The Relationship Between Dissociation and Panic Symptoms in Adolescence and the Exploration of Potential Mediators

Dissociative experiences have been linked to panic symptoms in adolescents, yet the nature of the association remains unclear. In the present study, we investigated the longitudinal relationship between dissociative experiences (both depersonalisation and felt sense of anomaly subtypes) and panic, as well as the potential mediating roles of emotion regulation strategies (expressive suppression and cognitive reappraisal), alexithymia, and cognitive appraisals of dissociation. 4501 adolescents aged 13 to 18 years were recruited via social media advertising to take part in an online survey at two timepoints, one month apart. Analysis of 421 datasets found a significant positive relationship between initial dissociative experiences and panic symptoms reported one month later. This was mediated by the emotion regulation strategy of cognitive reappraisal, and cognitive appraisals of dissociation. Thus, dissociative experiences that are persistently misinterpreted in a catastrophic manner may lead to escalating anxiety and panic symptoms, which could in turn heighten and maintain the feared dissociation sensation. However, neither alexithymia nor expressive suppression were significant mediators. These results indicate that dissociative experiences are associated with panic symptoms in adolescence, with cognitive appraisals of dissociation and cognitive reappraisal playing a role in this relationship.