Original Article

Relationship between Dissociative Experiences and Schizotypal Personality Traits: Mediating Role of Inferential Confusion

Abstract

Objective: Previous research has shown a relationship between schizotypal personality traits and dissociative tendencies. The Inference-Based Approach (IBA) can explain this relationship to some extent. Purpose of this study was to investigate the mediating role of inferential confusion in relation to dissociative experiences and schizotypal personality traits.

Method: A total of 341 students from Shahed University participated in this cross-sectional study. Sampling was conducted randomly by the cluster sampling method. Data were collected using the Inferential Confusion Questionnaire (ICQ-EV), Schizotypal Personality Questionnaire-Brief (SPQ-B), and Dissociative Experiences Scale (DES-II). Data were analyzed using SPSS-22 software based on statistical methods including Pearson correlation, Baron and Kenny hierarchical regression and the Sobel test.

Results: There were significant positive relationships between dissociative experiences, schizotypal personality traits, and inferential confusion (P < 0.01). Findings showed that inferential confusion mediates the relationship between dissociative experiences and schizotypal personality traits (β = 0.29; P < 0.001).

Conclusion: According to the obtained results, the present study, considering role of inferential confusion, succeeded in explaining the relationship between dissociative experiences and schizotypal personality traits to some extent.

1. Lyssenko L, Schmahl C, Bockhacker L, Vonderlin R, Bohus M, Kleindienst N. Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale. Am J Psychiatry. 2018;175 (1) :37-46.
2. Şar V. The many faces of dissociation: opportunities for innovative research in psychiatry. Clin Psychopharmacol Neurosci. 2014;12 (3) :171-9.
3. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association; 2013.
4. O'Driscoll C, Laing J, Mason O. Cognitive emotion regulation strategies, alexithymia and dissociation in schizophrenia, a review and meta-analysis. Clin Psychol Rev. 2014;34 (6) :482-95.
5. Burton MS, Feeny NC, Connell AM, Zoellner LA. Exploring evidence of a dissociative subtype in PTSD: Baseline symptom structure, etiology, and treatment efficacy for those who dissociate. J Consult Clin Psychol. 2018;86 (5) :439-51.
6. Ball S, Robinson A, Shekhar A, Walsh K. Dissociative symptoms in panic disorder. J Nerv Ment Dis. 1997;185 (12) :755-60.
7. Mula M, Pini S, Preve M, Masini M, Giovannini I, Cassano GB. Clinical correlates of depersonalization symptoms in patients with bipolar disorder. J Affect Disord. 2009;115 (1-2) :252-6.
8. Parlar M, Frewen PA, Oremus C, Lanius RA, McKinnon MC. Dissociative symptoms are associated with reduced neuropsychological performance in patients with recurrent depression and a history of trauma exposure. Eur J Psychotraumatol. 2016;7:29061.
9. Aardema F, Wu KD. Imaginative, dissociative, and schizotypal processes in obsessive-compulsive symptoms. J Clin Psychol. 2011;67 (1) :74-81.
10. Pozza A, Torniai S, Dèttore D. Inferential Confusion moderates the effects of dissociative experiences on OCD symptoms severity in a clinical sample with Obsessive-Compulsive Disorder. Clin. Neuropsychiatry. 2016(6):108-14.
11. La Mela C, Maglietta M, Castellini G, Amoroso L, Lucarelli S. Dissociation in eating disorders: relationship between dissociative experiences and binge-eating episodes. Compr Psychiatry. 2010;51 (4) :393-400.
12. Černis E, Evans R, Ehlers A, Freeman D. Dissociation in relation to other mental health conditions: An exploration using network analysis. J Psychiatr Res. 2021;136:460-7.
13. Longden E, Branitsky A, Moskowitz A, Berry K, Bucci S, Varese F. The Relationship Between Dissociation and Symptoms of Psychosis: A Meta-analysis. Schizophr Bull. 2020;46 (5) :1104-13.
14. Giesbrecht T, Merckelbach H, Kater M, Sluis AF. Why dissociation and schizotypy overlap: the joint influence of fantasy proneness, cognitive failures, and childhood trauma. J Nerv Ment Dis. 2007;195 (10) :812-8.
15. Merckelbach H, Giesbrecht T. Subclinical dissociation, schizotypy, and traumatic distress. Pers Individ Dif. 2006;40(2):365-74.
16. Fonseca Pedrero E, Debbané M. Schizotypal traits and psychotic-like experiences during adolescence: An update. Psicothema. 2017;29 (1) :5-17.
17. Linscott RJ, van Os J. An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med. 2013;43 (6) :1133-49.
18. Dodell-Feder D, Saxena A, Rutter L, Germine L. The network structure of schizotypal personality traits in a population-based sample. Schizophr Res. 2019;208:258-67.
19. Barrantes-Vidal N, Grant P, Kwapil TR. The role of schizotypy in the study of the etiology of schizophrenia spectrum disorders. Schizophr Bull. 2015;41 Suppl 2 (Suppl 2) :S408-16.
20. Fonseca-Pedrero E, Debbané M, Ortuño-Sierra J, Chan RCK, Cicero DC, Zhang LC, et al. The structure of schizotypal personality traits: a cross-national study. Psychol Med. 2018;48 (3) :451-62.
21. Ellason JW, Ross CA. Positive and negative symptoms in dissociative identity disorder and schizophrenia: a comparative analysis. J Nerv Ment Dis. 1995;183 (4) :236-41.
22. Kluft RP. First-rank symptoms as a diagnostic clue to multiple personality disorder. Am J Psychiatry. 1987;144 (3) :293-8.
23. Ross CA, Miller SD, Reagor P, Bjornson L, Fraser GA, Anderson G. Schneiderian symptoms in multiple personality disorder and schizophrenia. Compr Psychiatry. 1990;31 (2) :111-8.
24. Simeon D, Guralnik O, Knutelska M, Nelson D. Dissection of schizotypy and dissociation in depersonalization disorder. J Trauma Dissociation. 2004;5(4):111-9.
25. Haugen MC, Castillo RJ. Unrecognized dissociation in psychotic outpatients and implications of ethnicity. J Nerv Ment Dis. 1999;187 (12) :751-4.
26. Merckelbach H, J àC, Hardy S, Giesbrecht T. Dissociation and fantasy proneness in psychiatric patients: a preliminary study. Compr Psychiatry. 2005;46 (3) :181-5.
27. Spitzer C, Haug HJ, Freyberger HJ. Dissociative symptoms in schizophrenic patients with positive and negative symptoms. Psychopathology. 1997;30 (2) :67-75.
28. Irwin HJ. The relationship between dissociative tendencies and schizotypy: an artifact of childhood trauma? J Clin Psychol. 2001;57 (3) :331-42.
29. Merckelbach H, Rassin E, Muris P. Dissociation, schizotypy, and fantasy proneness in undergraduate students. J Nerv Ment Dis. 2000;188 (7) :428-31.
30. Moskowitz AK, Barker-Collo S, Ellson L. Replication of dissociation-psychosis link in New Zealand students and inmates. J Nerv Ment Dis. 2005;193 (11) :722-7.
31. Pope CA, Kwapil TR. Dissociative experience in hypothetically psychosis-prone college students. J Nerv Ment Dis. 2000;188 (8) :530-6.
32. Watson D. Dissociations of the night: individual differences in sleep-related experiences and their relation to dissociation and schizotypy. J Abnorm Psychol. 2001;110 (4) :526-35.
33. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986;174 (12) :727-35.
34. Chapman LJ, Chapman JP, Raulin ML. Body-image aberration in Schizophrenia. J Abnorm Psychol. 1978;87 (4) :399-407.
35. Chapman JP, Chapman LJ, Kwapil, TR.Scales for the measurement of schizotypy. In: Raine A, Lencz T, Mednick S, Editors. Schizotypal Personality. Cambridge: Cambridge University Press; 1995.
36. Claridge G, Broks P. Schizotypy and hemisphere function—I: Theoretical considerations and the measurement of schizotypy. Pers Individ Dif. 1984;5(6):633-48.
37. Raine A, Benishay D. The SPQ-B: A brief screening instrument for schizotypal personality disorder. J Pers Disord. 1995;9(4):346-55.
38. Pervin LA. The Science of Personality, 2nd. New York: Oxford University Press Inc; 2002.
39. Zhang Y, Wang Y, Shen C, Ye Y, Shen S, Zhang B, et al. Relationship between hypnosis and personality trait in participants with high or low hypnotic susceptibility. Neuropsychiatr Dis Treat. 2017;13:1007-12.
40. Giesbrecht T, Merckelbach H. Dreaming to reduce fantasy?–Fantasy proneness, dissociation, and subjective sleep experiences. Pers Individ Dif. 2006;41(4):697-706.
41. Piedmont RL, Sherman MF, Sherman NC, Dy-Liacco GS, Williams JE. Using the five-factor model to identify a new personality disorder domain: the case for experiential permeability. J Pers Soc Psychol. 2009;96 (6) :1245-58.
42. Startup M. Schizotypy, dissociative experiences and childhood abuse: relationships among self-report measures. Br J Clin Psychol. 1999;38(4):333-44.
43. Lee J, Park S. Working memory impairments in schizophrenia: a meta-analysis. J Abnorm Psychol. 2005;114(4):599-611.
44. Aardema F, O'Connor KP, Emmelkamp PM, Marchand A, Todorov C. Inferential confusion in obsessive-compulsive disorder: the inferential confusion questionnaire. Behav Res Ther. 2005;43 (3) :293-308.
45. O'Connor K, Robillard S. Inference processes in obsessive-compulsive disorder: some clinical observations. Behav Res Ther. 1995;33 (8) :887-96.
46. O’Connor KP, & Robillard SA.Cognitive approach tomodifying primary inferencesin obsessive compulsive disorder.J CognTher 1999;13:1-17.
47. O’Leary N. The relationship between inferential confusion, obsessive compulsiveness, schizotypy and dissociation in a non-clinical sample [dissertation]. Guildford, United Kingdom: University of Surrey; 2015.
48. Aardema F, Kleijer TM, Trihey M, O'Connor K, Emmelkamp PM. Processes of inference, schizotypal thinking, and obsessive-compulsive behaviour in a normal sample. Psychol Rep. 2006;99(1):213-20.
49. Paradisis SM, Aardema F, Wu KD. Schizotypal, Dissociative, and Imaginative Processes in a Clinical OCD Sample. J Clin Psychol. 2015;71 (6) :606-24.
50. Aardema F, Emmelkamp PM, O'Connor KP. Inferential confusion, cognitive change and treatment outcome in Obsessive–Compulsive Disorder. Psychol Psychother 2005;12 (5) :337-45.
51. O'Connor K, Aardema F. Living in a Bubble dissociation, relational consciousness, and obsessive compulsive disorder. J Conscious Stud. 2012;19(7-8):216-46.
52. Morrison K. The Relationship between Dissociation, Susceptibility to Doubt and Obsessive-Compulsiveness: University of Surrey (United Kingdom); 2015.
53. O'Connor K, Aardema F. Clinician's handbook for Obsessive Compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell; 2012.
54. Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics. Boston, MA: Pearson; 2007.
55. Carlson EB, Putnam FW. An update on the dissociative experiences scale. Dissociation: Progress in the Dissociative Disorders1993;6:16-27.
56. Kianpoor M, Ghanizadeh A, Badiei H. The relationship between dissociative experiences and the success of treatment through abstinence from opioid-use disorders. Zahedan J Res Med Sci. 2012;14(10):56-60.
57. Raine A, Benishay D. The SPQ-B: A brief screening instrument for schizotypal personality disorder. J Pers Disord. 1995;9(4):346-55.
58. Mohammadzadeh A. The study of psychometric properties of schizotypal personality questionnaire-brief (SPQ-B). Int J Psychol. 2007;1(2):47-61.
59. Aardema F, Wu KD, Careau Y, O’Connor K, Julien D, Dennie S. The expanded version of the Inferential Confusion Questionnaire: further development and validation in clinical and non-clinical samples. J Psychopathol Behav Assess. 2010;32(3):448-62.
60. Ghorbali A, Shairi M, Gholami-Fesharaki MA. Preliminary study of the psychometric properties of the Persian version of the expanded version of the Inferential Confusion Questionnaire (ICQ-EV) in a non-clinical sample. J Psychol Sci. 2018;17:373- 379. [In Persian]
61. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51 (6) :1173-82.
62. van de Ven V, Merckelbach H. The role of schizotypy, mental imagery, and fantasy proneness in hallucinatory reports of undergraduate students. Pers Individ Dif. 2003;35(4):889-96.
63. Frewen PA, Lanius RA. Neurobiology of dissociation: unity and disunity in mind-body-brain. Psychiatr Clin North Am. 2006;29(1):113-28, ix.
64. Soffer-Dudek N. Dissociation and dissociative mechanisms in panic disorder, obsessive–compulsive disorder, and depression: A review and heuristic framework. Psychol Conscious: Theory Res Pract. 2014;1 (3):243-270.
65. Goods NA, Rees CS, Egan SJ, Kane RT. The relationship between magical thinking, inferential confusion and obsessive-compulsive symptoms. Cogn Behav Ther. 2014;43(4):342-50.
66. Bocci L, Gordon PK. Does magical thinking produce neutralising behaviour? An experimental investigation. Behav Res Ther. 2007;45 (8) :1823-33.
67. O'Connor K, Aardema F. Fusion or confusion in obsessive compulsive disorder. Psychol Rep. 2003;93 (1) :227-32.
68. Holmes EA, Brown RJ, Mansell W, Fearon RP, Hunter EC, Frasquilho F, et al. Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clin Psychol Rev. 2005;25 (1) :1-23.
69. Brown RJ. Different types of "dissociation" have different psychological mechanisms. J Trauma Dissociation. 2006;7 (4) :7-28.
Files
IssueVol 17 No 1 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijps.v17i1.8049
Keywords
Confusion Dissociation Imagination Schizotypal Personality

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ghorbali A, Shaeiri MR, Gholami Fesharaki M. Relationship between Dissociative Experiences and Schizotypal Personality Traits: Mediating Role of Inferential Confusion. Iran J Psychiatry. 2021;17(1):52-60.