Asking Good Questions

Today, we’re looking at three very different studies, but each raises an important question. First, Kratzer et al. (2026) published “Questioning the structural validity of trauma-related dissociative disorders: The latent structure of pathological dissociation across diagnostic groups. In Traumatology. Here are the edited abstract and impact statement:

Models of trauma-related dissociation rely on two conflicting assumptions: dissociation as a single transdiagnostic severity continuum versus dissociative disorders as categorically distinct from posttraumatic stress disorder (PTSD). Neither has been tested at the level of symptom organization across diagnostic contexts. We investigated whether pathological dissociation retains its internal structure across psychiatric populations or reorganizes specifically in trauma-related conditions. We analyzed cross-sectional data from 1,475 psychiatric inpatients: dissociative disorders (n = 388); PTSD without dissociative disorders (n = 861); and other diagnoses, predominantly depressive disorders (n = 226). Measurement invariance (MI) testing and multigroup exploratory factor analysis were applied to the Dissociative Experiences Scale–Taxon. Results: MI was rejected, scaled Δχ²(14) = 33.96, p = .002. In general psychiatric patients, dissociation formed a single dimension. In trauma-related conditions, it separated into three partially independent components: Depersonalization/Derealization, Amnesia, and Identity Dissociation. This organization was nearly identical across PTSD and dissociative disorder groups. These groups differed primarily in childhood trauma severity and dissociative symptoms, while maintaining comparable PTSD symptom burden. Dissociation is not a universal severity continuum. Instead, trauma exposure is associated with a qualitative reorganization into separable clinical domains shared by PTSD and dissociative disorders. Diagnostic boundaries between these conditions may reflect different severity levels of shared trauma-related processes rather than distinct pathologies. Current treatment pathways excluding highly dissociative patients from trauma-focused therapy lack empirical justification and require reconsideration. 

The common clinical practice of excluding highly dissociative patients from trauma-focused therapy lacks empirical support. Because dissociation in posttraumatic stress disorder and dissociative disorders shares the same internal structure, evidence-based trauma-focused interventions should be considered for both groups rather than defaulting to stabilization-only approaches. Practitioners should not rely solely on total dissociation scores, as they can be clinically misleading. In trauma-affected patients, dissociation is not a single severity dimension but consists of three distinct areas; depersonalization/derealization, amnesia, and identity dissociation, each requiring different therapeutic strategies. Hearing voices in patients with a history of severe trauma often relates to identity dissociation rather than psychosis. Accurate assessment of these symptoms as dissociative processes is critical for avoiding misdiagnosis and ensuring patients receive appropriate trauma-informed care. The results suggest that trauma-related dissociative disorders and posttraumatic stress disorder are not fundamentally different conditions but represent different severity levels of the same trauma-driven processes. Organizations should prioritize integrated care pathways that treat these conditions as part of a single trauma-related spectrum. 

I started with this one because it makes an important point about treatment. Here we see the importance of not excluding patients from trauma-informed therapy simply because they have high levels of dissociative symptoms. The next study looks at gender-related assumptions about emotional intelligence. Hausfeld, Hampel, Bach & Menges (2026) published “Putting Assumptions to the Test: A meta-analytic review of gender differences in emotional intelligence and specific emotion abilities” in Emotion. Here’s the edited abstract:

Are women more emotionally intelligent than men? Emotional intelligence (EI) is often colloquially ascribed to women, yet the extant empirical literature yields inconclusive results and EI theories are largely oblivious to gender as an explanatory dimension. To re-evaluate the literature, test key moderators, and develop stronger theory on EI, we examine whether and to what extent gender differences manifest in EI through a meta-analytic review of 1,279 articles comprised of 1,428 samples containing 609,278 participants drawn from published and unpublished work until December 31, 2023. The results suggest gender differences in general EI such that women appear to have higher EI on average, as well as more nuanced gender differences across specific emotional abilities, including some where there may be no difference. Women’s advantage is stronger for other- than self-focused emotional abilities and varies by measurement type, with smaller differences in subjective than in performance-based assessments. Additionally, we find that contextual moderators, including leadership position, male-dominated industry, data collection year, participant age, and geographical region, are associated with the presence, magnitude, and direction of gender differences, suggesting that gender differences in EI vary across contexts. Overall, these findings show that women hold advantages in many emotional abilities, but that gender differences in EI are contingent on the target of emotional abilities, measurement type, and context, informing future research and theory building. 

Our meta-analysis examined 1,279 articles, comprising 1,428 samples and more than 609,000 participants across 76 countries. On average, women scored higher than men in overall emotional intelligence. But that simple conclusion hides a much more interesting story. Gender differences varied depending on the specific emotional ability being assessed, whether the ability involved one's own emotions or other people's emotions, how emotional intelligence was measured, and the context in which it was studied. In particular, women's advantage was stronger for abilities focused on other people's emotions than for abilities focused on their own. Differences were also substantially larger on performance-based tests than on self- or other-report measures. Overall, our findings suggest that asking simply whether women or men are “more emotionally intelligent” misses important differences in what emotional intelligence means and how it is measured.

Our findings suggest that gender differences in emotional intelligence are not simply fixed differences between women and men. Instead, they are consistent with the idea that emotional abilities develop, in part, through socialization and the different expectations and opportunities people encounter. For example, gender differences in general emotional intelligence and emotion recognition were smaller among children and adolescents compared to adults. Gender differences also became smaller in more recent studies, with some of these changes occurring more quickly among children than adults. Together with our finding that women’s advantages are larger for abilities involving other people’s emotions, these patterns are consistent with socialization accounts in which girls and women receive more encouragement and practice in attending to, understanding, and responding to others’ emotions. This matters because it shifts the conversation away from assuming that women and men are simply born with different emotional capabilities. Instead, our findings point toward the importance of understanding how social expectations and contexts may help shape the emotional skills people have opportunities to develop and practice.

I thought the most important takeaways from this study were that (1) women generally do better than men in processing other people’s emotions but not necessarily their own, (2) the differences in emotional intelligence are becoming smaller, and (3) socialization and context matter. The final study looks at adolescent anxiety, depression, and school avoidance and the difference in who we ask about it. Batky, Smith, Rohrig, Chiu & Bennett, S. M. (2026) published “Informant Discrepancies in Adolescent Anxiety Assessment: The roles of adolescent depression and school avoidance” in Psychological Assessment. Again, the edited abstract and impact statement:

When assessing adolescent psychopathology, discrepancies in adolescent self-report versus caregiver informant-report scores on symptom measures are typical. As anxiety is the most common mental health concern among adolescents, understanding variables associated with adolescent–caregiver informant discrepancies on anxiety measures is valuable for assessment and treatment planning. However, although anxiety often co-occurs with other problems, no existing work has examined how other common emotional/behavioral problems (i.e., depression, school avoidance) among adolescents moderate the magnitude of adolescent–caregiver score discrepancies on anxiety measures. The present study used latent difference score modeling within a sample of adolescent–caregiver dyads recruited from an adolescent partial hospitalization program (N = 328, 47.81% female, 46.06% White; N = 145–204 for primary analyses) to examine whether adolescent depression, school avoidance, and adolescent–caregiver (dis)agreement on top problems for treatment moderate adolescent–caregiver score discrepancies on anxiety scales. Results suggest adolescents and caregivers provide similar scores for adolescents’ anxiety symptoms. However, adolescents who self-report higher levels of depression and school avoidance behavior may self-report higher panic/somatic symptom levels and generalized anxiety levels than their caregivers attribute to them. Adolescent–caregiver agreement on top problems for treatment was not associated with adolescent–caregiver agreement on anxiety scale scores. Carefully assessing experiences of somatic and worry-related symptoms may be beneficial for adolescents presenting with depression and/or school avoidance. Moreover, identifying reasons why adolescents and caregivers provide similar anxiety scale scores but vary in endorsing anxiety as a top problem for treatment or vice versa would aid in further understanding adolescent–caregiver informant discrepancies. 

This study suggests that adolescents with higher depression and school avoidance behaviors rate themselves higher on panic/somatic and generalized anxiety symptoms than their caregivers rate them. Results highlight the value of clinicians assessing for anxiety symptoms that may be difficult to notice in the context of mood and/or behavioral challenges that could be more readily apparent to observers. 

I thought this one is important because it highlights the differences in perceptions of anxiety by parents and teens, especially when depression and school-avoidance are present. I found it interesting that teen-caregiver agreement on top problems for treatment is not associated with their agreement on anxiety scale scores. Teens with depression and school avoidance problems differ substantially from their caregivers in reporting other important symptoms, e.g., panic/ somatic symptoms and general anxiety. The most important message is never trust the caregiver to know the teen well and, if depression and school refusal are present, talk more to the kid. Taken together, I thought each of these studies raised important questions and provided thought-provoking answers.