Spontaneous and Deliberate Dissociative Symptoms in Military Personnel: Are Such Symptoms Helpful?

摘要

Objecticve: This study was designed to explore distinctions between spontaneous and deliberate dissociative states in military personnel exposed to stressful survival training. Method: Three hundred thirty-four military members completed the Clinician-Administered Dissociative States Scale (CADSS) after a stressful mock-captivity event during survival training. They were also asked to indicate whether the dissociative experiences just happened, (i.e., spontaneous) or whether they chose to have them happen (i.e., deliberate); and whether they appraised the dissociative experience as helpful (i.e., facilitative) or hurtful (i.e., debilitative) to their ability to cope with the stressful event. Results: The majority of subjects (95.4%) endorsed dissociative symptoms during military stress. Fifty-six percent described dissociative experiences as spontaneous, 13.8% as deliberate, and 29.6% endorsed neither. Spontaneous and deliberate dissociators did not differ on military performance. Among Special Forces soldiers only, those who endorsed facilitative dissociation exhibited higher total CADSS scores than those who endorsed debilitative dissociation, but no differences in military performance were observed. Seventy-two percent of spontaneous dissociators described the experience as debilitative to coping with stress; conversely, 77% of deliberate dissociators said their symptoms facilitated coping with stress. Conclusion: The spontaneous-deliberate and facilitativedebilitative distinctions may enhance the fidelity of studies of dissociation constructs and may offer pivot points for prevention and treatment of stress-related disorders.