Dissociation: Factor Structure and the Role of Trauma Among Treatment-Seeking Adolescents

Objective: Research examining the factor structure of the Adolescent Dissociative Experiences Scale (A-DES) has yielded mixed findings. This study sought to further clarify the factor structure of the A-DES among youth with histories of exposure to multiple traumas and adversities. Method: We conducted a factor analysis of the A-DES using data from 1,157 treatment-seeking adolescents with histories of trauma exposure in order to expand understanding of dissociation's construct validity and provide the first attempt at post hoc analysis of trauma-impacted adolescents. Results: A bifactor CFA model fit the data best and identified a strong general factor, supporting a unidimensional latent structure. Only the general dissociation factor was associated with cumulative trauma exposure, operationalized as the number of different types of exposure endorsed on the Trauma History Profile (THP), but this association was small. Conclusions: The study findings point toward a unidimensional conceptualization of dissociation. A developmental psychopathology framework is recommended for future research, allowing a nuanced and integrated approach to understanding dissociation and increasing generalizability across adolescents. Clinical Impact Statement This study examined the construct validity of dissociation in trauma-impacted adolescents. Results indicated that dissociation is related to trauma, and in contrast to recent research, was unidimensional in presentation or experience. Further research is needed to examine the context of dissociation to a greater depth, believed possible by applying a developmental or age-specific lens.