Examination of the Pathological Dissociation Taxon in Depersonalization Disorder

Simeon, Daphne; Knutelska, Margaret; Nelson, Dorothy; Guralnik, Orna; Schmeidler, James

doi:10.1097/01.nmd.0000095126.21206.3e

Cited by 46 publications

(24 citation statements)

References 13 publications

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“…A cutoff score of 25 proved useful in identifying severe dissociative disorders (Draijer & Boon, 1993). Since its introduction, the DES has been used in hundreds of dissociation studies; a sophisticated taxonometric analysis of the DES, known as the DES‐Taxon score (Simeon et al., 2003), identified eight designated pathologic dissociation items (Waller et al., 1997). The SDQ‐20 is a self‐rating scale developed to investigate somatic component of dissociation.…”

Section: Methodsmentioning

confidence: 99%

Neuroanatomic correlates of psychogenic nonepileptic seizures: A cortical thickness and VBM study

et al. 2011

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SUMMARYPurpose: Psychogenic nonepileptic seizures (PNES) are among the most common clinical manifestations of conversion disorder and consist of paroxysmal behavior that resembles epileptic seizures. Preliminary data from functional neuroimaging studies gave plausible evidence that limbic circuits and sensorimotor cortex might be engaged in conversion disorder. Nonetheless, no advanced magnetic resonance imaging (MRI) studies have focused on patients with PNES. Methods: We enrolled 20 consecutive patients in whom the diagnosis of PNES was based on ictal video-electroencephalography (EEG) of the habitual episodes and 40 healthy subjects matched for age and sex All patients underwent a formal neuropsychological investigation and a neuropsychiatric assessment. All of the patients also underwent two distinct morphologic whole-brain MR measurements, voxel-based morphometry (VBM), and cortical thickness analysis, in a multimethod approach.Key Findings: None of the patients had serious medical or neurologic illness, substance abuse, or psychotic disorder, or were taking antipsychotic drugs. VBM and cortical thickness analyses in the patients with PNES revealed abnormal cortical atrophy of the motor and premotor regions in the right hemisphere and the cerebellum bilaterally. We also observed a significant association between increasing depression scores and atrophy involving the premotor regions. Significance: The results of this study illustrate that motor and premotor regions in the right hemisphere and the cerebellum bilaterally play an important role in the pathogenesis of PNES and that these structures are correlated with depressive symptoms. Our findings suggest a multistep model in the pathogenesis of PNES, in which the phenomenology is driven by psychological factors interacting with specific biologic abnormalities.

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Section: Methodsmentioning

confidence: 99%

Neuroanatomic correlates of psychogenic nonepileptic seizures: A cortical thickness and VBM study

et al. 2011

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“…These include high dissociation scores on the DES, limbic system abnormalities, alterations in gray matter volume, and changes in fractional anisotropy of white matter in the corpus callosum, corona radiata, and other areas, comparable to those found in individuals with histories of childhood sexual abuse. [99,103,104] NOSOLOGY Studies of two large cohorts [46,105] have documented a consistent nosology for DPD, including age of onset, acute and remote antecedents, symptomatology, cognitive organization, course, treatment response (primarily lack of treatment response), and gender ratio. [106] Factor analysis from these studies suggest that DPD symptoms are characterized by either four or five factors: numbing, unreality of self, unreality of other, temporal disintegration, and perceptual alterations (i.e.…”

Section: Dpd and Derealizationmentioning

confidence: 99%

Dissociative Disorders in DSM-5

Spiegel

Lewis‐Fernández

Lanius

et al. 2013

Annu. Rev. Clin. Psychol.

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The rationale, research literature, and proposed changes to the dissociative disorders and conversion disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are presented. Dissociative identity disorder will include reference to possession as well as identity fragmentation, to make the disorder more applicable to culturally diverse situations. Dissociative amnesia will include dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia but does not always include confused wandering or loss of personality identity. Depersonalization disorder will include derealization as well, since the two often co-occur. A dissociative subtype of posttraumatic stress disorder (PTSD), defined by the presence of depersonalization or derealization in addition to other PTSD symptoms, is being recommended, based upon new epidemiological and neuroimaging evidence linking it to an early life history of adversity and a combination of frontal activation and limbic inhibition. Conversion disorder (functional neurological symptom disorder) will likely remain with the somatic symptom disorders, despite considerable dissociative comorbidity.

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“…Die immer wieder berichteten Zusammenhänge zwischen (biografisch frühen) Traumatisierungen und dissoziativer Psychopathologie [28] konnten auch für das Konzept der pathologischen Dissoziation bestätigt werden: So wurde in einer nicht-klinischen Stichprobe eine Assoziation mit Kindheitstraumata, v. a. mit körperlicher Vernachlässigung und sexuellem Missbrauch, gefunden, die für normalpsychologische Dissoziation nicht bestand [29]. Auch bei delinquenten Jugendlichen sowie bei Patienten mit einer Depersonalisationsstörung wurde dieser Zusammenhang bestätigt [25,30]. Offen ist auch die Frage, wie zeitlich stabil sowohl die dimensionalen DES-Taxon Werte als auch die kategoriale Taxon-Zugehörigkeit sind [31].…”

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Teststatistische Überprüfung der Dissociative Experiences Scale-Taxon (DES-T)

Spitzer

Freyberger

Brähler

et al. 2015

Psychother Psych Med

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Current refinements of the dissociation concept have arrived at the distinction between a dimensional, non-pathological type and a discontinuous, pathological class of dissociation, which can be identified by a subset of 8 items of the Dissociative Experiences Scale, the DES-Taxon (DES-T). This study reports on the psychometric evaluation of the German version of the DES-T in a large general population sample (n = 2,359). The distributions of all items and the total score of the DES-T emerged to be non-normal and right-skewed with a sharp peak. The internal consistency proved to be high (Cronbach's α = 0.92), and all items discriminated well with item-total correlations above 0.65. An explorative factor analysis revealed that all items loaded on the first, unrotated factor with loadings of a ≥ 0.7 (explained variance 64%). The DES-T is a one-dimensional measure as indicated by confirmatory factor analysis. There were no relevant associations between the DES-T, sociodemographic characteristics, depression or anxiety. The prevalence of pathological dissociation was 1.6% in the general population. The DES-T proved to be an economic and psychometrically sound self-report measure for the assessment of pathological dissociative phenomena.

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Examination of the Pathological Dissociation Taxon in Depersonalization Disorder

Cited by 46 publications

References 13 publications

Neuroanatomic correlates of psychogenic nonepileptic seizures: A cortical thickness and VBM study

Neuroanatomic correlates of psychogenic nonepileptic seizures: A cortical thickness and VBM study

Dissociative Disorders in DSM-5

Teststatistische Überprüfung der Dissociative Experiences Scale-Taxon (DES-T)

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