Abstract
BackgroundDisembodiment is a core feature of depersonalization disorder (DPD). Given the narratives of DPD patients about their disembodiment and emotional numbing and neurobiological findings of an inhibition of insular activity, DPD may be considered as a mental disorder with specific impairments of interoceptive awareness and body perception.MethodsWe investigated cardioceptive accuracy (CA) of DPD patients (n = 24) as compared to healthy controls (n = 26) with two different heartbeat detection tasks (“Schandry heartbeat counting task” and “Whitehead heartbeat discrimination task”). Self-rated clearness of body perception was measured by questionnaire.ResultsContrary to our hypothesis, DPD patients performed similarly to healthy controls on the two different heartbeat detection tasks, and they had equal scores regarding their self-rated clearness of body perception. There was no correlation of the severity of “anomalous body experiences” and depersonalization with measures of interoceptive accuracy. Only among healthy controls CA in the Schandry task was positively correlated with self-rated clearness of body perception. Depersonalization was unrelated to severity of depression or anxiety, while depression and anxiety were highly correlated. Anxiety and depression did not modify the associations of depersonalization with interoceptive accuracy.ConclusionsOur main findings highlight a striking discrepancy of normal interoception with overwhelming experiences of disembodiment in DPD. This may reflect difficulties of DPD patients to integrate their visceral and bodily perceptions into a sense of their selves. This problem may be considered an important target for psychotherapeutic treatment approaches.
Highlights
Depersonalization-derealization disorder (DPD, DSM-5: 300.6 [1]) is characterized by an impairment of self-awareness, mainly feelings of disembodiment and emotional numbing [2]
With regard to personality disorders, a common comorbid condition of depersonalization disorder (DPD) patients, a recent study found no differences between n = 24 patients with borderline-personality disorder and healthy controls concerning their performance on measures of interoceptive accuracy [38]. Against this background and with the above considerations in mind, we aimed to investigate for the first time interoceptive accuracy in a sample of DPD patients using a healthy comparison group free from ‘‘anomalous body experiences’’
Psychometric data of DPD patients and healthy controls DPD patients did not differ from healthy controls (HC) with regards to age and sex
Summary
Depersonalization-derealization disorder (DPD, DSM-5: 300.6 [1]) is characterized by an impairment of self-awareness, mainly feelings of disembodiment and emotional numbing [2]. DPD patients feel detached or as if being like an outside observer with respect to their sensations, actions, feelings and body. During these experiences reality testing remains intact, the symptoms are not attributable to direct effects of a substance or another medical condition and they are not better explained by another mental disorder [1]. Given the narratives of DPD patients about their disembodiment and emotional numbing and neurobiological findings of an inhibition of insular activity, DPD may be considered as a mental disorder with specific impairments of interoceptive awareness and body perception
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