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Journal of Behavior Therapy and... Dec 2021Anecdotal and research evidence suggests that individuals with dissociative symptoms exhibit hyperassociativity, which might explain several key features of their...
BACKGROUND AND OBJECTIVES
Anecdotal and research evidence suggests that individuals with dissociative symptoms exhibit hyperassociativity, which might explain several key features of their condition. The aim of our study was to investigate the link between dissociative tendencies and hyperassociativity among college students.
METHODS
The study (n = 118) entailed various measures of hyperassociativity, measures of dissociative tendencies, depressive experiences, unusual sleep experiences, cognitive failures, and alexithymia.
RESULTS
We found a positive association between dissociative experiences (i.e., depersonalization) and hyperassociativity specific for associative fluency and associative flexibility tasks (including neutral and valenced material), but not for a remote association task. We also found tentative evidence for cognitive failures and alexithymia explaining the link between hyperassociativity and daytime dissociation and nighttime unusual sleep experiences.
LIMITATIONS
Limitations include the use of hyperassociation tasks limited to verbal associations vs. imagistic associations, the lack of a measure of trauma history, and a sample limited to college students.
CONCLUSION
Our study reports a link between depersonalization and hyperassociativity on tasks that allow for free associations across different semantic domains, potentially explained by alexithymia and cognitive failures. This finding may, with replication, open the pathway to applied intervention studies.
Topics: Affective Symptoms; Dissociative Disorders; Humans; Sleep; Students
PubMed: 34091386
DOI: 10.1016/j.jbtep.2021.101665 -
European Journal of Psychotraumatology 2023The clinical guidelines for the treatment of dissociation focus primarily on psychotherapy. However, different psychoactive drugs are used in clinical practice. The use... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The clinical guidelines for the treatment of dissociation focus primarily on psychotherapy. However, different psychoactive drugs are used in clinical practice. The use of opioid antagonists has been proposed as a therapeutic option based on the theory that dissociation might be a phenomenon mediated by dysregulation of the endogenous opioid system.
OBJECTIVE
To review and meta-analyse the available evidence on the efficacy of the opioid antagonists naltrexone, naloxone, and nalmefene as treatments for dissociative symptoms and disorders.
METHOD
The PRISMA guidelines were followed, and this review was registered in Prospero with reference number CRD42021280976. The search was performed in the PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and PubPsych databases.
RESULTS
1,798 citations were obtained. After removing duplicates and applying inclusion and exclusion criteria, we included 5 comparative studies with 9 dissociation measures that had included a total of 154 participants, of whom 134 had been treated with an opioid antagonist. The results of the meta-analysis showed a treatment effect for dissociation when using opioid antagonists [pooled = 1.46 (95% CI: 0.62-2.31)]. However, the studies we included were very heterogeneous [Q = 66.89 ( < .001)] and there may have been publication bias.
CONCLUSIONS
Although more research is needed and the results must be interpreted with caution because of the limited amount of data and heterogeneity in the studies and their methodological qualities, opioid antagonists (particularly naltrexone) are promising candidates for the treatment of dissociative symptoms and showed a moderate - large effect size in reducing these symptoms.
Topics: Humans; Narcotic Antagonists; Naltrexone; Naloxone; Dissociative Disorders
PubMed: 37860852
DOI: 10.1080/20008066.2023.2265184 -
Neuroscience and Biobehavioral Reviews Jan 2022Dissociative disorders (DD) and conversion disorders (CD) are frequent in general and psychiatric populations. Some evidence suggest that the hypothalamic-pituitary axis... (Review)
Review
Dissociative disorders (DD) and conversion disorders (CD) are frequent in general and psychiatric populations. Some evidence suggest that the hypothalamic-pituitary axis (HPA) and autonomic nervous system (ANS) are dysregulated in both disorders. We carried out a systematic review of the literature to summarize the existing knowledge on the stress response, via HPA and/or ANS, in patients with DD, CD, or dissociative symptoms. We systematically searched Medline and Web of Science using the Medical Subject Headings related to stress axis, CD, DD, and dissociative symptoms following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results suggest that in participants without psychiatric history, high cortisol secretion is related to high dissociation scores. Conversely the stress system might be blunted in patients with post-traumatic stress disorder who develop dissociative symptoms. Stress response changes seem to be associated with the emergence and persistence of dissociative and conversion disorders. Hence, monitoring the stress response and examining closely the history of stress exposure in DD and CD should be encouraged in future larger studies.
Topics: Autonomic Nervous System; Conversion Disorder; Dissociative Disorders; Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Stress Disorders, Post-Traumatic
PubMed: 34740754
DOI: 10.1016/j.neubiorev.2021.10.049 -
Nature Communications Dec 2020Ketamine produces immediate antidepressant effects and has inspired research into next-generation treatments. Ketamine also has short term dissociative effects, in which... (Review)
Review
Ketamine produces immediate antidepressant effects and has inspired research into next-generation treatments. Ketamine also has short term dissociative effects, in which individuals report altered consciousness and perceptions of themselves and their environment. However, whether ketamine's dissociative side effects are necessary for its antidepressant effects remains unclear. This perspective examines the relationship between dissociative effects and acute and longer-lasting antidepressant response to ketamine and other N-methyl-D-aspartate (NMDA) receptor antagonists. Presently, the literature does not support the conclusion that dissociation is necessary for antidepressant response to ketamine. However, further work is needed to explore the relationship between dissociation and antidepressant response at the molecular, biomarker, and psychological levels.
Topics: Animals; Antidepressive Agents; Dissociative Disorders; Humans; Ketamine; Receptors, N-Methyl-D-Aspartate
PubMed: 33353946
DOI: 10.1038/s41467-020-20190-4 -
Psychiatria Polska Feb 2020Mental disorders occur in patients with epilepsy significantly more frequently than in the general population or in those with other chronic diseases. The specificity of... (Review)
Review
Mental disorders occur in patients with epilepsy significantly more frequently than in the general population or in those with other chronic diseases. The specificity of epilepsy as a condition of the central nervous system with complex somatic, psychic and social consequences contributes to co-occurrence of these disorders. Moreover, common patomechanisms are suggested for epilepsy and mental disorders, associated with disturbances of bioelectrical activity and neurotransmission in certain areas of the brain.The authors present a review of main groups of mental disorders observed in epileptic patients: psychotic, affective, anxiety, personality, and conduct disorders. They discuss their epidemiology and clinical presentation, with a particular focus on their risk factors and temporal relation to epileptic seizures. They also highlight problems associated with differential diagnosis and optimal therapeutic strategy. Mental disorders have a significant impact on the quality of life and functioning of patients with epilepsy. Further exploration of interrelationships between these illnesses, as well as cooperation between neurologists and psychiatrists promote an early and precise diagnosis of mental disturbances in this group of patients and their effective treatment.
Topics: Adult; Affective Symptoms; Antisocial Personality Disorder; Dissociative Disorders; Epilepsy; Female; Humans; Male; Mental Disorders; Prevalence; Quality of Life; Risk Factors; Somatoform Disorders
PubMed: 32447356
DOI: 10.12740/PP/93886 -
Behavioral Sciences & the Law 2023Because a wide range of disorders incorporate dissociative symptoms, evaluators should be familiar with evidence-based approaches to evaluating dissociation claims in... (Review)
Review
Because a wide range of disorders incorporate dissociative symptoms, evaluators should be familiar with evidence-based approaches to evaluating dissociation claims in the clinical and forensic context. This article provides specific guidelines for practitioners when conducting a forensic assessment of individuals who report dissociative symptoms. We review the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition disorders that include dissociation as a symptom, highlight how to distinguish genuine versus atypical symptoms of dissociative identity disorder, and summarize strengths and weaknesses of structured assessments in the evaluation of dissociative claims.
Topics: Humans; Dissociative Disorders; Diagnostic and Statistical Manual of Mental Disorders
PubMed: 37010094
DOI: 10.1002/bsl.2622 -
Neuroscience and Biobehavioral Reviews Aug 2022Elevated responsiveness to verbal suggestions is hypothesized to represent a predisposing factor for the dissociative disorders (DDs) and related conditions. However,... (Meta-Analysis)
Meta-Analysis Review
Elevated responsiveness to verbal suggestions is hypothesized to represent a predisposing factor for the dissociative disorders (DDs) and related conditions. However, the magnitude of this effect has not been estimated in these populations nor has the potential moderating influence of methodological limitations on effect size variability across studies. This study assessed whether patients with DDs, trauma- and stressor-related disorders (TSDs), and functional neurological disorder (FND) display elevated hypnotic suggestibility. A systematic literature search identified 20 datasets. A random-effects meta-analysis revealed that patients displayed greater hypnotic suggestibility than controls, Hedges's g = 0.92 [0.66, 1.18]. This effect was observed in all subgroups but was most pronounced in the DDs. Although there was some evidence for publication bias, a bias-corrected estimate of the group effect remained significant, g = 0.57 [0.30, 0.85]. Moderation analyses did not yield evidence for a link between effect sizes and methodological limitations. These results demonstrate that DDs and related conditions are characterized by elevated hypnotic suggestibility and have implications for the mechanisms, risk factors, and treatment of dissociative psychopathology.
Topics: Dissociative Disorders; Humans; Hypnosis; Hypnotics and Sedatives; Suggestion
PubMed: 35760389
DOI: 10.1016/j.neubiorev.2022.104751 -
Schizophrenia Research Jan 2022A deficient sense of self, typically observed in schizophrenia spectrum disorders, is often accompanied by abnormalities in bodily perception and awareness. These...
A deficient sense of self, typically observed in schizophrenia spectrum disorders, is often accompanied by abnormalities in bodily perception and awareness. These abnormalities are seemingly among the most powerful predictive factors for the onset of schizophrenic illnesses. According to the hypothesis of the psychosis continuum, high schizotypal traits in the general population may be characterized by a progressive sense of detachment from one's lived body. Building upon previous research that found an abnormal Body Structural Representation (BSR) in individuals with schizophrenia, this study aims to extend these findings to schizotypy. To investigate this, we utilized the Finger Localization Task (FLT), in which participants must identify the finger touched by the experimenter, and the In Between Task (IBT), in which two fingers are touched and participants must specify the number of fingers in between the two stimulated fingers. We found that individuals with high schizotypy were significantly less accurate than individuals with low schizotypy in determining the spatial configuration of their own fingers relative to each other. Most significantly, performances on both tasks were negatively correlated with the score on the Dissociative Experiences Scale (DES). These findings support the hypothesis that the progressive loss of one's sense of self is associated with abnormal bodily experiences and dissociative symptomatology which may represent a potential marker for schizophrenia proneness.
Topics: Body Image; Dissociative Disorders; Humans; Psychotic Disorders; Schizophrenia; Schizotypal Personality Disorder
PubMed: 34775304
DOI: 10.1016/j.schres.2021.11.002 -
Annual Review of Clinical Psychology May 2022For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that... (Review)
Review
For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identifyempirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation.
Topics: Dissociative Disorders; Humans; Metacognition; Stress Disorders, Post-Traumatic
PubMed: 35226824
DOI: 10.1146/annurev-clinpsy-081219-102424 -
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