1
|
De Oliveira P, Juneau C, Stinus C, Corman M, Michelli N, Pellerin N, Shankland R, Dambrun M. Cultivating Self-Transcendence Through Meditation Practice: A Test of the Role of Meta-Awareness, (Dis)identification and Non-Reactivity. Psychol Rep 2024:332941241246469. [PMID: 38669443 DOI: 10.1177/00332941241246469] [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: 04/28/2024]
Abstract
In this paper, we present a study comprising two distinct stages to examine the extent to which metacognitive processes of decentering facilitate the emergence of self-transcendence experiences in everyday life (i.e., the frequency of self-transcendent emotions, flow proneness, and adopting an interconnected identity). In the course of conducting this research, the first stage (N = 374) focused on assessing the structure and validity of the French version of the Metacognitive Processes of Decentering Scale (MPoD-t). Building on this, the second stage (N = 294) examined the potential relationship between meditative practices and psychological decentering processes (i.e., meta-awareness, (dis)identification with internal experiences, and (non)reactivity to thought content) and explored whether these mechanisms explain the association between meditative practices and the experience of self-transcendent states. Overall, the results demonstrated satisfactory psychometric properties of the French version of the MPoD and provided enhanced insights into the distinct mediating roles played by various decentering components in the manifestation of self-transcendence experiences in daily life. Indeed, the findings revealed that the relationship between practice and the occurrence of self-transcendent emotions or flow was mediated by the meta-awareness component, while the association between practice and the development of an interconnected identity was explained by the (dis)identification with internal experiences component. The implications of these findings are discussed.
Collapse
Affiliation(s)
| | | | - Céline Stinus
- C2S, Université de Reims Champagne-Ardenne, Reims, France
| | - Maya Corman
- LAPSCO CNRS, Université Clermont Auvergne (UCA), Clermont-Ferrand, France
| | - Noemi Michelli
- LabPsy UR 4139, Université de Bordeaux, Bordeaux, France
| | | | | | - Michael Dambrun
- LAPSCO CNRS, Université Clermont Auvergne (UCA), Clermont-Ferrand, France
| |
Collapse
|
2
|
Kent L, Nelson B, Northoff G. Can disorders of subjective time inform the differential diagnosis of psychiatric disorders? A transdiagnostic taxonomy of time. Early Interv Psychiatry 2023; 17:231-243. [PMID: 36935204 DOI: 10.1111/eip.13333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/09/2022] [Accepted: 05/29/2022] [Indexed: 12/01/2022]
Abstract
AIM Time is a core aspect of psychopathology with potential for clinical use and early intervention. Temporal experience, perception, judgement and processing are distorted in various psychiatric disorders such as mood (depression and mania), anxiety, autistic, impulse-control, dissociative and attention-deficit/hyperactivity disorders. Can these disorders of time be used as early diagnostic or predictive markers? To answer this question, we develop a Transdiagnostic Taxonomy of (disordered) Time (TTT) that maps on to the symptomatological, phenomenal, perceptual and functional descriptions of each underlying disorder in a 2 × 2 × 2 state space. Temporal distortions may precede functional decline, and so assist efforts at early detection and intervention in at-risk groups. METHOD Firstly, this article integrates a psychological model of how time is processed with a subjective or phenomenological model of how time is experienced or perceived. Secondly, the integrated combined model of time is then used to heuristically map major psychiatric disorders on to the basic elements of temporal flow and integration. RESULTS The TTT systematically describes the basic temporal nature of eight diagnostic categories of psychiatric illness. It differentiates between diagnoses primarily associated with distorted "macro-level" phenomenal temporal experiences (i.e. anxiety, dissociation/PTSD, depression, and mania) from those primarily related to distorted 'micro-level' temporal processing (i.e. psychotic, impulse-control, autistic and attention-deficit/hyperactivity disorders). CONCLUSIONS The TTT allows differential diagnostic classification of various psychiatric disorders in terms of a possible underlying time disorder, making it useful for future diagnostic and predictive purposes using novel techniques of temporal processing, time perception, passage of time, and time perspective.
Collapse
Affiliation(s)
- Lachlan Kent
- Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Georg Northoff
- Mental Health Center, Zhejiang University School of Medicine, Zhejiang, Hangzhou, People's Republic of China
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, People's Republic of China
| |
Collapse
|
3
|
Sahota PBK, D’Mello RJ, Shanbhag V, Nanjundaswamy MH, Ganjekar S, Kashyap H, Chandra PS. Finding One’s Voice: Psychotherapy for Dissociative Motor Disorders in the Indian Context. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09538-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
4
|
Heggdal D, Borgejordet S, Fosse R. "Existential Catastrophe Anxiety": Phenomenology of Fearful Emotions in a Subset of Service Users With Severe Mental Health Conditions. Front Psychol 2022; 13:766149. [PMID: 35360621 PMCID: PMC8960201 DOI: 10.3389/fpsyg.2022.766149] [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: 08/28/2021] [Accepted: 02/21/2022] [Indexed: 12/03/2022] Open
Abstract
A subset of people with severe mental health conditions feels they are on the verge of losing control, even in the absence of external threats or triggers. Some go to extreme ends to avoid affective arousal and associated expectations of a possible, impending catastrophe. We have learned about such phenomenological, emotional challenges in a group of individuals with severe, composite mental health problems and psychosocial disabilities. These individuals have had long treatment histories in the mental health care system. They have been encountered at a specialized inpatient ward offering exposure-based therapy that aims at restoring self-regulation and recovery. We describe the phenomenology of anxiety and fear presented by these service users, a fear we have coined existential catastrophe anxiety (ECa). We also suggest a set of underlying, interacting, psychological mechanisms that may give rise to ECa, before comparing ECa with three other constructs previously described in the literature—annihilation anxiety, ontological insecurity, and affect phobia. These comparisons show several similarities, but also unique qualities with ECa and its suggested underlying mechanisms. The conceptualization of ECa may aid clinicians in addressing extreme experiential turmoil and engage service users in empowering therapeutic projects.
Collapse
Affiliation(s)
- Didrik Heggdal
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Synne Borgejordet
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Roar Fosse
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| |
Collapse
|
5
|
Arzy S, Kaplan R. Transforming Social Perspectives with Cognitive Maps. Soc Cogn Affect Neurosci 2022; 17:939-955. [PMID: 35257155 PMCID: PMC9527473 DOI: 10.1093/scan/nsac017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/17/2021] [Accepted: 03/07/2022] [Indexed: 01/29/2023] Open
Abstract
Growing evidence suggests that cognitive maps represent relations between social knowledge similar to how spatial locations are represented in an environment. Notably, the extant human medial temporal lobe literature assumes associations between social stimuli follow a linear associative mapping from an egocentric viewpoint to a cognitive map. Yet, this form of associative social memory doesn't account for a core phenomenon of social interactions in which social knowledge learned via comparisons to the self, other individuals, or social networks are assimilated within a single frame of reference. We argue that hippocampal-entorhinal coordinate transformations, known to integrate egocentric and allocentric spatial cues, inform social perspective switching between the self and others. We present evidence that the hippocampal formation helps inform social interactions by relating self versus other social attribute comparisons to society in general, which can afford rapid and flexible assimilation of knowledge about the relationship between the self and social networks of varying proximities. We conclude by discussing the ramifications of cognitive maps in aiding this social perspective transformation process in states of health and disease.
Collapse
Affiliation(s)
- Shahar Arzy
- Faculty of Medicine and the Department of Cognitive Sciences, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Department of Neurology, Hadassah Hebrew University Medical School, Jerusalem 91120, Israel
| | - Raphael Kaplan
- Correspondence should be addressed to Raphael Kaplan, Department of Basic Psychology, Clinical Psychology, and Psychobiology, Universitat Jaume I, Avinguda de Vicent Sos Baynat, Castelló de la Plana, Spain. E-mail:
| |
Collapse
|
6
|
High dissociatives, nature versus nurture? CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02663-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractNon-pathological dissociative experiences are common among the general population, and anyone may experience them to some degree. Thus, the aim of this study was to assess the degree of dissociative experiences such as fantasy proneness, imagination, and absorption in fine arts undergraduates prior to beginning their artistic studies, and at the end of their studies at the faculty of fine arts. Moreover, education undergraduates were used as a comparison group. The sample consisted of 440 undergraduates (204 fine arts, and 236 education undergraduates; 224 first-year undergraduates, and 216 fourth-year undergraduates), who were administered three dissociative experiences tests: Dissociative Ability Scale, Dissociative Experiences Scale, and Questionnaire of Experiences of Dissociation. The working hypotheses were substantiated with dissociative experiences being a distinctive personality trait of fine arts undergraduates. We have found a grade level difference between first-year and fourth-year fine arts undergraduates, although the study does not examine the nature of the change itself. The results are discussed in the light of previous studies, and new lines of research proposed.
Collapse
|
7
|
Emran A, Sharma V, Singh R, Jha M, Iqbal N. Lived Experiences of Women with Dissociative Disorder: An Interpretative Phenomenological Analysis. Indian J Psychol Med 2021; 43:492-499. [PMID: 35210677 PMCID: PMC8826197 DOI: 10.1177/02537176211044801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In the Indian setting, several studies have documented that dissociative disorders (DDs) are more common in females, and the most commonly elicited stressors are interpersonal. However, much of the research up to now has been quantitative. There is a notable paucity of qualitative studies exploring the subjective experiences of women with DD. Therefore, the present study sought to explore and gain an in-depth understanding of the lived experiences of women diagnosed with DD. METHODS Five women were recruited who were seeking psychological treatment for dissociative symptoms at a tertiary care neuropsychiatric institute in North India. In-depth interviews were conducted with each, and the transcripts were analyzed using the analytic method of interpretative phenomenological analysis. RESULTS Three superordinate themes that emerged were: patients' illness perspectives, the salience of relationships, and dealing with relationship conflicts. CONCLUSIONS Our findings highlight the role of culture in influencing the participants' illness perspectives. Women with DD tend to define their self in relational terms and, thus, inhibit the expression of one's needs and opinions, to avoid conflict and to maintain harmony in relationships.
Collapse
Affiliation(s)
- Ashti Emran
- Dept. of Psychology, Jamia Millia Islamia, New Delhi, India
| | - Vibha Sharma
- Dept. of Clinical Psychology, Institute of Human Behavior and Allied Sciences, IHBAS, Delhi, India
| | - Ravinder Singh
- Dept. of Medical Anthropology, Institute of Human Behavior and Allied Sciences, IHBAS, Delhi, India
| | - Manisha Jha
- Dept. of Clinical Psychology, Institute of Human Behavior and Allied Sciences, IHBAS, Delhi, India
| | - Naved Iqbal
- Dept. of Psychology, Jamia Millia Islamia, New Delhi, India
| |
Collapse
|
8
|
Stroink L, Mens E, Ooms MHP, Visser S. Maladaptive schemas of patients with functional neurological symptom disorder. Clin Psychol Psychother 2021; 29:933-940. [PMID: 34585455 DOI: 10.1002/cpp.2671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND The psychological underpinnings of functional neurological symptom disorders (FNSD) remain poorly understood. A disintegration of explicit and implicit information processing in patients with FNSD has previously been suggested; however, this suggestion has so far received little empirical support. Trauma and maladaptive schemas probably reinforce disintegration in FNSD. The present study explored the occurrence of maladaptive schemas and investigated the impact of trauma-related maladaptive schemas in patients with FNSD. METHODS Forty-eight FNSD patients were assessed at the start of treatment using the Young Schema Questionnaire (YSQ-2) to explore maladaptive schemas. The Life Event Checklist (LEC-5) and the PTSD Checklist for DSM-5 (PCL-5) were used to explore trauma states, and the Sickness Impact Profile (SIP-68) was used to measure health dysfunction. RESULTS The self-sacrifice schema scored within a clinically relevant range where no increased scores were found in other maladaptive schemas. Linear regression models showed a positive association between mistrust/abuse and severity of health dysfunction. DISCUSSION Results suggest that maladaptive schemas play a modest role in FNSD at the start of treatment. It is suggested to examine the occurrence of maladaptive schemas in FNS-disordered patients with a longitudinal design.
Collapse
Affiliation(s)
- Luuk Stroink
- Pro Persona Integrated Mental Health Care, Pro Persona Behavioral Science Institute, Nijmegen, The Netherlands
| | - Ellen Mens
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Martijn H P Ooms
- Department of Rehabilitation Medicine, Klimmendaal Rehabilitation Medical Center, Arnhem, The Netherlands
| | - Sako Visser
- Pro Persona Integrated Mental Health Care, Pro Persona Behavioral Science Institute, Nijmegen, The Netherlands
| |
Collapse
|
9
|
Piedfort-Marin O, Rignol G, Tarquinio C. Le trouble dissociatif de l’identité : les mythes à l’épreuve des recherches scientifiques. ANNALES MEDICO-PSYCHOLOGIQUES 2021. [DOI: 10.1016/j.amp.2021.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
10
|
Ouwersloot G, Derksen J, Glas G. Reintroducing Consciousness in Psychopathology: Review of the Literature and Conceptual Framework. Front Psychol 2020; 11:586284. [PMID: 33312152 PMCID: PMC7704432 DOI: 10.3389/fpsyg.2020.586284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 10/27/2020] [Indexed: 11/22/2022] Open
Abstract
Alterations in consciousness are among the most common transdiagnostic psychopathological symptoms. Therefore clinical practice would benefit from a clear conceptual framework that guides the recognition, comprehension, and treatment of consciousness disorders. However, contemporary psychopathology lacks such a framework. We describe how pathology of consciousness is currently being addressed in clinical psychology and psychiatry so far, and how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases, Tenth Edition (ICD-10) refer to this subject. A brief review of the literature on consciousness is then given. After describing psychological perspectives on consciousness and discussing theoretical issues involved in exploring consciousness, we offer a practical clinical working definition of consciousness and we illustrate its connections with a variety of diagnoses. Making use of Jean-Paul Sartre’s distinctions among: states, functions, qualities, and structure, provide a conceptual framework to understand consciousness, to refine diagnostics and to guide the development of therapeutic possibilities in clinical practice.
Collapse
Affiliation(s)
| | - Jan Derksen
- Faculty of Social Sciences, Psychology, Radboud University, Nijmegen, Netherlands
| | - Gerrit Glas
- Department of Philosophy, Faculty of Humanities, Free University of Amsterdam, Amsterdam, Netherlands.,Department of Anatomy and Neurosciences, Amsterdam UMC, Faculty of Medicine, Psychiatry, Free University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
11
|
Abstract
In recent years, many adolescents in Nepal have been affected by episodes of mass psychogenic illness, which seem to involve dissociative symptoms. To identify the potential contributors to dissociation, the present study examined correlates of dissociative experiences among adolescents in Nepal. In a cross-sectional survey, 314 adolescents were assessed with the Adolescent Dissociative Experiences Scale and measures of childhood trauma exposure, as well as cognitive and personality traits found to be associated with dissociation in studies on other populations. Path analysis confirmed that childhood trauma, cognitive and personality traits, and current distress each predicted dissociative experiences and behaviors. However, an integrated path model found that the effect of childhood trauma on dissociation was mediated either by posttraumatic stress symptoms or by cognitive failures. Future studies should develop and test multifactorial models of dissociation and multiple pathways.
Collapse
|
12
|
Lynn SJ, Maxwell R, Merckelbach H, Lilienfeld SO, Kloet DVHVD, Miskovic V. Dissociation and its disorders: Competing models, future directions, and a way forward. Clin Psychol Rev 2019; 73:101755. [DOI: 10.1016/j.cpr.2019.101755] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/20/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022]
|
13
|
Basten C, Touyz S. Sense of Self: Its Place in Personality Disturbance, Psychopathology, and Normal Experience. REVIEW OF GENERAL PSYCHOLOGY 2019. [DOI: 10.1177/1089268019880884] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sense of self (SOS) is a cornerstone of psychological inquiry and therapy and is a defining feature of a range of psychological conditions including borderline personality disorder, yet it is poorly understood. SOS is that continuous experience of being a complete and authentic person who feels in control of their own activities. It is a part of normal development of the self and, when weakened by trauma or developmental neglect, is a vulnerability for developing many different disorders, including depression and dissociative, personality, and eating disorders. This review aims to provide a working definition and description of SOS and to summarize its transdiagnostic role in contributing to psychological disorders. To achieve this aim, the article encompasses and unites the literature from various theoretical domains including developmental psychology, identity theory, cognitive psychology, personality disorders, and psychodynamic theories. Implications are raised for psychological therapy and research into psychopathology and its underpinnings.
Collapse
Affiliation(s)
| | - Stephen Touyz
- The University of Sydney, Sydney, New South Wales, Australia
- InsideOut Institute, Sydney, New South Wales, Australia
| |
Collapse
|
14
|
Harricharan S, Nicholson AA, Thome J, Densmore M, McKinnon MC, Théberge J, Frewen PA, Neufeld RWJ, Lanius RA. PTSD and its dissociative subtype through the lens of the insula: Anterior and posterior insula resting‐state functional connectivity and its predictive validity using machine learning. Psychophysiology 2019; 57:e13472. [DOI: 10.1111/psyp.13472] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 06/24/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sherain Harricharan
- Department of Neuroscience Western University London Ontario Canada
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
| | - Andrew A. Nicholson
- Department of Psychological Research and Research Methods University of Vienna Vienna Austria
| | - Janine Thome
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
| | - Maria Densmore
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
| | - Margaret C. McKinnon
- Mood Disorders Program St. Joseph's Healthcare Hamilton Ontario Canada
- Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton Ontario Canada
- Homewood Research Institute Guelph Ontario Canada
| | - Jean Théberge
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
- Department of Medical Imaging Western University London Ontario Canada
- Department of Medical Biophysics Western University London Ontario Canada
- Department of Diagnostic Imaging St. Joseph's Healthcare London Ontario Canada
| | - Paul A. Frewen
- Department of Neuroscience Western University London Ontario Canada
- Department of Psychiatry Western University London Ontario Canada
- Department of Psychology Western University London Ontario Canada
| | - Richard W. J. Neufeld
- Department of Psychiatry Western University London Ontario Canada
- Department of Psychology Western University London Ontario Canada
| | - Ruth A. Lanius
- Department of Neuroscience Western University London Ontario Canada
- Department of Psychiatry Western University London Ontario Canada
- Imaging Division Lawson Health Research Institute London Ontario Canada
| |
Collapse
|
15
|
Tomlinson K, Baker C. Women's Auto/Biography and Dissociative Identity Disorder: Implications for Mental Health Practice. THE JOURNAL OF MEDICAL HUMANITIES 2019; 40:365-387. [PMID: 28875484 DOI: 10.1007/s10912-017-9471-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Dissociative Identity Disorder (DID) is an uncommon disorder that has long been associated with exposure to traumatic stressors exceeding manageable levels commonly encompassing physical, psychological and sexual abuse in childhood that is prolonged and severe in nature. In DID, dissociation continues after the traumatic experience and produces a disruption in identity where distinct personality states develop. These personalities are accompanied by variations in behaviour, emotions, memory, perception and cognition. The use of literature in psychiatry can enrich comprehension over the subjective experience of a disorder, and the utilisation of 'illness narratives' in nursing research have been considered a way of improving knowledge about nursing care and theory development. This research explores experiences of DID through close textual reading and thematic analysis of five biographical and autobiographical texts, discussing the lived experience of the disorder. This narrative approach aims to inform empathetic understanding and support the facilitation of therapeutic alliances in mental healthcare for those experiencing the potentially debilitating and distressing symptoms of DID. Although controversies surrounding the biomedical diagnosis of DID are important to consider, the lived experiences of those who mental health nurses encounter should be priority.
Collapse
Affiliation(s)
- Kendal Tomlinson
- School of Health Sciences, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, UK
| | - Charley Baker
- School of Health Sciences, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, UK.
| |
Collapse
|
16
|
Systema Temporis: A time-based dimensional framework for consciousness and cognition. Conscious Cogn 2019; 73:102766. [PMID: 31254738 DOI: 10.1016/j.concog.2019.102766] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 12/11/2022]
Abstract
This study uses a combined categorical-dimensional approach to depict a hierarchical framework for consciousness similar to, and contiguous with, factorial models of cognition (cf., intelligence). On the basis of the longstanding definition of time consciousness, the analysis employs a dimension of temporal extension, in the same manner that psychology has temporally organised memory (i.e., short-term, long-term, and long-lasting memories). By defining temporal extension in terms of the structure of time perception at short timescales (<100 s), memory and time consciousness are proposed to fit along the same logarithmic dimension. This suggests that different forms of time consciousness (e.g., experience, wakefulness, and self-consciousness) are embedded within, or supported by, the ascending timescales of different modes of memory (i.e., short-term, long-term, etc.). A secondary dimension is also proposed to integrate higher-order forms of consciousness/emotion and memory/cognition. The resulting two-dimensional structure accords with existing theories of cognitive and emotional intelligence.
Collapse
|
17
|
Wahbeh H, Cannard C, Okonsky J, Delorme A. A physiological examination of perceived incorporation during trance. F1000Res 2019; 8:67. [PMID: 30815253 DOI: 10.12688/f1000research.17157.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Numerous world cultures believe channeling provides genuine information, and channeling rituals in various forms are regularly conducted in both religious and non-religious contexts. Little is known about the physiological correlates of the subjective experience of channeling. Methods: We conducted a prospective within-subject design study with 13 healthy adult trance channels. Participants alternated between 5-minute blocks of channeling and no-channeling three times while electroencephalography (EEG), electrocardiography (ECG), galvanic skin response (GSR), and respiration were collected on two separate days. Voice recordings of the same story read in channeling and no-channeling states were also analyzed. Results: The pre-laboratory survey data about demographics, perception of the source, purpose and utility of channeled information reflected previous reports. Most participants were aware of their experience (rather than in a full trance) and had varying levels of perceived incorporation (i.e. control of their body). Voice analysis showed an increase in voice arousal and power (dB/Hz) differences in the 125 Hz bins between 0 and 625 Hz, and 3625 and 3875 Hz when reading during the channeling state versus control. Despite subjective perceptions of distinctly different states, no substantive differences were seen in EEG frequency power, ECG measures, GSR and respiration. Conclusions: Voice parameters were different between channeling and no-channeling states using rigorous controlled methods, but other physiology measure collected were not. Considering the subjective and phenomenological differences observed, future studies should include other measures such as EEG connectivity analyses, fMRI and biomarkers.
Collapse
Affiliation(s)
- Helané Wahbeh
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA.,Department of Neurology, School of Medicine, Oregon Health & Science University, Portland , OR, 97239, USA
| | - Cedric Cannard
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA
| | - Jennifer Okonsky
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA
| | - Arnaud Delorme
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA
| |
Collapse
|
18
|
Wahbeh H, Cannard C, Okonsky J, Delorme A. A physiological examination of perceived incorporation during trance. F1000Res 2019; 8:67. [PMID: 30815253 PMCID: PMC6384530 DOI: 10.12688/f1000research.17157.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Numerous world cultures believe channeling provides genuine information, and channeling rituals in various forms are regularly conducted in both religious and non-religious contexts. Little is known about the physiological correlates of the subjective experience of channeling. Methods: We conducted a prospective within-subject design study with 13 healthy adult trance channels. Participants alternated between 5-minute blocks of channeling and no-channeling three times while electroencephalography (EEG), electrocardiography (ECG), galvanic skin response (GSR), and respiration were collected on two separate days. Voice recordings of the same story read in channeling and no-channeling states were also analyzed. Results: The pre-laboratory survey data about demographics, perception of the source, purpose and utility of channeled information reflected previous reports. Most participants were aware of their experience (rather than in a full trance) and had varying levels of perceived incorporation (i.e. control of their body). Voice analysis showed an increase in voice arousal and power (dB/Hz) differences in the 125 Hz bins between 0 and 625 Hz, and 3625 and 3875 Hz when reading during the channeling state versus control. Despite subjective perceptions of distinctly different states, no substantive differences were seen in EEG frequency power, ECG measures, GSR and respiration. Conclusions: Voice parameters were different between channeling and no-channeling states using rigorous controlled methods, but other physiology measure collected were not. Considering the subjective and phenomenological differences observed, future studies should include other measures such as EEG connectivity analyses, fMRI and biomarkers.
Collapse
Affiliation(s)
- Helané Wahbeh
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA.,Department of Neurology, School of Medicine, Oregon Health & Science University, Portland , OR, 97239, USA
| | - Cedric Cannard
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA
| | - Jennifer Okonsky
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA
| | - Arnaud Delorme
- Research, Institute of Noetic Sciences, Petaluma, California, 94954, USA
| |
Collapse
|
19
|
Leave everything to the imagination: Cognitive functioning of individuals high in dissociative absorption and imaginative involvement. JOURNAL OF RESEARCH IN PERSONALITY 2018. [DOI: 10.1016/j.jrp.2018.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
20
|
Soffer‐Dudek N, Todder D, Shelef L, Deutsch I, Gordon S. A neural correlate for common trait dissociation: Decreased EEG connectivity is related to dissociative absorption. J Pers 2018; 87:295-309. [DOI: 10.1111/jopy.12391] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 02/05/2018] [Accepted: 03/26/2018] [Indexed: 12/21/2022]
Affiliation(s)
| | - Doron Todder
- Mental Health Center, Ministry of HealthBeer‐Sheva Israel
- Zlotowski Center for NeuroscienceBen‐Gurion University of the Negev
| | - Leah Shelef
- Israel Defense Force Medical CorpsTel Hashomer Ramat‐Gan Israel
| | - Inbal Deutsch
- Israel Defense Force Medical CorpsTel Hashomer Ramat‐Gan Israel
| | - Shirley Gordon
- Department of PsychologyBen‐Gurion University of the Negev
- Israel Defense Force Medical CorpsTel Hashomer Ramat‐Gan Israel
| |
Collapse
|
21
|
|
22
|
Wahbeh H, Radin D. People reporting experiences of mediumship have higher dissociation symptom scores than non-mediums, but below thresholds for pathological dissociation. F1000Res 2017; 6:1416. [PMID: 29416850 PMCID: PMC5782403 DOI: 10.12688/f1000research.12019.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 11/20/2022] Open
Abstract
Background: Dissociative states exist on a continuum from nonpathological forms, such as highway hypnosis and day-dreaming, to pathological states of derealization and depersonalization. Claims of communication with deceased individuals, known as mediumship, were once regarded as a pathological form of dissociation, but current definitions recognize the continuum and include distress and functional disability as symptoms of pathology. This study examined the relationship between dissociative symptoms and mediumship in a large convenience sample. Methods: Secondary analyses of cross-sectional survey data were conducted. The survey included demographics, the Dissociation Experience Scale Taxon (DES-T, score range 0-100), as well as questions about instances of mediumship experiences. Summary statistics and linear and logistic regressions explored the relationship between dissociative symptoms and mediumship endorsement. Results: 3,023 participants were included and were mostly middle-aged (51 years ± 16; range 17-96), female (70%), Caucasian (85%), college educated (88%), had an annual income over $50,000 (55%), and were raised Christian (71%) but were presently described as Spiritual but not Religious (60%). Mediumship experiences were endorsed by 42% of participants, the experiences usually began in childhood (81%), and 53% had family members who reported similar experiences. The mean DES-T score across all participants was 14.4 ± 17.3, with a mean of 18.2 ± 19.3 for those claiming mediumship experiences and 11.8 ± 15.2 for those who did not (t = -10.3, p < 0.0005). The DES-T threshold score for pathological dissociation is 30. Conclusions: On average, individuals claiming mediumship experiences had higher dissociation scores than non-claimants, but neither group exceeded the DES-T threshold for pathology. Future studies exploring dissociative differences between these groups may benefit from using more comprehensive measures of dissociative symptoms as well as assessments of functional impairment, which would help in discerning between pathological and non-pathological aspects of these experiences.
Collapse
Affiliation(s)
- Helané Wahbeh
- Institute of Noetic Sciences, Petaluma, CA, 94952, USA
| | - Dean Radin
- Institute of Noetic Sciences, Petaluma, CA, 94952, USA
| |
Collapse
|
23
|
Abstract
INTRODUCTION Patients diagnosed with dissociative identity disorder (DID) usually present with alternative personality states (alters) who take separate control of consciousness. Commonly, one alter will claim they have no awareness of events which took place when another alter was in control. However, some kinds of material are transferred across the alter boundary. Huntjens et al. devised an objective method of demonstrating such transfer. METHODS In the main study, following Huntjens et al., for three patients, two alters were taught different sets of nouns. The following week, one of the alters was given a recognition memory test including both sets plus distractor words. The patients in the Huntjens experiment responded in the same way to words in both sets. RESULTS In the present experiemnt, two of the patients tested had pairs of alters where there was no interference from the material which was presented to the other alter. In one of these cases, there was breakthrough with one pairing of alters, a pattern matched in a subsidiary experiment. CONCLUSIONS The population of individuals with DID are not homogeneous with respect to the depth of the blocking of episodic material from one alter to another.
Collapse
Affiliation(s)
- John Morton
- a Institute of Cognitive Neuroscience, University College , London , UK
| |
Collapse
|
24
|
COMT genotype is associated with plasticity in sense of body ownership: a pilot study. PSYCHOLOGICAL RESEARCH 2017; 82:634-644. [PMID: 28251370 DOI: 10.1007/s00426-017-0849-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
The sense of body ownership constantly adapts to new environments, and awareness of a distinction between oneself and others is a fundamental ability. However, it remains unclear whether plasticity in the sense of body ownership is dependent on genetic factors. The present study investigated the influence of the catechol-O-methyltransferase (COMT) Val158Met genotype on illusory learning of a sense of body ownership and dissociation. 76 healthy Japanese participants experienced the rubber hand illusion (RHI), which is produced by sensory integration of conflicting modalities, with the intent to experimentally alter objective perceived locations and subjective ownership ratings. We found that Val/Val homozygous participants had more intense RHI experiences than Val/Met heterozygous and Met homozygous participants. Furthermore, RHI sensation was correlated with a dissociative personality trait in Val/Val homozygous participants. Our findings indicate an interaction between COMT genotype, RHI sensation, and dissociative personality traits: Val/Val genotypes were associated with RHI induction and greater vulnerability to dissociation. The findings suggest that Val/Val homozygous individuals may be more flexible regarding self-attribution/body ownership and that biological factors may contribute to reduced awareness regarding the distinction between self and others.
Collapse
|
25
|
Tailby C, Rayner G, Wilson S, Jackson G. The spatiotemporal substrates of autobiographical recollection: Using event-related ICA to study cognitive networks in action. Neuroimage 2017; 152:237-248. [PMID: 28263928 DOI: 10.1016/j.neuroimage.2017.02.088] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 01/12/2023] Open
Abstract
Higher cognitive functions depend upon dynamically unfolding brain network interactions. Autobiographical recollection - the autonoetic re-experiencing of context rich, emotionally laden, personally experienced episodes - is an excellent example of such a process. Autobiographical recollection unfolds over time, with different cognitive processes engaged at different times throughout. In this paper we apply a recently developed analysis technique - event related independent components analysis (eICA) - to study the spatiotemporal dynamics of neural activity supporting autobiographical recollection. Participants completed an in-scanner autobiographical recollection paradigm in which the recalled episodes varied in chronological age and emotional content. By combining eICA with these cognitive manipulations we show that the brain-wide response to autobiographical recollection comprises brain networks with (i) different sensitivities to psychological aspects of the to-be-recollected material and (ii) distinct temporal profiles of activity during recollection. We identified networks with transient activations (in language and cognitive control related regions) and deactivations (in auditory and sensorimotor regions) to each autobiographical probe question, as well as networks with responses that are sustained over the course of the recollection period. These latter networks together overlapped spatially with the broader default mode network (DMN), indicating subspecialisation within the DMN. The vividness of participants' recollection was associated with the magnitude of activation in left dorsolateral prefrontal cortex and deactivation in visual association cortices. We interpret our results in the context of current theories of the spatial and temporal organisation of the human autobiographical memory system. Our findings demonstrate the utility of eICA as a tool for studying higher cognitive functions. The application of eICA to high spatial and temporal resolution datasets identifies in a single experimental protocol spatially specific networks that are recruited during cognitive activity, as well as the temporal order of activation of these networks.
Collapse
Affiliation(s)
- Chris Tailby
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia.
| | - Genevieve Rayner
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia
| | - Sarah Wilson
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia
| | - Graeme Jackson
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Neurology, Austin Health, Melbourne, VIC, Australia
| |
Collapse
|
26
|
Soffer-Dudek N, Shelef L, Oz I, Levkovsky A, Erlich I, Gordon S. Absorbed in sleep: Dissociative absorption as a predictor of sleepiness following sleep deprivation in two high-functioning samples. Conscious Cogn 2017; 48:161-170. [DOI: 10.1016/j.concog.2016.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 12/29/2022]
|
27
|
Abstract
OBJECTIVE There have, as yet, been few experimental studies of explicit facial affect recognition in patients with dissociative seizures (DS). The aim of the study was to examine explicit recognition and physiological responses to facial expressions in this group, relative to healthy controls. METHODS Forty patients with DS and 43 controls completed a computerized test of facial affect recognition, including five basic expressions (happiness, anger, disgust, fear, neutral). Recognition accuracy, emotional intensity judgements, and skin conductance levels and responses were dependent measures. Analyses controlled for a range of potentially confounding variables, including anxiety, depression, and medication effects. RESULTS The DS group was less accurate at identifying facial expressions than controls (p = .005, ηp = 0.10). No group difference emerged for intensity judgements (p = .72, ηp = 0.002). Mean skin conductance levels were higher in the DS group relative to controls (p = .046, ηp = 0.053). However, a subgroup of DS patients showed attenuated skin conductance responses to the facial stimuli, compared with controls (p = .015, ηp = 0.18). These differences could not be accounted for by possible confounding variables. Recognition accuracy for neutral faces correlated negatively with trauma scores (r = -0.486, p = .002) and abandonment concerns (r = -0.493, p = .002) in the DS group. CONCLUSIONS Patients with DS showed reduced recognition accuracy for facial affect, despite accurately perceiving its intensity. Elevated autonomic arousal may characterize patients with DS in general, alongside reduced phasic autonomic responses to facial expressions in some patients with the disorder.
Collapse
|
28
|
Byun S, Brumariu LE, Lyons-Ruth K. Disorganized attachment in young adulthood as a partial mediator of relations between severity of childhood abuse and dissociation. J Trauma Dissociation 2016; 17:460-79. [PMID: 26836233 PMCID: PMC5004628 DOI: 10.1080/15299732.2016.1141149] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Disorganized attachment has been proposed as a mediating mechanism in the relation between childhood abuse and dissociation. However, support for mediation has been mixed when interview or self-report measures of attachment have been used. In the current work, relations among severity of abuse, attachment disorganization, and dissociation were assessed in young adulthood using both interview and interaction-based measures of attachment. A total of 112 low-income young adults were assessed for socioeconomic stresses, abusive experiences in childhood, and attachment disorganization at age 20. Attachment disorganization was assessed with the Adult Attachment Interview, coded independently for Unresolved states of mind and for Hostile-Helpless states of mind. Attachment disorganization was also measured using a newly validated assessment of young adult-parent interaction during a conflict discussion. Mediation analyses revealed that the link between childhood abuse and dissociation was partially explained by disturbances in young adult-parent interaction. Narrative disturbances on the Adult Attachment Interview were related to abuse and to dissociation but did not mediate the link between the two. Results are discussed in relation to the role of parent-child communication processes in pathways to dissociation.
Collapse
Affiliation(s)
- Sooyeon Byun
- a WHOK Educational Research Center , Seoul , South Korea
| | - Laura E Brumariu
- b Gordon F. Derner Institute of Advanced Psychological Studies , Adelphi University , Garden City , New York , USA
| | - Karlen Lyons-Ruth
- c Department of Psychiatry , Harvard Medical School , Cambridge , Massachusetts , USA
| |
Collapse
|
29
|
Brand BL, Sar V, Stavropoulos P, Krüger C, Korzekwa M, Martínez-Taboas A, Middleton W. Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder. Harv Rev Psychiatry 2016; 24:257-70. [PMID: 27384396 PMCID: PMC4959824 DOI: 10.1097/hrp.0000000000000100] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/27/2015] [Accepted: 05/22/2015] [Indexed: 01/08/2023]
Abstract
Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertaining to recurrently expressed beliefs regarding DID: (1) belief that DID is a fad, (2) belief that DID is primarily diagnosed in North America by DID experts who overdiagnose the disorder, (3) belief that DID is rare, (4) belief that DID is an iatrogenic, rather than trauma-based, disorder, (5) belief that DID is the same entity as borderline personality disorder, and (6) belief that DID treatment is harmful to patients. The absence of research to substantiate these beliefs, as well as the existence of a body of research that refutes them, confirms their mythical status. Clinicians who accept these myths as facts are unlikely to carefully assess for dissociation. Accurate diagnoses are critical for appropriate treatment planning. If DID is not targeted in treatment, it does not appear to resolve. The myths we have highlighted may also impede research about DID. The cost of ignorance about DID is high not only for individual patients but for the whole support system in which they reside. Empirically derived knowledge about DID has replaced outdated myths. Vigorous dissemination of the knowledge base about this complex disorder is warranted.
Collapse
Affiliation(s)
- Bethany L Brand
- From Towson University (Dr. Brand); Koç University School of Medicine (Istanbul) (Dr. Sar); Blue Knot Foundation, Sydney, Australia (Dr. Stavropoulos); University of Pretoria (Dr. Krüger); McMaster University (Dr. Korzekwa); Carlos Albizu University (San Juan) (Dr. Martínez-Taboas); Latrobe University, University of New England, University of Canterbury (New Zealand), and University of Queensland (Australia) (Dr. Middleton)
| | | | | | | | | | | | | |
Collapse
|
30
|
The Classification of Hysteria and Related Disorders: Historical and Phenomenological Considerations. Behav Sci (Basel) 2015; 5:496-517. [PMID: 26561836 PMCID: PMC4695775 DOI: 10.3390/bs5040496] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/31/2015] [Accepted: 11/03/2015] [Indexed: 12/18/2022] Open
Abstract
This article examines the history of the conceptualization of dissociative, conversion, and somatoform syndromes in relation to one another, chronicles efforts to classify these and other phenomenologically-related psychopathology in the American diagnostic system for mental disorders, and traces the subsequent divergence in opinions of dissenting sectors on classification of these disorders. This article then considers the extensive phenomenological overlap across these disorders in empirical research, and from this foundation presents a new model for the conceptualization of these disorders. The classification of disorders formerly known as hysteria and phenomenologically-related syndromes has long been contentious and unsettled. Examination of the long history of the conceptual difficulties, which remain inherent in existing classification schemes for these disorders, can help to address the continuing controversy. This review clarifies the need for a major conceptual revision of the current classification of these disorders. A new phenomenologically-based classification scheme for these disorders is proposed that is more compatible with the agnostic and atheoretical approach to diagnosis of mental disorders used by the current classification system.
Collapse
|
31
|
Dissociative absorption: An empirically unique, clinically relevant, dissociative factor. Conscious Cogn 2015; 36:338-51. [DOI: 10.1016/j.concog.2015.07.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 07/22/2015] [Accepted: 07/27/2015] [Indexed: 11/22/2022]
|
32
|
Helmes E, Brown JM, Elliott L. A case of dissociative fugue and general amnesia with an 11-year follow-up. J Trauma Dissociation 2015; 16:100-13. [PMID: 25365262 DOI: 10.1080/15299732.2014.969469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Dissociative fugue refers to loss of personal identity, often with the associated loss of memories of events (general amnesia). Here we report on the psychological assessment of a 54-year-old woman with loss of identity and memories of 33 years of her life attributed to dissociative fugue, along with a follow-up 11 years later. Significant levels of personal injury and stress preceded the onset of the amnesia. A detailed neuropsychological assessment was completed at a university psychology clinic, with a follow-up assessment there about 11 years later with an intent to determine whether changes in her cognitive status were associated with better recall of her life and with her emotional state. Psychomotor slowing and low scores on measures of attention and both verbal and visual memory were present initially, along with significant psychological distress associated with the diagnosis of posttraumatic stress disorder. Although memories of her life had not returned by follow-up, distress had abated and memory test scores had improved. The passage of time and a better emotional state did not lead to recovery of lost memories. Contrary to expectations, performance on tests of executive functions was good on both occasions. Multiple stressful events are attributed as having a role in maintaining the loss of memories.
Collapse
Affiliation(s)
- Edward Helmes
- a Department of Psychology , James Cook University , Townsville , Australia
| | | | | |
Collapse
|
33
|
Haltigan JD, Roisman GI. INFANT ATTACHMENT INSECURITY AND DISSOCIATIVE SYMPTOMATOLOGY: FINDINGS FROM THE NICHD STUDY OF EARLY CHILD CARE AND YOUTH DEVELOPMENT. Infant Ment Health J 2014; 36:30-41. [DOI: 10.1002/imhj.21479] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
34
|
Suetani S, Markwick E. Meet Dr Jekyll: a case of a psychiatrist with dissociative identity disorder. Australas Psychiatry 2014; 22:489-91. [PMID: 25147320 DOI: 10.1177/1039856214547424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Dissociative identity disorder (DID) is a controversial psychiatric diagnosis. This case review presents a retired psychiatrist with a history of DID. CONCLUSIONS This case is used to illustrate current thinking about the characteristics and aetiology of DID. It also argues for the importance of being aware of both our personal and professional biases in our own clinical practice.
Collapse
Affiliation(s)
- Shuichi Suetani
- Registrar, The Queen Elizabeth Hospital, Woodville, SA, and; Clinical Lecturer, Discipline of Psychiatry, University of Adelaide, SA, Australia
| | - Elizabeth Markwick
- Consultant Psychiatrist, The Queen Elizabeth Hospital, Woodville, SA, Australia
| |
Collapse
|
35
|
Reinders AATS, Willemsen ATM, den Boer JA, Vos HPJ, Veltman DJ, Loewenstein RJ. Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: a PET study and neurobiological model. Psychiatry Res 2014; 223:236-43. [PMID: 24976633 DOI: 10.1016/j.pscychresns.2014.05.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 04/27/2014] [Accepted: 05/13/2014] [Indexed: 11/19/2022]
Abstract
Imaging studies in posttraumatic stress disorder (PTSD) have shown differing neural network patterns between hypo-aroused/dissociative and hyper-aroused subtypes. Since dissociative identity disorder (DID) involves different emotional states, this study tests whether DID fits aspects of the differing brain-activation patterns in PTSD. While brain activation was monitored using positron emission tomography, DID individuals (n=11) and matched DID-simulating healthy controls (n=16) underwent an autobiographic script-driven imagery paradigm in a hypo-aroused and a hyper-aroused identity state. Results were consistent with those previously found in the two PTSD subtypes for the rostral/dorsal anterior cingulate, the prefrontal cortex, and the amygdala and insula, respectively. Furthermore, the dissociative identity state uniquely activated the posterior association areas and the parahippocampal gyri, whereas the hyper-aroused identity state uniquely activated the caudate nucleus. Therefore, we proposed an extended PTSD-based neurobiological model for emotion modulation in DID: the hypo-aroused identity state activates the prefrontal cortex, cingulate, posterior association areas and parahippocampal gyri, thereby overmodulating emotion regulation; the hyper-aroused identity state activates the amygdala and insula as well as the dorsal striatum, thereby undermodulating emotion regulation. This confirms the notion that DID is related to PTSD as hypo-aroused and hyper-arousal states in DID and PTSD are similar.
Collapse
Affiliation(s)
- Antje A T S Reinders
- Department of Psychosis Studies, Institute of Psychiatry, King׳s College London, United Kingdom; Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Antoon T M Willemsen
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Johan A den Boer
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Herry P J Vos
- Outpatient Department Addiction Clinic Groningen/Drenthe, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Richard J Loewenstein
- Sheppard Pratt Health System, Department of Psychiatry, University of Maryland, Baltimore, MD, USA
| |
Collapse
|
36
|
George C, Buchheim A. Use of the adult attachment projective picture system in psychodynamic psychotherapy with a severely traumatized patient. Front Psychol 2014; 5:865. [PMID: 25140164 PMCID: PMC4122203 DOI: 10.3389/fpsyg.2014.00865] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 07/20/2014] [Indexed: 11/24/2022] Open
Abstract
The following case study is presented to facilitate an understanding of how the attachment information evident from Adult Attachment Projective Picture System (AAP) assessment can be integrated into a psychodynamic perspective in making therapeutic recommendations that integrate an attachment perspective. The Adult Attachment Projective Picture System (AAP) is a valid representational measure of internal representations of attachment based on the analysis of a set of free response picture stimuli designed to systematically activate the attachment system (George and West, 2012). The AAP provides a fruitful diagnostic tool for psychodynamic-oriented clinicians to identify attachment-based deficits and resources for an individual patient in therapy. This paper considers the use of the AAP with a traumatized patient in an inpatient setting and uses a case study to illustrate the components of the AAP that are particularly relevant to a psychodynamic conceptualization. The paper discusses also attachment-based recommendations for intervention.
Collapse
Affiliation(s)
- Carol George
- Department of Psychology, Mills College Oakland, CA, USA
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck Innsbruck, Austria
| |
Collapse
|
37
|
Bob P. Psychophysiology of dissociated consciousness. Curr Top Behav Neurosci 2014; 21:3-21. [PMID: 24850082 DOI: 10.1007/7854_2014_320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Recent study of consciousness provides an evidence that there is a limit of consciousness, which presents a barrier between conscious and unconscious processes. This barrier likely is specifically manifested as a disturbance of neural mechanisms of consciousness that through distributed brain processing, attentional mechanisms and memory processes enable to constitute integrative conscious experience. According to recent findings a level of conscious integration may change during certain conditions related to experimental cognitive manipulations, hypnosis, or stressful experiences that can lead to dissociation of consciousness. In psychopathological research the term dissociation was proposed by Pierre Janet for explanation of processes related to splitting of consciousness due to traumatic events or during hypnosis. According to several recent findings dissociation of consciousness likely is related to deficits in global distribution of information and may lead to heightened levels of "neural complexity" that reflects brain integration or differentiation based on numbers of independent neural processes in the brain that may be specifically related to various mental disorders.
Collapse
Affiliation(s)
- Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Ke Karlovu 11, 128 00, Prague, Czech Republic,
| |
Collapse
|
38
|
Zoellner LA, Bedard-Gilligan MA, Jun JJ, Marks LH, Garcia NM. The Evolving Construct of Posttraumatic Stress Disorder (PTSD): DSM-5 Criteria Changes and Legal Implications. PSYCHOLOGICAL INJURY & LAW 2013; 6:277-289. [PMID: 24470838 PMCID: PMC3901120 DOI: 10.1007/s12207-013-9175-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In the DSM-5, the diagnosis of posttraumatic stress disorder (PTSD) has undergone multiple, albeit minor, changes. These changes include shifting PTSD placement from within the anxiety disorders into a new category of traumatic and stressor-related disorders, alterations in the definition of a traumatic event, shifting of the symptom cluster structure from three to four clusters, the addition of new symptoms including persistent negative beliefs and expectations about oneself or the world, persistent distorted blame of self or others, persistent negative trauma-related emotions, and risky or reckless behaviors, and the addition of a dissociative specifier. The evidence or lack thereof behind each of these changes is briefly reviewed. These changes, although not likely to change overall prevalence, have the potential to increase the heterogeneity of individuals receiving a PTSD diagnosis both by altering what qualifies as a traumatic event and by adding symptoms commonly occurring in other disorders such as depression, borderline personality disorder, and dissociative disorders. Legal implications of these changes include continued confusion regarding what constitutes a traumatic stressor, difficulties with differential diagnosis, increased ease in malingering, and improper linking of symptoms to causes of behavior. These PTSD changes are discussed within the broader context of DSM reliability and validity concerns.
Collapse
Affiliation(s)
- Lori A Zoellner
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Michele A Bedard-Gilligan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Janie J Jun
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Libby H Marks
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Natalia M Garcia
- Department of Psychology, University of Washington, Seattle, Washington, USA
| |
Collapse
|
39
|
McKinstry J. Perpetual bodily trauma: wounding and memory in the Middle English romances. MEDICAL HUMANITIES 2013; 39:59-64. [PMID: 23129819 DOI: 10.1136/medhum-2012-010199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In the 21st century, the concept of trauma is deeply ingrained in psychological discourse despite the term's origins in literal, physical wounding and affecting experience. However, to understand the sources or causes of trauma, psychologists recognise the paramount importance of somatic evidence. The body provides corporeal systems for inputs that might trigger a later remembrance which might be auditory, visual, even tactile. The same body will continue to experience the trauma throughout its life, only alleviated, perhaps, by an appropriate therapeutic or chemical treatment. The body is therefore an important source of the trauma as an affected entity inscribed with experience, but the corporeal form also offers a way in which to identify and understand traumatic suffering itself. In the medieval period, trauma or violent experiences were similarly viewed as corporeal inscriptions which may fade but, metaphorically, remain immediately wounding. This paper explores the presentation of trauma in medieval romances, narratives strewn with injured bodies and correspondingly altered personalities and reputations, and compares this with contemporary research relating to trauma and the neurobiology of consciousness. The core issue is one of experience and expression: how an individual feels and continues to suffer trauma, and the ways in which that suffering can be communicated to those around. Through considering this issue, the paper argues for a relationship between the human experience of trauma across the centuries, and with this the combination of corporeal symbol and affect, and the dynamic interaction of a wounded body with time and its later life.
Collapse
Affiliation(s)
- Jamie McKinstry
- Department of English Studies, Durham University, Hallgarth House, 77 Hallgarth Street, Durham DH1 3AY, UK.
| |
Collapse
|
40
|
Bob P, Selesova P, Raboch J, Kukla L. 'Pseudoneurological' symptoms, dissociation and stress-related psychopathology in healthy young adults. BMC Psychiatry 2013; 13:149. [PMID: 23705894 PMCID: PMC3667100 DOI: 10.1186/1471-244x-13-149] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 05/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Somatoform dissociation is a specific form of dissociation with somatic manifestations represented in the form of 'pseudoneurological' symptoms due to disturbances or alterations of normal integrated functions of consciousness, memory or identity mainly related to trauma and other psychological stressors. With respect to the distinction between psychological and somatoform manifestations of dissociation current data suggest a hypothesis to which extent mild manifestations of 'pseudoneurological' symptoms in healthy young population may be linked to stress-related psychopathological symptoms or whether these symptoms more likely could be attributed to unexplained somatic factors. METHODS With this aim we have assessed the relationship between somatoform dissociation and stress-related psychopathology (i.e. anxiety, depression, symptoms of traumatic stress, alexithymia) in a group of 250 healthy non-psychiatric and non-clinical young adults. RESULTS Results of this study show that the symptoms of somatoform dissociation are significantly linked to stress-related psychopathology. CONCLUSIONS Findings of this study show that the 'pseudoneurological' symptoms may be linked to stress-related psychopathological processes which indicate that also mild levels of stress may influence somatic feelings and may lead to various somatoform dissociative symptoms.
Collapse
Affiliation(s)
- Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress & Department of Psychiatry, First Faculty of Medicine of Charles University, Ke Karlovu 11, 128 00 Prague, Czech Republic.
| | - Petra Selesova
- Center for Neuropsychiatric Research of Traumatic Stress & Department of Psychiatry, First Faculty of Medicine of Charles University, Ke Karlovu 11, 128 00 Prague, Czech Republic
| | - Jiri Raboch
- Center for Neuropsychiatric Research of Traumatic Stress & Department of Psychiatry, First Faculty of Medicine of Charles University, Ke Karlovu 11, 128 00 Prague, Czech Republic
| | - Lubomir Kukla
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Brno, Czech Republic
| |
Collapse
|
41
|
Cox RE, Barnier AJ. Shifting self, shifting memory: testing the self-memory system model with hypnotic identity delusions. Int J Clin Exp Hypn 2013; 61:416-62. [PMID: 23957262 DOI: 10.1080/00207144.2013.810479] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
According to Conway's self-memory system (SMS) model, autobiographical memories may be facilitated, inhibited, or misremembered to be consistent with current self. In 3 experiments, the authors tested this by hypnotically suggesting an identity delusion and indexing whether this shift in self produced a corresponding shift in autobiographical memory. High hypnotizable participants displayed a compelling identity delusion and elicited specific autobiographical events that they could justify when challenged. These memories were reinterpretations of previous experiences that supported the suggested identity. Importantly, autobiographical memories that were no longer consistent with the hypnotically deluded self were less accessible than other memories. The authors discuss these findings in the context of Conway's SMS model and propose 2 accounts of autobiographical remembering during hypnotic and clinical delusions.
Collapse
Affiliation(s)
- Rochelle E Cox
- Australian Research Council Centre of Excellence in Cognition and its Disorders (CCD), Macquarie University, Sydney, NSW, Australia.
| | | |
Collapse
|
42
|
Abstract
Dissociative identity disorder (DID), once considered rare, was frequently diagnosed during the 1980s and 1990s, after which interest declined. This is the trajectory of a medical fad. DID was based on poorly conceived theories and used potentially damaging treatment methods. The problem continues, given that the DSM-5 includes DID and accords dissociative disorders a separate chapter in its manual.
Collapse
|
43
|
Jayaprakash RR, Rajkumar AP, Nandyal M, Kurian S, Jacob KS. Dissociative stupor, mutism and amnesia in a young man. Indian J Psychiatry 2012; 54:198-9. [PMID: 22988333 PMCID: PMC3440920 DOI: 10.4103/0019-5545.99545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- R R Jayaprakash
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | | | | |
Collapse
|
44
|
Boysen GA. The scientific status of childhood dissociative identity disorder: a review of published research. PSYCHOTHERAPY AND PSYCHOSOMATICS 2012; 80:329-34. [PMID: 21829044 DOI: 10.1159/000323403] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 12/02/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dissociative identity disorder (DID) remains a controversial diagnosis due to conflicting views on its etiology. Some attribute DID to childhood trauma and others attribute it to iatrogenesis. The purpose of this article is to review the published cases of childhood DID in order to evaluate its scientific status, and to answer research questions related to the etiological models. METHODS I searched MEDLINE and PsycINFO records for studies published since 1980 on DID/multiple personality disorder in children. For each study I coded information regarding the origin of samples and diagnostic methods. RESULTS The review produced a total of 255 cases of childhood DID reported as individual case studies (44) or aggregated into empirical studies (211). Nearly all cases (93%) emerged from samples of children in treatment, and multiple personalities was the presenting problem in 23% of the case studies. Four US research groups accounted for 65% of all 255 cases. Diagnostic methods typically included clinical evaluation based on Diagnostic and Statistical Manual of Mental Disorder criteria, but hypnosis, structured interviews, and multiple raters were rarely used in diagnoses. CONCLUSION Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth. Nearly all of the research that does exist on childhood DID is from the 1980s and 1990s and does not resolve the ongoing controversies surrounding the disorder.
Collapse
Affiliation(s)
- Guy A Boysen
- Department of Psychology, State University of New York (SUNY) at Fredonia, Fredonia, NY 14063, USA.
| |
Collapse
|
45
|
Lynn SJ, Lilienfeld SO, Merckelbach H, Giesbrecht T, van der Kloet D. Dissociation and Dissociative Disorders. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2012. [DOI: 10.1177/0963721411429457] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Conventional wisdom holds that dissociation is a coping mechanism triggered by exposure to intense stressors. Drawing on recent research from multiple laboratories, we challenge this prevailing posttraumatic model of dissociation and dissociative disorders. Proponents of this model hold that dissociation and dissociative disorders are associated with (a) intense objective stressors (e.g., childhood trauma), (b) serious cognitive deficits that impede processing of emotionally laden information, and (c) an avoidant information-processing style characterized by a tendency to forget painful memories. We review findings that contradict these widely accepted assumptions and argue that a sociocognitive model better accounts for the extant data. We further propose a perspective on dissociation based on a recently established link between a labile sleep–wake cycle and memory errors, cognitive failures, problems in attentional control, and difficulties in distinguishing fantasy from reality. We conclude that this perspective may help to reconcile the posttraumatic and sociocognitive models of dissociation and dissociative disorders.
Collapse
|
46
|
Stone J, LaFrance WC, Brown R, Spiegel D, Levenson JL, Sharpe M. Conversion disorder: current problems and potential solutions for DSM-5. J Psychosom Res 2011; 71:369-76. [PMID: 22118377 DOI: 10.1016/j.jpsychores.2011.07.005] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 07/10/2011] [Accepted: 07/19/2011] [Indexed: 11/16/2022]
Abstract
Conversion disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) describes neurological symptoms, including weakness, numbness and events resembling epilepsy or syncope, which can be positively identified as not being due to recognised neurological disease. This review combines perspectives from psychiatry, psychology and neurology to identify and discuss key problems with the current diagnostic DSM-IV criteria for conversion disorder and to make the following proposals for DSM-5: (a) abandoning the label "conversion disorder" and replacing it with an alternative term that is both theoretically neutral and potentially more acceptable to patients and practitioners; (b) relegating the requirements for "association of psychological factors" and the "exclusion of feigning" to the accompanying text; (c) adding a criterion requiring clinical findings of internal inconsistency or incongruity with recognised neurological or medical disease and altering the current 'disease exclusion' criteria to one in which the symptom must not be 'better explained' by a disease if present, (d) adding a 'cognitive symptoms' subtype. We also discuss whether conversion symptoms are better classified with other somatic symptom disorders or with dissociative disorders and how we might address the potential heterogeneity of conversion symptoms in classification.
Collapse
Affiliation(s)
- Jon Stone
- Dept Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Rd, Edinburgh EH4 2XU, UK.
| | | | | | | | | | | |
Collapse
|
47
|
Nilsson D, Holmqvist R, Jonson M. Self-reported attachment style, trauma exposure and dissociative symptoms among adolescents. Attach Hum Dev 2011; 13:579-95. [DOI: 10.1080/14616734.2011.609004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
48
|
Abstract
Videogame players commonly report reaching deeply "immersive" states of consciousness, in some cases growing to feel like they actually are their characters and really in the game, with such fantastic characters and places potentially only loosely connected to offline selves and realities. In the current investigation, we use interview and survey data to examine the effects of such "dissociative" experiences on players of the popular online videogame, World of Warcraft (WoW). Of particular interest are ways in which WoW players' emotional identification with in-game second selves can lead either to better mental well-being, through relaxation and satisfying positive stress, or, alternatively, to risky addiction-like experiences. Combining universalizing and context-dependent perspectives, we suggest that WoW and similar games can be thought of as new "technologies of absorption"--contemporary practices that can induce dissociative states in which players attribute dimensions of self and experience to in-game characters, with potential psychological benefit or harm. We present our research as an empirically grounded exploration of the mental health benefits and risks associated with dissociation in common everyday contexts. We believe that studies such as ours may enrich existing theories of the health dynamics of dissociation, relying, as they often do, on data drawn either from Western clinical contexts involving pathological disintegrated personality disorders or from non-Western ethnographic contexts involving spiritual trance.
Collapse
|
49
|
Kranick SM, Gorrindo T, Hallett M. Psychogenic movement disorders and motor conversion: a roadmap for collaboration between neurology and psychiatry. PSYCHOSOMATICS 2011; 52:109-16. [PMID: 21397102 PMCID: PMC3073765 DOI: 10.1016/j.psym.2010.12.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 08/25/2010] [Accepted: 08/26/2010] [Indexed: 10/14/2022]
Abstract
BACKGROUND There are a host of vague terms to describe psychologically-mediated symptoms that mimic neurological disease, such as "functional," "non-organic," "psychogenic," or "medically unexplained." None of these terms has a direct translation in psychiatric classification, and psychiatrists are often faced with patients who do not believe in a psychological origin for their symptoms. OBJECTIVE Within the framework of psychogenic movement disorders, we discuss the roadblocks to effective collaboration and treatment in these patients and the current state of the literature regarding diagnosis and treatment. RESULTS We describe the approach to these patients from the perspective of neurology and psychiatry, illustrating the differences in terminology and categorization. CONCLUSION Psychogenic movement disorders represent a unique opportunity for these fields to collaborate in the care of a potentially curable but significantly disabling disorder.
Collapse
Affiliation(s)
- Sarah M Kranick
- Human Motor Control Section, Medical Neurology Branch, National Institutes of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1428, USA.
| | | | | |
Collapse
|
50
|
|