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Journal of Psychiatric Research Sep 2020There is currently no general agreement on how to best conceptualize dissociative symptoms and whether they share similar neural underpinnings across dissociative... (Review)
Review
INTRODUCTION
There is currently no general agreement on how to best conceptualize dissociative symptoms and whether they share similar neural underpinnings across dissociative disorders. Neuroimaging data could help elucidate these questions.
OBJECTIVES
The objective of this review is to summarize empirical evidence for neural aberrations observed in patients suffering from dissociative symptoms.
METHODS
A systematic literature review was conducted including patient cohorts diagnosed with primary dissociative disorders, post-traumatic stress disorder (PTSD), or borderline personality disorder.
RESULTS
Results from MRI studies reporting structural (gray matter and white matter) and functional (during resting-state and task-related activation) brain aberrations were extracted and integrated. In total, 33 articles were included of which 10 pertained to voxel-based morphology, 2 to diffusion tensor imaging, 10 to resting-state fMRI, and 11 to task-related fMRI. Overall findings indicated aberrations spread across diverse brain regions, especially in the temporal and frontal cortices. Patients with dissociative identity disorder and with dissociative PTSD showed more overlap in brain activation than each group showed with depersonalization/derealization disorder.
CONCLUSION
In conjunction, the results indicate that dissociative processing cannot be localized to a few distinctive brain regions but rather corresponds to differential neural signatures depending on the symptom constellation.
Topics: Brain; Diffusion Tensor Imaging; Dissociative Disorders; Gray Matter; Humans; Magnetic Resonance Imaging; Stress Disorders, Post-Traumatic
PubMed: 32480060
DOI: 10.1016/j.jpsychires.2020.05.006 -
Medecine Sciences : M/S Apr 2023The category of dissociative identity disorder (DID) has puzzled medical science and fascinated popular culture for almost 200 years. Its occurrence in young people...
The category of dissociative identity disorder (DID) has puzzled medical science and fascinated popular culture for almost 200 years. Its occurrence in young people raises at least two new questions addressed by science studies and embedded philosophy: self-diagnosis (related to cyberchondria and mass media-induced illness) and transient disease (related to looping effect and identity claim specific to adolescence). In an attempt to refine the sociocognitive model, we analyze the impact of these notions in understanding the local ecological niche in which contemporary adolescent DID occurs.
Topics: Humans; Adolescent; Dissociative Identity Disorder; Dissociative Disorders
PubMed: 37094271
DOI: 10.1051/medsci/2023042 -
Epilepsia 2008Transient loss of consciousness (T-LOC) with abnormal posture or movements reflects a temporary dysfunction of the brain, either primary or secondary. In a period of... (Comparative Study)
Comparative Study Review
Transient loss of consciousness (T-LOC) with abnormal posture or movements reflects a temporary dysfunction of the brain, either primary or secondary. In a period of high technological medical access, patients with T-LOC constitute a challenge to improve the medical "art of listening." The difficulty in dealing with isolated paroxysmal phenomena is associated with the probability of the occurrence of a second event and therefore the entrance of the patient into a chronic disorder. We present a detailed analysis of symptoms that should help the general practitioner in the differential diagnosis among three main entities in the adult populations: syncope, epileptic seizure, and psychogenic seizure (dissociative convulsion).
Topics: Adult; Child; Comorbidity; Diagnosis, Differential; Dissociative Disorders; Epilepsies, Myoclonic; Epilepsy; Epilepsy, Frontal Lobe; Female; Humans; Incidence; Male; Middle Aged; REM Sleep Behavior Disorder; REM Sleep Parasomnias; Somatoform Disorders; Syncope
PubMed: 18184147
DOI: 10.1111/j.1528-1167.2008.01442.x -
Psychological Review Jan 2023Mounting evidence suggests an association between aberrant sleep phenomena and dissociative experiences. However, no wake-sleep boundary theory provides a compelling...
Mounting evidence suggests an association between aberrant sleep phenomena and dissociative experiences. However, no wake-sleep boundary theory provides a compelling explanation of dissociation or specifies its physiological substrates. We present a theoretical account of dissociation that integrates theories and empirical results from multiple lines of research concerning the domain of dissociation and the regulation of rapid eye movement (REM) sleep. This theory posits that individual differences in the circuitry governing the REM sleep promoting Pedunculopontine Nucleus and Laterodorsal Tegmental Nucleus determine the degree of similarity in the cortical connectivity profiles of wakefulness and REM sleep. We propose that a latent trait characterized by elevated dissociative experiences emerges from the decoupling of frontal executive regions due to a REM sleep-like aminergic/cholinergic balance. The Pedunculopontine-Induced Cortical Decoupling Account of Dissociation (PICDAD) suggests multiple fruitful lines of inquiry and provides novel insights. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Sleep, REM; Dissociative Disorders
PubMed: 35084921
DOI: 10.1037/rev0000353 -
European Journal of Psychotraumatology 2022We present a case study of the remission of a chemically resistant schizophrenia disorder after a single session of EMDR. Our patient had been followed-up for...
We present a case study of the remission of a chemically resistant schizophrenia disorder after a single session of EMDR. Our patient had been followed-up for schizophrenia according to DSM5 criteria, since 4 years. During our subject's fourth hospitalization for major delirious decompensation, a single EMDR session, according to the standard protocol, resulted in a complete and total remission of the delirious disorder and the disorganization/dissociative syndrome in 8 weeks. This allowed us to interrupt the patient's antipsychotic treatment without relapse at 18 months. This case study allows us to highlight, as many authors have previously done, the necessity of researching the traumatic history of patients diagnosed with schizophrenia in order to provide therapies focused on traumatic dissociation. It also questions the relevance of our diagnostic criteria for schizophrenia and other dissociative disorders.
Topics: Adult; Antipsychotic Agents; Clozapine; Dissociative Disorders; Eye Movement Desensitization Reprocessing; Humans; Male; Remission, Spontaneous; Schizophrenia, Treatment-Resistant
PubMed: 35140878
DOI: 10.1080/20008198.2021.2014660 -
Culture, Medicine and Psychiatry Jun 2022Channeling experiences are often compared with Dissociative Trance/Possession Disorders and Dissociative Identity Disorders and more recent diagnostic criteria presented...
Channeling experiences are often compared with Dissociative Trance/Possession Disorders and Dissociative Identity Disorders and more recent diagnostic criteria presented in the DSM 5 and ICD-11. From this comparison, it emerges quite clearly that, for most cases, channeling can either be considered an exceptional non-ordinary mental experience or a non-pathological Dissociative Trance/Possession experience. If this characterization is valid, the next step is to understand the origin of channeling experiences. Are they an expression of channeler's unconscious or voluntary mental mechanisms, or real connections with "other discarnate entities"? Given their peculiar characteristics, channeling experiences offer a unique opportunity for a scientific investigation and in particular, the origin of the information received by the channelers.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans
PubMed: 34212272
DOI: 10.1007/s11013-021-09730-9 -
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 -
The American Journal of Psychiatry Jun 2010In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from... (Review)
Review
In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.
Topics: Affect; Amygdala; Cerebral Cortex; Chronic Disease; Dissociative Disorders; Gyrus Cinguli; Humans; Magnetic Resonance Imaging; Memory Disorders; Neural Inhibition; Stress Disorders, Post-Traumatic
PubMed: 20360318
DOI: 10.1176/appi.ajp.2009.09081168 -
Revue Medicale de Liege Dec 2002Through a few clinical case histories stemming from their daily activities at the psychiatric section of the Lantin Prison, the authors propose to revisit the classic... (Review)
Review
Through a few clinical case histories stemming from their daily activities at the psychiatric section of the Lantin Prison, the authors propose to revisit the classic concept of Prison psychosis. They broaden its limits to include other psychotic and dissociative phenomena common to the jail population. This requires a strict differential diagnosis, allowing to eliminate some similar pathologies; nevertheless, some difficulties and imperfections persist. The development of the psychosis, the input from the jail architecture and milieu, the predisposing as well as facilitating factors linked to the personality of the inmate, and triggering phenomena are discussed. Finally, the comorbidity between these psychotic/dissociative phenomena and the borderline & histrionic personality disorders is envisaged.
Topics: Dissociative Disorders; Humans; Prisoners; Psychotic Disorders
PubMed: 12632838
DOI: No ID Found -
Tijdschrift Voor Psychiatrie 2019Dissociation is a prevalent symptom in borderline personality disorder (BPD), which can have detrimental effects on everyday functioning and treatment. Until now, little... (Review)
Review
Dissociation is a prevalent symptom in borderline personality disorder (BPD), which can have detrimental effects on everyday functioning and treatment. Until now, little is known about the brain networks implicated in dissociation in BPD. Research on dissociative disorders and posttraumatic stress disorder found alterations in networks implicated in cognitive control and arousal modulation. However, it is unknown whether these alterations are also affected in BPD.
AIM: To provide an overview of the definitions, neurobiological models, and neuroimaging research on dissociation in BPD.
METHOD: Review of the literature.
RESULTS: During dissociation in BPD, there is evidence for an altered recruitment and interplay of brain regions implicated in the regulation of stress responses and emotions, attention, memory, and self-referential processing (amygdala, anterior cingulate cortex, inferior frontal gyrus, medial prefrontal cortex, superior temporal gyrus, and inferior parietal lobule).
CONCLUSION: Dissociation is associated with alterations in brain networks that regulate affect-cognitive processing in BPD. Given the substantial impact of dissociation on treatment and neural processing, dissociative symptoms should be taken into account in future research and treatment of BPD, even if they are not the primary focus.Topics: Borderline Personality Disorder; Dissociative Disorders; Emotions; Humans; Neuroimaging
PubMed: 31017285
DOI: No ID Found