Testing causal mechanisms of transdiagnostic dissociation in 16-to-25-year-olds: A randomised multiple baseline experimental design series using brief targeted CBT.
Year: 2026
Type: preprint
Abstract: BackgroundDissociative experiences are common and transdiagnostic. Yet causal evidence for psychological mechanisms of dissociation remains scarce, particularly in youth. Our group has developed a translational cognitive-behavioural model of a subset of common dissociative experiences (FSA-dissociation), but causal relationships proposed within this model remain to be tested.AimsThis study sought to experimentally test three causal relationships proposed in the FSA-dissociation CBT model using an interventionist-causal paradigm. A benefit of this method is the opportunity it provides to simultaneously develop targeted therapeutic techniques whilst empirically testing the underlying theory.MethodWe conducted a randomised multiple baseline experimental design study with nine NHS patients (aged 16 to 23), targeting three hypothesised mechanisms of change: cognitive appraisals of dissociation, perseverative thinking, and affect intolerance. The study was registered on ClinicalTrials.gov (NCT06054009). Each participant received four sessions of individual CBT with a clinical psychologist targeting one hypothesised mechanism. ResultsAnalysis indicated successful targeting of cognitive appraisals, and partial success for affect intolerance and perseverative thinking. Findings tentatively support cognitive appraisals and affect intolerance as candidate causal mechanisms in youth dissociation. Any effect of targeting perseverative thinking was better accounted for by reduced cognitive appraisals. DiscussionAlthough phase instability limited inference, this study offers novel causal insights into transdiagnostic dissociation and informs early-stage treatment development for this presentation. Namely, it suggests that future psychological interventions for transdiagnostic dissociation in youth should incorporate targeting of cognitive appraisals, but that further research is required to determine whether affect intolerance constitutes a therapeutic target in this context.
Source: PsyArXiv (OSF Preprints)
Authors: Emma Černis, Milan Antonovic, Gwynnevere Suter
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7223231617