Altered orientation of spatial attention in depersonalization disorder

Behavioural, autonomic, and neural responsivity in depersonalisation-derealisation disorder: A systematic review of experimental evidence

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.

Inhibition, Attentional Control and Binding Abilities in Relation to Dissociative Symptoms Among PTSD Patients

INTRODUCTION

The relationship between dissociation and cognitive abilities remains controversial. Empirical studies have reported positive, negative and non-existent associations between dissociation and cognition. These inconsistent results may be due to the fact that the studies focused mainly on trait dissociation, while dissociation is not stable but transient. After validating the French version of the Clinician Administered Dissociative States Scale (CADSS), the aim of the present study was to evaluate the relationship between state dissociation and cognitive abilities.

METHOD

We recruited 83 patients suffering from post-traumatic stress disorder (PTSD) and assessed them twice. At T1, they performed a neutral Stroop task and a neutral binding task. At T2 (one to three weeks later), after a script-driven dissociative induction, they performed an emotional Stroop task and an emotional binding task. Between the two sessions, they completed questionnaires at home evaluating PTSD severity, trait dissociation and cognitive difficulties. State dissociation was assessed at T1 and T2 using the Clinician-Administered Dissociative States Scale (CADSS).

RESULTS

We found good psychometric properties of the French version of the CADSS. After inducing dissociation, significantly lower attentional performance was found among patients with than without dissociative reactions. We found a significant positive correlation between state dissociation and increased attention and memory difficulties after induction.

CONCLUSION

The French version of the CADSS is a reliable and valid tool to assess state dissociation, which is correlated with attentional difficulties. Attentional training is recommended to help patients control dissociative symptoms.

Eye movement characteristics are not significantly influenced by psychiatric comorbidities in people with visual snow syndrome

Visual snow syndrome (VSS) is a neurological disorder primarily affecting the processing of visual information. Using ocular motor (OM) tasks, we previously demonstrated that participants with VSS exhibit altered saccade profiles consistent with visual attention impairments. We subsequently proposed that OM assessments may provide an objective measure of dysfunction in these individuals. However, VSS participants also frequently report significant psychiatric symptoms. Given that that these symptoms have been shown previously to influence performance on OM tasks, the objective of this study was to investigate whether psychiatric symptoms (specifically: depression, anxiety, fatigue, sleep difficulties, and depersonalization) influence the OM metrics found to differ in VSS. Sixty-one VSS participants completed a battery of four OM tasks and a series of online questionnaires assessing psychiatric symptomology. We revealed no significant relationship between psychiatric symptoms and OM metrics on any of the tasks, demonstrating that in participants with VSS, differences in OM behaviour are a feature of the disorder. This supports the utility of OM assessment in characterising deficit in VSS, whether supporting a diagnosis or monitoring future treatment efficacy.

The role of cognitive factors and personality traits in the perception of illusory self-motion (vection)

Vection is a perceptual phenomenon that describes the visually induced subjective sensation of self-motion in the absence of physical motion. Previous research has discussed the potential involvement of top-down cognitive mechanisms on vection. Here, we quantified how cognitive manipulations such as contextual information (i.e., expectation) and plausibility (i.e., chair configuration) alter vection. We also explored how individual traits such as field dependence, depersonalization, anxiety, and social desirability might be related to vection. Fifty-one healthy adults were exposed to an optic flow stimulus that consisted of horizontally moving black-and-white bars presented on three adjacent monitors to generate circular vection. Participants were divided into three groups and given experimental instructions designed to induce either strong, weak, or no expectation with regard to the intensity of vection. In addition, the configuration of the chair (rotatable or fixed) was modified during the experiment. Vection onset time, duration, and intensity were recorded. Results showed that expectation altered vection intensity, but only when the chair was in the rotatable configuration. Positive correlations for vection measures with field dependence and depersonalization, but no sex-related effects were found. Our results show that vection can be altered by cognitive factors and that individual traits can affect the perception of vection, suggesting that vection is not a purely perceptual phenomenon, but can also be affected by top-down mechanisms.

The Detached Self: Investigating the Effect of Depersonalisation on Self-Bias in the Visual Remapping of Touch

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.

Symptoms of depersonalisation/derealisation disorder as measured by brain electrical activity: A systematic review

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.

A mathematical and biological plausible model of decision-execution regulation in "Go/No-Go" tasks: Focusing on the fronto-striatal-thalamic pathway

Discovering factors influencing the speed and accuracy of responses in tasks such as "Go/No-Go" is one of issues which have been raised in neurocognitive studies. Mathematical models are considered as tools to identify and to study decision making procedure from different aspects. In this paper, a mathematical model has been presented to show several factors can alter the output of decision making procedure before execution in a "Go/No-Go" task. The dynamic of this model has two stable fixed points, each of them corresponds to the "Press" and "Not-press" responses. This model that focuses on the fronto-striatal-thalamic direct and indirect pathways, receives planned decisions from frontal cortex and sends a regulated output to motor cortex for execution. The state-space analysis showed that several factors could affect the regulation procedure such as the input strength, noise value, initial condition, and the values of involved neurotransmitters. Some probable analytical reasons that may lead to changes in decision-execution regulation have been suggested as well. Bifurcation diagram analysis demonstrates that an optimal interaction between these factors can compensate the weaknesses of some others. It is predicted that abnormalities of response control in different brain disorders such as attention deficit hyperactivity disorder may be resolved by providing treatment techniques that target the regulation of the interaction. The model also suggests a possible justification to show why so many studies insist on the important role of dopamine in some brain disorders.

Altered patterns of heartbeat-evoked potentials in depersonalization/derealization disorder: neurophysiological evidence for impaired cortical representation of bodily signals

OBJECTIVE

Core features of depersonalization/derealization disorder (DPD) are emotional numbing and feelings of disembodiment. Although there are several neurophysiological findings supporting subjective emotional numbing, the psychobiology of disembodiment remains unclear.

METHODS

Heartbeat-evoked potentials (HEPs), which are considered psychophysiological indicators for the cortical representation of afferent signals originating from the cardiovascular system, were assessed in 23 patients with DPD and 24 healthy control individuals during rest and while performing a heartbeat perception task.

RESULTS

Absolute HEP amplitudes did not differ between groups. Nevertheless, healthy individuals showed higher HEPs during the heartbeat perception task than during rest, whereas no such effect was found in patients with DPD (p = .031). Patients with DPD had higher total levels of salivary α-amylase than did healthy individuals (9626.6 [8200.0] versus 5344.3 [3745.8] kU min/l; p = .029), but there were no group differences in cardiovascular measures (heart rate = 76.2 [10.1] versus 74.3 [7.5] beats/min, p = .60; normalized low-frequency heart rate variability = 0.63 [0.15] versus 0.56 [0.15] normalized units, p = .099; low frequency/high frequency ratio = 249.3 [242.7] versus 164.8 [108.8], p = .10), salivary cortisol (57.5 [46.7] versus 55.1 [43.6] nmol min/l, p = .86), or cortisone levels (593.2 [260.3] versus 543.8 [257.1] nmol min/l, p = .52).

CONCLUSIONS

These results suggest altered cortical representation of afferent signals originating from the cardiovascular system in patients with DPD, which may be associated with higher sympathetic tone. These findings may reflect difficulties of patients with DPD to attend to their actual bodily experiences.