Publications by authors named "Warwick Middleton"

Objective: This study aimed to explore the experience of therapists whose clients report incestuous abuse continuing into adulthood.

Method: Ten Australian therapist-participants were recruited through professional forums. After giving informed consent, they completed a semistructured interview.

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Prolonged incest, where children are sexually abused by familial perpetrators into adulthood, has been documented in clinical and criminological scholarship, however it is often overlooked in research, policy and practice approaches to familial sexual abuse. This article draws on interviews with ten Australian therapists about their clinical work with clients subject to incestuous abuse continuing into adulthood. It outlines their descriptions of these cases, the nature of the reported abuse and factors that facilitated prolonged and ongoing incest, including at the time of therapy.

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Objectives: Dissociative identity disorder (DID) and schizophrenia-spectrum disorders (SSD) share some overlapping phenomenological features making accurate diagnosis more difficult. Childhood abuse and depersonalization have been associated with psychotic symptoms across psychological disorders but their relationship to psychotic phenomenology remains understudied.

Method: The present study used quantitative measures to examine (1) similarities and differences in phenomenological voice hearing experiences, interpretations of voices, and thought disorder symptoms in individuals with DID (n = 44) or SSD (n = 45), and (2) whether depersonalization and childhood maltreatment influenced the initial pattern of findings.

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Article Synopsis
  • - The study explored how different relationship contexts (with a friend, an acquaintance, or alone) affect feelings of shame in individuals experiencing dissociation or sadness.
  • - Participants with dissociative disorders reported feeling more shame and annoyance when experiencing dissociation or sadness in the presence of an acquaintance compared to when they were with close friends or alone.
  • - The findings suggest that being with an acquaintance heightens feelings of vulnerability and the risk of being misunderstood or rejected, leading to increased shame responses.
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Article Synopsis
  • - The study examines how childhood abuse influences auditory hallucinations through dissociation, focusing on two groups: those with Dissociative Identity Disorder (DID) and those with schizophrenia spectrum disorders (SSD).
  • - Findings indicate that in the DID group, depersonalization mediates the distress related to auditory hallucinations, while both depersonalization and amnesia are linked to non-auditory hallucinations like visual and tactile experiences.
  • - In contrast, the SSD group shows that absorption mediates the relationship between childhood abuse and various non-auditory hallucinations, suggesting different dissociative mechanisms at play in the two disorders.
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Objective: Discontinuities in memory are the hallmark symptoms of most dissociative disorders but are also reported by patients diagnosed with related disorders, including PTSD. Memory discontinuity is most evident in dissociative identity disorder (DID), where patients may report amnesia in 1 identity for information available in other identities (i.e.

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The Australian history of the false memory (FM) movement has similarities to that of the UK and America, but also important differences that are rarely described in the literature. This article, through an examination of cross-discipline professional literature, media reports, and the personal observations of the second author, describes the history of the FM Movement in Australia and outlines similarities and differences between Australia, the UK and America. All three countries experienced the establishment of false memory syndrome (FMS) societies and a backlash against those reporting or treating child sexual abuse (CSA).

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This Australian study explores a person's self-reported exposure to childhood abuse to identify the characteristics that are predictive of clinical levels of dissociation in adulthood. The final sample comprised 303 participants, including 26 inpatients and outpatients (24 females and two males) receiving treatment for a dissociative disorder (DD), and 277 university participants, including 220 controls (186 females, 34 males), 31 with elevated levels of dissociation consistent with a DD or posttraumatic stress disorder (27 females and four males), and 26 with clinical levels of dissociation (20 females and six males). The findings demonstrate clinical levels of dissociation and DDs occur in individuals reporting a history of childhood abuse, particularly sexual abuse and experiences that are potentially life-threatening to a child, such as choking, smothering, and physical injury that breaks bones or teeth, or that compromise the child's survival needs, including threats of abandonment and deprivation of basic needs.

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Dissociative experiences have been associated with diachronic disunity. Yet, this work is in its infancy. Dissociative identity disorder (DID) is characterized by different identity states reporting their own relatively continuous sense of self.

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Amnesia is a core diagnostic criterion for Dissociative Identity Disorder (DID), however previous research has indicated memory transfer. As DID has been conceptualised as being a disorder of distinct identities, in this experiment, behavioral tasks were used to assess the nature of amnesia for episodic 1) self-referential and 2) autobiographical memories across identities. Nineteen DID participants, 16 DID simulators, 21 partial information, and 20 full information comparison participants from the general population were recruited.

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Firmly held beliefs that have a delusional quality are commonly experienced in those with schizophrenia spectrum disorders (SSD) and have been reported in those with dissociative identity disorder (DID). However, no study to date has compared delusional belief content and characteristics between these diagnostic groups. This study examined delusional content, and the degree of conviction, preoccupation and distress associated with them in 50 participants with DID and 50 with an SSD exploring also dissociation and childhood trauma as predictors of delusional beliefs.

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This paper investigated a 60-item version of the Multidimensional Inventory of Dissociation (MID) with the potential to capture the full range of dissociative symptoms that characterize each of the dissociative disorders (DD). The 28-item Dissociative Experiences Scale (DES) was designed to capture a wide range of dissociative phenomena, but college population studies indicate it may not be adept at identifying the full range of dissociative symptoms and disorders. The 218-item MID has the advantage of capturing the full range of dissociative symptoms and has diagnostic capabilities for all DSM-5 DD, but the disadvantage of taking considerably longer than the DES to complete.

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While evidence suggests a division between two qualitatively distinct forms of dissociation, no scale has been specifically designed to differentiate between them. This study describes the development and validation of the Detachment and Compartmentalization Inventory (DCI). The DCI was developed from dissociation theory, 29 existing dissociation scales and expert opinion.

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Individuals with dissociative identity disorder (DID) often report having no access to autobiographical experiences encoded by other identities. This research used the autobiographical Implicit Association Test (aIAT) to determine whether there was transfer of episodic self-referential memory events across amnesic identities. Nineteen DID individuals, 16 DID simulators, and 41 comparison participants (divided into amnesic and nonamnesic groups) engaged with an audio vignette of embarrassing scenarios to produce the experience of episodic self-referential events.

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This study examined shame and responses to it in adult dissociative disorder (DD; n = 24) and comparison psychiatric (n = 14) samples. To investigate how helpful different therapeutic responses are after shame disclosures in therapy, participants heard two vignettes from "mock" patients disclosing a) shame and b) surprise. Participants rated the helpfulness of five potential responses.

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This paper examines Kluft's construct of "weaponized sex" through the prism of long-term clinical and research involvement with individuals subjected to ongoing sexual abuse during adulthood, a group that by definition has been exposed to more sexual abuse and for longer than any other defined victim population. Examples of the same sort of phenomena described by Kluft are repeatedly observed in therapy with members of this population, but usually not in a dramatic form. As might be anticipated, in order to survive, when an individual is closely attached to a long-term and extreme abuser, the sort of enduring ambivalence carried by the victim towards their primary abuser is manifested in compartmentalized states that wish their abuser dead, while other states in equally compartmentalized ways maintain the attachment via the use of sex-by continuing to be sexually involved with their primary abuser (usually their father), by fantasizing about sex with their abuser, by being sexually involved with those who co-abused with their father, or by staging reenactments with individuals whose sexual behavior re-evokes the abuse by the absent (or deceased) father.

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Objectives: Elevated shame and dissociation are common in dissociative identity disorder (DID) and chronic posttraumatic stress disorder (PTSD) and are part of the constellation of symptoms defined as complex PTSD. Previous work examined the relationship between shame, dissociation, and complex PTSD and whether they are associated with intimate relationship anxiety, relationship depression, and fear of relationships. This study investigated these variables in traumatized clinical samples and a nonclinical community group.

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Controversy exists regarding the merits of exposure-based treatments for posttraumatic stress disorder (PTSD) versus a phased approach when prominent dissociative symptoms are present. The first aim of this study was to examine the degree to which diagnosing dissociation in two traumatized patients' vignettes influenced clinicians' preference for phase-oriented treatment and whether clinicians' treatment experience contributed to their treatment preference. The second aim was to assess the extent to which participants had observed traumatized patients worsen when treated with exposure therapy or phase-oriented therapy and whether the theoretical orientation and treatment experience of the clinician were related to the observed deterioration.

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Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertaining to recurrently expressed beliefs regarding DID: (1) belief that DID is a fad, (2) belief that DID is primarily diagnosed in North America by DID experts who overdiagnose the disorder, (3) belief that DID is rare, (4) belief that DID is an iatrogenic, rather than trauma-based, disorder, (5) belief that DID is the same entity as borderline personality disorder, and (6) belief that DID treatment is harmful to patients. The absence of research to substantiate these beliefs, as well as the existence of a body of research that refutes them, confirms their mythical status.

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Objectives: To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt.

Methods: A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations-complex trauma (n = 65), dissociative identity disorder (DID; n = 20), and general mental health (n = 41)-and a control group of healthy volunteers (n = 125).

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Only a select number of studies have examined different forms of child maltreatment in complex dissociative disorders (DDs) in comparison to other groups. Few of these have used child abuse-related chronic posttraumatic stress disorder (C-PTSD) and mixed psychiatric (MP) patients with maltreatment as comparison groups. This study examined child sexual, physical, and emotional abuse as well as physical and emotional neglect in DD (n = 39), C-PTSD (n = 13), and MP (n = 21) samples, all with abuse and neglect histories.

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Background: Whilst a growing body of research has examined dissociation and other psychiatric symptoms in severe dissociative disorders (DDs), there has been no systematic examination of shame and sense of self in relationships in DDs. Chronic child abuse often associated with severe DDs, like dissociative identity disorder, is likely to heighten shame and relationship concerns. This study investigated complex posttraumatic stress disorder (PTSD), borderline and Schneiderian symptoms, dissociation, shame, child abuse, and various markers of self in relationships (e.

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