Original Research Article
Year: 2019 | Month: July | Volume: 9 | Issue: 7 | Pages: 1-11
Management of Dissociative Disorders: The Stress Loading Hypothesis and Utility of Students Stress Dimension Questionnaire (SSDQ)
Prof. (Dr.) Sanjay Gupta1, Dr Nitesh Kumar Singh2, Dr Vinod Verma3
1Professor, Department of Psychiatry, Institute of Medical Sciences, BHU, Varanasi &
Coordinator, Stress Management and Counselling Centre, BHU, Varanasi
2Senior Resident, Department of Psychiatry, Institute of Medical Sciences, BHU, Varanasi
3Junior Resident, Department of Psychiatry, Institute of Medical Sciences, BHU, Varanasi
Corresponding Author: Sanjay Gupta
ABSTRACT
Introduction- The Dissociative Disorder diagnosis is largely attributable to, and being preceded by, stressful life events or psychological trauma. Targeted intervention is mostly not possible in Dissociative Disorder making management ineffective. We sought to explore utility of Student Stress Dimension Questionnaire (SSDQ) in detecting stressors in Dissociative Disorder patients. Also, we hypothesized that not only a single, but multiple stressors across different life domains add up, leading to significantly high stress loads which are associated with the causation of Dissociative Disorder and treatment should be focussed on reducing these high stress loads, which we postulate to lead to clinical recovery.
Materials And Methods- We tested our hypothesis through three Cases of Dissociative Disorder, randomly selected for the study. Stress was evaluated through 1) routine semi structured clinical psychiatric interview (scpi) 2) Presumptive Stressful Life Events Scale (PSLES) and 3) SSDQ. Cases were evaluated at baseline and further at Week 2 and Week 4 for Stress Loading and clinical improvement.
In Statistical method, means of Cumulative Stress Loading and number of Dissociative episodes over time were calculated and percentage improvement analysed over time.
Results- The scpi and PSLES failed to identify varied Stressors in affected Cases effectively whereas SSDQ proved highly useful in their detection. Also, SSDQ alone was found applicable and effective in guiding therapeutic intervention in patients of Dissociative Disorder.
Conclusion- These findings support our hypothesis of Cumulative Stress Loading being associated with Dissociative Disorder.
Key words: Dissociative Disorder, Stress, SSDQ, PSLES. Cumulative Stress Load, Targeted intervention