Trauma-Related Altered States of Consciousness (TRASC) in an Online Community Sample: Further Support for the 4-D Model of Trauma-Related Dissociation

A recent “4-D model” of trauma-related dissociation differentiates trauma-related symptoms into distressing experiences nevertheless associated with normal waking consciousness (NWC-distress) versus dissociative experiences exemplary of trauma-related altered states of consciousness (TRASC) along 4 dimensions: One’s experience of (a) time and memory, (b) thought, (c) one’s body, and (d) emotion. However, experiences of TRASC have not been assessed in large community samples in relation to the revised Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM–5) posttraumatic stress disorder (PTSD) criteria. We evaluated TRASC as well as PTSD symptoms by self-report in participants recruited online (n = 2478). We also evaluated the hypotheses of the 4-D model via measures of PTSD and related psychological symptoms, dissociative experiences, and childhood trauma history. Consistent with hypotheses, relative to symptoms of NWC-distress, experiences of TRASC were (a) endorsed less frequently, (b) coendorsed less frequently, (c) predicted incremental variance in measures of dissociative experiences, and (d) were more specific to a history of childhood traumatization. An exploratory factor analysis generated a 2-factor solution that also supports the distinction between NWC-distress and TRASC. The present results generally support differentiating between dissociative versus nondissociative experiences as outcomes of posttraumatic stress.