Dissociation in the laboratory: a comparison of strategiesKari Nations Leonard, Michael J. Telch *, Patrick J. HarringtonDepartment of Psychology, The University of Texas at Austin, Mezes Hall 330, Austin, TX 78712, USAAccepted 20 February 1998AbstractSeveral methods for inducing dissociation in the laboratory were examined in a sample of 78undergraduate students. Participants scoring high or low on the Dissociative Experiences Scaleparticipated in three dissociation challenge conditions: (a) dot-staring task, (b) administration of pulsedphotic and audio stimulation and (c) stimulus deprivation. Participants recorded their dissociativeexperiences both before and after each of the three challenge conditions. Across conditions, high DESparticipants reported signi®cantly more dissociative sensations than low DES participants, even aftercontrolling for pre-challenge dissociation. Moreover, regardless of DES status, pulsed photo and audiostimulation produced the greatest level of dissociative symptoms. The ®ndings suggest that the inductionof dissociative symptoms in a nonclinical sample is easily accomplished in the laboratory and that thosewho report more dissociative symptoms in their day-to-day life exhibit more pronounced dissociativesymptoms when undergoing dissociative challenge in the laboratory. Implications for the study andtreatment of dissociative symptoms are discussed. # 1998 Elsevier Science Ltd. All rights reserved.1. IntroductionDissociation has proved to be an enigmatic subject; it manages to surface not only throughseveral pathological states, both psychological and physiological, but also through normalhuman experience. Dissociation is de®ned as a temporary disruption in conscious awareness,memory or sense of identity (American Psychiatric Association, 1994). Bernstein and Putnam(1986) conceptualize dissociation on a severity continuum in which normal dissociation lies atone end and the most severe form, dissociative identity disorder (DID, formerly multiplepersonality disorder), lies at the other.Dissociative disorders including dissociative amnesia, dissociative fugue, dissociative identitydisorder and depersonalization disorder are estimated to aect up to 11% of psychiatricBehaviour Research and Therapy 37 (1999) 49±610005-7967/98/$19.00 # 1998 Elsevier Science Ltd. All rights reserved.PII: S 0005 -7 96 7( 9 8 ) 0 0 07 2- 2BEHAVIOURRESEARCH ANDTHERAPYPERGAMON* Corresponding author. Tel.: +1-512-471-3393; e-mail: [email protected] (Bliss and Jeppsen, 1985; Ross, 1991). Dissociative symptoms are also commonlyfound in medical conditions such as migraine headaches, head trauma and temporal lobeepilepsy (Steinberg, 1991; Grigsby and Kaye, 1993).The linkage between trauma and dissociation has received considerable attention. Not onlyhas dissociation been linked to childhood physical and sexual abuse in both clinical (Chu andDill, 1990; Ross, 1991; Anderson et al., 1992; Zlotnick et al., 1996) and nonclinical populations(Sanders et al., 1989; Ross et al., 1991), but symptoms of dissociation are also commonlyreported following adult trauma (Bremner et al., 1993; Marmar et al., 1996; Van der Kolk etal., 1996). It has been suggested that by altering one's state of consciousness, dissociationlessens the impact of extremely distressing events (Shilony and Grossman, 1993).Dissociation has also been linked to a host of other psychological disorders including panicdisorder (Telch et al., 1989a,b; Schneier et al., 1991), depression (Schumaker et al., 1995),eating disorders (Demitrack et al., 1990; Schumaker et al., 1995), somatoform disorders (Priboret al., 1993) and borderline personality disorder (Ross et al., 1991; Brodsky et al., 1995).In addition to its co-occurrence among people aicted with psychiatric disorders,dissociative experiences such as daydreaming, `tuning out' and feeling detached from others arealso common in the general population (Ross et al., 1990; Ray and Faith, 1995) and are oftenperceived as a normal part of everyday life (Trueman, 1984). Certain activities such asmeditation or the ingestion of marijuana and other hallucinogens are associated with increasedincidence of dissociation experiences (Castillo, 1990; Mathew et al., 1993).Despite the high prevalence of dissociative experiences in both clinical and nonclinicalpopulations, few investigations have examined the induction of dissociative symptoms in thelaboratory. Mathew et al. (1993) administered high and low-THC marijuana cigarettes andTHC-free marijuana cigarettes to participants on separate occasions. Not surprisingly, moredissociation was reported by those who smoked marijuana cigarettes than those who smokedplacebo cigarettes. Although the results con®rm the dissociative powers of marijuana, its use asa laboratory challenge is problematic due to the obvious legal and ethical constraints ofmarijuana use.Based on observations linking serotonergic dysfunction and dissociation, Simeon et al.(1995) administered the serotonin agonist, chlorophenylipiperazine (m-CPP) to 67 normal andpatient volunteers. As predicted, those who received m-CPP reported signi®cantly moresymptoms of depersonalization than did those who received placebo. However, only 12 of the67 participants experienced dissociation symptoms.To our knowledge, only one study has used non-pharmacological methods for inducingdissociation in the laboratory. Miller et al. (1994) administered several focusing techniques (i.e.dot staring, staring at one's own re¯ection in a mirror and silently repeating one's name) alongwith two neutral activities (i.e. reading names from a phone book and looking through a photoalbum) to 10 panic patients with depersonalization/derealization (DD), 10 panic patientswithout DD and 10 non-anxious controls. Each subject completed all ®ve conditions. Aftereach activity, participants completed an author-constructed dissociation/depersonalizationquestionnaire. Results showed that regardless of group status, the mirror and dot staring taskswere more successful at eliciting DD than the other three conditions. Moreover, panic patientswithout DD and normal volunteers experienced few DD sensations relative to the panicpatients with DD. Although this study successfully induced dissociation, the design was limitedB.J. Cox et al. / Behaviour Research and Therapy 37 (1999) 49±6150in several respects: (a) small sample size, (b) brief rest periods between tasks thus increasing thein¯uence of carry-over
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