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Journal of Personalized Medicine Aug 2022Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless,... (Review)
Review
BACKGROUND
Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless, neuroimaging studies, albeit scarce, have suggested the existence of particular brain activation patterns in patients belonging to this diagnostic category. The aim of this review is to identify the main functional neuroimaging correlates of dissociative disorders.
METHODS
we searched the PubMed database to identify functional neuroimaging studies conducted on subjects with a diagnosis of a dissociative disorder, following the PRISMA guidelines. In the end, we included 13 studies in this systematic review, conducted on 51 patients with dissociative identity disorder (DID), 28 subjects affected by depersonalization disorder, 24 with dissociative amnesia, and 6 with other or not specified dissociative disorders.
RESULTS
Prefrontal cortex dysfunction seems prominent. In addition, changes in the functional neural network of the caudate are related to alterations of identity state and maintenance of an altered mental status in DID. Another role in DID seems to be played by a dysfunction of the anterior cingulate gyrus. Other regions, including parietal, temporal, and insular cortices, and subcortical areas were reported to be dysfunctional in dissociative disorders.
CONCLUSIONS
Prefrontal dysfunction is frequently reported in dissociative disorders. Functional changes in other cortical and subcortical areas can be correlated with these diagnoses. Further studies are needed to clarify the neurofunctional correlations of each dissociative disorder in affected patients, in order to identify better tailored treatments.
PubMed: 36143190
DOI: 10.3390/jpm12091405 -
Current Behavioral Neuroscience Reports 2018In this article, we aim to give an overview over recent neuroimaging research on dissociation in borderline personality disorder (BPD). Stress-related dissociation is... (Review)
Review
PURPOSE OF REVIEW
In this article, we aim to give an overview over recent neuroimaging research on dissociation in borderline personality disorder (BPD). Stress-related dissociation is highly prevalent in BPD, while so far only little is known about its neural underpinnings.
RECENT FINDINGS
Based on research in depersonalization and the dissociative subtype of posttraumatic stress disorder, it has been proposed that dissociation involves alterations in a cortico-limbic network. In BPD, neuroimaging research explicitly focusing on dissociation is still scarce.
SUMMARY
Functional neuroimaging studies have provided preliminary evidence for an altered recruitment and interplay of fronto-limbic regions (amygdala, anterior cingulate, inferior frontal gyrus, medial and dorsolateral prefrontal cortices) and temporoparietal areas (superior temporal gyrus, inferior parietal lobule, fusiform gyrus), which may underlie disrupted affective-cognitive processing during dissociation in BPD. More neuroimaging research with larger samples, clinical control groups, and repeated measurements is needed to deepen the understanding of dissociation in BPD.
PubMed: 29577011
DOI: 10.1007/s40473-018-0146-9 -
Frontiers in Psychology 2023Philosophers maintain that touch confers a sense of reality or grounding to perceptual experience. In touching oneself, one is simultaneously both subject and object of...
Philosophers maintain that touch confers a sense of reality or grounding to perceptual experience. In touching oneself, one is simultaneously both subject and object of touch, a template for experiencing oneself as subject and object of intentions, feelings, and motivations, or intersubjectivity. Here, I explore a form of self-touch carefully documented by Winnicott in observing how the infant engages the transitional object. I compare the processes of self-loss in transitional states, including absorption in art, empathic immersion, drug-induced ego dissolution, and depersonalization. I use examples drawn from Rodin, Dante, and the Beatles; research correlating neurophysiological findings with aspects of self-representation; predictive processing-based models; Hohwy's concepts of minimal and narrative self; Clark's notion of the extended mind; and phenomenological perspectives on touch, to postulate a role for self-touch in the pre-reflective sense of mine-ness, or grounding, in transitional states.
PubMed: 37533722
DOI: 10.3389/fpsyg.2023.1097402 -
Annals of Physical and Rehabilitation... Jun 2017This review article summarizes neuropsychological descriptions of abnormal body representations in brain-damaged patients and recent neuroscientific investigations of... (Review)
Review
This review article summarizes neuropsychological descriptions of abnormal body representations in brain-damaged patients and recent neuroscientific investigations of their sensorimotor underpinnings in healthy participants. The first part of the article describes unilateral disorders of the bodily self, such as asomatognosia, feelings of amputation, supernumerary phantom limbs and somatoparaphrenia, as well as descriptions of non-lateralized disorders of the bodily self, including Alice in Wonderland syndrome and autoscopic hallucinations. Because the sensorimotor mechanisms of these disorders are unclear, we focus on clinical descriptions and insist on the importance of reporting clinical cases to better understand the full range of bodily disorders encountered in neurological diseases. The second part of the article presents the advantages of merging neuroscientific approaches of the bodily self with immersive virtual reality, robotics and neuroprosthetics to foster the understanding of the multisensory, motor and neural mechanisms of bodily representations.
Topics: Agnosia; Alice in Wonderland Syndrome; Body Image; Brain Injuries; Delusions; Depersonalization; Hallucinations; Humans; Phantom Limb; Robotics; Virtual Reality
PubMed: 27318928
DOI: 10.1016/j.rehab.2016.04.007 -
The American Journal of Managed Care Dec 2018Physician burnout receives much attention in healthcare circles because it poses serious threats to clinicians, staff, and patients. The forces leading to detachment and...
Physician burnout receives much attention in healthcare circles because it poses serious threats to clinicians, staff, and patients. The forces leading to detachment and depersonalization among primary care physicians are similar to the factors responsible for populist movements more broadly-the perception of a rigged system favoring a managerial elite, disregarding the values and welfare of those who must play by the rules. The disconnect between systems initiatives and the burdens and uncertainty they create for primary care clinicians contributes to physicians' loss of confidence, expressed as resistance to organized medical specialty and regulatory structures, as well as migrations of medical students and practicing physicians away from the prevailing primary care service model. A failure among healthcare leaders to recognize the link between the root causes of burnout and populism will result in further exacerbation of an already existent primary care crisis.
Topics: Burnout, Professional; Depersonalization; Humans; Physicians, Primary Care; Politics; Primary Health Care; Psychology
PubMed: 30586484
DOI: No ID Found -
Healthcare (Basel, Switzerland) Jan 2022The aim of this current study was to identify the prevalence of burnout manifestation in a sample recruited from the emergency department of a hospital. Moreover, we...
OBJECTIVE
The aim of this current study was to identify the prevalence of burnout manifestation in a sample recruited from the emergency department of a hospital. Moreover, we aimed to assess the role of professional experience, age, and the professional category in shaping burnout manifestations.
RESULTS
The results showed that higher proportions of burnout symptoms were reported by resident physicians, nurses, and physicians whereas lower proportions were encountered in the orderly group. Moreover, the results revealed a significant difference between men and women in the nurse group concerning depersonalization; men presented higher levels of depersonalization compared with women. Concerning emotional exhaustion and depersonalization, multiple comparisons showed differences among the professional categories.
CONCLUSIONS
The implications of these results for preventing burnout syndrome are discussed.
PubMed: 35206873
DOI: 10.3390/healthcare10020258 -
International Journal of Environmental... Sep 2018The correlation between the burnout syndrome and sociodemographic variables in nursing professionals has been widely studied though research results are contradictory.... (Meta-Analysis)
Meta-Analysis Review
The correlation between the burnout syndrome and sociodemographic variables in nursing professionals has been widely studied though research results are contradictory. The aim of this study was to assess the impact of gender, marital status, and children on the dimensions of the burnout syndrome (emotional exhaustion, depersonalization, and personal accomplishment) in nursing professionals, as measured with the Maslach Burnout Inventory. The search was performed in May 2018 in the next databases: CINAHL, CUIDEN, Dialnet, Psicodoc, ProQuest Platform, OVID Platform, and Scopus with the search equation ("Maslach Burnout Inventory" OR "MBI") AND "nurs*", without using any search restriction. The sample was = 78 studies: 57 studies for gender; 32 for marital status; 13 for having children. A statistically significant relation between depersonalization and gender ( = 0.078), marital status ( = 0.047), and children ( = 0.053) was found. A significant relation was also found between emotional exhaustion and children ( = 0.048). The results showed that being male, being single or divorced, and not having children were related to the highest levels of burnout in nurses. Moreover, these relations could be accentuated by the influence of moderator variables (age, seniority, job satisfaction, etc.), which, in combination with the previously mentioned significant relations, should be evaluated in the design burnout risk profiles for nursing professionals.
Topics: Achievement; Burnout, Professional; Depersonalization; Emotions; Female; Humans; Male; Nurses; Nursing Staff; Risk Factors; Severity of Illness Index
PubMed: 30257449
DOI: 10.3390/ijerph15102102 -
Frontiers in Psychology 2020Parenting is a meaningful endeavor but it also induces stress, which can cause parental burnout. In China, the assessment and study of parental burnout are still in...
Parenting is a meaningful endeavor but it also induces stress, which can cause parental burnout. In China, the assessment and study of parental burnout are still in their formative stages. To contribute to advancing this field, the present study aimed to develop and validate a Chinese version of the Parental Burnout Assessment (PBA). Questionnaires were distributed to 614 families (comprising students in the eighth grade and both of their parents; one questionnaire for each person) on two separate occasions (Time 1 and Time 2). The students were asked to self-report their loneliness and life satisfaction at Time 1 and their anti-social behavior at Time 2. Meanwhile, parents were asked to self-report their parental burnout and job burnout at both Time 1 and Time 2, their marriage satisfaction at Time 1, and their levels of agreeableness and neuroticism at Time 2. Using the data obtained, we performed exploratory and confirmatory factor analyses, which indicated that this version of the PBA had a single-factor structure. The α of the PBA was 0.938 at Time 1 and 0.952 at Time 2. At Time 1, parental burnout was positively related to their job burnout in emotional exhaustion and depersonalization, and negatively related to their marriage satisfaction. In addition, parental burnout was positively related to students' life satisfaction, and mothers' parental burnout was positively related to students' loneliness. At Time 2, parental burnout showed positive relations with neuroticism and job burnout in emotional exhaustion and depersonalization, and was negatively related to agreeableness. In addition, mothers' parental burnout was positively related to students' anti-social behavior. Furthermore, parental burnout at Time 1 also showed positive relations with job burnout through emotional exhaustion and depersonalization measured at Time 2, and parental burnout at Time 1 was positively related to students' anti-social behavior at Time 2. Overall, the present study confirmed the reliability and validity of the Chinese version of the PBA.
PubMed: 32231609
DOI: 10.3389/fpsyg.2020.00321 -
Family Medicine Apr 2022Burnout impacts medical students, residents, and practicing physicians. Existing research oversimplifies characteristics associated with burnout. Our study examined...
BACKGROUND AND OBJECTIVES
Burnout impacts medical students, residents, and practicing physicians. Existing research oversimplifies characteristics associated with burnout. Our study examined relationships between burnout, depressive symptoms, and evidence-based risk factors.
METHODS
Our study questions were part of a larger survey conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA), from May 9-23, 2020. Three emails were used to recruit a national sample of family medicine residents (n=283; questions completed via Survey Monkey). We determined descriptive statistics (frequency, means) for demographic and work environment characteristics, UCLA Loneliness Scale items, health behaviors, burnout (emotional exhaustion, depersonalization), and depressive symptoms. Multivariate data analysis included developing three logistic regression (LR) equations (emotional exhaustion, depersonalization, depressive symptoms) based on four blocks of potential risk factors (demographics, work environment characteristics, UCLA Loneliness items, and health behaviors).
RESULTS
Rates of psychological distress included 33.1% emotional exhaustion, 31.1% depersonalization, and 53.0% depressive symptoms. We determined stepwise forward-entry LR models for emotional exhaustion (feel isolated OR=6.89, low quality of wellness program OR=5.91, and low companionship OR=4.82); depersonalization (feel isolated OR=5.59, low quality of wellness program OR=15.11, graduate US osteopathic medical school OR=0.329, and African American OR=7.55); and depressive symptoms (feel isolated OR=5.31, inadequate time for restful sleep OR=0.383, and no dependent children OR=2.14).
CONCLUSIONS
Current findings document substantial social disconnection, substandard residency wellness programs, inadequate time for exercise, sleep, and other forms of self-care in addition to substantial levels of emotional exhaustion, depersonalization, and depressive symptoms. We explore implications for the design of future burnout prevention efforts and research.
Topics: Burnout, Professional; Family Practice; Humans; Internship and Residency; Students, Medical; Surveys and Questionnaires
PubMed: 35421241
DOI: 10.22454/FamMed.2022.526799 -
Frontiers in Human Neuroscience Oct 2013The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly... (Review)
Review
The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly reliant on visual information to determine self-motion. Since the vestibular system first evolved in invertebrate species in order to detect gravitational vertical, it is likely that the central nervous system has developed a special dependence upon vestibular input. In addition to the deficits in eye movement and postural reflexes that occur following vestibular dysfunction, there is convincing evidence that vestibular loss also causes cognitive and emotional disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in the sense of spatial orientation. Beyond this, however, patients with vestibular disorders have been reported to experience other personality changes that suggest that vestibular sensation is implicated in the sense of self. These are depersonalization and derealization symptoms such as feeling "spaced out", "body feeling strange" and "not feeling in control of self". We propose in this review that these symptoms suggest that the vestibular system may make a unique contribution to the concept of self through information regarding self-motion and self-location that it transmits, albeit indirectly, to areas of the brain such as the temporo-parietal junction (TPJ).
PubMed: 24194706
DOI: 10.3389/fnhum.2013.00678