ARTICLEDepersonalization, adversity, emotionality, and cop

ARTICLE
Depersonalization, adversity, emotionality, and coping
with stressful situations
Paula Thomson, PsyD and S. Victoria Jaque, PhD
Department of Kinesiology, California State University,
Northridge, California, USA
ABSTRACT
Depersonalization is defined as persistent or recurrent episodes
of feeling detached or estranged from a sense of self and the
world. This study addressed the primary question: Do
nonclinical
individuals who endorse high symptomatic depersonalization
have inherently more intense emotional responses, along with
more childhood adversity and past trauma? In this IRB approved
study, participants who met clinical levels of depersonalization
(n = 43, 16.3%) were compared to a group without clinical
levels
of depersonalization (n = 221, 83.7%). Adverse childhood
experi-
ences, adult traumatic events, emotional overexcitability,
coping
strategies under stress, and anxiety were examined in both
groups. The variables to assess depersonalization severity
included the Dissociative Experience Scale-II, Cambridge
Depersonalization Scale, and Multiscale Dissociation Inventory.
The results indicated that clinical levels of depersonalization
were identified in 16.3% of the sample. The high depersonaliza-
tion group had significantly more adverse childhood
experiences,

in particular, emotional abuse and neglect. They also
experienced
more adult traumatic events, higher levels of anxiety, more
emo-
tional overexcitability, and they employed a less adaptive emo-
tion-oriented coping strategy under stress. It is recommended
that treating depersonalization symptoms should include exam-
ining childhood adversity, especially emotional abuse and
neglect. Based on study findings, emotion regulation skills
should
be promoted to help individuals with elevated depersonalization
manage their emotion-oriented coping strategies, anxiety, and
emotional overexcitability.
ARTICLE HISTORY
Received 3 September
Accepted 17 March 2017
KEYWORDS
Anxiety; childhood adversity;
coping; depersonalization;
emotion; trauma
Introduction
Depersonalization (DP) causes significant distress; the
symptoms may be
transient, persistent, or recurrent, and it is often difficult to
fully treat
(Mula, Pini, & Cassano, 2007). According to the DSM-5
diagnostic criteria
(APA, 2013), individuals with depersonalization disorder (DPD)
experience a
sense of unreality, detachment, and being an outside observer to
their feel-
ings, thoughts, sensations, and perceptions, although reality

testing remains
CONTACT Paula Thomson, PsyD [email protected] California
State University, Northridge, 18111
Nordhoff St., Northridge 91330-8287.
Note: Preliminary results presented at 2015 ISSTD Conference
JOURNAL OF TRAUMA & DISSOCIATION
2018, VOL. 19, NO. 2, 143–161
https://doi.org/10.1080/15299732.2017.1329770
© 2017 Taylor & Francis Group, LLC
intact. Time and external surroundings are distorted and the
individual often
feels sensations such as emotional or physical numbness, foggy,
dreamlike, or
lifeless. A sense of estrangement from self and the world is
often the hallmark
of this disorder. Generally, lifetime prevalence for a
depersonalization dis-
order is approximately 2% (APA, 2013; Michal et al., 2009;
Simeon, 2004);
however, depersonalization experiences, in themselves, are
relatively com-
mon, with prevalence rates ranging from 26–74% (Michal et al.,
2009). DP
operates on a continuum; differentiating between DP and DPD
is contingent
on degree of impairment, with clinical diagnosis reflecting
significant distress
(Michal et al., 2009; Mula et al., 2007).
DPD individuals are often self-absorbed and may experience a

form of com-
pulsive self-scrutiny (Sierra, Baker, Medford, & David, 2005).
DPD may operate as
an index of severity in other disorders, such as anxiety and
depression (APA, 2013;
Bob et al., 2008; Lee, Kwok, Hunter, Richards, & David, 2012;
Michal et al., 2011;
Mula et al., 2007). It can be exacerbated by stress, whether in
novel and over-
stimulating settings or negative conflict-laden situations
(interpersonal, financial,
occupational). Physical exhaustion, including lack of sleep, can
also exacerbate DP
(APA, 2013). DPD individuals also exhibit cognitive difficulties
in focusing and
retaining information, prolonged absorption, and alexithymia
(Simeon,
Giesbrecht, Knutelska, Smith, & Smith, 2009). According to the
DSM-5 (APA,
2013), behavioral responses of flattened affect and demeanor
can be incongruent
to the emotional pain that the individual reports.
Childhood interpersonal trauma is a strong predictor of
dissociative disorders
in general (Simeon, Guralnik, Schmeidler, Sirof, & Knutelska,
2001). Emotional
abuse or neglect is strongly associated with depersonalization,
along with other
stressors such as domestic violence, being parented by a
mentally ill family
member, or unexpected death of a loved one (Michal et al.,
2009; Mula et al.,
2007; Simeon et al., 2001). Depersonalization disordered
patients also manifest
increased physiologic stress responses, even during baseline

resting phases
(Simeon, Guralnik, Knutelska, Hollander, & Schmeidler, 2001;
Simeon,
Guralnik, Knutelska, Yehuda, & Schmeidler, 2003). This
heightened stress
response is further demonstrated in studies that indicate a
strong association
between heightened anxiety, increased panic attacks, and
catastrophic appraisals
(Hunter, Phillips, Chalder, Sierra, & David, 2003).
Individuals with elevated DP frequently employ stress-coping
strategies such as
social isolation, self-blame, and rumination, along with
decreased efforts to
regulate negative emotions and control stressful situations
(Wolfradt &
Engelmann, 2003). According to Endler and Parker (1990),
there are three
primary dispositional coping strategies employed under stress:
task-oriented,
emotion-oriented, and avoidant-oriented. These three coping
strategies are
strongly related to personality traits and can be considered traits
in and of
themselves (Cosway, Endler, Sadler, & Deary, 2000; Deary,
Blenkin, Agius,
Endler, Zealley, & Wood, 1996; Moos & Holohan, 2003). Task-
oriented stress
144 P. THOMSON AND S. V. JAQUE
management is directed toward solving the problem and
cognitively restructuring

it in an attempt to alter the situation. This is the most effective
dispositional
strategy (Moos & Holohan, 2003). Emotion-oriented coping
strategies suggest
that individuals have more emotional reactions that include
more self-oriented
preoccupation and fantasizing. This approach actually increases
stress, is nega-
tively related to adaptation and good health, and is associated
with more psycho-
pathology (Cosway et al., 2000; McWilliams, Cox, & Enns,
2003; Robinaugh &
McNally, 2010). Avoidant-oriented stress coping is also
considered less adaptive in
the long term, because it does not produce change during stress
and can be
draining over time, although it is generally better than
emotional-oriented coping
in the short term (Myers, Fleming, Lancman, Perrine, &
Lancman, 2013). It is
clinically important to understand these three coping strategies
and how they
manifest in individuals with depersonalization symptoms. Given
that DP indivi-
duals report a diminished sense of agency, a general sense of
disconnectedness
from life (APA, 2013), along with blunted autonomic responses
(Giesbrecht,
Smeets, Merckelbach, & Marko, 2007; Sierra, Senior, Phillips,
& David, 2006),
suggests that they may also have difficulty coping under
stressful situations.
Adding to the difficulties managing stress, DP individuals
frequently
fluctuate in their emotional reactivity and body sensations,

despite report-
ing emotional numbing. DPD patients struggle with intense
anxiety and
constant emotional perseveration; harm avoidant behavior is
often engaged
to decrease these reactions (Medford, Sierra, Baker, & David,
2005;
Mendoza et al., 2011). Whether individuals prone to more DP
are also
innately more emotionally sensitive and aware is seldom
explored, although
personality studies suggest that DPD patients are more
emotionally reactive
(Mendoza et al., 2011; Michal, Wiltink, Till, Wild, Munzel,
Blankenberg, &
Beutel, 2010)). The overexcitability theoretical model may add
insight into
how some individuals are vulnerable to heightened DP.
Overexcitability is
considered an “intense response pattern” to internal or external
stimuli
(Ackerman, 2009, p. 89; Mendaglio & Tillier, 2006). There are
five over-
excitability traits: psychomotor, intellectual, sensual,
imaginational, and
emotional (Ackerman, 2009). Emotional overexcitability (OE-E)
is a dis-
positional trait that is marked by strong expressions of valuing
and finding
meaning in relationships, extreme range of feelings, intense
affective mem-
ory, and greater anxiety (Ackerman, 2009; Falk, Lind, Miller,
Piechowski, &
Silverman, 1999). It is believed that emotional overexcitability
influences
how an individual responds to conflict and shapes how they

move towards
their optimal development (Ackerman, 2006; Mika, 2005).
However, excit-
ability can also negatively increase the intensity of an
experience and the
sensitivity to situational stimuli (Alias, Rahman, Majid, &
Yassin, 2013;
Tieso, 2007). Elevated overexcitability traits often increase
difficulty inte-
grating into social settings and amplify states of anxiety and
depression
JOURNAL OF TRAUMA & DISSOCIATION 145
(Mika, 2005; Sears, Urizar, & Garrett, 2000; Seubert, 2012;
Wellisch &
Brown, 2013).
Study goals
In this study, differences between individuals with high versus
low deperso-
nalization were examined. The psychological variables included
in this study
were based on a desire to further understand coping strategies
employed
under stressful situations, along with the emotional
overexcitability trait.
Increased adverse childhood experiences, past traumatic events,
and heigh-
tened anxiety were included because they are strongly
associated with deper-
sonalization. To our knowledge, no study has examined all of
these

psychological constructs together, although preliminary
findings from our
laboratory were reported at the 2015 International Society for
the Study of
Trauma and Dissociation conference. We selected a nonclinical
sample, in
part, to determine if depersonalization is under-reported and
under-diag-
nosed in the general population. Based on other studies, it is
hypothesized
that a higher incidence of depersonalization will be found in
this population
(Hunter, Sierra, & David, 2004). It is believed that clinicians
might benefit
from the findings in this study, in particular, the relationship
between
emotional responses and DP.
The study addressed the primary question: Do nonclinical
individuals who
endorse high symptomatic depersonalization have inherently
more intense
emotional responses, along with more childhood adversity and
past trauma?
The first hypothesis is that the DPD group can be identified by
higher
emotionality (emotional overexcitability trait and coping
strategy), anxiety,
cumulative exposure to childhood adversity, and cumulative
adult traumatic
events. The second hypothesis reinforces previous findings
(Michal et al.,
2009; Mula et al., 2007; Simeon et al., 2001) that the DPD
group exhibits a
specific pattern of exposure to childhood adversity, in
particular, more

incidence of neglect compared to the no-DPD group.
Methods
Participants
This Institutional Review Board (IRB) approved cross-sectional
study incorpo-
rated a community sample of participants (n = 276) who were
invited into a larger
psychophysiological study that measures the psychological and
physiologic effects
of stress on healthy individuals. This larger study examines
variables such as past
trauma, childhood adversity, dissociation, shame, coping
strategies, anxiety,
depression, PTSD, attachment, trait overexcitability, difficulties
with emotional
regulation, and capacity to experience positive flow states.
Recruitment into the
large psychophysiological study, and this smaller sub-study,
included inviting
participants from university athletic and arts programs,
professional arts training
programs offered outside of the university, and word of mouth
recruitment in the
community. The study was conducted at a large academic
institution that is located
in a major city with strong athletic and arts programing. There
were no restrictions
for gender, race, or ethnicity.

There were 75 (27.3%) male participants and 200 (72.7%)
female participants
(1 missing data); mean age was 23.63 (sd = 5.45). In this
investigation, we
divided the sample into two groups. The groups were developed
based on
clinical cut off scores on at least one of three depersonalization
self-report scales
(Dissociative Experience Scale—II depersonalization subscale
≥30, Cambridge
Depersonalization Scale ≥70, and Multiscale Dissociation
Inventory ≥20). In the
MANCOVA calculations, the sample size decreased to a total of
264 partici-
pants. This decrease occurred due to incomplete data from
several of the
participants. There were 221 (83.7%) participants who scored
below the clinical
cutoff score for DPD and 43 (16.3%) who scored within the
clinical range.
Measurements
Adverse Childhood Experiences (ACE): The ACE is a
dichotomous 10 item self-
report instrument that assesses categories of childhood abuse,
neglect, and house-
hold dysfunction (Felitti & Anda, 2010). A total score of yes
responses are derived,
regardless of frequency or intensity. The abuse category probes
for emotional,
physical, and sexual abuse; the neglect category probes for
emotional and physical
neglect. The household dysfunction category includes mother
treated violently,

substance abuse, parental separation or divorce, household
member imprisoned,
or suffering a mental illness. For the purposes of this study,
three subscales were
also calculated based on aggregate scores: (1) abuse (emotional,
physical, sexual),
(2) neglect (emotional, physical), and (3) family dysfunction
(domestic violence,
substance abuse, separation/divorce, mental illness,
imprisonment). In this study,
the test–retest reliability calculation for the ACE was stable (r =
.86, p < .01). The
test–retest process was based on a second round of testing that
occurred 6 months
after the initial data collection.
Beck Anxiety Inventory (BAI-II): The BAI-II (Beck, Epstein,
Brown, &
Steer, 1988) assesses the severity of patient anxiety. It is a self-
report, 21
item instrument that measures how much the respondent was
bothered by
the symptom in the past week, ranging from 0 (not at all) to 3
(severely).
Each item is descriptive of subjective, somatic, or panic-related
symptoms of
anxiety. The BAI-II is appropriate for individuals between the
ages of
13–80 years, requiring approximately 5 minutes to administer.
The summed
score is then ranked: 0–7 (minimal level of anxiety), 8–15 (mild
anxiety), with
2 clinical ranges that include 16–25 (moderate anxiety), and 26–
63 (severe
anxiety). Unlike the State-Trait Anxiety Inventory (STAI-Y)
(Spielberger,

1983) that is highly confounded with measures of depression
(Fydrich,
Dowdall, & Chambless, 1992), the BAI-II’s strongest quality is
its ability to
assess panic symptomatology such as trembling, difficulty
breathing, numb-
ness or tingling, heart racing, dizziness or lightheadedness, and
fears of losing
control, dying or the worst happening (de Ayala, Vonderharr-
Carlson, &
Kim, 2005; Leyfer, Ruberg, & Woodruff-Borden, 2006). The
BAI-II has
excellent internal consistency reliability (α = .92) and high test–
retest relia-
bility (r = .75) (Beck & Steer, 1990). In this study, the
Cronbach’s alpha for
the BAI-II was α of .91.
Coping Inventory for Stressful Situations (CISS): The CISS
(Endler & Parker,
1990) is a 48 item 5 point Likert scale that measures three main
coping strategies:
task-oriented focus (dealing with the problem at hand),
emotion-oriented focus
(concentrating on the resultant emotions), and avoidance-
oriented coping (trying
to avoid the problem). In each coping strategy scale, there are
16 items. The Likert
scale ranges from 1 (not at all) to 5 (very much) and the
questions ask participants
to indicate how much they engage in various coping activities

during a stressful
situation. The CISS has stable factor structure, excellent
internal validity, adequate
test–retest reliability, and good construct validity (Cosway et
al., 2000; Endler &
Parker, 1990; McWilliams et al., 2003). In this study,
Cronbach’s alpha for task-
oriented focus was α of.86, emotion-oriented focus was αof.89,
and avoidance was
α of .87.
Overexcitability Questionnaire-II (OEQ-II): The OEQ-II (Falk
et al.,
1999) is a 50 item measurement used to assess the five forms of
over-
excitability (OE). Each OE subscale (psychomotor, sensual,
imaginational,
intellectual, emotional) consists of ten 5-point Likert items
ranging from 1
(not at all) to 5 (very much like me). Mean scores are derived
for each scale.
There is an indication that gender differences exist in this
measure
(Bouchet & Falk, 2001; Miller, Falk, & Huang, 2009), with
women scoring
higher on emotional and sensual OE; whereas, men score higher
on intel-
lectual and psychomotor OEs (van den Broeck, Hofmans,
Cooremans, &
Staels, 2014). The OEQ-II has high internal reliability and
internal consis-
tency and good content validity. Because this study examined
the relation-
ship between emotion and DP, we only included the emotional
overexcitability scale. The Cronbach’s alpha score for
emotional overexcit-

ability was excellent (α = .85).
Traumatic Events Questionnaire (TEQ): The TEQ (Lauterbach
& Vrana,
2001) is a self-report 11 item dichotomously scored instrument
that assesses
exposure to nine different traumatic events (accidents, natural
disasters,
crime, child abuse, rape, adult abusive experiences, witnessing
death/mutila-
tion of someone, being in a dangerous/life-threatening situation,
and receiv-
ing news of an unexpected death of a loved one). The final two
items probe
for any other traumatic event not listed and for traumatic
event(s) that were
too difficult to discuss with anyone. Since calculating the
internal consistency
of the TEQ was inappropriate a test–retest calculation was
conducted: The
TEQ in this study was stable (r = .75, p < .01). The test–retest
process was
based on a second round of testing that occurred 6 months after
the initial
data collection.
Depersonalization testing measurements
Cambridge Depersonalization Scale (CDS): The CDS (Sierra &
Berrios, 2000)
contains 29 items, each with a Likert scale for frequency and
duration. The

scale was designed to measure the sum of frequency and
duration; it addresses
the fluctuating and intermittent symptomatology of
depersonalization. The
global score is the aggregate score of both the frequency and
duration scales,
with a cut off score of ≥70 indicting a depersonalization
disorder. The items
probe for abnormal experiences during the past 6 months that
affect different
sensory modalities, inability to experience a range of different
emotions,
heightened self-awareness with a simultaneous feeling of a lack
of body own-
ership and agency. Cognitive components include thoughts of
feeling empty,
changes in personal memory recall, inability to evoke images,
and distortions
of time and space experiences. The CDS has high internal
consistency and
reliability. In this study, Cronbach’s alpha was α = .96.
Dissociative Experience Scale—II (DES-II): The DES-II
(Carlson et al.,
1993; Waller, Putnam, & Carlson, 1996) is a 28 item self-report
instrument
that asks subjects to indicate the frequency of dissoci ative
experiences in their
daily life. Persons who are administered the DES-II are asked to
endorse
experiences that are not related to situations when the subject is
under the
influence of alcohol or drugs. Each item is given a score
between 0 (never) to
100 (always), and a mean total score is calculated. The DES-II
and its sub-

scales have very high internal consistency scores (Van
Ijzendoorn &
Schuengel, 1996). In this study, we included the
depersonalization /derealiza-
tion subscale (DES-Dep/Der) (6 items: 7, 11, 12, 13, 27, 28)
(Carlson &
Putnam, 1992) with an α = .85. To determine clinical levels of
depersonaliza-
tion, a cutoff score was established (≥30) (Waller et al., 1996).
For descriptive
purposes, a DES-II taxon group was defined based on scores
≥20 on the
taxon scale (8 items: 3, 5,7, 8, 12, 13, 22, 27) (Waller et al.,
1996) with an
α = .82. This was calculated to determine shared distribution
patterns for
individuals in both the DPD and taxon groups.
Multiscale Dissociation Inventory (MDI): This 30 item Likert
self-report
scale (1 = never to 5 = very often) measures the frequency of
dissociative
symptoms during the past month (Briere, 2002). The MDI
provides a total
dissociation score, along with six subscales that measure
disengagement,
depersonalization, derealization, emotional constriction,
memory distur-
bances, and identity dissociation. The test yields raw scores that
can be
converted to T-scores to determine clinically significant levels
of each type
of dissociation. The raw clinical cutoff score for
depersonalization is ≥9, and

for derealization, it is ≥11. It has excellent validity and
reliability. In this
study, in an effort to match the DP items listed in the DES-II
and CDS, we
merged the depersonalization and derealization scale (raw
clinical cut off
score ≥20) (Briere, Weathers, & Runtz, 2005). Cronbach’s alpha
for the
depersonalization/derealization scale was excellent (α = .88).
The three depersonalization measurements provide valuable
information
about the nature and severity of symptoms; however, each self-
report instru-
ment assesses a different time period. The DES-II measures
daily life, the
CDS time range is for a six-month period, and the MDI
evaluates symptoms
experienced during the past month. When determining
individuals in the
clinical cut off range, the DES-II captured 53.1% of the sample,
the CDS
identified 31.3% of the sample, and the MDI dep/der scale
determined 93.1%
of the sample. These differences may be due to the three
different time
periods being assessed. Of note, approximately 25% of the DPD
individuals
were identified by all three measures; however, the majority
was collectively
identified by both the DES-II and the MDI.
Procedure and analysis

Participants who were accepted into the study completed an
informed consent,
followed by a package of self-report measures. They completed
these forms in a
laboratory or studio setting. The majority of participants
returned 6 months later
to complete a second package. A smaller randomly selected
sample participated in
physiological testing that measured heart rate variability while
performing under
stressful conditions (not reported in this study). SPSS version
22.0 was used for all
statistical analyses. First, descriptive statistical analyses were
conducted.
Participants were assigned to the depersonalization (DPD)
group if they scored
≥ the cutoff scores designated in one of the three
depersonalization measures: (1)
≥30 on the DES-II depersonalization subscale, (2) ≥70 on the
CDS, or (3) ≥20 on
the MDI dep/der combined scale. Those who did not reach the
clinical cutoff
scores on any of these measures were placed in the no-
depersonalization disorder
group (no-DPD). To analyze group differences, multivariate
analyses of covar-
iance (MANCOVA) were conducted (with age and gender as the
covariates). The
first MANCOVA was calculated to examine whether there were
significant
between group effects for cumulative childhood adverse
experiences, cumulative
traumatic events, anxiety, emotional overexcitability, and
coping strategies (task,
emotion, avoidant). A second MANCOVA (age and gender as

covariates) was
calculated to address the second hypothesis related to the
specific nature of adverse
childhood exposure. In the second MANCOVA, group
differences were examined
for the following adverse childhood experiences: family
dysfunction, abuse, and
neglect. Gender and age were included as covariates in both
MANCOVA calcula-
tions to account for any effects of gender and age on these
variables. These were
included based on studies that demonstrated more females
experience DP
(Aberibigbe, Bloch, & Walker, 2001; Medford et al., 2005) and
that DP decreases
with age (Michal et al., 2009). We also wanted to account for
the fact that there
were more women in the sample. In the MANCOVA analyses,
Bonferroni alpha
(.05) corrections were used to determine the nature of the
differences between the
group means.
Results
Descriptive statistics
The descriptive statistics include demographic distribution
(gender, age, ethnicity,
and DES-II taxon distribution). The distribution pattern
demonstrates that more

individuals placed in the DPD group experienced dissociative
taxon membership
(cut off score of ≥20 on the taxon subscale). This finding
suggests that 59.2% of the
DPD group may have more dissociative pathology beyond DPD.
Gender differ-
ences were minimal in the DPD group with 46.9% males and
53.1% females. The
ethnicity distribution was similar for both the no-DPD and DPD
groups for both
African andLatino groups; however, there were moreAsians and
fewer Caucasians
in the DPD group compared to the no-DPD groups. See Table 1
for details.
Distribution patterns for each ACE item were also calculated for
both groups;
the DPD group endorsed more ACE experiences. The highest
distribution pattern
was evident in emotional abuse (39.5%), followed by emotional
neglect (30.2%)
and divorce/separation (30.2%). Two other ACE items, physical
abuse (27.9%) and
family mental illness (27.9%), were also elevated in the DPD
group. See Table 2 for
details.
Depersonalization related differences
Hypothesis One: The DPD group will be identified by higher
emotionality (trait
and coping strategy), anxiety, cumulative exposure to childhood
adversity, and
cumulative adult traumatic events. This hypothesis was
examined by comparing
Table 1. Descriptive Statistics and Percentages for Demographic

Information.
No-DPD DPD
n = 221 n = 43
Gender: Males 62 (24.2%) 23 (46.9%)
Females 194 (75.8%) 26 (53.1%)
Ethnicity: African 27 (11.8%) 6 (14.3%)
Asian 38 (16.7%) 14 (33.3%)
Caucasian 12.1 (53.1%) 15 (35.7%)
Latino 42 (18.4%) 7 (16.7%)
DES-II Taxon 14 (5.5%) 29 (59.2%)
Age 23.66 (sd = 5.20) 23.47 (sd = 6.65)
Note: DES-II Taxon = dissociative experience scale—II
discriminating pathological subscale
group differences for mean score variables: task-oriented
coping, emotion-
oriented coping, avoidant-oriented coping, emotional
overexcitability, anxiety,
total ACE, and total traumatic experiences. In the first
MANCOVA (with gender
and age as covariates), group differences between no-DPD and
DPD groups were
calculated. The MANCOVA demonstrated that significant main
effects (Wilks’s
Λ = .854, F(7, 254) = 6.220, p = .000, η2 = .146). Age (p =
.005) and gender (p = .000)
were significant covariates in this calculation. In the pairwise
comparisons between
the no-DPD and DPD groups, there were significant differences,

specifically
significantly higher scores in the DPD group for OEQ
emotionality (p = .005),
CISS emotional coping (p < .001), anxiety (p < .001),
cumulative ACEs (p = .005),
and cumulative adult traumatic events (p = .004). There were no
group differences
for the variables CISS task-oriented coping (p = .188) and
avoidant coping
(p = .147). These findings demonstrate that gender and age were
cofounding
variables; in particular, younger age and female gender were
significant variables
in the DPD group. Also trait emotionality, emotional coping
strategies and anxiety
Table 2. Descriptive Percentage Statistics for Adverse
Childhood Experience
Items.
No-DPD DPD
n = 221 n = 43
ACE #1 Abuse—Emotional 26.4% 39.5%
ACE #2 Abuse—Physical 14.7% 27.9%
ACE #3 Abuse—Sexual 10.0% 9.3%
ACE #4 Neglect—Emotional 14.7% 30.2%
ACE #5 Neglect—Physical 2.2% 4.7%
ACE #6 Family Dysfunction—Separated/Divorced 28.1% 30.2%
ACE #7 Family Dysfunction—Domestic Violence 8.7% 18.6%
ACE #8 Family Dysfunction—Addiction 14.3% 20.9%
ACE #9 Family Dysfunction—Mental Illness 16.5% 27.9%
ACE #10 Family Dysfunction—Prison 5.2% 11.6%
Note: ACE = adverse childhood experiences

Table 3. Mean Descriptive Statistics and Standard Deviation
(SD) for Psychological Variables.
No-DPD DPD
n = 221 n = 43
ACE 1.43 (1.86) 2.21 (2.37)**
TEQ 1.86 (1.90) 2.91 (2.51)**
BAI-II 8.21 (7.64) 14.53 (11.51)***
OE-E 3.56 (.72) 3.78 (.83)**
CISS-task 59.00 (11.63) 56.02 (11.84)
CISS-emotion 42.84 (11.93) 51.70 (10.68)***
CISS-avoid 50.26 (12.04) 53.16 (12.01)
Note: ACE = adverse childhood experiences, TEQ = traumatic
event questionnaire, BAI-II = Beck anxiety
inventory, OE-E = overexcitability-emotional, CISS-task =
coping with stressful situations: Task-oriented,
CISS-emotion = coping with stressful situations: Emotion-
oriented, CISS-avoid = coping with stressful
situations: Avoidant-oriented
MANCOVA (age and gender covariates) comparison of mean
scores showing significant group differences
between high depersonalization (DPD) and low
depersonalization …

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