Peritraumatic dissociation and posttraumatic stress symptoms: the moderating role of perceived threat

Background: Although peritraumatic dissociation (PD) is viewed as a risk factor for posttraumatic stress disorder (PTSD), prospective studies taking into account other well-known risk factors for PTSD have been scarce, and the exploration of potential moderators within the relations between PD and PTSD has been lacking.Objective: Filling this gap, this prospective study explored the moderating role of perceived threat within the relations between PD and PTSD, above and beyond age, gender, education, and early trauma-related symptoms.Method: A convenience sample of 200 Israeli civilians filled out self-report questionnaires during the peritraumatic phase (T1) and one to two months after the posttraumatic phase (T2) of being exposed to rocket attacks.Results: The results showed that perceived threat and PD were associated with early trauma-related symptoms and PTSD symptoms. Moreover, perceived threat moderated the relationship between PD and all PTSD symptom clusters apart from avoidance.Conclusions: The present results suggest that the implications of PD are shaped by levels of perceived threat, so that detriments of PD are evident when the trauma is appraised as being highly threatening. Therefore, early interventions that aim to decrease PD may be beneficial in preventing PTSD symptoms of intrusion, hyper arousal, and negative alterations in mood and cognition, for individuals who perceive traumatic events as highly threatening. Perceived threat was related to early trauma-related symptoms and PTSD symptoms.Peritraumatic dissociation was related to early trauma-related symptoms and PTSD symptoms.Perceived threat moderated the link between peritraumatic dissociation and PTSD symptoms. Antecedentes: Aunque la disociacion peritraumatica (DP) es considerada como un factor de riesgo para el trastorno de estres postraumatico (TEPT), los estudios prospectivos que toman en cuenta otros factores de riesgo bien conocidos para el TEPT han sido escasos y ha faltado la exploracion de moderadores potenciales dentro de las relaciones entre la DP y el TEPT.Objetivo: Para llenar este vacio, este estudio prospectivo exploro el papel moderador de la amenaza percibida dentro de las relaciones entre la DP y el TEPT, mas alla de la edad, genero, educacion y sintomas tempranos relacionados con trauma.Metodo: Una muestra por conveniencia de 200 civiles israelies contestaron cuestionarios de auto-reporte durante la fase peritraumatica (T1) y uno a dos meses despues de la fase postraumatica (T2) de exposicion a los ataques con cohetes.Resultados: Los resultados mostraron que la amenaza percibida y la DP estuvieron relacionadas con sintomas tempranos relacionados con el trauma y sintomas de TEPT. Ademas, la amenaza percibida moderaba la relacion entre la DP y todos los grupos de sintomas del TEPT a excepcion de la evitacion.Conclusiones: Los resultados actuales sugieren que las implicaciones de la DP estan determinadas por los niveles de amenaza percibida, de modo que los perjuicios de la DP son evidentes cuando el trauma se evalua como altamente amenazante. Por lo tanto, las intervenciones precoces que buscan disminuir la DP pueden ser beneficiosas para prevenir los sintomas intrusivos, la hiperalerta y las alteraciones negativas en el animo y la cognicion del TEPT, para las personas que perciben eventos traumaticos como altamente amenazantes.