Depersonalization: neurobiological perspectives

Sierra, Mauricio; Berríos, Germán E.

doi:10.1016/s0006-3223(98)00015-8

Cited by 315 publications

(239 citation statements)

References 74 publications

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“…36 Positive correlations between the intensity of dissociation and activation of the left medial frontal gyrus as found in our study are consistent with the corticolimbic model of depersonalization. 15 This model postulates that the medial frontal regions inhibit limbic structures during states of depersonalization. Also, in agreement with this model, we found a negative correlation between dissociation and activation in the right parahippocampal gyrus.…”

Section: Discussionmentioning

confidence: 99%

“…Sierra and Berrios 15 proposed a corticolimbic model of depersonalization which suggests that hypoemotionality and decreased arousal results from activation of the left medial prefrontal cortex with reciprocal amygdala inhibition, whereas dorsolateral prefrontal cortex activation with reciprocal anterior cingulate inhibition leads to hypervigilance and emptiness of mental contents.…”

Section: Introductionmentioning

confidence: 99%

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Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study

Ludäscher

Valerius

Stiglmayr

et al. 2010

jpn

108

113

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Background: Stress-induced dissociative states involving analgesia are a common feature of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD). Our aim was to investigate the psychologic, somatosensory (pain sensitivity) and neural correlates of dissociative states in patients with these disorders. Methods: We included 15 women with BPD who were not taking medication; 10 of these women had comorbid PTSD. While undergoing functional magnetic resonance imaging at 1.5 Tesla, participants were exposed to a script describing a personalized dissociation-inducing situation and a personalized script describing a neutral situation. We assessed dissociative psychopathology and pain sensitivity. Results: Dissociative psychopathology scores were significantly higher and pain sensitivity was lower after the dissociation-inducing script was read compared with the neutral script. The blood oxygen level-dependent (BOLD) signal was significantly increased in the left inferior frontal gyrus (Brodmann area [BA] 9) during the presentation of the dissociationinducing script. Regression analyses revealed positive correlations between BOLD signal and dissociative psychopathology in the left superior frontal gyrus (BA 6) and negative correlations in the right middle (BA 21) and inferior temporal gyrus (BA 20). In the subgroup of participants with comorbid PTSD, we also found increased activity in the left cingulate gyrus (BA 32) during script-driven imagery-induced dissociation, a positive correlation between dissociation scores and activity in the right and left insula (BA 13) and a negative correlation in the right parahippocampal gyrus (BA 35). Limitations: The main limitation of this pilot study is the absence of a control group. Therefore, the results may also reflect the neural correlates of non-BPD/PTSD specific dissociative states or the neural correlates of emotionally stressful or "loaded" memories. Another limitation is the uncorrected statistical level of the functional magnetic resonance imaging results. Conclusion: Our results showed that the script-driven imagery method is capable of inducing dissociative states in participants with BPD with and without comorbid PTSD. These states were characterized by reduced pain sensitivity and a fronto limbic activation pattern, which resembles the findings in participants with PTSD while in dissociative states.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study

Ludäscher

Valerius

Stiglmayr

et al. 2010

jpn

108

113

View full text Add to dashboard Cite

show abstract

“…Depersonalization has also been the focus of a number of neurobiological studies (Baker et al 2003;Medford et al 2005;Simeon et al 2000Simeon et al , 2004. These studies have lent support to a 'cortico-limbic' model (Sierra and Berrios 1998) in which inhibitory activity in the prefrontal cortex disrupts the "emotional tagging" of perceptual and cognitive material by the amygdala and related structures. The disruption results in suppressed autonomic arousal and a sense of disconnection from reality.…”

Section: The Neurobiology Of Dissociationmentioning

confidence: 73%

“…In one explicitly evolutionary version of this adaptive explanation, it is argued that depersonalization (a key dissociative symptom characterized by the feeling of being detached from one's physical and/or psychological being) is actually hardwired as an adaptive mechanism (Sierra and Berrios 1998). The argument is that in the face of certain types of acute stress-specifically, situations in which the individual lacks control over the environment and cannot localize the source of threat (e.g., natural disasters)-the inhibition of "non-functional emotional responses" would serve an adaptive purpose.…”

Section: The Psychiatric-adaptive Paradigmmentioning

confidence: 99%

Dissociative Experience and Cultural Neuroscience: Narrative, Metaphor and Mechanism

Seligman

Kirmayer

2008

Cult Med Psychiatry

225

129

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Approaches to trance and possession in anthropology have tended to use outmoded models drawn from psychodynamic theory or treated such dissociative phenomena as purely discursive processes of attributing action and experience to agencies other than the self. Within psychology and psychiatry, understanding of dissociative disorders has been hindered by polemical "either/or" arguments: either dissociative disorders are real, spontaneous alterations in brain states that reflect basic neurobiological phenomena, or they are imaginary, socially constructed role performances dictated by interpersonal expectations, power dynamics and cultural scripts. In this paper, we outline an approach to dissociative phenomena, including trance, possession and spiritual and healing practices, that integrates the neuropsychological notions of underlying mechanism with sociocultural processes of the narrative construction and social presentation of the self. This integrative model, grounded in a cultural neuroscience, can advance ethnographic studies of dissociation and inform clinical approaches to dissociation through careful consideration of the impact of social context.

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“…The observation of autonomic blunting in the face of considerable self-reported stress might be interpreted as an attempt to psychophysiologically remain within the ‘Window of Tolerance’ (Corrigan et al, 2011), eventually due to over-regulation of affect (van Dijke, 2012; van Dijke et al, 2010). It would be interesting to readminister our experiment in a fMRI scanner to explore whether autonomic blunting in our stress paradigm is accompanied by corticolimbic inhibition, a well-known pathomechanism in Depersonalization-Derealization Disorder (Sierra & Berrios, 1998). …”

Section: Discussionmentioning

confidence: 99%

The enemy in the mirror: self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder

Schäflein

Sattel

Schmidt

et al. 2018

European Journal of Psychotraumatology

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Background: Patients suffering from dissociative disorders (DD) are characterized by an avoidance of aversive stimuli. Clinical experience has shown that DD patients typically avoid the confrontation with their own faces in a mirror (CFM). Objective: To investigate potential CFM-associated self-reported and psychophysiological stress reactions of DD patients, which most likely inform on the still unknown pathophysiology of dysfunctional self-perception in DD. Method: Eighteen DD patients and 18 healthy controls (HCs) underwent CFM. They were assessed for CFM-induced subjective self-reported stress, acute dissociative symptoms and sympathetic and parasympathetic drive using impedance cardiography. Results: DD patients experienced more subjective stress and acute dissociation than HCs upon CFM. Their psychological stress response did not activate the sympathetic and parasympathetic nervous system. Conclusions: In DD patients, CFM constitutes serious self-reported stress and is associated with a blunted autonomic reactivity. Therapeutic approaches promoting self-perception and self-compassion, in particular by using CFM, might serve as goal-oriented diagnostic and therapeutic tools in DD.

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Depersonalization: neurobiological perspectives

Cited by 315 publications

References 74 publications

Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study

Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study

Dissociative Experience and Cultural Neuroscience: Narrative, Metaphor and Mechanism

The enemy in the mirror: self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder

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