Dissociation and memory for venipuncture in female adolescents and young adults with and without a history of childhood sexual abuse

This study examined how level of dissociation relates to autobiographical memory performance for venipuncture in female adolescents and young adults with and without a history of childhood sexual abuse (CSA). Thirty-seven females with a history of CSA and thirty-six females without a history of CSA ranging in age from ten to twenty-five experienced venipuncture. Six to nine years after venipuncture, these participants were asked to recall the details of this venipuncture experience. Level of dissociation at time of retrieval (as measured by the Adolescent Dissociative Experiences Scale) was negatively correlated with free recall, but not cued recall or visual recognition measures of memory for the venipuncture. This may be indicate that explicit memory, but not implicit memory, is impaired in individuals who evidence high dissociation levels. Level of dissociation at encoding (as measured by the Child Dissociative Checklist) was not related to memory performance regarding venipuncture. Given that the majority of participants did not experience venipuncture as stressful, state dependent memory effects regarding a stress-induced dissociative state at encoding and a non-dissociative state at retrieval could not be tested. A-DES scores (used at retrieval) may have predicted free recall memory impairment, whereas CDC scores (used at encoding) did not, because self-report measures of internalizing symptoms are often more accurate than parent-report measures. Also, dissociative symptoms may have increased over time due to revictimization, since individuals with a history of CSA are prone to be revictimized and likelihood of pathological dissociation increases with more instances of abuse. Given that explicit memory, but not implicit memory, seems to impaired in high dissociators in this study, clinical and legal interventions with this population may require use of cued recall procedures to attain efficacy and gather complete evidence. Further research exploring cognitive and neuroanatomical deficits associated with dissociation and trauma and how they inter-relate are indicated. Development of cued recall procedures that do not increase suggestibility in this population are also needed.