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Victor G. Carrión

, John A. Turner

, and Carl F. Weems

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date: 30 May 2020

Dissociation is a neurological state of acute disconnection with the reality of a situation or the self, and is often observed in PTSD. Because of its broad definition, diverse expression, and frequent comorbidity with other disorders, dissociation remains a challenging phenomenon to research and treat. The current chapter reviews the small amount of preclinical literature that has laid the groundwork of our understanding of the physiological underpinnings of dissociation, including theories of its mechanization of the endogenous opioid system. The challenges and importance of assessing dissociation are discussed, and the current instruments available for this assessment are reviewed. The experience of childhood sexual abuse has been specifically linked to the development of dissociative symptoms in PTSD. Future directions, including suggestions for categorical approaches to the identification and treatment of dissociative symptoms, are discussed.

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