted-by":"publisher","DOI":"10.1002\/9780470712184.ch8"},{"key":"S0033291722001647_ref44","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.13472"},{"key":"S0033291722001647_ref96","volume-title":"ICD-11: International classification of diseases","year":"2019"},{"key":"S0033291722001647_ref4","volume-title":"Diagnostic and statistical manual of mental disorders","year":"1980"},{"key":"S0033291722001647_ref68","unstructured":"National Heart Lung and Blood Institute. (2014). Quality assessment tool for observational, cohort and cross-sectional studies. National Heart Lung and Blood Institute. Retrieved from https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools."},{"key":"S0033291722001647_ref77","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2020.102222"},{"key":"S0033291722001647_ref14","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-200002000-00002"},{"key":"S0033291722001647_ref63","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000148"},{"key":"S0033291722001647_ref12","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.68.5.748"},{"key":"S0033291722001647_ref47","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2019.1678214"},{"key":"S0033291722001647_ref13","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.12.2295"},{"key":"S0033291722001647_ref61","doi-asserted-by":"publisher","DOI":"10.1007\/s40653-017-0153-0"},{"key":"S0033291722001647_ref28","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12464"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291722001647","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T15:55:54Z","timestamp":1727452554000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291722001647\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,23]]},"references-count":98,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["S0033291722001647"],"URL":"https:\/\/doi.org\/10.1017\/s0033291722001647","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,23]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}