Dissociation : Vol. 7, No. 3, p. 138-144 : Obstacles to the recognition of sexual abuse and dissociative disorders in child and adolescent males
Datum
1994-09
Autor:innen
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Verlag
Ridgeview Institute and the International Society for the Study of Dissociation
Zusammenfassung
Previous studies are reviewed which describe difficulties in diagnosing dissociative disorders in general, in children, and in males. Five cases are presented in which males from eight to fourteen years of age were diagnosed as having dissociative disorders after significant delays. In three cases, evaluation did not take place until years after substantiation of child abuse. In one case the child was reabused and in three cases the index victim reabused another child before the dissociative disorder was recognized. Delay in evaluation and diagnosis occurred despite the presence of documented sexual abuse in all cases and typical symptoms including amnestic periods, sudden shifts in behavior and emotion, denial of witnessed behavior, and somnambulistic or trance states. Three patients had at least one first degree relative with a dissociative disorder. Obstacles to recognition included denial of sexual abuse and symptoms by the boys themselves and their families and therapists; other problems included family dysfunction, and the patients' self-isolation. In these cases some qualities of the dissociative systems mitigated against recognition including: 1) the presence of a secret-keeping alter that shielded all victimization memories; and 2) hypermasculine traits in the host including aggressivity and stoicism, which were perceived as hypernormal rather than as resulting from dissociative fragmentation.
Beschreibung
p. 138-144