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Psychology of Addictive Behaviors :... May 2021Multilevel consequences related to gambling disorder (GD) are glaring enough to make gambling a worldwide public health issue. Dissociation has been pointed out in... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Multilevel consequences related to gambling disorder (GD) are glaring enough to make gambling a worldwide public health issue. Dissociation has been pointed out in clinical, empirical, and theoretical contributions as a key variable accounting for the development and maintenance of GD. However, we still lack a systematization of available empirical data that may facilitate further accurate conclusions.
METHOD
A systematic review and meta-analysis were performed with the goal to answer to open questions. We followed the PRISMA guidelines conducting a systematic search of 5 scientific databases (PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, and PubMed) including grey literature.
RESULTS
A total of 843 records were screened, and 20 studies were included in the qualitative and quantitative analyses. A systematic review of selected studies outlines the high heterogeneity in the operationalization of the dissociation construct as well as the absence of studies examining the role played by the specific dimensions of the pathological dissociative feature in GD. A significant, positive, and moderate effect size (r = .37) was found linking GD to dissociation. Moreover, this effect appears to not be moderated by the quality of studies, age, and gender of participants nor measures used to evaluate dissociation.
CONCLUSIONS
Despite empirical evidences supporting the theoretical assertions toward the relationship between GD and dissociation, few studies have reached an articulated understanding of this topic, mostly failing to identify specific dissociative features involved in GD. Furthermore, the existence of the current gap in the literature are discussed to delineate future lines of research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Dissociative Disorders; Gambling; Humans
PubMed: 33646797
DOI: 10.1037/adb0000693 -
Der Nervenarzt Oct 2017Patient history taking and semiology provide seminal clues to the diagnosis of dissociative seizures. Openness and alertness of the treating physician are essential.... (Review)
Review
Patient history taking and semiology provide seminal clues to the diagnosis of dissociative seizures. Openness and alertness of the treating physician are essential. Video-electroencephalogram(EEG)-based analyses of the events are crucial to establish the correct diagnosis, particularly in complex cases. The patient-doctor relationship is of particular importance in order to successfully motivate the patient for psychotherapeutic treatment. Coexisting psychiatric morbidity as well as other functional somatic symptoms must be actively explored. Current changes in the established diagnostic manuals, including ICD-11, reflect the ongoing vivid interest and controversial discussions in the field of dissociative disorders.
Topics: Comorbidity; Diagnosis, Differential; Dissociative Disorders; Electroencephalography; Epilepsy; Humans; Medical History Taking; Physician-Patient Relations; Psychotherapy; Seizures; Somatoform Disorders; Video Recording
PubMed: 28871346
DOI: 10.1007/s00115-017-0401-4 -
Journal of Trauma & Dissociation : the... 2017During the 19th century, high hypnotizability was considered to be a form of psychopathology that was inseparable from hysteria. Today, hypnotizability is considered to... (Review)
Review
During the 19th century, high hypnotizability was considered to be a form of psychopathology that was inseparable from hysteria. Today, hypnotizability is considered to be a normal trait that has no meaningful relationship with psychopathology. Psychiatric patients generally manifest medium to low hypnotizability. Nevertheless, several psychiatric diagnoses are marked by an unexpectedly large proportion of patients with high hypnotizability. This is especially true of the diagnostic categories that were subsumed by the 19th-century concept of hysteria: dissociative identity disorder, somatization disorder, and complex conversion disorders. These hysteria-related modern diagnoses are also highly dissociative. A review and analysis of the literature regarding the relationship between hypnotizability and dissociation indicates that high hypnotizability is almost certainly a necessary diathesis for the development of a severe dissociative disorder. Such a diathesis has significant implications for (a) the psychiatric nosologies of the American Psychiatric Association and the World Health Organization, (b) the hypnosis field, and (c) the etiology and construct validity of dissociative identity disorder and other severe dissociative disorders. Specifically, the dissociative disorders (excepting depersonalization disorder, which is not classified as a dissociative disorder by the World Health Organization) are manifestations of hypnotic pathology.
Topics: Conversion Disorder; Depersonalization; Dissociative Disorders; Humans; Hypnosis; Somatoform Disorders
PubMed: 27216366
DOI: 10.1080/15299732.2016.1191579 -
Journal of Trauma & Dissociation : the... 2019The dissociative disorders field and the hypnosis field currently reject the autohypnotic model of the dissociative disorders, largely because many correlational studies... (Review)
Review
The dissociative disorders field and the hypnosis field currently reject the autohypnotic model of the dissociative disorders, largely because many correlational studies have shown hypnotizability and dissociation to be minimally related ( = .12). Curiously, it is also widely accepted that dissociative patients are highly hypnotizable. If dissociative patients are highly hypnotizable because - as the author proposes - then the methodology of correlational studies of hypnotizability and dissociation in random clinical and community samples would necessarily be constitutively unable to detect, and statistically unable to reflect, that fact. That is, the autohypnotic, dissociative distancing of that small subset of highly hypnotizable individuals who repeatedly encountered intolerable circumstances is statistically lost among the data of (1) the highly hypnotizable subjects who do not dissociate and (2) subjects (of all levels of hypnotizability) who manifest kinds of dissociation. The author proposes that, when highly hypnotizable individuals repeatedly engage in autohypnotic distancing from intolerable circumstances, they develop an overlearned, highly-motivated, automatized pattern of dissociative self-protection (i.e., a dissociative disorder). The author urges that theorists of hypnosis and the dissociative disorders explicitly include in their theories (a) the trait of high hypnotizability, (b) the phenomena of autohypnosis, and (c) the manifestations of systematized, autohypnotic pathology. Said differently, the author is suggesting that autohypnosis and autohypnotic pathology are unacknowledged nodes in the nomothetic networks of both hypnosis and dissociation.
Topics: Dissociative Disorders; Humans; Hypnosis; Models, Psychological
PubMed: 29565750
DOI: 10.1080/15299732.2018.1451806 -
Neurobiological and genetic correlates of the dissociative subtype of posttraumatic stress disorder.Journal of Psychopathology and Clinical... May 2023Approximately 10%-30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization...
Approximately 10%-30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization and derealization. This study examined the psychometric evidence for the dissociative subtype of PTSD in a sample of young, primarily male post-9/11-era Veterans ( = 374 at baseline and = 163 at follow-up) and evaluated its biological correlates with respect to resting state functional connectivity (default mode network [DMN]; = 275), brain morphology (hippocampal subfield volume and cortical thickness; = 280), neurocognitive functioning ( = 337), and genetic variation ( = 193). Multivariate analyses of PTSD and dissociation items suggested a class structure was superior to dimensional and hybrid ones, with 7.5% of the sample comprising the dissociative class; this group showed stability over 1.5 years. Covarying for age, sex, and PTSD severity, linear regression models revealed that derealization/depersonalization severity was associated with: decreased DMN connectivity between bilateral posterior cingulate cortex and right isthmus ( = .015; adjusted- [] = .097); increased bilateral whole hippocampal, hippocampal head, and molecular layer head volume ( = .010-.034; = .032-.053); worse self-monitoring ( = .018; = .079); and a candidate genetic variant (rs263232) in the adenylyl cyclase 8 gene ( = .026), previously associated with dissociation. Results converged on biological structures and systems implicated in sensory integration, the neural representation of spatial awareness, and stress-related spatial learning and memory, suggesting possible mechanisms underlying the dissociative subtype of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Male; Stress Disorders, Post-Traumatic; Multivariate Analysis; Gyrus Cinguli; Dissociative Disorders; Hippocampus
PubMed: 37023279
DOI: 10.1037/abn0000795 -
European Neurology 2016This historical essay outlines early ideas and clinical accounts of hysteria. It reproduces verbatim parts of a remarkable text of Thomas Sydenham. This provides the...
This historical essay outlines early ideas and clinical accounts of hysteria. It reproduces verbatim parts of a remarkable text of Thomas Sydenham. This provides the most detailed description of hysterical symptoms, contemporary treatment and particularly Sydenham's opinions about the nature of the disorder. His portrayal is compared to later and modern concepts and classification.
Topics: Dissociative Disorders; England; History, 17th Century; Humans; Hysteria; Somatoform Disorders
PubMed: 27658273
DOI: 10.1159/000450605 -
Current Psychiatry Reports Jan 2017Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization,... (Review)
Review
Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia). While the precise neurobiological underpinnings of dissociation remain elusive, neuroimaging studies in disorders, characterized by high dissociation (e.g., depersonalization/derealization disorder (DDD), dissociative identity disorder (DID), dissociative subtype of posttraumatic stress disorder (D-PTSD)), have provided valuable insight into brain alterations possibly underlying dissociation. Neuroimaging studies in borderline personality disorder (BPD), investigating links between altered brain function/structure and dissociation, are still relatively rare. In this article, we provide an overview of neurobiological models of dissociation, primarily based on research in DDD, DID, and D-PTSD. Based on this background, we review recent neuroimaging studies on associations between dissociation and altered brain function and structure in BPD. These studies are discussed in the context of earlier findings regarding methodological differences and limitations and concerning possible implications for future research and the clinical setting.
Topics: Borderline Personality Disorder; Brain; Brain Mapping; Cerebral Cortex; Depersonalization; Dissociative Disorders; Humans; Limbic System; Neuroimaging; Stress Disorders, Post-Traumatic
PubMed: 28138924
DOI: 10.1007/s11920-017-0757-y -
Psychiatry and Clinical Neurosciences Dec 2016The cross-cultural validity of dissociative possession and trance disorders is a matter of some debate, limiting research and meaningful interpretation of prevalence... (Review)
Review
The cross-cultural validity of dissociative possession and trance disorders is a matter of some debate, limiting research and meaningful interpretation of prevalence data. Intimate to these concerns is the status of spirit possession categories studied in the social sciences, particularly anthropology. These two categories are phenomenologically related and display similar epidemiological associations. In India, dissociative and conversion disorders are fairly common in clinical settings. There is no doubt that there are true cultural variations in possession and trance disorders. A new framework may enable clinicians to better understand possession states and spirit possession.
Topics: Conversion Disorder; Dissociative Disorders; Humans; Spirit Possession
PubMed: 27485275
DOI: 10.1111/pcn.12425 -
Games For Health Journal Aug 2022The use of virtual reality (VR) has been increasing worldwide, as devices are becoming more sophisticated and provide an escape from reality during the COVID-19...
The use of virtual reality (VR) has been increasing worldwide, as devices are becoming more sophisticated and provide an escape from reality during the COVID-19 lockdown. This recent rise in the use of VR leads to new side effects being reported, such as dissociative symptoms that may or may not constitute a mental health concern. This retrospective study investigated the prevalence and intensity of dissociative symptoms in VR users, as well as some potential predisposing conditions that may trigger them, and their impact on the subjects' wellbeing. We conducted a survey ( = 358) that was posted on VR Facebook groups. This survey was approved by the University of Lisbon Medical Faculty's IRB, and comprised a modified version of the Clinician-Administered Dissociative State Scale (CADSS) and questions regarding potential risk factors known to induce dissociative disorders or experiences. Data analysis revealed that 83.9% participants reported dissociative symptoms, with varying intensity according to CADSS (). Significant correlations were found between CADSS score and the time spent playing, the use of software applications (apps) that involve virtual hands or hand tracking, history of previous dissociative experiences, traumatic childhood events, avoidant coping strategies, and psychiatric disorders. Nonetheless, most participants categorized the symptoms as nonanxiogenic (85.8%) and minute lasting (77.4%). In conclusion, this study revealed that although VR can induce dissociative experiences, they seem to be short lasting and nonthreatening to the individual's wellbeing and might be predicted or attenuated by managing other known risk factors for dissociative phenomena.
Topics: COVID-19; Child; Communicable Disease Control; Dissociative Disorders; Humans; Retrospective Studies; Video Games; Virtual Reality
PubMed: 35648035
DOI: 10.1089/g4h.2022.0009 -
Psychological Medicine Jul 2022The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders... (Meta-Analysis)
Meta-Analysis Review
The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria ( = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5-45.0%) across all samples, 45.5% (95% CI 37.7-53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8-32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0-61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.
Topics: Adult; Child; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans; Prevalence; Stress Disorders, Post-Traumatic
PubMed: 35734787
DOI: 10.1017/S0033291722001647