Dissociation in Posttraumatic Stress Disorder Part II: How Theoretical Models Fit the Empirical Evidence and Recommendations for Modifying the Diagnostic Criteria for PTSD

The purpose of this article is to examine how closely six theoretical models fit the empirical evidence reviewed in Part 1 on the relationship between trauma and dissociation and to apply the resulting conclusions to make recommendations about diagnostic criteria for PTSD. We describe six models for the relationships among traumatic stress, dissociation, and PTSD, including models for fantasy-proneness, mediation, comorbidity, interactional comorbidity, component, and subtype. The research reviewed strongly supports component and subtype models of the relationship between dissociation and PTSD, and recommendations are made for including dissociative symptoms in the diagnostic criteria for PTSD in ICD-11 and DSM-5 and adding either a dissociative subtype or a complex PTSD diagnosis in both diagnostic systems.