Sammanfattning
Background: Dissociative experiences are common in traumatized individuals, and can sometimes
be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of
traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative
phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures
perform in this clinical group. Aims: To describe the phenomenology of dissociative symptoms in
Bosnian treatment-seeking refugees in Denmark. Method: As a part of a larger study, dissociation
was assessed systematically in 86 Bosnian treatment-seeking refugees using a semi-structured
clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale;
SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). Results: The SIDES-D
indicated twice as high prevalence of pathological dissociation as the DES. According to the DES,
30% of the refugees had pathological dissociation 15 years after their resettlement. On the SIDES-D,
depersonalization and derealization experiences were the most common. Also, questions about
depersonalization and derealization at times elicited reporting of visual and perceptual
hallucinations, which were unrelated to traumatic re-experiencing. Questions about personality
alteration elicited spontaneous reports of a phenomenon of "split" pre- and post-war identity in the
refugee group. Whether this in fact is a dissociative phenomenon, characteristic of severe
traumatization in adulthood, needs further examination. Conclusions: Knowledge of dissociative
symptoms in traumatized refugees is important in clinical settings to prevent misclassification and to
better target psychotherapeutic interventions. Much development in the measurement of dissociation
in refugees is needed.