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Gillmeister H, Šmate I, Savva D, Li H, Parapadakis C, Adler J. Confrontation with others' emotions changes bodily resonance differently in those with low and high levels of depersonalization. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230248. [PMID: 39005042 DOI: 10.1098/rstb.2023.0248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/06/2024] [Indexed: 07/16/2024] Open
Abstract
We present novel research on the cortical dynamics of atypical perceptual and emotional processing in people with symptoms of depersonalization-derealization disorder (DP-DR). We used electroencephalography (EEG)/event-related potentials (ERPs) to delineate the early perceptual mechanisms underlying emotional face recognition and mirror touch in adults with low and high levels of DP-DR symptoms (low-DP and high-DP groups). Face-sensitive visual N170 showed markedly less differentiation for emotional versus neutral face-voice stimuli in the high- than in the low-DP group. This effect was related to self-reported bodily symptoms like disembodiment. Emotional face-voice primes altered mirror touch at somatosensory cortical components P45 and P100 differently in the two groups. In the high-DP group, mirror touch occurred only when seeing touch after being confronted with angry face-voice primes. Mirror touch in the low-DP group, however, was unaffected by preceding emotions. Modulation of mirror touch following angry others was related to symptoms of self-other confusion. Results suggest that others' negative emotions affect somatosensory processes in those with an altered sense of bodily self. Our findings are in line with the idea that disconnecting from one's body and self (core symptom of DP-DR) may be a defence mechanism to protect from the threat of negative feelings, which may be exacerbated through self-other confusion. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.
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Affiliation(s)
- Helge Gillmeister
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
| | - Ieva Šmate
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
| | - Dimitra Savva
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
| | - Haojie Li
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
| | - Christina Parapadakis
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
| | - Julia Adler
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
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Millman LSM, Huang X, Wainipitapong S, Medford N, Pick S. Behavioural, autonomic, and neural responsivity in depersonalisation-derealisation disorder: A systematic review of experimental evidence. Neurosci Biobehav Rev 2024; 163:105783. [PMID: 38944228 DOI: 10.1016/j.neubiorev.2024.105783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/28/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting from alterations in affective, cognitive, and physiological functions. This systematic review aimed to synthesise current experimental evidence of relevance to proposed mechanisms underlying DDD, to appraise existing theoretical models, and to inform future research and theoretical developments. Studies were included if they tested explicit hypotheses in DDD samples, with experimental manipulations of at least one independent variable, alongside behavioural, subjective, neurological, affective and/or physiological dependent variables. Some evidence for diminished subjective responsivity to aversive images and sounds, and hyperactivation in neurocircuits associated with emotional regulation when viewing aversive images emerged, corroborating neurobiological models of DDD. Inconsistencies were present regarding behavioural and autonomic responsivity to facial expressions, emotional memory, and self-referential processing. Common confounds included small sample sizes, medication, and comorbidities. Alterations in affective reactivity and regulation appear to be present in DDD; however, further research employing more rigorous research designs is required to provide stronger evidence for these possible mechanisms.
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Affiliation(s)
- L S Merritt Millman
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Xi Huang
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Sorawit Wainipitapong
- Department of Global Health and Social Medicine, King's College London, London, United Kingdom; Department of Psychiatry and Center of Excellence in Transgender Health, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nick Medford
- Lishman Unit, Bethlem Royal Hospital, London, United Kingdom
| | - Susannah Pick
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
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3
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Woelk SP, Garfinkel SN. Dissociative Symptoms and Interoceptive Integration. Curr Top Behav Neurosci 2024. [PMID: 38755513 DOI: 10.1007/7854_2024_480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Dissociative symptoms and disorders of dissociation are characterised by disturbances in the experience of the self and the surrounding world, manifesting as a breakdown in the normal integration of consciousness, memory, identity, emotion, and perception. This paper aims to provide insights into dissociative symptoms from the perspective of interoception, the sense of the body's internal physiological state, adopting a transdiagnostic framework.Dissociative symptoms are associated with a blunting of autonomic reactivity and a reduction in interoceptive precision. In addition to the central function of interoception in homeostasis, afferent visceral signals and their neural and mental representation have been shown to shape emotional feeling states, support memory encoding, and contribute to self-representation. Changes in interoceptive processing and disrupted integration of interoceptive signals into wider cognition may contribute to detachment from the body and the world, blunted emotional experience, and altered subjective recall, as experienced by individuals who suffer from dissociation.A better understanding of the role of altered interoceptive integration across the symptom areas of dissociation could thus provide insights into the neurophysiological mechanisms underlying dissociative disorders. As new therapeutic approaches targeting interoceptive processing emerge, recognising the significance of interoceptive mechanisms in dissociation holds potential implications for future treatment targets.
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Affiliation(s)
- Sascha P Woelk
- Institute of Cognitive Neuroscience, University College London, London, UK.
| | - Sarah N Garfinkel
- Institute of Cognitive Neuroscience, University College London, London, UK
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An Experimental Study of Subliminal Self-Face Processing in Depersonalization-Derealization Disorder. Brain Sci 2022; 12:brainsci12121598. [PMID: 36552058 PMCID: PMC9775423 DOI: 10.3390/brainsci12121598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 11/25/2022] Open
Abstract
The self-perception or self-experience of patients with depersonalization/derealization disorder (DPD) is altered, leading to a profound disruption in self-awareness. The main aim of the study is to explore the characteristics of subliminal self-face processing in DPD patients. To our knowledge, this is the first experimental study that has measured and evaluated subliminal self-processing in DPD. To better understand this, we examined the ability of patients with DPD and healthy controls (HC) to identify pictures of faces using an experimental paradigm of breaking continuous flash suppression. There were 23 DPD outpatients from Beijing Anding Hospital, Capital Medical University and 23 matched HC who participated in this experiment. The time needed for a face to break into awareness was taken as the measure of participants' subliminal processing of that face. The results indicated that there were significant differences between the DPD patients and HC in subliminal reaction times to different faces. Under experimental conditions, the average reaction response of self-face recognition in the HC group was significantly faster than for a famous face. However, this difference was not observed in DPD patients, which means that DPD patients did not show the processing advantage of their own faces as did the HC. The results suggest a deficit in subliminal self-face processing in DPD.
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Modesti MN, Rapisarda L, Capriotti G, Del Casale A. Functional Neuroimaging in Dissociative Disorders: A Systematic Review. J Pers Med 2022; 12:jpm12091405. [PMID: 36143190 PMCID: PMC9502311 DOI: 10.3390/jpm12091405] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/21/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless, neuroimaging studies, albeit scarce, have suggested the existence of particular brain activation patterns in patients belonging to this diagnostic category. The aim of this review is to identify the main functional neuroimaging correlates of dissociative disorders. Methods: we searched the PubMed database to identify functional neuroimaging studies conducted on subjects with a diagnosis of a dissociative disorder, following the PRISMA guidelines. In the end, we included 13 studies in this systematic review, conducted on 51 patients with dissociative identity disorder (DID), 28 subjects affected by depersonalization disorder, 24 with dissociative amnesia, and 6 with other or not specified dissociative disorders. Results: Prefrontal cortex dysfunction seems prominent. In addition, changes in the functional neural network of the caudate are related to alterations of identity state and maintenance of an altered mental status in DID. Another role in DID seems to be played by a dysfunction of the anterior cingulate gyrus. Other regions, including parietal, temporal, and insular cortices, and subcortical areas were reported to be dysfunctional in dissociative disorders. Conclusions: Prefrontal dysfunction is frequently reported in dissociative disorders. Functional changes in other cortical and subcortical areas can be correlated with these diagnoses. Further studies are needed to clarify the neurofunctional correlations of each dissociative disorder in affected patients, in order to identify better tailored treatments.
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Affiliation(s)
- Martina Nicole Modesti
- Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Ludovica Rapisarda
- Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Gabriela Capriotti
- Unit of Nuclear Medicine, Department of Medical-Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sant’Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Antonio Del Casale
- Unit of Psychiatry, Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sant’Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
- Correspondence:
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Potential Targets for Noninvasive Brain Stimulation on Depersonalization-Derealization Disorder. Brain Sci 2022; 12:brainsci12081112. [PMID: 36009174 PMCID: PMC9406113 DOI: 10.3390/brainsci12081112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Non-invasive brain stimulation seems to be beneficial for DPD patients. However, the sites used in previous studies were empirical. Exploring new stimulation locations via functional magnetic resonance imaging may improve the efficacy. OBJECTIVES The objective was to find potential locations for non-invasive brain stimulation on the depersonalization-derealization disorder. METHODS We explored the potential brain surface regions from three pipelines: pipeline 1: activation likelihood estimation meta-analysis (five studies with 36 foci included); pipeline 2: functional connectivity analysis based on DPD-network (76 subjects included); and pipeline 3: functional connectivity analysis based on DPD regions of interest from the meta-analysis. Potential targets were the 10-20 system coordinates for brain surface regions. RESULTS We identified several potential brain surface regions, including the bilateral medial prefrontal cortex, dorsal lateral prefrontal cortex, superior parietal gyrus, superior temporal gyrus, and right ventrolateral prefrontal cortex as potential sites. CONCLUSION Our findings of the potential stimulation targets might help clinicians optimize the application of non-invasive brain stimulation therapy in individuals with DPD.
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Vannikov-Lugassi M, Shalev H, Soffer-Dudek N. From brooding to detachment: Rumination longitudinally predicts an increase in depersonalization and derealisation. Psychol Psychother 2021; 94 Suppl 2:321-338. [PMID: 32333727 DOI: 10.1111/papt.12279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 03/31/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Depersonalization-derealization (DEP-DER) is a dissociative experience which is related to psychopathology and distress. Yet, the aetiological factors leading to DEP-DER are not sufficiently clear. In this study, we suggest rumination as one possible antecedent. Thus, the goal of the study was to explore the longitudinal relationship between rumination and DEP-DER. DESIGN Longitudinal self-report study; mixed clinical and community sample. METHODS The study was conducted on 98 participants, 49 of them were diagnosed with depression, anxiety disorders, or obsessive-compulsive disorder, and the other 49 were healthy, matched community controls. The participants underwent a structured clinical interview and completed a battery of questionnaires. Then, the participants completed the same battery again once a month, for five additional assessment points (6 months in total). The data were analysed using multilevel linear modelling with time-lag analysis. RESULTS We found that levels of rumination and DEP-DER increased and decreased simultaneously, meaning that on assessments in which people reported that they tended to ruminate, they also reported higher levels of DEP-DER symptoms. In addition, we found support for a unidirectional association, consistent with our theoretical hypothesis. Specifically, rumination levels on a certain month longitudinally predicted a higher likeliness for reporting DEP-DER on the following month, even when controlling for the contemporaneous relationship. Conversely, DEP-DER symptoms did not longitudinally predict increased rumination. CONCLUSIONS These findings suggest that rumination may be an antecedent of DEP-DER, but not vice versa. Possible mechanisms to explain this link are discussed. PRACTITIONER POINTS Rumination and DEP-DER oscillate together over time; additionally, rumination predicts a longitudinal increase in DEP-DER. Clinicians noticing ruminative thought followed by decreased emotionality should distinguish between an authentic decrease of distress versus detachment. The findings provide one possible explanation for the frequency of DEP-DER symptoms in anxiety and depressive disorders. Poor sleep quality and emotion regulation difficulties should be explored as potential mediators explaining this link.
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Affiliation(s)
| | - Hadar Shalev
- Ben-Gurion University of the Negev, Be'er-Sheva, Israel.,Soroka Medical Center, Be'er Sheva, Israel
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Roydeva MI, Reinders AATS. Biomarkers of Pathological Dissociation: A Systematic Review. Neurosci Biobehav Rev 2020; 123:120-202. [PMID: 33271160 DOI: 10.1016/j.neubiorev.2020.11.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/20/2020] [Accepted: 11/15/2020] [Indexed: 02/06/2023]
Abstract
Pathological dissociation is a severe, debilitating and transdiagnostic psychiatric symptom. This review identifies biomarkers of pathological dissociation in a transdiagnostic manner to recommend the most promising research and treatment pathways in support of the precision medicine framework. A total of 205 unique studies that met inclusion criteria were included. Studies were divided into four biomarker categories, namely neuroimaging, psychobiological, psychophysiological and genetic biomarkers. The dorsomedial and dorsolateral prefrontal cortex, bilateral superior frontal regions, (anterior) cingulate, posterior association areas and basal ganglia are identified as neurofunctional biomarkers of pathological dissociation and decreased hippocampal, basal ganglia and thalamic volumes as neurostructural biomarkers. Increased oxytocin and prolactin and decreased tumor necrosis factor alpha (TNF-α) are identified as psychobiological markers. Psychophysiological biomarkers, including blood pressure, heart rate and skin conductance, were inconclusive. For the genetic biomarker category studies related to dissociation were limited and no clear directionality of effect was found to warrant identification of a genetic biomarker. Recommendations for future research pathways and possible clinical applicability are provided.
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Affiliation(s)
- Monika I Roydeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
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Farmer H, Cataldo A, Adel N, Wignall E, Gallese V, Deroy O, Hamilton A, Ciaunica A. The Detached Self: Investigating the Effect of Depersonalisation on Self-Bias in the Visual Remapping of Touch. Multisens Res 2020; 34:1-22. [PMID: 33535167 DOI: 10.1163/22134808-bja10038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 08/31/2020] [Indexed: 11/19/2022]
Abstract
There is a growing consensus that our most fundamental sense of self is structured by the ongoing integration of sensory and motor information related to our own body. Depersonalisation (DP) is an intriguing form of altered subjective experience in which people report feelings of unreality and detachment from their sense of self. The current study used the visual remapping of touch (VRT) paradigm to explore self-bias in visual-tactile integration in non-clinical participants reporting high and low levels of depersonalisation experiences. We found that the high-DP group showed an increased overall VRT effect but a no-self-face bias, instead showing a greater VRT effect when observing the face of another person. In addition, across all participants, self-bias was negatively predicted by the occurrence of anomalous body experiences. These results indicate disrupted integration of tactile and visual representations of the bodily self in those experiencing high levels of DP and provide greater understanding of how disruptions in multisensory perception of the self may underlie the phenomenology of depersonalisation.
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Affiliation(s)
- Harry Farmer
- 1Institute of Cognitive Neuroscience, University College London, Gower Street, London, WC1E 6BT, UK
- 2School of Human Sciences, University of Greenwich, Dreadnought Building, London, SE10 9LS, UK
- 3Institute for Lifecourse Development, University of Greenwich, Dreadnought Building, Greenwich, London SE10 9LS, UK
| | - Antonio Cataldo
- 4Institute of Philosophy, School of Advanced Study, University of London, Senate House, Malet Street, London, WC1E 7HU, UK
| | - Nagela Adel
- 1Institute of Cognitive Neuroscience, University College London, Gower Street, London, WC1E 6BT, UK
| | - Emma Wignall
- 1Institute of Cognitive Neuroscience, University College London, Gower Street, London, WC1E 6BT, UK
| | - Vittorio Gallese
- 4Institute of Philosophy, School of Advanced Study, University of London, Senate House, Malet Street, London, WC1E 7HU, UK
- 5Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Via Volturno 39, 43100 Parma, Italy
| | - Ophelia Deroy
- 4Institute of Philosophy, School of Advanced Study, University of London, Senate House, Malet Street, London, WC1E 7HU, UK
- 6Munich Center for Neuroscience, Ludwig Maximilian University, Ludwigstraße 31, 80539 Munich, Germany
- 7Faculty of Philosophy and Philosophy of Science, Ludwig Maximilian University, Geschwister-Scholl-Platz 1, 80539 Munich, Germany
| | - Antonia Hamilton
- 1Institute of Cognitive Neuroscience, University College London, Gower Street, London, WC1E 6BT, UK
| | - Anna Ciaunica
- 1Institute of Cognitive Neuroscience, University College London, Gower Street, London, WC1E 6BT, UK
- 8Department of Philosophy, University of Porto, Via Panorâmica s/n, 4150-564 Porto, Portugal
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Lotfinia S, Soorgi Z, Mertens Y, Daniels J. Structural and functional brain alterations in psychiatric patients with dissociative experiences: A systematic review of magnetic resonance imaging studies. J Psychiatr Res 2020; 128:5-15. [PMID: 32480060 DOI: 10.1016/j.jpsychires.2020.05.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/15/2020] [Accepted: 05/10/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION There is currently no general agreement on how to best conceptualize dissociative symptoms and whether they share similar neural underpinnings across dissociative disorders. Neuroimaging data could help elucidate these questions. OBJECTIVES The objective of this review is to summarize empirical evidence for neural aberrations observed in patients suffering from dissociative symptoms. METHODS A systematic literature review was conducted including patient cohorts diagnosed with primary dissociative disorders, post-traumatic stress disorder (PTSD), or borderline personality disorder. RESULTS Results from MRI studies reporting structural (gray matter and white matter) and functional (during resting-state and task-related activation) brain aberrations were extracted and integrated. In total, 33 articles were included of which 10 pertained to voxel-based morphology, 2 to diffusion tensor imaging, 10 to resting-state fMRI, and 11 to task-related fMRI. Overall findings indicated aberrations spread across diverse brain regions, especially in the temporal and frontal cortices. Patients with dissociative identity disorder and with dissociative PTSD showed more overlap in brain activation than each group showed with depersonalization/derealization disorder. CONCLUSION In conjunction, the results indicate that dissociative processing cannot be localized to a few distinctive brain regions but rather corresponds to differential neural signatures depending on the symptom constellation.
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Affiliation(s)
- Shahab Lotfinia
- Department of Clinical Psychology, Zahedan University of Medical Science, Zahedan, Iran
| | - Zohre Soorgi
- Department of Psychiatry, Zahedan University of Medical Science, Zahedan, Iran
| | - Yoki Mertens
- Department of Clinical Psychology, University of Groningen, the Netherlands
| | - Judith Daniels
- Department of Clinical Psychology, University of Groningen, the Netherlands.
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11
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Salami A, Andreu-Perez J, Gillmeister H. Symptoms of depersonalisation/derealisation disorder as measured by brain electrical activity: A systematic review. Neurosci Biobehav Rev 2020; 118:524-537. [PMID: 32846163 DOI: 10.1016/j.neubiorev.2020.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 11/30/2022]
Abstract
Depersonalisation/derealisation disorder (DPD) refers to frequent and persistent detachment from bodily self and disengagement from the outside world. As a dissociative disorder, DPD affects 1-2 % of the population, but takes 7-12 years on average to be accurately diagnosed. In this systematic review, we comprehensively describe research targeting the neural correlates of core DPD symptoms, covering publications between 1992 and 2020 that have used electrophysiological techniques. The aim was to investigate the diagnostic potential of these relatively inexpensive and convenient neuroimaging tools. We review the EEG power spectrum, components of the event-related potential (ERP), as well as vestibular and heartbeat evoked potentials as likely electrophysiological biomarkers to study DPD symptoms. We argue that acute anxiety- or trauma-related impairments in the integration of interoceptive and exteroceptive signals play a key role in the formation of DPD symptoms, and that future research needs analysis methods that can take this integration into account. We suggest tools for prospective studies of electrophysiological DPD biomarkers, which are urgently needed to fully develop their diagnostic potential.
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Affiliation(s)
- Abbas Salami
- School of Computer Science and Electronic Engineering, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK; Smart Health Technologies Group, Centre for Computational Intelligence, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK.
| | - Javier Andreu-Perez
- School of Computer Science and Electronic Engineering, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK; Smart Health Technologies Group, Centre for Computational Intelligence, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK.
| | - Helge Gillmeister
- Department of Psychology and Centre for Brain Science, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK; Smart Health Technologies Group, Centre for Computational Intelligence, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK.
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Paul ER, Farmer M, Kämpe R, Cremers HR, Hamilton JP. Functional Connectivity Between Extrastriate Body Area and Default Mode Network Predicts Depersonalization Symptoms in Major Depression: Findings From an A Priori Specified Multinetwork Comparison. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:627-635. [PMID: 31103548 DOI: 10.1016/j.bpsc.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Depersonalization/derealization disorder is a dissociative disorder characterized by feelings of unreality and detachment from the self and surroundings. Depersonalization/derealization disorder is classified as a primary disorder, but depersonalization symptoms are frequently observed in mood and anxiety disorders. In the context of major depressive disorder (MDD), depersonalization symptoms are associated with greater depressive severity as indexed by treatment resistance, inpatient visits, and duration of depressive episodes. In the current investigation, we tested four network-based, neural-functional hypotheses of depersonalization in MDD. These hypotheses were framed in terms of functional relationships between 1) extrastriate body area and default mode network (DMN); 2) hippocampus and DMN; 3) medial prefrontal cortex and ventral striatum; and 4) posterior and anterior insular cortex. METHODS We conducted functional magnetic resonance imaging during resting state on 28 female patients with MDD and 27 control subjects with no history of a psychiatric disorder. Functional connectivity between seed and target regions as specified by our network-level hypotheses was computed and correlated with scores on the Cambridge Depersonalization Scale. We used a conservative, unbiased bootstrapping procedure to test the significance of neural-behavioral correlations observed under each of the four models tested. RESULTS Of the four neural-functional models of depersonalization symptoms tested, only the model proposing that reduced connectivity between the extrastriate body area and DMN predicts higher levels of depersonalization symptoms in MDD was confirmed. CONCLUSIONS Our results indicate that depersonalization/derealization disorder symptoms in patients with depression are related to reduced functional connectivity between brain regions that are proposed to support processing of body-related (extrastriate body area) and autobiographical (DMN) information.
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Affiliation(s)
- Elisabeth R Paul
- Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Madison Farmer
- Department of Industrial and Organizational Psychology, Roosevelt University, Chicago, Illinois
| | - Robin Kämpe
- Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Henk R Cremers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - J Paul Hamilton
- Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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13
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Groves K, Kennett S, Gillmeister H. Affective responses to body stimuli: comparing male and female bodies with cropped heads and masked faces. JOURNAL OF COGNITIVE PSYCHOLOGY 2018. [DOI: 10.1080/20445911.2018.1518962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Katie Groves
- Department of Psychology, University of Essex, Colchester, UK
| | - Steffan Kennett
- Department of Psychology, University of Essex, Colchester, UK
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14
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Krause-Utz A, Elzinga B. Current Understanding of the Neural Mechanisms of Dissociation in Borderline Personality Disorder. Curr Behav Neurosci Rep 2018; 5:113-123. [PMID: 29577011 PMCID: PMC5857558 DOI: 10.1007/s40473-018-0146-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose of Review In this article, we aim to give an overview over recent neuroimaging research on dissociation in borderline personality disorder (BPD). Stress-related dissociation is highly prevalent in BPD, while so far only little is known about its neural underpinnings. Recent Findings Based on research in depersonalization and the dissociative subtype of posttraumatic stress disorder, it has been proposed that dissociation involves alterations in a cortico-limbic network. In BPD, neuroimaging research explicitly focusing on dissociation is still scarce. Summary Functional neuroimaging studies have provided preliminary evidence for an altered recruitment and interplay of fronto-limbic regions (amygdala, anterior cingulate, inferior frontal gyrus, medial and dorsolateral prefrontal cortices) and temporoparietal areas (superior temporal gyrus, inferior parietal lobule, fusiform gyrus), which may underlie disrupted affective-cognitive processing during dissociation in BPD. More neuroimaging research with larger samples, clinical control groups, and repeated measurements is needed to deepen the understanding of dissociation in BPD.
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Affiliation(s)
- Annegret Krause-Utz
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
| | - Bernet Elzinga
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
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15
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Van Dam NT, van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Kerr CE, Gorchov J, Fox KC, Field BA, Britton WB, Brefczynski-Lewis JA, Meyer DE. Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2018; 13:36-61. [PMID: 29016274 PMCID: PMC5758421 DOI: 10.1177/1745691617709589] [Citation(s) in RCA: 507] [Impact Index Per Article: 84.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and "key to building more resilient soldiers." Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state of mindfulness research, comprehensively summarizing what we do and do not know, while providing a prescriptive agenda for contemplative science, with a particular focus on assessment, mindfulness training, possible adverse effects, and intersection with brain imaging. Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.
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Affiliation(s)
- Nicholas T. Van Dam
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marieke K. van Vugt
- Institute of Artificial Intelligence and Cognitive Engineering, University of Groningen, The Netherlands
| | - David R. Vago
- Osher Center for Integrative Medicine, Departments of Psychiatry and Physical Medicine & Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Laura Schmalzl
- College of Science and Integrative Health, Southern California University of Health Sciences, Whittier, CA, USA
| | - Clifford D. Saron
- Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | | | - Ted Meissner
- Center for Mindfulness, University of Massachusetts Medical School, Shrewsbury, MA, USA
| | - Sara W. Lazar
- Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Catherine E. Kerr
- Department of Family Medicine, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Jolie Gorchov
- Silver School of Social Work, New York University, New York, NY, USA
| | - Kieran C.R. Fox
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Brent A. Field
- Princeton Neuroscience Institute, Princeton University, Princeton, NJ, USA
| | - Willoughby B. Britton
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Julie A. Brefczynski-Lewis
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - David E. Meyer
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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16
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Abstract
Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia). While the precise neurobiological underpinnings of dissociation remain elusive, neuroimaging studies in disorders, characterized by high dissociation (e.g., depersonalization/derealization disorder (DDD), dissociative identity disorder (DID), dissociative subtype of posttraumatic stress disorder (D-PTSD)), have provided valuable insight into brain alterations possibly underlying dissociation. Neuroimaging studies in borderline personality disorder (BPD), investigating links between altered brain function/structure and dissociation, are still relatively rare. In this article, we provide an overview of neurobiological models of dissociation, primarily based on research in DDD, DID, and D-PTSD. Based on this background, we review recent neuroimaging studies on associations between dissociation and altered brain function and structure in BPD. These studies are discussed in the context of earlier findings regarding methodological differences and limitations and concerning possible implications for future research and the clinical setting.
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17
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Frewen P, Thornley E, Rabellino D, Lanius R. Neuroimaging the traumatized self: fMRI reveals altered response in cortical midline structures and occipital cortex during visual and verbal self- and other-referential processing in women with PTSD. Eur J Psychotraumatol 2017; 8:1314164. [PMID: 28649298 PMCID: PMC5475303 DOI: 10.1080/20008198.2017.1314164] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Changes to the diagnostic criteria for PTSD in DSM-5 reflect an increased emphasis on negative cognition referring to self and other, including self-blame, and related pervasive negative affective states including for self-conscious emotions such as guilt and shame. Objective: Investigate the neural correlates of valenced self-referential processing (SRP) and other-referential processing (ORP) in persons with PTSD. Method: We compared response to the Visual-Verbal Self-Other Referential Processing Task in an fMRI study of women with (n = 20) versus without (n = 24) PTSD primarily relating to childhood and interpersonal trauma histories using statistical parametric mapping and group independent component analysis. Results: As compared to women without PTSD, women with PTSD endorsed negative words as more descriptive both of themselves and others, whereas positive words were endorsed as less descriptive both of themselves and others. Women with PTSD also reported a greater experience of negative affect and a lesser experience of positive affect during SRP specifically. Significant differences between groups were observed within independent components defined by ventral- and middle-medial prefrontal corte x, mediolateral parietal cortex, and visual cortex, depending on experimental conditions. Conclusions: This study reveals brain-based disturbances during SRP and ORP in women with PTSD related to interpersonal and developmental trauma. Psychological assessment and treatment should address altered sense of self and affective response to others in PTSD.
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Affiliation(s)
- Paul Frewen
- School and Applied Child Psychology, University of Western Ontario, London, ON, Canada
| | - Elizabeth Thornley
- School and Applied Child Psychology, University of Western Ontario, London, ON, Canada
| | - Daniela Rabellino
- School and Applied Child Psychology, University of Western Ontario, London, ON, Canada
| | - Ruth Lanius
- Posttraumatic Stress Disorder (PTSD) Research Unit, University of Western Ontario, London, ON, Canada
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18
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Adler J, Schabinger N, Michal M, Beutel ME, Gillmeister H. Is that me in the mirror? Depersonalisation modulates tactile mirroring mechanisms. Neuropsychologia 2016; 85:148-58. [PMID: 26970140 DOI: 10.1016/j.neuropsychologia.2016.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 02/19/2016] [Accepted: 03/08/2016] [Indexed: 11/17/2022]
Abstract
Our sense of self is thought to develop through sensory-motor contingencies provided, not only by observing one's own body, but also by mirroring interactions with others. This suggests that there is a strong link between mirroring mechanisms and the bodily self. The present study tested whether this link is expressed at early, implicit stages of the mirroring process or at later, more cognitive stages. We also provide, to the best of our knowledge, the first demonstration of how inter-individual differences in our sense of bodily self may affect mirroring mechanisms. We used somatosensory event-related potentials (SEPs) to investigate the temporal dynamics of mirroring highly self-related information (viewed touch on one's own face) compared to other-related information (viewed touch on a stranger's face), in individuals with low and high levels of depersonalisation, a mental condition characterised by feeling detached or estranged from one's self and body. For the low-depersonalisation group, mirroring for self-related events (P45) preceded mirroring for other-related events (N80). At later stages (P200), mirroring was stronger for other-related than self-related events. This shows that early, implicit and later, more cognitive processes play different relative roles in mirroring self- and other-related bodily events. Critically, mirroring differed in the high-depersonalisation group, specifically for self-related events. An absence of early, implicit mirroring for self-related events over P45 suggests that the associated processes may be the neural correlates of the disembodiment experienced in depersonalisation. A lack of differential mirroring for self- and other-related events over P200 may reflect compensatory mechanisms that redress deficiencies in mirroring at earlier stages, which may break down to give rise to symptoms of depersonalisation. Alternatively, or in addition, they may represent an attenuation of processes related to self-other distinction. Our study thus shows that mirroring, especially for events on one's own face, can be strongly affected by how connected the observer feels to their own bodily self.
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Affiliation(s)
- Julia Adler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg - University Mainz, Mainz, Germany.
| | - Nadine Schabinger
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg - University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg - University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg - University Mainz, Mainz, Germany
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19
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Hu C, Di X, Eickhoff SB, Zhang M, Peng K, Guo H, Sui J. Distinct and common aspects of physical and psychological self-representation in the brain: A meta-analysis of self-bias in facial and self-referential judgements. Neurosci Biobehav Rev 2016; 61:197-207. [DOI: 10.1016/j.neubiorev.2015.12.003] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/25/2015] [Accepted: 12/09/2015] [Indexed: 12/24/2022]
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20
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Brand BL, Lanius RA. Chronic complex dissociative disorders and borderline personality disorder: disorders of emotion dysregulation? Borderline Personal Disord Emot Dysregul 2014; 1:13. [PMID: 26401297 PMCID: PMC4579511 DOI: 10.1186/2051-6673-1-13] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 08/27/2014] [Indexed: 11/25/2022] Open
Abstract
Emotion dysregulation is a core feature of chronic complex dissociative disorders (DD), as it is for borderline personality disorder (BPD). Chronic complex DD include dissociative identity disorder (DID) and the most common form of dissociative disorder not otherwise specified (DDNOS, type 1), now known as Other Specified Dissociative Disorders (OSDD, type 1). BPD is a common comorbid disorder with DD, although preliminary research indicates the disorders have some distinguishing features as well as considerable overlap. This article focuses on the epidemiology, clinical presentation, psychological profile, treatment, and neurobiology of chronic complex DD with emphasis placed on the role of emotion dysregulation in each of these areas. Trauma experts conceptualize borderline symptoms as often being trauma based, as are chronic complex DD. We review the preliminary research that compares DD to BPD in the hopes that this will stimulate additional comparative research.
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Affiliation(s)
| | - Ruth A Lanius
- />University of Western Ontario, London, ON N6A 5A5 Canada
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