{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:58:00Z","timestamp":1770829080257,"version":"3.50.1"},"reference-count":72,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Background: Patients with panic disorder (PD) may experience increased vulnerability to dissociative and anxious phenomena in the presence of repeated traumatic events, and these may be risk factors for the development of complex post-traumatic stress disorder (cPTSD). The present study aims to find out whether the presence of cPTSD exacerbates anxiety symptoms in patients suffering from panic disorder and whether this is specifically associated with the occurrence of dissociative symptoms. Methods: One-hundred-and-seventy-three patients diagnosed with PD were recruited and divided into two groups based on the presence (or absence) of cPTSD using the International Trauma Questionnaire (ITQ) scale. Dissociative and anxious symptoms were assessed using the Cambridge Depersonalization Scale (CDS) and Hamilton Anxiety Scale (HAM-A), respectively. Results: Significant differences in re-experienced PTSD (p &lt; 0.001), PTSD avoidance (p &lt; 0.001), PTSD hyperarousal (p &lt; 0.001), and DSO dysregulation (p &lt; 0.001) were found between the cPTSD-positive and cPTSD-negative groups. A statistically significant association between the presence of cPTSD and total scores on the HAM-A (p &lt; 0.001) and CDS (p &lt; 0.001) scales was found using regression analysis. Conclusions: This study highlights the potential link between dissociative symptoms and a more severe clinical course of anxiety-related conditions in patients with PD. Early intervention programs and prevention strategies are needed.<\/jats:p>","DOI":"10.3390\/bs14030166","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T11:28:47Z","timestamp":1708601327000},"page":"166","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Unraveling the Complexity: Exploring the Intersection of Panic Disorder, Dissociation, and Complex Post-Traumatic Stress Disorder"],"prefix":"10.3390","volume":"14","author":[{"given":"Martina","family":"D\u2019Angelo","sequence":"first","affiliation":[{"name":"Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2326-3896","authenticated-orcid":false,"given":"Marta","family":"Valenza","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology \u201cVittorio Erspamer\u201d, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Maria","family":"Iazzolino","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grazia","family":"Longobardi","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2333-0637","authenticated-orcid":false,"given":"Valeria","family":"Di Stefano","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Lanzara","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, University Giustino Fortunato, 82100 Benevento, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Visalli","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Steardo","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology \u201cVittorio Erspamer\u201d, Sapienza University of Rome, 00185 Rome, Italy"},{"name":"Department of Clinical Psychology, University Giustino Fortunato, 82100 Benevento, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7314-1539","authenticated-orcid":false,"given":"Caterina","family":"Scuderi","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology \u201cVittorio Erspamer\u201d, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-3506","authenticated-orcid":false,"suffix":"Jr.","given":"Luca","family":"Steardo","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.31887\/DCNS.2003.5.3\/pmartin","article-title":"The Epidemiology of Anxiety Disorders: A Review","volume":"5","author":"Martin","year":"2003","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"327","DOI":"10.31887\/DCNS.2015.17.3\/bbandelow","article-title":"Epidemiology of Anxiety Disorders in the 21st Century","volume":"17","author":"Bandelow","year":"2015","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_3","unstructured":"Cackovic, C., Nazir, S., and Marwaha, R. (2023). Panic Disorder, StatPearls Publishing."},{"key":"ref_4","first-page":"197","article-title":"The Diagnosis and Management of Panic Disorder","volume":"8","author":"Wood","year":"1990","journal-title":"Psychiatr. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1037\/0022-006X.65.2.203","article-title":"Misinterpretation of Body Sensations in Panic Disorder","volume":"65","author":"Clark","year":"1997","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"434","DOI":"10.30773\/pi.2020.0425","article-title":"Functional Impairment in Patients with Panic Disorder","volume":"18","author":"Kim","year":"2021","journal-title":"Psychiatry Investig."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/00005053-199907000-00006","article-title":"Quality of Life in Patients with Panic Disorder","volume":"187","author":"Candilis","year":"1999","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1001\/archpsyc.1989.01810110026004","article-title":"Quality of Life in Panic Disorder","volume":"46","author":"Markowitz","year":"1989","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1176\/ajp.153.2.213","article-title":"Functioning and Well-Being of Patients With Panic Disorder","volume":"153","author":"Sherbourne","year":"1996","journal-title":"Am. J. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.psc.2009.06.002","article-title":"Anxiety and Anxiety Disorders in Children and Adolescents: Developmental Issues and Implications for DSM-V","volume":"32","author":"Beesdo","year":"2009","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"159","DOI":"10.31887\/DCNS.2017.19.2\/kdomschke","article-title":"Genetics of Generalized Anxiety Disorder and Related Traits","volume":"19","author":"Gottschalk","year":"2017","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1093\/pch\/9.8.547","article-title":"Behavioural Inhibition: A Predictor of Anxiety","volume":"9","author":"Svihra","year":"2004","journal-title":"Pediatric. Child Health"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Luis-Joaquin, G.L., Lourdes, E.F., and Muela-Mart\u00ednez, J.A. (2020). Behavioral Inhibition in Childhood as a Risk Factor for Development of Social Anxiety Disorder: A Longitudinal Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17113941"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/0022-3956(91)90015-3","article-title":"Further evidence of an association between behavioral inhibition and anxiety disorders: Results from a family study of children from a non-clinical sample","volume":"25","author":"Rosenbaum","year":"1991","journal-title":"J. Psychiatry Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"207","DOI":"10.31887\/DCNS.2003.5.3\/dcharney","article-title":"The Psychobiology of Resilience and Vulnerability to Anxiety Disorders: Implications for Prevention and Treatment","volume":"5","author":"Charney","year":"2003","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/0005-7967(93)90025-P","article-title":"Somatic Symptoms and Panic Attacks: A Retrospective Study of Learning Experiences","volume":"31","author":"Ehlers","year":"1993","journal-title":"Behav. Res. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1001\/archpsyc.61.9.913","article-title":"Somatic Symptoms and Physiologic Responses in Generalized Anxiety Disorder and Panic Disorder: An Ambulatory Monitor Study","volume":"61","author":"McLeod","year":"2004","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1348\/014466505X28766","article-title":"The Role of Panic in Acute Dissociative Reactions Following Trauma","volume":"44","author":"Bryant","year":"2005","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1176\/appi.ajp.2017.17010025","article-title":"Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale","volume":"175","author":"Lyssenko","year":"2018","journal-title":"Am. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.concog.2017.01.007","article-title":"Symptom Overreporting and Dissociative Experiences: A Qualitative Review","volume":"49","author":"Merckelbach","year":"2017","journal-title":"Conscious. Cogn."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S0010-440X(00)90044-0","article-title":"Depersonalization in Panic Disorder: A Clinical Study","volume":"41","author":"Segui","year":"2000","journal-title":"Compr. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"78","DOI":"10.32481\/djph.2022.05.010","article-title":"Trauma-Related Dissociation and the Dissociative Disorders: Neglected Symptoms with Severe Public Health Consequences","volume":"8","author":"Boyer","year":"2022","journal-title":"Dela J. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1176\/ajp.156.3.379","article-title":"Childhood Trauma and Perceived Parental Dysfunction in the Etiology of Dissociative Symptoms in Psychiatric Inpatients","volume":"156","author":"Draijer","year":"1999","journal-title":"Am. J. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1521\/psyc.2006.69.4.362","article-title":"The Long\u2013Term Consequences of Early Childhood Trauma: A Case Study and Discussion","volume":"69","author":"Kaplow","year":"2006","journal-title":"Psychiatry Interpers. Biol. Process."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.psc.2005.10.008","article-title":"Dissociative Disorders as a Confounding Factor in Psychiatric Research","volume":"29","author":"Sar","year":"2006","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.1177\/15248380221120835","article-title":"The Relationship Between Dissociation and Complex Post-Traumatic Stress Disorder: A Scoping Review","volume":"24","author":"Fung","year":"2023","journal-title":"Trauma Violence Abus."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/jts.2490090208","article-title":"Dissociative Experiences and Posttraumatic Stress Disorder among Female Victims of Criminal Assault and Rape","volume":"9","author":"Dancu","year":"1996","journal-title":"J. Trauma. Stress."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"59","DOI":"10.2466\/pr0.1996.78.1.59","article-title":"Dissociation in an Outpatient Sample of Women Reporting Childhood Sexual Abuse","volume":"78","author":"Keaney","year":"1996","journal-title":"Psychol. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/da.10028","article-title":"Childhood Trauma in Obsessive-Compulsive Disorder, Trichotillomania, and Controls","volume":"15","author":"Lochner","year":"2002","journal-title":"Depress. Anxiety"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1017\/S0033291797005990","article-title":"Unemployment and Serious Suicide Attempts","volume":"28","author":"Beautrais","year":"1998","journal-title":"Psychol. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/S0010-440X(96)90044-9","article-title":"The Relationship between Dissociative Symptoms, Alexithymia, Impulsivity, Sexual Abuse, and Self-Mutilation","volume":"37","author":"Zlotnick","year":"1996","journal-title":"Compr. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/0145-2134(95)00098-6","article-title":"Childhood Abuse and Recovery from Major Depression","volume":"19","author":"Zlotnick","year":"1995","journal-title":"Child. Abus. Negl."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"263","DOI":"10.31887\/DCNS.2011.13.2\/jsherin","article-title":"Post-Traumatic Stress Disorder: The Neurobiological Impact of Psychological Trauma","volume":"13","author":"Sherin","year":"2011","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1046\/j.1440-1819.2003.01088.x","article-title":"Suicide Attempt and Self-Mutilation among Turkish High School Students in Relation with Abuse, Neglect and Dissociation","volume":"57","author":"Zoroglu","year":"2003","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"583","DOI":"10.2165\/00044011-200727080-00007","article-title":"Effect of Dissociative Experiences on Drug Treatment of Panic Disorder","volume":"27","author":"Gulsun","year":"2007","journal-title":"Clin. Drug Investig."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"6809","DOI":"10.1038\/s41598-022-10787-8","article-title":"Mentalization and Dissociation after Adverse Childhood Experiences","volume":"12","author":"Riedl","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Iazzolino, A.M., Valenza, M., D\u2019Angelo, M., Longobardi, G., Stefano, V., Scuderi, C., and Steardo, L. (2023). How Effective Are Mood Stabilizers in Treating Bipolar Patients Comorbid with CPTSD? Results from an Observational Study. Int. J. Bipolar Disord., preprint.","DOI":"10.21203\/rs.3.rs-3776264\/v1"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"D\u2019Angelo, M., Valenza, M., Iazzolino, A.M., Longobardi, G., Di Stefano, V., Lanzara, E., Visalli, G., Steardo, L., and Scuderi, C. (2024). Exploring the Interplay between Complex PTSD and Obsessive-Compulsive Disorder Severity: Implications for Clinical Practice. Preprints, 2024011222.","DOI":"10.20944\/preprints202401.1222.v1"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Iazzolino, A.M., Valenza, M., D\u2019Angelo, M., Longobardi, G., Di Stefano, V., Visalli, G., Steardo, L., Scuderi, C., and Steardo, L. (2024). The Impact of Complex PTSD on Suicide Risk in Patients with Bipolar Disorder: A Cross-Sectional Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13030673"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Yang, L., Wei, C., and Liang, Y. (2023). Symptom Structure of Complex Posttraumatic Stress Disorder among Chinese Young Adults with Childhood Trauma: A Network Analysis. BMC Psychiatry, 23.","DOI":"10.1186\/s12888-023-05423-2"},{"key":"ref_41","first-page":"2114451","article-title":"Prevalence and Characterization of Psychological Trauma in Patients with Fibromyalgia: A Cross-Sectional Study","volume":"2022","author":"Fontana","year":"2022","journal-title":"Pain. Res. Manag."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.comppsych.2014.06.007","article-title":"Depersonalization: An Exploratory Factor Analysis of the Italian Version of the Cambridge Depersonalization Scale","volume":"60","author":"Fagioli","year":"2015","journal-title":"Compr. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0165-1781(00)00100-1","article-title":"The Cambridge Depersonalization Scale: A New Instrument for the Measurement of Depersonalization","volume":"93","author":"Sierra","year":"2000","journal-title":"Psychiatry Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jad.2019.11.137","article-title":"Dissociative Symptoms as Measured by the Cambridge Depersonalization Scale in Patients with a Bipolar Disorder","volume":"263","author":"Tuineag","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"387","DOI":"10.5455\/msm.2016.28.387-391","article-title":"Papageorgiou, and Reliability, Validity, and Psychometric Properties of the Greek Translation of the Cambridge Depersonalization Scale (CDS)","volume":"28","author":"Kontoangelos","year":"2016","journal-title":"Mater. Socio Medica"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/0165-0327(88)90072-9","article-title":"The Hamilton Anxiety Scale: Reliability, Validity and Sensitivity to Change in Anxiety and Depressive Disorders","volume":"14","author":"Maier","year":"1988","journal-title":"J. Affect. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"112788","DOI":"10.1016\/j.psychres.2020.112788","article-title":"A Comparison of the Dimensionality of the Hamilton Rating Scale for Anxiety and the DSM-5 Anxious-Distress Specifier Interview","volume":"284","author":"Thompson","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/occmed\/kqv054","article-title":"Hamilton Rating Scale for Anxiety (HAM-A)","volume":"65","author":"Thompson","year":"2015","journal-title":"Occup. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1796187","DOI":"10.1080\/20008198.2020.1796187","article-title":"Psychometric Properties of the International Trauma Questionnaire (ITQ) Examined in a Norwegian Trauma-Exposed Clinical Sample","volume":"65","author":"Sele","year":"2020","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1930961","DOI":"10.1080\/20008198.2021.1930961","article-title":"The International Trauma Questionnaire (ITQ) Measures Reliable and Clinically Significant Treatment-Related Change in PTSD and Complex PTSD","volume":"12","author":"Cloitre","year":"2021","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1665617","DOI":"10.1080\/20008198.2019.1665617","article-title":"Validation of a Clinician-Administered Diagnostic Measure of ICD-11 PTSD and Complex PTSD: The International Trauma Interview in a Swedish Sample","volume":"10","author":"Bondjers","year":"2019","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s00127-004-0701-4","article-title":"The Epidemiology of Depersonalisation and Derealisation","volume":"39","author":"Sierra","year":"2004","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1176\/appi.ajp.157.3.451","article-title":"Childhood Trauma and Dissociative Symptoms in Panic Disorder","volume":"157","author":"Marshall","year":"2000","journal-title":"Am. J. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s11013-007-9077-8","article-title":"Dissociative Experience and Cultural Neuroscience: Narrative, Metaphor and Mechanism","volume":"32","author":"Seligman","year":"2008","journal-title":"Cult. Med. Psychiatry"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"70","DOI":"10.4103\/psychiatry.IndianJPsychiatry_896_20","article-title":"Dissociative Experiences and Health Anxiety in Panic Disorder","volume":"63","author":"Ray","year":"2021","journal-title":"Indian J. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Carbone, E.A., Menculini, G., de Filippis, R., D\u2019Angelo, M., Zebi, L., and Steardo, L. (2023). Sleep Disturbances in Panic Disorder with Comorbid Complex PTSD: A Possible Relationship and Different Psychopathology?. Life, 13.","DOI":"10.3390\/life13081636"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1080\/15299732.2015.1019175","article-title":"Childhood Traumatic Experiences, Dissociative Symptoms, and Dissociative Disorder Comorbidity among Patients with Panic Disorder: A Preliminary Study","volume":"16","author":"Ural","year":"2015","journal-title":"J. Trauma. Dissociation"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/0010-440X(93)90008-R","article-title":"Correlates of Dissociative Symptomatology in Patients with Physical and Sexual Abuse Histories","volume":"34","author":"Kirby","year":"1993","journal-title":"Compr. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1192\/bja.2018.29","article-title":"A Paradigm Shift: Relationships in Trauma-Informed Mental Health Services","volume":"24","author":"Sweeney","year":"2018","journal-title":"BJPsych Adv."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"7","DOI":"10.31887\/DCNS.2000.2.1\/bvdkolk","article-title":"Posttraumatic Stress Disorder and the Nature of Trauma","volume":"2","year":"2000","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1016\/j.injury.2020.07.014","article-title":"Seasonal Variation in Trauma Admissions to a Level III Trauma Unit over 10 Years","volume":"51","author":"Hind","year":"2020","journal-title":"Injury"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1176\/appi.ps.201300255","article-title":"Trauma-Focused Cognitive-Behavioral Therapy for Children and Adolescents: Assessing the Evidence","volume":"65","author":"Lyman","year":"2014","journal-title":"Psychiatr. Serv."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1348\/147608304X21400","article-title":"Control Theory and Psychopathology: An Integrative Approach","volume":"78","author":"Mansell","year":"2005","journal-title":"Psychol. Psychother."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"23970","DOI":"10.3402\/ejpt.v5.23970","article-title":"Psychosocial Facets of Resilience: Implications for Preventing Posttrauma Psychopathology, Treating Trauma Survivors, and Enhancing Community Resilience","volume":"5","author":"Iacoviello","year":"2014","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1038\/s41386-022-01468-1","article-title":"Deconstructing Dissociation: A Triple Network Model of Trauma-Related Dissociation and Its Subtypes","volume":"47","author":"Lebois","year":"2022","journal-title":"Neuropsychopharmacology"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Han, H.R., Miller, H.N., Nkimbeng, M., Budhathoki, C., Mikhael, T., Rivers, E., Gray, J., Trimble, K., Chow, S., and Wilson, P. (2021). Trauma Informed Interventions: A Systematic Review. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252747"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2147\/NDT.S10389","article-title":"Cognitive Behavioral Therapy for the Treatment of Post-Traumatic Stress Disorder: A Review","volume":"7","author":"Kar","year":"2011","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1111\/jcpp.12566","article-title":"Research Review: Changes in the Prevalence and Symptom Severity of Child Post-Traumatic Stress Disorder in the Year Following Trauma\u2014A Meta-Analytic Study","volume":"57","author":"Hiller","year":"2016","journal-title":"J. Child. Psychol. Psychiatry"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.jad.2021.09.103","article-title":"The Influence of Childhood Trauma on the Treatment Outcomes of Pharmacological and\/or Psychological Interventions for Adolescents and Adults with Bipolar Disorder: A Systematic Review and Meta-Analysis","volume":"296","author":"Wrobel","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3389\/fnbeh.2018.00258","article-title":"Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions","volume":"12","author":"Watkins","year":"2018","journal-title":"Front. Behav. Neurosci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/j.1600-0447.2008.01157.x","article-title":"Is a Combined Therapy More Effective than Either CBT or SSRI Alone? Results of a Multicenter Trial on Panic Disorder with or without Agoraphobia","volume":"117","author":"Mersch","year":"2008","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Seitz, K.I., Sicorello, M., Schmitz, M., Valencia, N., Herpertz, S.C., Bertsch, K., and Neukel, C. (2024). Childhood Maltreatment and Amygdala Response to Interpersonal Threat in a Transdiagnostic Adult Sample: The Role of Trait Dissociation. Biol. Psychiatry Cogn. Neurosci. Neuroimaging, in press.","DOI":"10.1016\/j.bpsc.2024.01.003"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/14\/3\/166\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:03:26Z","timestamp":1760105006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/14\/3\/166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,22]]},"references-count":72,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["bs14030166"],"URL":"https:\/\/doi.org\/10.3390\/bs14030166","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,22]]}}}