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The TOP DD Studies

Few studies have assessed how patients with dissociative disorders (DD) respond to treatment. The paucity of research contributes to the limited awareness of DD and the lack of training for treatment providers.

The Treatment of Patients with Dissociative Disorders (TOP DD) Studies examine DD treatment process and progress in the service of identifying the most effective treatments for DD. Finding the most beneficial and cost effective interventions for DD patients is crucial because DD are associated with severe symptoms and considerable suffering, serious impairment in functioning, and high treatment costs.  So far, the TOP DD research team has conducted two studies: A prospective, naturalistic study of treatment outcome among DD patients from around the world (“the naturalistic treatment study”), and a survey aimed at capturing DD experts' recommendations to identify the specific treatment interventions experts have found effective at various stages in DD treatment (“the expert survey”).

Thanks to the generous sharing of time and treatment experiences by our TOP DD participants, the naturalistic treatment study was very successful. We were able to recruit approximately 290 therapists and their patients from 19 countries around the world — the largest and only international study of dissociative disorders.  The consistent reports of patients and therapists in the naturalistic study demonstrated that DD treatment is associated with decreased symptoms and improved functioning.  Data collected at four time points across 30 months revealed that over the course of this period, DD patients in treatment exhibited less depression, dissociation, PTSD, and general distress as well as decreases in suicide attempts, self-injurious behaviors, and hospitalizations. In addition, therapist ratings indicated that patients had also improved in adaptive functioning.  

The Expert Survey, which surveyed 36 international experts in the treatment of DD, underscored the importance of providing DD-related information as part of treatment. The experts recommended that for DD patients in the early stages of treatment the following should be emphasized: establishing and maintaining safety, providing education about symptoms and their management, developing healthy coping skills including grounding (to increase control over dissociation), appropriate self-care, emotion regulation, and containment skills (to manage intrusive trauma symptoms).

Our current study, the TOP DD Network study, will examine whether a web-based intervention, in combination with individual psychotherapy, is more effective for DD patients than individual psychotherapy alone.  The TOP DD Network program is a year-long web-based educational program for DD patients and their therapists that is informed by the results of our previous studies. More specifically, the TOP DD Network program provides education about DD and healthy coping skills (including managing dissociation, unsafe urges and emotions) with a focus on the enhancement of DD patients’ safety.

If you’d like to make a donation to support our work, please visit our Donate page.  To see a listing of TOP DD publications to date, please visit our Publications page.  Visit our enneacontahedron page to learn more about our current study, and our Participate page if you are a DD patient or therapist interested in participating in our next study.  Finally, if you’d like to learn about the TOP DD research team, visit our 8476804604 page.   Thank you for your interest!