-
Frontiers in Neurology 2020
PubMed: 32153485
DOI: 10.3389/fneur.2020.00022 -
Innovations in Clinical Neuroscience 2023Depersonalization and derealization refer to an estranged state of mind that involves a profound feeling of detachment from one's sense of self and the surrounding...
Depersonalization and derealization refer to an estranged state of mind that involves a profound feeling of detachment from one's sense of self and the surrounding environment, respectively. The phenomena co-occur on a continuum of severity, ranging from a transient experience as a normal reaction to a traumatic event to a highly debilitating condition with persistent symptoms, formally described as depersonalization/derealization disorder (DPDR). Lack of awareness of DPDR is partly due to a limited neurobiological framework, and there remains a significant risk of misdiagnosis in clinical practice. Earlier literature has focused on several brain regions involved in the experience of depersonalization and derealization, including adaptive responses to stress via defense cascades comprising autonomic functioning, the hypothalamic-pituitary-adrenal (HPA) axis, and various other neurocircuits. Recent evidence has also demonstrated the role of more complex mechanisms that are bolstered by dissociative features, such as emotional dysregulation and disintegration of the body schema. This review intends to abridge the prevailing knowledge regarding structural and functional brain alterations associated with DPDR with that of its heterogenic manifestations. DPDR is not merely the disruption of various sensory integrations, but also of several large-scale brain networks. Although a comprehensive antidote is not available for DPDR, a holistic route to the neurobiological context in DPDR may improve general understanding of the disorder and help afflicted individuals re-establish their sense of personal identity. Such information may also be useful in the development of novel pharmacological agents and targeted psychological interventions.
PubMed: 37122581
DOI: No ID Found -
AIMS Neuroscience 2021The temporal-parietal junction (TPJ) is a key structure for the embodiment, term referred to as the sense of being localized within one's physical body and is a... (Review)
Review
Targeting temporal parietal junction for assessing and treating disembodiment phenomena: a systematic review of TMS effect on depersonalization and derealization disorders (DPD) and body illusions.
The temporal-parietal junction (TPJ) is a key structure for the embodiment, term referred to as the sense of being localized within one's physical body and is a fundamental aspect of the self. On the contrary, the sense of disembodiment, an alteration of one's sense of self or the sense of being localized out of one's physical body, is a prominent feature in specific dissociative disorders, namely depersonalization/derealization disorders (DPD). The aims of the study were to provide: 1) a qualitative synthesis of the effect of Transcranial Magnetic Stimulation (TMS), taking into account its use for therapeutic and experimental purposes; 2) a better understanding on whether the use of TMS could support the treatment of DPD and other clinical conditions in which depersonalization and derealization are displayed. To identify suitable publications, an online search of the PubMed, Cochrane Library, Web of science and Scopus databases was performed using relevant search terms. In addition, an in-depth search was performed by screening review articles and the references section of each included articles. Our search yielded a total of 108 records through multiple databases searching and one additional record was identified through other sources. After duplicates removal, title and abstract reading, we retained 16 records for the assessment of eligibility. According to our inclusion criteria, we retained 8 studies. The selected studies showed that TMS targeting the TPJ is a promising technique for treating disembodiment phenomena DPD and for inducing reversible disembodiment states in healthy subjects. These data represent the first step towards a greater understanding of possible treatments to be used in disembodiment disorders. The use of TMS over the TPJ appears to be promising for treating disembodiment phenomena.
PubMed: 33709023
DOI: 10.3934/Neuroscience.2021009 -
Journal of Primary Care & Community... 2023During the surge of the COVID-19 pandemic, burnout among physicians increased significantly. In the spring of 2023, the COVID national emergency was terminated in the...
OBJECTIVE
During the surge of the COVID-19 pandemic, burnout among physicians increased significantly. In the spring of 2023, the COVID national emergency was terminated in the U.S. To investigate whether provider burnout rates have returned to pre-pandemic levels, the current study compared dimensions of burnout among pediatricians pre- and post-pandemic.
METHOD
As part of 2 separate behavioral health trainings held at a Midwest academic health center in 2019 and virtually in 2023, data on burnout was collected from 52 pediatricians pre-pandemic and 38 pediatricians post-pandemic. Participants completed an online survey during the trainings and responded to items reflecting 3 dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment.
RESULTS
There were no statistically significant differences in pre- and post-pandemic burnout amongst pediatricians in terms of total scores, number of pediatricians who met the clinical cutoff for each dimension, number of cutoffs met, or number of providers reporting elevated burnout on at least 1 dimension ( > .05 for all comparisons). Participants were 1.77 times more likely to meet the cutoff for emotional exhaustion post-pandemic than pre-pandemic. Over half of providers met this cutoff post-pandemic, compared to only 35% pre-pandemic.
CONCLUSIONS
While post-pandemic rates of burnout among pediatricians appear to be statistically similar to pre-pandemic levels, there appear to be clinically significant differences in emotional exhaustion between groups. With 63% of the post-pandemic group meeting the cutoff score for at least 1 dimension, it is imperative for the healthcare system to consider ways to mitigate burnout.
Topics: Humans; Pandemics; COVID-19; Depersonalization; Pediatricians; Burnout, Professional; Surveys and Questionnaires
PubMed: 37599442
DOI: 10.1177/21501319231194148 -
Revista Da Associacao Medica Brasileira... Apr 2017To evaluate burnout syndrome in its three aspects, jointly as well as independently, in physiotherapists from the Extremadura region (Spain).
OBJECTIVE:
To evaluate burnout syndrome in its three aspects, jointly as well as independently, in physiotherapists from the Extremadura region (Spain).
METHOD:
Analytic descriptive epidemiological transversal trial in primary care and institutional practice, with physiotherapists practicing in Extremadura who met the inclusion criteria, after having signed an informed consent form. Emotional exhaustion, depersonalization and low professional accomplishment were the outcomes measured.
RESULTS:
Physiotherapists from Extremadura show a 65.23 point level of burnout syndrome, according to the Maslach Burnout Inventory questionnaire. Therefore, they are positioned in the middle of the rating scale for the syndrome, and very near to the high level at starting score of 66 points.
CONCLUSION:
Physiotherapists in Extremadura present moderate scores for the three dimensions of burnout syndrome, namely, emotional exhaustion, depersonalization and low professional accomplishment. For this reason, they are in the moderate level of the syndrome and very near to the high level, which starts at a score of 66 points. No relation between burnout syndrome and age has been found in our study.
Topics: Analysis of Variance; Burnout, Professional; Cross-Sectional Studies; Depersonalization; Humans; Mental Fatigue; Physical Therapists; Prevalence; Private Sector; Public Sector; Severity of Illness Index; Spain; Surveys and Questionnaires; Time Factors; Workload
PubMed: 28614540
DOI: 10.1590/1806-9282.63.04.361 -
Frontiers in Psychology 2021In his paper "Whatever next? Predictive brains, situated agents, and the future of cognitive science," Andy Clark seminally proposed that the brain's job is to predict... (Review)
Review
In his paper "Whatever next? Predictive brains, situated agents, and the future of cognitive science," Andy Clark seminally proposed that the brain's job is to predict whatever information is coming "next" on the basis of prior inputs and experiences. Perception fundamentally subserves survival and self-preservation in biological agents, such as humans. Survival however crucially depends on rapid and accurate information processing of what is happening in the here and now. Hence, the term "next" in Clark's seminal formulation must include not only the temporal dimension (i.e., what is perceived ) but also the spatial dimension (i.e., what is perceived or next-to-my-body). In this paper, we propose to focus on perceptual experiences that happen "next," i.e., close-to-my-body. This is because perceptual processing of proximal sensory inputs has a key impact on the organism's survival. Specifically, we focus on tactile experiences mediated by the skin and what we will call the "extended skin" or "second skin," that is, immediate objects/materials that envelop closely to our skin, namely, clothes. We propose that the skin and tactile experiences are not a mere border separating the self and world. Rather, they simultaneously and inherently distinguish connect the bodily self to its environment. Hence, these proximal and pervasive tactile experiences can be viewed as a "transparent bridge" intrinsically relating and facilitating exchanges between the self and the physical and social world. We conclude with potential implications of this observation for the case of Depersonalization Disorder, a condition that makes people feel estranged and detached from their self, body, and the world.
PubMed: 34135800
DOI: 10.3389/fpsyg.2021.613587 -
Arhiv Za Higijenu Rada I Toksikologiju Sep 2022The aim of this cross-sectional study was to compare occupational burnout in two groups of teachers from the district of Bijeljina (Bosnia and Herzegovina) measured with...
The aim of this cross-sectional study was to compare occupational burnout in two groups of teachers from the district of Bijeljina (Bosnia and Herzegovina) measured with the Serbian version of the Maslach Burnout Inventory survey for workers in human services (MBI-HSS) at the beginning (group 1) and the end of the school year 2018/2019 (group 2) to see if there are seasonal differences. The questionnaire also included standard sociodemographic data and job description (primary and/or secondary school position, length of service, and overtime work). The prevalence of emotional exhaustion and depersonalisation was low in both groups. However, emotional exhaustion and depersonalisation scores significantly shifted to higher values between the beginning and the end of the school year. We also found a statistically significant association between emotional exhaustion and overtime and between depersonalisation and work in a secondary school (p<0.05). These findings invite further research of occupational burnout seasonality in schoolteachers, preferably by following up cohorts which would be controlled for sociodemographic and work-related variables.
Topics: Burnout, Professional; Cross-Sectional Studies; Humans; Job Satisfaction; Seasons; Surveys and Questionnaires
PubMed: 36226818
DOI: 10.2478/aiht-2022-73-3582 -
Current Psychology (New Brunswick, N.J.) Nov 2022Nurses' mental health is related to the quality of medical care and the outcome of treatment, and has become an important issue in nursing management. However, the role...
UNLABELLED
Nurses' mental health is related to the quality of medical care and the outcome of treatment, and has become an important issue in nursing management. However, the role of burnout in the relationship between job satisfaction and psychological distress have not been evaluated. This study aimed to examine the prevalence of psychological distress among Chinese nurses and explore the associations of job satisfaction and burnout with psychological distress. A cross-sectional survey of 866 nurses was conducted in Qiqihar City, Heilongjiang Province of China. Job satisfaction, burnout, and psychological distress were assessed via the single-item, the Maslach Burnout Inventory-Human Services Survey, and the 12-item General Health Questionnaire respectively, followed by a mediation analysis through the multiple regression analysis and a PROCESS macro method. The prevalence of psychological distress was 35.2% among the participants. After controlling the potential confounding factors, job satisfaction and burnout were found to be still associated with psychological distress ( < 0.001). Furthermore, psychological distress was negatively correlated with both job satisfaction ( = -0.312) and personal accomplishment ( = -0.422) but positively correlated with both emotional exhaustion ( = 0.491) and depersonalization ( = 0.449). Burnout may mediate the association between job satisfaction and psychological distress ( = 0.139, = 0.440, < 0.001 for emotional exhaustion; = 0.226, = 0.382, < 0.001 for depersonalization; and = -0.105, = -0.368, < 0.001 for personal accomplishment). The mental health status of Chinese nurses remains to be improved. Low job satisfaction and burnout could increase the risk of psychological distress among Chinese nurses. Moreover, job satisfaction may partially affect psychological distress among Chinese nurses through emotional exhaustion, personal accomplishment, and depersonalization.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12144-022-04006-w.
PubMed: 36406845
DOI: 10.1007/s12144-022-04006-w -
Innovations in Clinical Neuroscience Jul 2014Depersonalization/derealization disorder is characterized by depersonalization often co-occurring with derealization in the absence of significant psychosis, memory, or...
Depersonalization/derealization disorder is characterized by depersonalization often co-occurring with derealization in the absence of significant psychosis, memory, or identity disturbance. Depersonalization/derealization is categorized as one of the dissociative disorders, which also includes dissociative amnesia, dissociative fugue, dissociative identity disorder, and forms of dissociative disorder not otherwise specified. Although these disorders may be under-diagnosed or misdiagnosed, many persons with psychiatric illness who have experienced trauma report symptoms consistent with dissociative disorders. There are limited scientific data on prevalence of depersonalization/derealization disorder specifically. This paper reviews clinical, phenomenological and epidemiological information regarding diagnosis and treatment of dissociative disorders in general, and illustrates common presenting histories of persons with derealization/depersonalization disorder utilizing composite cases. The clinical vignettes focus on recommended psychotherapy and pharmacotherapy interventions as part of a comprehensive multidisciplinary treatment plan for these individuals.
PubMed: 25337444
DOI: No ID Found -
Journal of Trauma & Dissociation : the... 2020Borderline personality disorder (BPD) is a serious psychiatric illness, and it is often associated with dissociative symptoms. The purpose of this study was to assess...
Borderline personality disorder (BPD) is a serious psychiatric illness, and it is often associated with dissociative symptoms. The purpose of this study was to assess the course of depersonalization and derealization symptoms in recovered and non-recovered borderline patients over 20 years of prospective follow-up. The Dysphoric Affect Scale (DAS) - a 50-item self-report measure was administered to 290 borderline inpatients at baseline, and the remaining participants (85%) at 10 follow-up interviews conducted over 20 years. The level of depersonalization and derealization experienced by borderline patients was assessed using three items (feeling unreal, feeling completely numb, and feeling like people and things aren't real) from the DAS. The patients who recovered from BPD reported significantly lower scores in all three inner states (62 - 63%) at baseline compared to those patients who did not recover. Furthermore, scores of recovered and non-recovered groups decreased significantly in all three inner states studied over 20 years of prospective follow-up. Overall, these results suggest that the severity of depersonalization and derealization symptoms decreased significantly over 20 years of prospective follow-up and had a strong association with BPD recovery status.
Topics: Adolescent; Adult; Borderline Personality Disorder; Depersonalization; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Prospective Studies; Psychiatric Status Rating Scales; Severity of Illness Index
PubMed: 32000616
DOI: 10.1080/15299732.2020.1719259