(PS14-36) Lifetime Sexual Victimization and Dissociation: Examining Pathways Through Emotion Dysregulation

Close to half of women who experience sexual violence (SV) in childhood also reporting SV in adulthood (“lifetime revictimization”; Walker et al., 2019). Women who experience lifetime revictimization often have greater mental health difficulties than those who experience SV in one developmental period, including higher rates of dissociation and emotion dysregulation (Cloitre et al., 1997; Charak et al., 2018). Prior studies suggest that dissociation may arise from compromised emotion regulatory systems following revictimization (Lanius et al., 2010), yet no study to date has assessed these relations longitudinally. The present study examined whether emotion dysregulation mediated the relation between SV history and dissociation. We predicted lifetime revictimization status at baseline (T1) would predict higher levels of dissociation 16 months later (T2) through greater emotion dysregulation (T1).

Participants were 490 community women from Mississippi, Nebraska, and Ohio. Analyses were conducted using two waves from a three-year long study. The Computer Assisted Maltreatment Inventory (CAMI; DiLillo et al., 2010) assessed sexual victimization prior to age 18 and the Modified Sexual Experiences Scale (MSES; Messman-Moore et al., 2000) assessed adult victimization. Three categories were created: (1) those reporting no SV, (2) those reporting SV in either childhood or adulthood (singly victimized), and (3) those reporting SV in both childhood and adulthood (lifetime revictimization). The six subscales from the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) assessed emotion dysregulation at T1 (i.e., impulse control difficulties, lack of emotional awareness, lack of emotional clarity, difficulties engaging in goal-directed behavior, emotion regulation strategies, and nonacceptance of emotional responses). The average total from the Dissociative Experiences Scale-II (DES-II; Carlson & Putnam, 1993) assessed dissociation at T2.

Six separate mediation models were conducted in MPlus to assess whether the various subscales of the DERS differentially mediated the relation between victimization status and dissociation. New victimizations during the study and prior levels of dissociation served as controls in the analyses. Consistent with hypotheses, T1 revictimization status was indirectly related to higher T2 dissociation through greater T1 lack of emotional clarity, (singly vs. non-victimized: B = 0.28, SE = 0.19, 95% CI [0.014, 0.825]; revictimized vs. non-victimized: B = 0.56, SE = 0.35, 95% CI [0.038, 1.464]. There were no significant mediating effects for other forms of emotion dysregulation. These results suggest that dysregulation associated with difficulty understanding one’s emotions may be particularly important in the etiology and/or maintenance of dissociation following repeated instances of SV. Clinicians may want to consider enhancing emotion identification among clients with revictimization histories to reduce dissociation.