Lead author Dr Bronwyn Milkins discusses the findings.
New research from The Kids Research Institute Australia has uncovered how adolescents experience high levels of dissociation symptoms, finding that distress is a frequent trigger, and that affected young people can feel disconnected to reality, their bodies and emotions.
The research also found that young people experiencing dissociation can have temporary failures of memory and attention.
And in a world-first, a soon-to-be-published paper has shown for the first time that adolescents use different coping strategies than adults when experiencing dissociation.
The paper, from the Healing Kids, Healing Families team at The Kids, is among the first to examine the under-recognised condition in adolescents.
Previous research has examined the coping strategies of adults, but in a novel finding, adolescents reported they valued having a trusted person present during an experience of dissociation.
“Clinically, we’ve just been assuming that the criteria developed for adults apply equally to young people,” lead author Dr Bronwyn Milkins said.
But we know that PTSD has different presentations and criteria for young people, as does depression. So we’ve been applying the dissociation criteria to young people without knowing the full picture.
Researchers from The Kids found that effective coping mechanisms, like having a trusted person present, were often counteracted by less effective coping mechanisms such as impulsive behaviours and avoiding friends and family.
“Young people would describe going and doing activities and knowing they were there but simultaneously feeling like they were not in control of their own body. They might go and get a tattoo just to reassure themselves they exist,” Dr Milkins said.
“What can look like strange, impulsive behaviours are really ways of dealing with this disorienting state. Also, sometimes they would cope with dissociation by dissociating even more. The initial moments may be quite scary, so they might use substances or daydream to enter a controlled state of altered consciousness. They’re still dissociating, but they feel more control. This technique unfortunately prolongs the dissociation.”
Having a trusted person present during the experience has not been found to be a coping mechanism for adults experiencing dissociation.
Dr Milkins has since launched a pilot training program, to help clinicians better identify and work more closely with adolescents who experience dissociation. A systematic review on younger children’s experiences of dissociation is also underway and coupled with these papers, will inform diagnostic criteria for dissociative disorders in young people in the future.
The project is being led by Healing Kids, Healing Families researchers at The Kids, in partnership with Child and Adolescent Mental Health Services, the University of Western Australia and Embrace. It received funding from Perth Children’s Hospital Foundation.