Dr. Brand has written over 135 published articles and book chapters on topics related to trauma, dissociation, assessment, and malingering, and authored one book (The Concise Guide to the Assessment and Treatment of Trauma-related Dissociation), and co-authored two books (Finding Solid Ground: Overcoming Obstacles in Trauma Treatment; The Finding Solid Ground Program Workbook: Overcoming Obstacles in Trauma Recovery). Her research focuses on assessing and treating trauma disorders, differentiating clinical from simulated dissociation, examining textbooks for the accuracy of the material presented about trauma, training therapists to treat traumatized clients, and examining and dispelling myths about dissociation.

Treatment Outcome Research

Dr. Brand was the Principal Investigator on a prospective, naturalistic longitudinal international treatment outcome study of dissociative disorders. This study, the Treatment of Patients with Dissociative Disorders (TOP DD), was the largest and and only international prospective treatment study of dissociative disorders to date. Her collaborators include Frank Putnam, M.D., Ruth Lanius, M.D., Ph.D., Richard Loewenstein, M.D., Hygge Schielke, Ph.D., and Amie Myrick, M.A., L.C.P.C. Twelve publications were published based on the TOP DD findings. The TOP DD participants were 280 patients with dissociative disorder and 292 therapists from 19 countries.

The cross-sectional results showed that patients in the later stages of treatment had fewer symptoms of dissociation, PTSD, and general distress; fewer recent hospitalizations; and better adaptive functioning than those in the early stages of treatment (Brand et al., 2009). The longitudinal results indicated that patients showed less dissociation, PTSD, general distress, depression, suicide attempts, self-harm, dangerous behaviors, drug use, physical pain, and hospitalizations as well as improved functioning over 30 months of treatment (Brand et al., 2013). Over the course of treatment, participants became more involved in volunteer jobs and/or attending school and socializing, and reported feeling good.  Treatment costs also decreased over time as the patients participated in dissociation-focused treatment and the TOP DD Network program.

Recently, the TOP DD research team conducted the first web-based educational program for dissociative clients and their therapists; the study based on this program is called the TOP DD Network study. The goals were to teach patients how to improve healthy management of their symptoms of PTSD and dissociation,  and stabilize their safety by improving their regulation of emotion, self-understanding and self-compassion.  The results were very promising: clients showed improvements in dissociation and PTSD symptoms, healthier management of emotions, and increased adaptive capacities.  Furthermore, they showed decreased non-suicidal self-injury.  This was the first study about dissociative disorders treatment published in the Journal of Traumatic Stress; find it here: http://dx.doi.org/10.1002/jts.22370

Dr. Brand is currently working with the TOP DD Team to conduct the first randomized control trial (RCT) of the Finding Solid Ground program; this is an updated version of the program used in the TOP DD Network study.  To learn more about the TOP DD Network RCT study, visit: https://topddstudy.com/

Assessment Research

1. Forensic Assessment Research. Dr. Brand’s research on distinguishing genuine from feigned dissociative disorders has contributed to a growing recognition that individuals with dissociative disorders are often inaccurately classified by psychological tests and interviews as exaggerating or feigning psychological disorders. For example, one of her studies found that the SIRS (a “gold standard” forensic interview) misclassified approximately one third of individuals with dissociative disorders as likely feigning psychological disorders. This study was one of the studies that led the author of the SIRS, Richard Rogers, Ph.D., to develop the updated SIRS-2; their research shows that the Trauma Index of the SIRS/SIRS-2 does not tend to misclassify dissociative disorders and complex trauma patients as malingerers.

This research is ongoing with publications in progress. Thus far, several papers have been published that clarify how dissociative patients and people feigning dissociation score on psychological tests.. One of the papers (Brand & Chasson, 2014) shows which MMPI-2 scales best differentiate genuine from feigned dissociative disorders. Another paper illustrates which of the validity scales on the PAI appear to be valid with severely dissociative patients (Stadnik, Brand, & Savoca, 2013).  Another shows that the TOMM has very good utility statistics when comparisons are made between individuals with clinical vs. simulated dissociative identity disorder (DID, Brand et al. 2019). Another paper indicates that the TSI-2 does not show acceptable utility statistics when used to distinguish dissociative patients from simulated dissociation (Palermo & Brand, 2019).  Another publication indicates that the SIMS has very low utility statistics when used to distinguish clinical DID from simulated DID (Brand et al. 2022).  These studies are critical to establishing evidence-based methods that assist clinicians and forensic assessors in determining if an individual suffers from severe dissociation, or if they are exaggerating or malingering symptoms of dissociation.

2. Distinguishing Dissociative Disorders from Borderline Personality Disorder and Psychotic Disorders. Dr. Brand has collaborated with Judith Armstrong, Ph.D. and Richard Loewenstein, M.D. on Rorschach research that has proven useful in distinguishing dissociative patients from those with borderline personality disorder and psychotic disorders. Using apriori, theoretically and empirically derived hypotheses, the researchers found that dissociative patients show greater self-reflection and logical thinking along with perceiving others as potentially collaborative despite a high level of traumatic intrusions.

Support Dr. Brand’s Research

Research investigating how to accurately assess traumatized and dissociative individuals is of great importance because much of the research on psychological assessment has not been conducted using individuals traumatized throughout childhood (sometimes referred to as complex trauma). As a result, current test and psychological interviews may misclassify individuals with complex trauma-related difficulties as feigning or exaggerating psychological problems, or as having psychotic or borderline disorders, or other psychological problems. Most psychological tests and interviews were not designed to detect dissociative disorders or complex trauma, nor were they trauma-informed.  Unfortunately, many tests include items that may be trauma-related, but that impact of trauma was not taken into account in the interpretive manuals and related publications. Thus, it is critical that assessment research is conducted using complex trauma survivors as participants so that valid and reliable data is developed so that clinicians can accurately interpret tests results for traumatized individuals.

It is also critical that treatment outcome studies on dissociative disorders are conducted. Research using rigorous designs is needed to provide stronger empirical support for the best treatment methods for this under-studied and highly symptomatic group of individuals.

If you would like to support Dr. Brand’s research, you may make a tax-deductible charitable donation through Towson University’s Foundation. Information about this option is available here: https://towsonuniversity.givingfuel.com/top-dd-network

Thank you for your consideration!