Document Type : Original Article


School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Dissociation is a symptom that can be related to traumatic childhood events. Dissociation in some cases is categorized in a distinct subgroup from other psychiatric disorders.
Objective: The purpose of this study was to investigate the prevalence of dissociative experiences in patients who have attempted suicide and who have referred to an emergency psychiatric center.
Methods: This was a cross-sectional epidemiological study in which dissociative experiences were evaluated in 98 patients who referred to Ibn Sina and Hafez hospitals after attempting suicide. In addition to determining the prevalence of these experiences, the relation between the symptoms and variables such as sex, age, marital status, education and suicide risk was determined.
Results: There was a significant difference in the level of disappointment between married and single patients (P = 0.047). The mean disappointment score for the overall population was 11.92, which is in the normal range. There was no significant relationship between the dissociation score and level of disappointment (P = 0.933). The prevalence of dissociative experiences was found to decrease as the age of the patients increased (P = 0.006). There was no significant difference between the rate of suicide as reflected in the measurement of disappointment and dissociative symptoms. There was no significant relationship between DES score and other variables.
Conclusion: One cause of psychological pressure in deciding to attempt suicide is family conflict. Many individuals who attempt suicide did not have a thought-out desire to take their lives, but attempted it impulsively in response to a periodic stressor.


  1. Dell PF, O’Neil JA. Preface. In: Dell PF, O’Neil JA. Dissociation and the Dissociative Disorders: DSM-V and Beyond. Routledge; 2010. doi:10.1016/B978-1-4160-3143-7.00030-0.
  2. Rodriguez AH, Caldera T, Kullgren G, Renberg ES. Suicidal expressions among young people in Nicaragua: a community-based study. Soc Psychiatry Psychiatr Epidemiol. 2006;41(9):692- 697. doi:10.1007/s00127-006-0083-x.
  3. Dell PF. A new model of dissociative identity disorder. Psychiatr Clin North Am. 2006;29(1):1-26, vii. doi:10.1016/j.psc.2005.10.013.
  4. Butler LD, Duran RE, Jasiukaitis P, Koopman C, Spiegel D. Hypnotizability and traumatic experience: a diathesis-stress model of dissociative symptomatology. Am J Psychiatry. 1996;153(7 Suppl):42-63. doi:10.1176/ajp.153.8.A42.
  5. Gleaves DH, May MC, Cardena E. An examination of the diagnostic validity of dissociative identity disorder. Clin Psychol Rev. 2001;21(4):577-608. doi:10.1016/S0272-7358(99)00073-2.
  6. Dell PF. The multidimensional inventory of dissociation (MID): A comprehensive measure of pathological dissociation. J Trauma Dissociation. 2006;7(2):77-106. doi:10.1300/J229v07n02_06.
  7. Weiten W, Lloyd MA, Dunn DS, Hammer EY. Psychology Applied to Modern Life: Adjustment in the 21st Century. 9th ed. Wadsworth Cengage Learning; 2008
  8. Snyder CR. Coping: The Psychology of What Works. New York: Oxford University Press; 1999. doi:10.1093/med:psych/9780195119343.001.0001.
  9. Zeidner M, Endler NS. Handbook of Coping: Theory, Research, Applications. New York: John Wiley Sons; 1996.
  10. Salter AC. Hilary Eldridge. Transforming Trauma: A Guide to Understanding and Treating Adult Survivors of Child Sexual Abuse. Sage Publications Inc; 1995:220.
  11. Myers JE, Berliner L, Briere J, Hendrix CT, Jenny C, Reid TA. The APSAC Handbook on Child Maltreatment. 2nd ed. Sage Publications; 2002:63.
  12. Bidaki R, Shirani S, Shamsian M, et al. A Review of the Various Suicide Methods Used Around the World. Int J Med Rev. 2016;3(4):504-507. doi:10.15171/ijmr.2016.11.
  13. Briere J. Dissociative symptoms and trauma exposure: specificity, affect dysregulation, and posttraumatic stress. J Nerv Ment Dis. 2006;194(2):78-82. doi:10.1097/01.nmd.0000198139.47371.54
  14. Sajadi SF, Arshadi N, Zargar Y, Honarmand MM, Hajjari Z. Borderline personality features in students: the predicting role of schema, emotion regulation, dissociative experience and suicidal ideation. Int J High Risk Behav Addict. 2015;4(2):e20021. doi:10.5812/ijhrba.20021v2.
  15. Merckelbach H, Muris P. The causal link between self-reported trauma and dissociation: a critical review. Behav Res Ther. 2001;39(3):245-254. doi:10.1016/S0005-7967(99)00181-3.
  16. Snow MS, Beckman D, Brack G. Results of the dissociative experiences scale in a jail population. Dissociation. 1996;9(2):98- 103.
  17. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986;174(12):727-735. doi:10.1097/00005053-198612000-00004.
  18. Ross CA, Halpern N. Trauma Model Therapy: A Treatment Aproach for Trauma, Dissociation and Complex Comorbidity. Greenleaf Book Group; 2009:485.
  19. van Ijzendoorn MH, Schuengel C. The measurement of dissociation in normal and clinical populations: Meta-analytic validation of the Dissociative Experiences Scale (DES). Clin Psychol Rev. 1996;16(5):365-382. doi:10.1016/0272-7358(96)00006-2.
  20. Firoozabadi A, Abedi Z, Aliyari R, Zolfaghari B, Ghanizadeh A. Psychometric characteristics of the Persian (Farsi) version of attachment style questionnaire. Iran J Med Sci. 2014;39(6):506- 514.
  21. Sar V, Tutkun H, Alyanak B, Bakim B, Baral I. Frequency of dissociative disorders among psychiatric outpatients in Turkey. Compr Psychiatry. 2000;41(3):216-222. doi:10.1016/S0010-440X(00)90050-6.
  22. Sar V, Kundakci T, Kiziltan E, et al. The Axis-I Dissociative Disorder Comorbidity of Borderline Personality Disorder Among Psychiatric Outpatients. J Trauma Dissociation. 2003;4(1):119-136. doi:10.1300/J229v04n01_08.