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New ‘Unreal’ Subtype of PTSD Proposed

New Unreal Subtype of PTSD Proposed A provocative new study suggests that dissociation is associated with one form of post-traumatic stress disorder (PTSD).

Dissociation typically reflects problems in consciousness and awareness. Understanding that the course of PTSD may take alternative paths is an important discovery for treatment of the disorder.

Researchers discovered dissociation is often associated with unique PTSD symptoms of derealization, the feeling that one’s surroundings are unreal or unfamiliar, and depersonalization, or the feeling that one’s body is unfamiliar or strange.

Researchers studied PTSD and dissociative symptoms in 492 veterans and their intimate partners, all of whom had histories of trauma.

Participants reported exposure to a variety of traumatic events including combat, childhood physical and sexual abuse, partner abuse, motor vehicle accidents and natural disasters with most participants reporting exposure to multiple types of traumatic events.

Clinicians interviewed participants with the Clinician Administered PTSD Scale (CAPS), a diagnostic instrument that measures the frequency and severity of PTSD and dissociation symptoms.

Analysis revealed a small but distinct subset of participants characterized by high symptoms of dissociation and PTSD along with high rates of sexual assault history.

Researchers believe the findings contribute to a growing body of research, which could provide a basis for adding the new dissociative subtype distinction to the PTSD diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The study was led by Erika J. Wolf, Ph.D., and Mark W. Miller, Ph.D., both from the National Center for PTSD at the VA Boston Healthcare System and Department of Psychiatry at Boston University School of Medicine.

“This study helps to identify a small group of individuals who show a unique pattern of post-traumatic symptoms marked by derealization, or feeling that one’s surroundings are unreal or unfamiliar, and depersonalization, or feeling that one’s body is unfamiliar or strange,” said Wolf.

“The results clarify that these symptoms are not a core part of PTSD for most people with the disorder. However, identification of this group of individuals is important for maximizing PTSD treatment effectiveness.”

The study findings are published in the journal Archives of General Psychiatry.

Source: Boston University Medical Center

Girls mouth being covered by mans hand photo by shutterstock.

New ‘Unreal’ Subtype of PTSD Proposed

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). New ‘Unreal’ Subtype of PTSD Proposed. Psych Central. Retrieved on September 25, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 4 Jul 2012)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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