Cognitive and neural facets of dissociation in a traumatized population.

Fani, Negar; King, Tricia Z.; Powers, Abigail; Hardy, Raven A.; Siegle, Greg J.; Blair, James; Surapaneni, Sindhuja; Rooij, Sanne J.H. van; Ressler, Kerry J.; Jovanović, Tanja; Bradley, Bekh

doi:10.1037/emo0000466

Cited by 19 publications

(37 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…112 The latter may be critical to establish readiness to react, 71–73,75,106–110 while importantly, this is found to be reduced during states of derealization/depersonalization in PTSD+DS. 14,19,113–122 Hence, as reduced thalamic engagement has been reported repeatedly in PTSD, with most pronounced changes observed in PTSD+DS, 5,123–126 the present investigation extends these findings by highlighting the importance of deep-layer neuronal circuitries in the functioning of higher brain structures involved in depersonalization.…”

Section: Discussionsupporting

confidence: 84%

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

et al. 2019

View full text Add to dashboard Cite

Background Brainstem and midbrain neuronal circuits that control innate, reflexive responses and arousal are increasingly recognized as central to the neurobiological framework of post-traumatic stress disorder (PTSD). The reticular activation system represents a fundamental neuronal circuit that plays a critical role not only in generating arousal but also in coordinating innate, reflexive responding. Accordingly, the present investigation aims to characterize the resting state functional connectivity of the reticular activation system in PTSD and its dissociative subtype. Methods We investigated patterns of resting state functional connectivity of a central node of the reticular activation system, namely, the pedunculopontine nuclei, among individuals with PTSD (n = 77), its dissociative subtype (PTSD+DS; n = 48), and healthy controls (n = 51). Results Participants with PTSD and PTSD+DS were characterized by within-group pedunculopontine nuclei resting state functional connectivity to brain regions involved in innate threat processing and arousal modulation (i.e., midbrain, amygdala, ventromedial prefrontal cortex). Critically, this pattern was most pronounced in individuals with PTSD+DS, as compared to both control and PTSD groups. As compared to participants with PTSD and controls, individuals with PTSD+DS showed enhanced pedunculopontine nuclei resting state functional connectivity to the amygdala and the parahippocampal gyrus as well as to the anterior cingulate and the ventromedial prefrontal cortex. No group differences emerged between PTSD and control groups. In individuals with PTSD+DS, state derealization/depersonalization was associated with reduced resting state functional connectivity between the left pedunculopontine nuclei and the anterior nucleus of the thalamus. Altered connectivity in these regions may restrict the thalamo-cortical transmission necessary to integrate internal and external signals at a cortical level and underlie, in part, experiences of depersonalization and derealization. Conclusions The present findings extend the current neurobiological model of PTSD and provide emerging evidence for the need to incorporate brainstem structures, including the reticular activation system, into current conceptualizations of PTSD and its dissociative subtype.

show abstract

Section: Discussionsupporting

confidence: 84%

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

et al. 2019

View full text Add to dashboard Cite

show abstract

“…At the same time, rigor inclusion-/exclusion criteria hamper recruitment, and studies with larger sample sizes as well as meta-analyses of larger data sets are strongly needed to extend and replicate previous findings with sufficient statistical power. Shared etiologies (e.g., trauma history) should be taken into account [ 132 ], e.g., by including control groups of participants that experienced trauma without developing psychiatric disorders. Careful screening for childhood trauma, symptom severity, and comorbidities may help to improve the understanding of trauma- and non-trauma-related pathways to dissociation.…”

Section: Discussionmentioning

confidence: 99%

Dissociation in Borderline Personality Disorder: Recent Experimental, Neurobiological Studies, and Implications for Future Research and Treatment

Krause-Utz

Frost

Chatzaki

et al. 2021

Curr Psychiatry Rep

View full text Add to dashboard Cite

Purpose of Review The aim of this review article is to give an overview over recent experimental neurobiological research on dissociation in borderline personality disorder (BPD), in order to inform clinicians and to stimulate further research. First, we introduce basic definitions and models that conceptualize dissociation from a transdiagnostic perspective. Then, we discuss recent findings in BPD. Recent Findings Stress-related dissociation is a key symptom of BPD, closely linked to other core domains of the disorder (emotion dysregulation, identity disturbances, and interpersonal disturbances). The understanding of neurobiological correlates of dissociation across different psychiatric disorders (e.g., dissociative disorders, post-traumatic stress disorder) is steadily increasing. At the same time, studies explicitly focusing on dissociation in BPD are still scarce. Summary There is evidence for adverse effects of dissociation on affective-cognitive functioning (e.g., interference inhibition), body perception, and psychotherapeutic treatment response in BPD. On the neural level, increased activity in frontal regions (e.g., inferior frontal gyrus) and temporal areas (e.g., inferior and superior temporal gyrus) during symptom provocation tasks and during resting state was observed, although findings are still diverse and need to be replicated. Conceptual differences and methodological differences in study designs and sample characteristics (e.g., comorbidities, trauma history) hinder a straightforward interpretation and comparison of studies. Given the potentially detrimental impact of dissociation in BPD, more research on the topic is strongly needed to deepen the understanding of this complex clinical condition.

show abstract

“…Furthermore, greater dissociation was related to decreased connectivity between cSN and rCEN regions. Taken together, these alterations may be an adaptive or compensatory response to childhood trauma and are a likely source of executive functioning differences, self-alteration experiences, and altered interoceptive/autonomic experiences reported by individuals with dissociative symptoms (5,35,36).…”

Section: Discussionmentioning

confidence: 99%

Categorical and dimensional brain network-based models of trauma-related dissociative subtypes

Lebois

Kumar

Palermo

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundTrauma-related pathological dissociation is a multidimensional and disabling phenomenon that involves disruptions or discontinuities in psychological functioning. Despite its prevalence, personal and societal burden, dissociation remains underappreciated in clinical practice, and it lacks a synthesized neurobiological model that could place it in context with other common psychiatric symptoms. To identify a nuanced neurobiological model of pathological dissociation, we examined the functional connectivity of three core neurocognitive networks as related to the dimensional dissociation subtypes of depersonalization/derealization and partially-dissociated intrusions, and the diagnostic category of a complex dissociation disorder, dissociative identity disorder (DID).MethodsParticipants were 91 adult women with and without: a history of childhood trauma, current posttraumatic stress disorder (PTSD) and varied levels of pathological dissociation. Participants provided interview and self-report data about pathological dissociation, PTSD symptoms, childhood maltreatment history, and completed a resting-state functional magnetic resonance imaging scan.ResultsAfter controlling for age, childhood maltreatment and PTSD symptom severity, we found that pathological dissociation was associated with hyperconnectivity within central executive, default, and salience networks, and decreased connectivity of central executive and salience networks with other areas. Moreover, we isolated unique connectivity markers linked to depersonalization/derealization, to partially-dissociated intrusions, and to DID.ConclusionsOur work suggests subtypes of pathological dissociation have robust, discernable, and unique functional connectivity signatures. The neural correlates of dissociation may serve as potential targets for treatment engagement to facilitate recovery from PTSD and pathological dissociation. These results underscore dissociation assessment as crucial in clinical and medical care settings.

show abstract

Cognitive and neural facets of dissociation in a traumatized population.

Cited by 19 publications

References 72 publications

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

Back to the Basics: Resting State Functional Connectivity of the Reticular Activation System in PTSD and its Dissociative Subtype

Dissociation in Borderline Personality Disorder: Recent Experimental, Neurobiological Studies, and Implications for Future Research and Treatment

Categorical and dimensional brain network-based models of trauma-related dissociative subtypes

Contact Info

Product

Resources

About