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Psychiatrike = Psychiatriki Dec 2021Depersonalization is a dissociative disorder associated to a profound disruption of self-awareness in the form of emotional numbing and feelings of disembodiment. The...
Depersonalization is a dissociative disorder associated to a profound disruption of self-awareness in the form of emotional numbing and feelings of disembodiment. The salient feature of depersonalization is a breakdown in the familiarity of one's psychological and somatic self (and surroundings when derealization is also present), in spite of being aware of the unreality of the change. At an early stage of research it was realized that people inclined to dissociation find it harder to tolerate discontinuity in perceptual environments, possibly due to a rigid perceptual attitude. Consequently, perceptual discontinuity experienced during momentary immersion into a VE would be expected to increase symptoms of dissociation among individuals prone to develop them. It has been put forward that a tendency toward immersion or absorption, linking to imaginative processes underlying the dissociative experience, significantly relates to the level of change in virtual reality-induced dissociative symptoms. Consequently, it has been implied that increased tolerability of perceptual discontinuities and a more flexible perceptual attitude in people suffering depersonalization/derealization disorder may be of help. We propose the use of adaptive immersive virtual environments to the treatment of depersonalization. In particular, we propose that implementation of biofeedback electrical stimulation to detect somato-sensory processing bias may contribute to selectively targeting deranged neurocognitive processing components, and as an indirect consequence promote, to some extent, the diagnostic process. Psychophysiological approaches may be of help in the treatment of depersonalization via additional series of afferent inputs - virtual reality (VR) stimuli - to alter the receptive fields of the affected proprioceptive systems and reorganize them. The aim of this paper is to stimulate future research towards the development of potential virtual rehabilitation programs based on biofeedback, electrical stimulation and concurrent measurement of galvanic skin response and EEG targeting selective somatosensory stimulation in patients with depersonalization. Our research hypotheses might constitute a starting point for the development of new treatment tools for depersonalization in particular and depersonalization/derealization disorder in general.
Topics: Awareness; Depersonalization; Dissociative Disorders; Emotions; Galvanic Skin Response; Humans
PubMed: 34390559
DOI: 10.22365/jpsych.2021.032 -
Psyche Mar 1974
Topics: Adult; Body Image; Conflict, Psychological; Defense Mechanisms; Depersonalization; Depression; Female; Humans; Male; Narcissism; Neurotic Disorders; Prisoners; Psychoanalytic Theory; Schizophrenic Psychology; Self Concept; Stress, Psychological; War Crimes
PubMed: 4847888
DOI: No ID Found -
Psychiatry Research Dec 2001Patients with depersonalization disorder (DP) experience a detachment from their own senses and surrounding events, as if they were outside observers. A particularly...
Patients with depersonalization disorder (DP) experience a detachment from their own senses and surrounding events, as if they were outside observers. A particularly common symptom is emotional detachment from the surroundings. Using functional magnetic resonance imaging (fMRI), we compared neural responses to emotionally salient stimuli in DP patients, and in psychiatric and healthy control subjects. Six patients with DP, 10 with obsessive-compulsive disorder (OCD), and six volunteers were scanned whilst viewing standardized pictures of aversive and neutral scenes, matched for visual complexity. Pictures were then rated for emotional content. Both control groups rated aversive pictures as much more emotive, and demonstrated in response to these scenes significantly greater activation in regions important for disgust perception, the insula and occipito-temporal cortex, than DP patients (covarying for age, years of education and total extent of brain activation). In DP patients, aversive scenes activated the right ventral prefrontal cortex. The insula was activated only by neutral scenes in this group. Our findings indicate that a core phenomenon of depersonalization--absent subjective experience of emotion--is associated with reduced neural responses in emotion-sensitive regions, and increased responses in regions associated with emotion regulation.
Topics: Adult; Arousal; Attention; Brain Mapping; Cerebral Cortex; Depersonalization; Emotions; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Obsessive-Compulsive Disorder; Occipital Lobe; Pattern Recognition, Visual; Temporal Lobe; Thinking
PubMed: 11756013
DOI: 10.1016/s0925-4927(01)00119-6 -
Journal of Psychiatric Research Jun 2023Dissociative and posttraumatic stress disorder (PTSD) symptoms are commonly co-occurring responses to psychological trauma. Yet, these two groups of symptoms appear to...
BACKGROUND
Dissociative and posttraumatic stress disorder (PTSD) symptoms are commonly co-occurring responses to psychological trauma. Yet, these two groups of symptoms appear to be related to diverging patterns of physiological response. To date, few studies have examined how specific dissociative symptoms, namely, depersonalization and derealization, relate to skin conductance response (SCR), a marker of autonomic function, within the context of PTSD symptoms. We examined associations among depersonalization, derealization, and SCR during two conditions - resting control and breath-focused mindfulness - in the context of current PTSD symptoms.
METHODS
Sixty-eight trauma-exposed women (82.4% Black; M = 42.5, SD = 12.1) were recruited from the community for a breath-focused mindfulness study. SCR data were collected during alternating resting control and breath-focused mindfulness conditions. Moderation analyses were conducted to examine relations among dissociative symptoms, SCR, and PTSD for these different conditions.
RESULTS
Moderation analyses revealed that depersonalization was linked to lower SCR during resting control, B = 0.0005, SE = 0.0002, p = .006, in participants low-to-moderate PTSD symptoms; however, depersonalization was associated with higher SCR during breath-focused mindfulness, B = -0.0006, SE = 0.0003, p = .029, in individuals with similar levels of PTSD symptoms. No significant interaction between derealization and PTSD symptoms on SCR was observed.
CONCLUSIONS
Depersonalization symptoms may associate with physiological withdrawal during rest, but greater physiological arousal during effortful emotion regulation in individuals with low-to moderate levels of PTSD, which has significant implications for barriers to treatment engagement as well as treatment selection in this population.
Topics: Humans; Female; Adult; Child; Depersonalization; Mindfulness; Stress Disorders, Post-Traumatic; Psychological Trauma; Dissociative Disorders
PubMed: 37172509
DOI: 10.1016/j.jpsychires.2023.05.028 -
The American Journal of Psychiatry Jun 1973
Topics: Adult; Affective Symptoms; Anxiety; Cognition Disorders; Depersonalization; Depression; Female; Humans; Male; Personality Inventory; Psychological Tests; Surveys and Questionnaires
PubMed: 4701963
DOI: 10.1176/ajp.130.6.702 -
Complementary Therapies in Clinical... May 2023Depersonalization-derealization disorder (DDD) is a dissociative disorder encompassing pronounced disconnections from the self and from external reality. As DDD is...
BACKGROUND
Depersonalization-derealization disorder (DDD) is a dissociative disorder encompassing pronounced disconnections from the self and from external reality. As DDD is inherently tied to a detachment from the body, dance/movement therapy could provide an innovative treatment approach.
MATERIALS AND METHODS
We developed two online dance tasks to reduce detachment either by training body awareness (BA task) or enhancing the salience of bodily signals through dance exercise (DE task). Individuals with DDD (n = 31) and healthy controls (n = 29) performed both tasks individually in a cross-over design. We assessed symptom severity (Cambridge Depersonalization Scale), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness - II), mindfulness (Five Facet Mindfulness Questionnaire), and body vigilance (Body Vigilance Scale) before, during and after the tasks.
RESULTS
At baseline, individuals with DDD exhibited elevated depersonalization-derealization symptoms alongside lower levels of interoceptive awareness and mindfulness compared to controls. Both tasks reduced symptoms in the DDD group, though dance exercise was perceived as easier. The DE task increased mindfulness in those with DDD more than the BA task, whereas controls showed the opposite pattern. In the DDD group, within-subject correlations showed that lower levels of symptoms were associated with task-specific elevations in interoceptive awareness and mindfulness.
CONCLUSION
Individual and structured dance/movement practice, performed at home without an instructor present, offers an effective tool to reduce symptoms in DDD and can be tailored to address specific cognitive components of a mindful engagement with the body.
Topics: Humans; Depersonalization; Dance Therapy; Dancing; Awareness; Surveys and Questionnaires
PubMed: 37018935
DOI: 10.1016/j.ctcp.2023.101749 -
Psychopathology 2010Depersonalization occurs in healthy individuals and across a broad range of psychiatric patients. Data on depersonalization in persons linked to patients through...
BACKGROUND
Depersonalization occurs in healthy individuals and across a broad range of psychiatric patients. Data on depersonalization in persons linked to patients through genetics, environment or education are scarce. Due to their higher risk of developing psychosis, first-degree healthy relatives might show differences with the general population. This study examines depersonalization in patients with schizophrenia or schizophrenia spectrum disorders, their first-degree healthy relatives and normal controls.
METHODS
The Cambridge Depersonalization Scale was used to measure depersonalization in a sample of 147 clinically stable patients with schizophrenia or schizophrenia spectrum disorders, 73 first-degree relatives with no psychiatric history and 172 healthy controls. Mixed effect models were used to account for both the familial structure of the data and the effect of sociodemographic characteristics.
RESULTS
Patients obtained higher scores than relatives and controls for frequency and duration of depersonalization experiences, number of items responded positively and total depersonalization, while first-degree relatives obtained lower scores than patients and controls for all these characteristics.
CONCLUSIONS
First-degree relatives of patients reported fewer episodes of depersonalization, which were less intense and of shorter duration, than healthy controls. This finding might be related to a protection mechanism that keeps first-degree relatives away from near-psychotic experiences. The nature of such a mechanism remains to be discovered.
Topics: Adult; Depersonalization; Family; Female; Genetic Predisposition to Disease; Health Surveys; Humans; Male; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Surveys and Questionnaires
PubMed: 20197707
DOI: 10.1159/000288635 -
Praxis Der Kinderpsychologie Und... Oct 1979
Topics: Anxiety; Child; Depersonalization; Ego; Humans; Male; Reality Testing; Schizophrenia, Childhood
PubMed: 538002
DOI: No ID Found -
Zeitschrift Fur Psychosomatische... 1993Patients with deliberate self harm syndrome and with factitious disorders often describe depersonalisation phenomena, during which they have a diminished pain...
Patients with deliberate self harm syndrome and with factitious disorders often describe depersonalisation phenomena, during which they have a diminished pain sensitivity or analgesia. The self-mutilating act can stop the depersonalisation temporarily. Concerning the psychodynamic processes there are common traits between depersonalisation and self-mutilation. The connections between depersonalisation and self-mutilating behaviour are described. Depersonalisation is understood as a defense mechanism, ranging between mature and immature defense mechanisms. An illustrative case is demonstrated.
Topics: Adult; Depersonalization; Factitious Disorders; Female; Humans; Object Attachment; Pain Threshold; Personality Development; Psychoanalytic Theory; Psychoanalytic Therapy; Self-Injurious Behavior
PubMed: 8212937
DOI: No ID Found -
Psychosomatics 1992
Topics: Bipolar Disorder; Depersonalization; Female; Fluoxetine; Humans; Male; Obsessive-Compulsive Disorder; Serotonin
PubMed: 1410214
DOI: 10.1016/S0033-3182(92)71984-7