The Clinician-Administered Dissociative States Scale (CADSS):Validation of the German Version

The Clinician-Administered Dissociative States Scale (CADSS) is a structured clinical interview to assess state dissociation rated by clinicians. The current study aimed to validate the German version of CADSS by comparing it to the established self-report measures for dissociation and exploring its underlying factor structure. Severity of within-session state dissociation was assessed directly following a standard psychotherapy session in a trauma-exposed patient sample (N= 105; 81.9% female). Internal consistency, convergent validity with other dissociation measures, and the factorial structure of the instrument were analyzed. The German version exhibited excellent internal consistency (Cronbach's α = .94) and correlated significantly with self-report measures of state dissociation (r = .86) and trait dissociation (r = .77) indicative of high convergent validity. Exploratory factor analysis revealed a three-factor solution with the factors (1) Depersonalization/Derealization, (2) Identity Confusion/Alteration, and (3) Amnesia. Results support the CADSS as a useful instrument to assess state dissociation, conceptualized as a multidimensional construct, in clinical practice

Predictors of Revictimization in Online Dating

Introduction. While a significant association between childhood maltreatment and sexual victimization in adulthood has been established in previous research, it is unknown whether this also applies to the context of online dating. Therefore, we aimed to investigate whether revictimization is common in online users and which mechanisms mediate this risk Method. The participants were 413 heterosexual women aged between 18 and 35 who used mobile dating applications in the year before the assessment. The participants reported information on using mobile dating applications, motives for engaging in casual sex, protective dating strategies and general motives for online dating. Results. Childhood maltreatment severity was positively related to both cyber and in-person sexual victimization severity. Motives related to regulating negative affect and self-esteem mediated the relationship between childhood maltreatment severity and in-person sexual victimization severity in adulthood. Furthermore, those motives moderated the association between cyber and in-person sexual victimization. The effect of cyber victimization on in-person sexual victimization was stronger at higher levels of affect/self-esteem regulatory sex motives compared to lower levels. The affect/self-esteem regulatory sex motives were not related to protective dating strategies. Discussion. The results of the study imply that a history of childhood maltreatment is a risk factor for sexual victimization in adulthood among young heterosexual women who use online dating. One of the factors linking these variables in this population might be affect/self-esteem regulatory sex motives. Future studies should aim at replicating these associations prospectively

Structural and functional brain alterations in psychiatric patients with dissociative experiences:A systematic review of magnetic resonance imaging studies

Introduction There is currently no general agreement on how to best conceptualize dissociative symptoms and whether they share similar neural underpinnings across dissociative disorders. Neuroimaging data could help elucidate these questions. Objectives The objective of this review is to summarize empirical evidence for neural aberrations observed in patients suffering from dissociative symptoms. Methods A systematic literature review was conducted including patient cohorts diagnosed with primary dissociative disorders, post-traumatic stress disorder (PTSD), or borderline personality disorder. Results Results from MRI studies reporting structural (gray matter and white matter) and functional (during resting-state and task-related activation) brain aberrations were extracted and integrated. In total, 33 articles were included of which 10 pertained to voxel-based morphology, 2 to diffusion tensor imaging, 10 to resting-state fMRI, and 11 to task-related fMRI. Overall findings indicated aberrations spread across diverse brain regions, especially in the temporal and frontal cortices. Patients with dissociative identity disorder and with dissociative PTSD showed more overlap in brain activation than each group showed with depersonalization/derealization disorder. Conclusion In conjunction, the results indicate that dissociative processing cannot be localized to a few distinctive brain regions but rather corresponds to differential neural signatures depending on the symptom constellation

Experiences of BSN Graduates Integrating Cultural Competence when Caring for Multicultural Patients

Registered nurses entering the workforce with baccalaureate of science degrees in nursing (BSN) are expected to be knowledgeable and skilled in planning and caring for multicultural patients, but there is little information on what experiences new nurses have in implementing culturally competent care. The purpose of this descriptive phenomenological study, guided by the Campinha-Bacote process of cultural competence in the delivery of health care services model, was to understand the lived experiences of BSN graduates with one year or less experience in implementing cultural competence in planning care for their multicultural patients. The research question directly addressed this purpose. Ten participants were interviewed using one-on-one, open-ended interviews. Coding and thematic analysis was conducted using Colaizzi’s process to analyze and interpret the data. Key findings were that BSN nurses practicing one year or less had (a) multidimensional views of cultural competence, (b) acquired cultural knowledge through experience, (c) believed open communication was essential to implementing cultural competence, and that (d) cultural accommodation was provided through advocacy. Thus, the nurses were able to use methods that over time increased their awareness, knowledge, skill, desire, and encounters of cultural competence. The results of this study can be used to inform academic institutions and health care organizations to ensure clinical experiences that develop cultural competence prior to graduation. Improving cultural competence among new graduates can prevent inequities in health care and support patient safety, supporting positive social change