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Yöyen E, Bal F, Barış TG, Arslan MS, Çokluk GF. Mediator Role of Dissociative Experiences in the Effect of Childhood Traumas on Emotion Regulation Difficulty and Parental Child-Containing Function. CHILDREN (BASEL, SWITZERLAND) 2024; 11:618. [PMID: 38929198 PMCID: PMC11201487 DOI: 10.3390/children11060618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
The aim of this study is to examine the mediating role of dissociation in emotional regulation and parental child-containing function skills of mothers exposed to childhood trauma. The research was conducted with 400 mothers between the ages of 20-60 who had childhood trauma and currently have children between the ages of 0-18. The relational screening model, one of the general screening models, was used in the research. The sample of the research was selected using the convenient sampling method and the simple random method. Research data were collected with the Sociodemographic Information Form, Childhood Trauma Scale (CTS), Parental Child-Containing Function Scale (PCCFS), Emotion Regulation Difficulty Scale (ERDS), and Dissociative Experiences Scale (DES). According to the results obtained in the study, physical abuse (β = 0.197; 95% CI [0.124; 0.268]), physical neglect (β = 0.232; 95% CI [0.161; 0.306]), emotional abuse (β = 0.238; 95% CI [0.169; 0.309]), emotional neglect (β = 0.210; 95% CI [0.150; 0.275]), and sexual abuse (β = 0.139; 95% CI [0.058; 0.220]) were found to have a significant indirect effect on emotion regulation difficulties through dissociative experiences. In addition, physical abuse (β = 0.122; 95% CI [0.071; 0.181]), physical neglect (β = 0.151; 95% CI [0.084; 0.228]), emotional abuse (β = 0.158; 95% CI [0.086; 0.238]), emotional neglect (β = 0.159; 95% CI [0.093; 0.235]), and sexual abuse (β = 0.086; 95% CI [0.039; 0.150] was found to have a significant indirect effect on parental child-containing function skills through dissociative experiences.
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Affiliation(s)
- Elif Yöyen
- Faculty of Humanities and Social Sciences, Department of Psychology, Sakarya University, 54050 Sakarya, Turkey;
| | - Fatih Bal
- Faculty of Humanities and Social Sciences, Department of Psychology, Sakarya University, 54050 Sakarya, Turkey;
| | - Tülay Güneri Barış
- Institute of Business Administration, Department of Health Sciences, Sakarya University, 54050 Sakarya, Turkey
| | - Meryem Selva Arslan
- Institute of Social Sciences, Department of Clinical Psychology, Marmara University, 34722 İstanbul, Turkey;
| | - Gülşen Filazoğlu Çokluk
- Faculty of Economics, Administrative and Social Sciences, Istanbul Gelişim University, 34310 İstanbul, Turkey
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2
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Boysen GA. Dissociative Identity Disorder: A Review of Research From 2011 to 2021. J Nerv Ment Dis 2024; 212:174-186. [PMID: 38412243 DOI: 10.1097/nmd.0000000000001764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
ABSTRACT Dissociative identity disorder (DID) has historically been one of the most controversial topics in the study of psychopathology. Building on a previous review of empirical research on DID from 2000 to 2010, the present review examined DID research from 2011 to 2021. The research output included 56 case studies and 104 empirical studies. Within the empirical studies, approximately 1354 new cases of DID emerged, which resulted in an average samples of approximately 20. Reanalysis of previous samples was standard in the literature with only 40% of reported cases being new. Studies emerged from dozens of countries across the world, but the majority of cases were from Western counties, especially the United States. Diagnosis primarily relied upon validated measures, but 74% of all new cases came from six research groups. Overall, research on DID is steady but methodologically limited in ways that make generalization, especially about etiology, difficult.
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Affiliation(s)
- Guy A Boysen
- Department of Psychology, McKendree University, Lebanon, Illinois
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3
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Wu Y, Guo Y, Xu N, Zhang H, Xiu Y, Lin D, Ying W. Risk factors for post-traumatic stress disorder in nurses from the regional medical alliance during the COVID-19 epidemic: A prospective cross-sectional study. Heliyon 2023; 9:e20289. [PMID: 37771525 PMCID: PMC10522950 DOI: 10.1016/j.heliyon.2023.e20289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
Mental health issues among nursing professionals have been increasingly reported during the coronavirus disease (COVID-19) pandemic. However, there is a paucity of research on post-traumatic stress disorder (PTSD) among nurses working in Medical Alliances. In this study, we aimed to investigate the risk factors associated with PTSD in the Regional Medical Alliance (MA) in Shantou (China) during the COVID-19 pandemic. A total of 1286 nurses from four MA hospitals participated in the study from February to March 2020. Our findings revealed that the incidences of PTSD, depression, anxiety, and sleep disorders among nurses from MA were 15.6%, 35.5%, 18.3%, and 36.4%, respectively. Moreover, PTSD was positively correlated with depression, anxiety, and sleep disorders. In addition, the results of logistic regression analysis showed that working in a tertiary hospital, older age, more severe depression, more severe anxiety, and prevalent sleep disorders were independent risk factors for PTSD among nurses. Therefore, mental health interventions targeting high-risk nurses in MA with an incidence of PTSD are urgently needed.
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Affiliation(s)
- Yanchun Wu
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Yulian Guo
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Nuo Xu
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Hong Zhang
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Yuqi Xiu
- School of Nursing, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Danna Lin
- School of Nursing, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Wenjuan Ying
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
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4
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Dimitrova LI, Dean SL, Schlumpf YR, Vissia EM, Nijenhuis ERS, Chatzi V, Jäncke L, Veltman DJ, Chalavi S, Reinders AATS. A neurostructural biomarker of dissociative amnesia: a hippocampal study in dissociative identity disorder. Psychol Med 2023; 53:805-813. [PMID: 34165068 PMCID: PMC9975991 DOI: 10.1017/s0033291721002154] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/12/2021] [Accepted: 05/11/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Little is known about the neural correlates of dissociative amnesia, a transdiagnostic symptom mostly present in the dissociative disorders and core characteristic of dissociative identity disorder (DID). Given the vital role of the hippocampus in memory, a prime candidate for investigation is whether total and/or subfield hippocampal volume can serve as biological markers of dissociative amnesia. METHODS A total of 75 women, 32 with DID and 43 matched healthy controls (HC), underwent structural magnetic resonance imaging (MRI). Using Freesurfer (version 6.0), volumes were extracted for bilateral global hippocampus, cornu ammonis (CA) 1-4, the granule cell molecular layer of the dentate gyrus (GC-ML-DG), fimbria, hippocampal-amygdaloid transition area (HATA), parasubiculum, presubiculum and subiculum. Analyses of covariance showed volumetric differences between DID and HC. Partial correlations exhibited relationships between the three factors of the dissociative experience scale scores (dissociative amnesia, absorption, depersonalisation/derealisation) and traumatisation measures with hippocampal global and subfield volumes. RESULTS Hippocampal volumes were found to be smaller in DID as compared with HC in bilateral global hippocampus and bilateral CA1, right CA4, right GC-ML-DG, and left presubiculum. Dissociative amnesia was the only dissociative symptom that correlated uniquely and significantly with reduced bilateral hippocampal CA1 subfield volumes. Regarding traumatisation, only emotional neglect correlated negatively with bilateral global hippocampus, bilateral CA1, CA4 and GC-ML-DG, and right CA3. CONCLUSION We propose decreased CA1 volume as a biomarker for dissociative amnesia. We also propose that traumatisation, specifically emotional neglect, is interlinked with dissociative amnesia in having a detrimental effect on hippocampal volume.
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Affiliation(s)
- Lora I. Dimitrova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Sophie L. Dean
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Yolanda R. Schlumpf
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | | | - Ellert R. S. Nijenhuis
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Vasiliki Chatzi
- Department of Biomedical Engineering, King's College London, London, UK
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Antje A. T. S. Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Smith DM, Terhune DB. Pedunculopontine-induced cortical decoupling as the neurophysiological locus of dissociation. Psychol Rev 2023; 130:183-210. [PMID: 35084921 PMCID: PMC10511303 DOI: 10.1037/rev0000353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Mounting evidence suggests an association between aberrant sleep phenomena and dissociative experiences. However, no wake-sleep boundary theory provides a compelling explanation of dissociation or specifies its physiological substrates. We present a theoretical account of dissociation that integrates theories and empirical results from multiple lines of research concerning the domain of dissociation and the regulation of rapid eye movement (REM) sleep. This theory posits that individual differences in the circuitry governing the REM sleep promoting Pedunculopontine Nucleus and Laterodorsal Tegmental Nucleus determine the degree of similarity in the cortical connectivity profiles of wakefulness and REM sleep. We propose that a latent trait characterized by elevated dissociative experiences emerges from the decoupling of frontal executive regions due to a REM sleep-like aminergic/cholinergic balance. The Pedunculopontine-Induced Cortical Decoupling Account of Dissociation (PICDAD) suggests multiple fruitful lines of inquiry and provides novel insights. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Derek M. Smith
- Department of Psychology, Northwestern University
- Department of Neurology, Division of Cognitive Neurology/Neuropsychology, The Johns Hopkins University School of Medicine
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Childhood trauma in patients with Dissociative Identity Disorder: A systematic Review of Data from 1990 to 2022. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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7
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Insomnia and Post-traumatic Stress Disorder: A Meta-analysis on Interrelated Association (n=57,618) and Prevalence (n=573,665). Neurosci Biobehav Rev 2022; 141:104850. [DOI: 10.1016/j.neubiorev.2022.104850] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/27/2022] [Accepted: 08/27/2022] [Indexed: 12/14/2022]
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Lynn SJ, Polizzi C, Merckelbach H, Chiu CD, Maxwell R, van Heugten D, Lilienfeld SO. Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework. Annu Rev Clin Psychol 2022; 18:259-289. [PMID: 35226824 DOI: 10.1146/annurev-clinpsy-081219-102424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identify empirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Steven Jay Lynn
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Craig Polizzi
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Harald Merckelbach
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Chui-De Chiu
- Department of Psychology, Chinese University of Hong Kong, Hong Kong, China
| | - Reed Maxwell
- Department of Psychiatry, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dalena van Heugten
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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9
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Atilan Fedai Ü, Asoğlu M. Analysis of Demographic and Clinical Characteristics of Patients with Dissociative Identity Disorder. Neuropsychiatr Dis Treat 2022; 18:3035-3044. [PMID: 36597464 PMCID: PMC9805736 DOI: 10.2147/ndt.s386648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/07/2022] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The prevalence of dissociative identity disorder (DID) is 1%. However, the diagnosis can be made less frequently. This rate is similar to that of schizophrenia, and it is a public health problem that should receive attention. In the wake of the research results and clinical experiences, it was determined that DID diagnosis was challenging. Despite prevalence rates being similar to those seen in schizophrenia, DID remains under-researched. This study aims to determine the sociodemographic features, complaints, aetiological traumas, comorbid psychiatric disorders, and previous psychiatric applications of patients who had DID diagnosis, as well as to increase the awareness and recognisability of DID. PATIENTS AND METHODS Seventy patients who were diagnosed with DID based on the DSM 5 criteria and admitted to the outpatient clinic of the Department of Psychiatry Harran University Faculty of Medicine agreed to participate in this study. Patients filled out dissociative experiences scale, dissociation scale, and sociodemographic data form. RESULTS Of the 70 patients, 47 (67.14%) were female, and 23 (32.85%) were male. The mean age was 26.5 ± 9.63, the age range was 18-62. It was the first psychiatric application for 34 (48.57%) patients. Of the 70 patients, 27 (38.57%) had four or more applications. Only 17 patients (24.28%) had the sole diagnosis of DID, while 47 patients (67.14%) had comorbid depressive symptoms. Regarding the first complaints, 35 patients (50.00%) had dissociative symptoms; 49 patients (70.00%) had depressive symptoms. As for the trauma types, 45 patients (64.28%) had histories of physical abuse, while 34 patients (48.57%) had histories of chronic neglect. CONCLUSION The symptoms of DID can be related to many psychiatric disorders. DID patients can be classified under many different symptom groups. Treatments for symptoms fail when the diagnosis of DID is neglected. Patients are generally misdiagnosed, as determined in this study and in previous studies. Dissociative symptoms should be checked regularly during psychiatric interviews to prevent misdiagnosis.
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Affiliation(s)
- Ülker Atilan Fedai
- Department of Psychiatry, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Mehmet Asoğlu
- Department of Psychiatry, Harran University Faculty of Medicine, Şanlıurfa, Turkey
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10
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Brand BL, Barth M, Schlumpf YR, Schielke H, Chalavi S, Vissia EM, Nijenhuis ERS, Jäncke L, Reinders AATS. The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls. Eur J Psychotraumatol 2021; 12:1984048. [PMID: 34868478 PMCID: PMC8635606 DOI: 10.1080/20008198.2021.1984048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Individuals with dissociative identity disorder (DID) have complex symptoms consistent with severe traumatic reactions. Clinicians and forensic assessors are challenged by distinguishing symptom exaggeration and feigning from genuine symptoms among these individuals. This task may be aided by administering validity measures. OBJECTIVE This study aimed to document how individuals with DID score on the Structured Inventory of Malingered Symptomatology (SIMS). The second objective was to compare coached DID simulators and healthy controls to DID patients on the SIMS's total score and subscales. The third objective was to examine the utility rates of the SIMS in distinguishing simulated DID from clinically diagnosed DID. METHOD We compared SIMS data gathered from participants from two Dutch sites, one Swiss site and one U.S. site. Sixty-three DID patients were compared to 77 coached DID simulators and 64 healthy controls on the SIMS. A multivariate analysis compared the groups on the SIMS total scores and subscales, and post-hoc Games Howell tests and univariate ANOVAs examined differences between the groups. Utility statistics assessed the accuracy of the SIMS in distinguishing clinical from simulated DID. RESULTS DID simulators scored significantly higher than DID individuals and healthy controls on every SIMS subscale as well as the total score. The majority (85.7%) of the individuals with DID scored above the cut-off, which is typically interpreted as indicative of possible symptom exaggeration. DID individuals scored higher than the healthy controls on every subscale except Low Intelligence, even after controlling for dissociation. The subscales and items most frequently endorsed by the DID group are consistent with symptoms associated with complex trauma exposure and dissociative reactions. The SIMS total score had a sensitivity of 96% but an unacceptably low specificity of 14%. CONCLUSIONS The findings indicate that the instrument is not accurate in assessing potential symptom exaggeration or feigning in DID.
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Affiliation(s)
- Bethany L Brand
- Psychology Department, Towson University, Towson, United States
| | - Michelle Barth
- Psychology Department, Towson University, Towson, United States
| | - Yolanda R Schlumpf
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Hugo Schielke
- Traumatic Stress Injury & Concurrent Program, Homewood Health Centre, Ontario, Canada
| | - Sima Chalavi
- Research Centre for Movement Control and Neuroplasticity, Department of Movement Sciences, Ku Leuven, Leuven, Belgium
| | | | - Ellert R S Nijenhuis
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Lutz Jäncke
- Department of Psychology, Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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11
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Abstract
The human circadian system creates and maintains cellular and systemic rhythmicity essential for the temporal organization of physiological processes promoting homeostasis and environmental adaptation. Sleep disruption and loss of circadian rhythmicity fundamentally affects master homeostasic regulating systems at the crossroads of peripheral and central susceptibility pathways, similar to acute or chronic stress and, thus, may play a central role in the development of stress-related disorders. Direct and indirect human and animal PTSD research accordingly suggests circadian-system-linked sleep, neuroendocrine, immune, metabolic and autonomic dysregulation, linking circadian misalignment to PTSD pathophysiology. Additionally, there is evidence that sleep and circadian disruption may represent a vital pre-existing risk factor in the prediction of PTSD development, while sleep-related symptoms are among the most prominent in trauma-associated disorders. These facts may represent a need for a shift towards a more chronobiological understanding of traumatic sequel and could support better prevention, evaluation and treatment of sleep and circadian disruption as first steps in PTSD management. In this special issue, we highlight and review recent advances from human sleep and chronobiological research that enhances our understanding of the development and maintenance of trauma-related disorders.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry, Division of Neurosciences, School of Medicine, Faculty of Medical Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,VA Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA, USA
| | - Miranda Olff
- Department of PsychiatryAmsterdam UMC, Amsterdam Neuroscience of Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
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12
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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: 45] [Impact Index Per Article: 11.3] [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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