Der Zusammenhang zwischen Trauma und Dissoziation: Eine kritische Betrachtung

Zusammenfassung

Dissoziation wird häufig konzeptualisiert als ein Abwehrmechanismus für traumatische Erfahrungen (z. B. sexuellen oder körperlichen Missbrauch) sowie emotionale und elterliche Vernachlässigung. Diese Überzeugung resultiert aus Studien, in denen ein Zusammenhang zwischen Selbsteinschätzung traumatischer Erfahrungen und dissoziativen Symptomen festgestellt wurde. Die kausale Interpretation dieses Zusammenhanges ist jedoch problematisch. In diesem Beitrag wird diskutiert, dass der Zusammenhang zwischen Trauma-Selbsteinschätzung und dissoziativen Symptomen nicht direkt und unikausal ist. Zunächst erfolgt eine zusammenfassende Darstellung einiger Studien, in denen dieser Zusammenhang untersucht wurde. Dann wird auf Untersuchungen eingegangen, die weitere, diesen Zusammenhang beeinflussende Faktoren, identifiziert haben. Im Folgenden werden unterschiedliche Korrelate von Dissoziation herausgearbeitet. Einige dieser Korrelate (z. B. Phantasieneigung, Suggestibilität und Dysfunktionen des Frontalhirns) sind besonders relevant, da sie die Genauigkeit retrospektiver Selbsteinschätzung traumatischer Erfahrungen infrage stellen. Letztlich erscheint die Verbindung zwischen Trauma und Dissoziation wesentlich komplexer als oft behauptet. Die Möglichkeit, dass dissoziative Symptome zu erhöhter Selbsteinschätzung traumatischer Erfahrungen führen, verdient besondere Aufmerksamkeit.

Abstract

Dissociation is often considered to be a psychological defense mechanism used by victims of traumatic events (e. g., sexual abuse, physical punishment, or emotional abuse). Evidence for this view comes from studies that found a connection between self-reported traumatic childhood experiences and high levels of dissociation. However, there are some problems with this causal interpretation. The aim of this review is to summarize evidence that casts doubts on the commonly voiced view that the connection between self-reported trauma and dissociation is a simple and robust one. First, we briefly summarize studies that looked at the link between trauma and dissociation as well as studies that identified factors that may modulate this link. Second, we review studies that explored the psychological correlates of dissociation. Over the past few years, our knowledge of these correlates has increased considerably. Some of these correlates (e. g., fantasy proneness, suggestibility, and frontal lobe dysfunction) are especially relevant because they may undermine the accuracy of retrospective self-reports of trauma. Finally, we conclude that the link between trauma and dissociation is more complex than many clinicians seem to assume. In particular, the possibility that dissociation acts as an antecedent of self-reported trauma warrants serious attention.

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