Objective: Peritraumatic dissociation (PD) and coping strategies (CS) around the time of trauma are significant predictors of acute and long-term posttraumatic symptomatology (PTS), but it is unclear how they relate to each other. The aim of this study was to examine their association using a nationwide, representative sample following the September 11 attacks in the United States (N = 3,134).

Method: We used exploratory and confirmatory network analyses to estimate reliable associations between PD and CS, as well as looking at those variables as predictors of PTS at 2, 6, and 12 months after the attack.      

Results: Analyses showed that: (a) PD formed 3 factors (alterations of consciousness, depersonalization, and compartmentalization) distinct from coping strategies; (b) PD related only to some CS; (c) coping through denial had a particularly strong link to alterations of consciousness among adults. Both altered consciousness and denial predicted PTS significantly 2, 6, and 12 months after the attack, with altered consciousness being the stronger predictor (and a better predictor of PTS than other types of PD). For teens, the only significant link between PD and CS was for compartmentalization and substance abuse.   

Conclusion: PD and CS were related in adults and contributed independently to later PTS. Future research should evaluate longitudinally the interactions between specific types of PD and CS.