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depersonalization derealization

Louis Sass, Juan P Borda, Luis Madeira, Elizabeth Pienkos, Barnaby Nelson
The self-disorder model offers a unifying way of conceptualizing schizophrenia's highly diverse symptoms (positive, negative, disorganized), of capturing their distinctive bizarreness, and of conceiving their longitudinal development. These symptoms are viewed as differing manifestations of an underlying disorder of ipseity or core-self: hyper-reflexivity/diminished-self-presence with accompanying disturbances of "grip" or "hold" on reality. Recent revision to this phenomenological theory, in particular distinguishing primary-vs-secondary factors, offers a bio-pheno-social model that is consistent with recent empirical findings and offers several advantages: (1) It helps account for the temporal variations of the symptoms or syndrome, including longitudinal progression, but also the shorter-term, situationally reactive, and sometimes defensive or quasi-intentional variability of symptom-expression that can occur in schizophrenia (consistent with understanding some aspects of ipseity-disturbance as dynamic and mutable, involving shifting attitudes or experiential orientations)...
February 5, 2018: Schizophrenia Bulletin
Mark J Niciu, Bridget J Shovestul, Brittany A Jaso, Cristan Farmer, David A Luckenbaugh, Nancy E Brutsche, Lawrence T Park, Elizabeth D Ballard, Carlos A Zarate
BACKGROUND: Ketamine induces rapid and robust antidepressant effects, and many patients also describe dissociation, which is associated with antidepressant response. This follow-up study investigated whether antidepressant efficacy is uniquely related to dissociative symptom clusters. METHODS: Treatment-resistant patients with major depressive disorder (MDD) or bipolar disorder (BD) (n = 126) drawn from three studies received a single subanesthetic (0.5 mg/kg) ketamine infusion...
February 17, 2018: Journal of Affective Disorders
Murat Boysan, Abdullah Yıldırım, Lütfullah Beşiroğlu, Mehmet Celal Kefeli, Mücahit Kağan
A growing body of research evidence documents the substantial associations between obsessive-compulsive disorder (OCD) and dissociation. This article describes the development and preliminary psychometric properties of the Van Obsessional Dissociation Questionnaire (VOD-Q). Obsessional dissociation is defined as a tendency to dissociate in reaction to distressing, unwanted and intrusive thoughts, images and impulses. The screening tool is conceptualized to tap obsessional dissociation across three dimensions: obsessional absorption, obsessional depersonalization/ derealization and obsessional amnesia...
January 4, 2018: Psychiatric Quarterly
Raffaele Sperandeo, Vincenzo Monda, Giovanni Messina, Marco Carotenuto, Nelson Mauro Maldonato, Enrico Moretto, Elena Leone, Vincenzo De Luca, Marcellino Monda, Antonietta Messina
Dissociative phenomena are common among psychiatric patients; the presence of these symptoms can worsen the prognosis, increasing the severity of their clinical conditions and exposing them to increased risk of suicidal behavior. Personality disorders as long duration stressful experiences may support the development of dissociative phenomena. In 933 psychiatric outpatients consecutively recruited, presence of dissociative phenomena was identified with the Dissociative Experience Scale (DES). Dissociative phenomena were significantly more severe in the group of people with mental disorders and/or personality disorders...
2018: Neuropsychiatric Disease and Treatment
Kristen R Choi, Julia S Seng, Ernestine C Briggs, Michelle L Munro-Kramer, Sandra A Graham-Bermann, Robert C Lee, Julian D Ford
OBJECTIVE: The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broader set of dissociation symptoms. METHOD: A sample of treatment-seeking, trauma-exposed adolescents 12 to 16 years old (N = 3,081) from the National Child Traumatic Stress Network Core Data Set was used to meet the study objectives...
December 2017: Journal of the American Academy of Child and Adolescent Psychiatry
Ana N Tibubos, Jennifer Grammes, Manfred E Beutel, Matthias Michal, Gabriele Schmutzer, Elmar Brähler
BACKGROUND: The aim of the present study was to investigate the relationships of common emotion regulation strategies (suppression and reappraisal) to self-reported fatigue and depersonalization/derealization symptoms. Specifically, we tested the moderating effect of suppression and reappraisal on the link of fatigue with depersonalization and derealization symptoms. Opposite effects were expected for both emotion regulation strategies assuming that cognitive reappraisal has an adaptive buffering effect, while suppression intensifies the association of fatigue and depersonalization/derealization experiences...
February 2018: Journal of Affective Disorders
Masoomeh Bakhshayesh, Fereshteh Golab, Fatemeh Kermanian, Mehdi Mehdizadeh, Amir Reza Katebi, Mansooreh Soleimani, Farzaneh Mohammadzadeh, Ronak Shabani, Elham Movahed, Majid Katebi
Introduction: The 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is a popular recreational drug and a major source of substance abuse, which ultimately leads to sensations of well-being, elation and euphoria, moderate derealization/depersonalization, and cognitive disruptions, as well as intense sensory awareness. The mechanisms involved in memory impairment induced by MDMA are not completely understood. Methods: The current study used 40 Sprague-Dawley rats, weighted 200 to 250 g...
July 2017: Basic and Clinical Neuroscience
Douglas J Lanska, John R Lanska
In 1955, English psychiatrist John Todd defined the Alice-in-Wonderland syndrome (AIWS) as self-experienced paroxysmal body-image illusions involving distortions of the size, mass, or shape of the patient's own body or its position in space, often accompanied by depersonalization and/or derealization. AIWS had been described by American Neurologist Caro Lippman in 1952, but Todd's report was the most influential. Todd named the syndrome for the perceptual disorder of altered body image experienced by the protagonist in Alice's Adventures in Wonderland (1865) by Lewis Carroll (Charles Lutwidge Dodgson)...
2018: Frontiers of Neurology and Neuroscience
David L Perez, Nassim Matin, Benjamin Williams, Kaloyan Tanev, Nikos Makris, W Curt LaFrance, Bradford C Dickerson
BACKGROUND: Links between dissociation and functional neurological disorder (FND)/conversion disorder are well-established, yet the pathophysiology of dissociation remains poorly understood. This MRI study investigated structural alterations associated with somatoform and psychological dissociation in FND. We hypothesized that multimodal, paralimbic cingulo-insular regions would relate to the severity of somatoform dissociation in patients with FND. METHODS: FreeSurfer cortical thickness and subcortical volumetric analyses were performed in 26 patients with motor FND and 27 matched healthy controls...
January 2018: Human Brain Mapping
Jytte van Huijstee, Eric Vermetten
Recently, a dissociative subtype of post-traumatic stress disorder (PTSD) has been included in the DSM-5. This review focuses on the clinical and neurobiological features that distinguish the dissociative subtype of PTSD from non-dissociative PTSD. Clinically, the dissociative subtype of PTSD is associated with high PTSD severity, predominance of derealization and depersonalization symptoms, a more significant history of early life trauma, and higher levels of comorbid psychiatric disorders. Furthermore, PTSD patients with dissociative symptoms exhibit different psychophysiological and neural responses to the recall of traumatic memories...
October 21, 2017: Current Topics in Behavioral Neurosciences
Jana Ross, Gabriel Baník, Mária Dědová, Gabriela Mikulášková, Cherie Armour
PURPOSE: Studies conducted in the USA, Canada and Denmark have supported the existence of the dissociative PTSD subtype, characterized primarily by symptoms of depersonalization and derealization. The current study aimed to examine the dissociative PTSD subtype in an Eastern European, predominantly female (83.16%) sample, using an extended set of dissociative symptoms. METHODS: A latent profile analysis was applied to the PTSD and dissociation data from 689 trauma-exposed university students from Slovakia...
September 29, 2017: Social Psychiatry and Psychiatric Epidemiology
Rüdiger Zwerenz, Jan Becker, Robert Johansson, Ronald J Frederick, Gerhard Andersson, Manfred E Beutel
BACKGROUND: Mental disorders have become a major health issue, and a substantial number of afflicted individuals do not get appropriate treatment. Web-based interventions are promising supplementary tools for improving health care for patients with mental disorders, as they can be delivered at low costs and used independently of time and location. Although psychodynamic treatments are used frequently in the face-to-face setting, there has been a paucity of studies on psychodynamic Web-based self-help interventions...
October 16, 2017: JMIR Mental Health
James S Spiegel
This article explores four major areas of moral concern regarding virtual reality (VR) technologies. First, VR poses potential mental health risks, including Depersonalization/Derealization Disorder. Second, VR technology raises serious concerns related to personal neglect of users' own actual bodies and real physical environments. Third, VR technologies may be used to record personal data which could be deployed in ways that threaten personal privacy and present a danger related to manipulation of users' beliefs, emotions, and behaviors...
September 23, 2017: Science and Engineering Ethics
Sherain Harricharan, Andrew A Nicholson, Maria Densmore, Jean Théberge, Margaret C McKinnon, Richard W J Neufeld, Ruth A Lanius
BACKGROUND: The vestibular system integrates multisensory information to monitor one's bodily orientation in space, and is influenced by interoceptive awareness. Post-traumatic stress disorder (PTSD) involves typically alterations in interoceptive and bodily self-awareness evidenced by symptoms of hyperarousal, as well as of emotional detachment, including emotional numbing, depersonalization, and derealization. These alterations may disrupt vestibular multisensory integration between the brainstem (vestibular nuclei) and key vestibular cortical regions (parieto-insular vestibular cortex, prefrontal cortex)...
September 11, 2017: Neuropsychologia
Paweł Rodziński, Krzysztof Rutkowski, Agnieszka Murzyn, Jerzy A Sobański, Katarzyna Cyranka, Edyta Dembińska, Karolina Grządziel, Katarzyna Klasa, Michał Mielimąka, Łukasz Müldner-Nieckowski, Bogna Smiatek-Mazgaj
OBJECTIVES: Analysis of associations between changes in the intensity of neurotic symptoms and reduction of suicidal ideation (SI) or lack of SI reduction, in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in a day hospital. METHODS: Symptom Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated in the psychotherapeutic day hospital due to neurotic, behavioral or personality disorders between 2005-2013...
June 18, 2017: Psychiatria Polska
Sunny J Dutra, Erika J Wolf
A dissociative subtype of PTSD was added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to denote a distinct presentation of PTSD marked by symptoms of derealization and depersonalization. The subtype has brought renewed interest in the conceptualization of dissociation in PTSD, and raised questions about its treatment. We review the evidence for two models of PTSD-related dissociative symptoms and the treatment approaches that align with each. We find support for the contributions of biologically-based trait-level factors to dissociation, and suggest that empirically supported treatments for PTSD demonstrate efficacy for patients with the subtype...
April 2017: Current Opinion in Psychology
Drew J Puxty, Johannes G Ramaekers, Rafael de la Torre, Magí Farré, Neus Pizarro, Mitona Pujadas, Kim P C Kuypers
Previous research has shown that a single dose of MDMA induce a dissociative state, by elevating feelings of depersonalization and derealization. Typically, it is assumed that action on the 5-HT2A receptor is the mechanism underlying these psychedelic experiences. In addition, other studies have shown associations between dissociative states and biological parameters (heart rate, cortisol), which are elevated by MDMA. In order to investigate the role of the 5-HT2 receptor in the MDMA-induced dissociative state and the association with biological parameters, a placebo-controlled within-subject study was conducted including a single oral dose of MDMA (75 mg), combined with placebo or a single oral dose of the 5-HT2 receptor blocker ketanserin (40 mg)...
2017: Frontiers in Pharmacology
Astrid M Kamperman, Marian J Veldman-Hoek, Richard Wesseloo, Emma Robertson Blackmore, Veerle Bergink
OBJECTIVES: Postpartum psychosis (PP) is known for its clear onset but its phenotype has never been clearly described in a cohort. The aim of this study was to describe PP symptomatology, and to identify subgroups of patients based on symptom profiles. METHODS: We prospectively assessed a wide range of symptoms in cases of PP in a cohort of women (N=130) admitted to the Mother-Baby inpatient unit. Using a person-centered analytic approach, we distinguished mutually exclusive subgroups of women...
September 2017: Bipolar Disorders
Melissa Parlar, Maria Densmore, Geoffrey B C Hall, Ruth Lanius, Margaret C McKinnon
Alterations in autobiographical memory (AM) performance have been identified in major depressive disorder (MDD) and in trauma-related disorders, however, the neural and behavioural correlates of AM retrieval in patients with MDD and a co-morbid history of trauma remain unexplored. Here, we used behavioural and neuroimaging techniques to investigate AM in this patient group and in matched healthy comparison subjects (HCs). Twenty patients with MDD and trauma exposure and 20 HCs underwent fMRI scanning while recalling positive, negative, and neutral events...
July 8, 2017: Neuropsychologia
Christophe Lopez, Maya Elzière
Out-of-body experiences (OBEs) are states during which people experience their centre of awareness as located outside of their physical body, along with the sensation of seeing the environment from an elevated viewpoint. OBE is encountered in epilepsy, migraine and depersonalization, and it is not an uncommon experience in the general population. Current neuroscientific models of bodily self-consciousness consider that OBE are related to a failure to integrate visual, somatosensory and vestibular signals. These models have highlighted the importance of visual-vestibular mismatch in OBE...
June 8, 2017: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
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