Depersonalization Scale Research Articles

Unraveling the brain dynamics of Depersonalization-Derealization Disorder: a dynamic functional network connectivity analysis

BackgroundDepersonalization-Derealization Disorder (DPD), a prevalent psychiatric disorder, fundamentally disrupts self-consciousness and could significantly impact the quality of life of those affected. While existing research has provided foundational insights for this disorder, the limited exploration of brain dynamics in DPD hinders a deeper understanding of its mechanisms. It restricts the advancement of diagnosis and treatment strategies. To address this, our study aimed to explore the brain dynamics of DPD.MethodsIn our study, we recruited 84 right-handed DPD patients and 67 healthy controls (HCs), assessing them using the Cambridge Depersonalization Scale and a subliminal self-face recognition task. We also conducted a Transcranial Direct Current Stimulation (tDCS) intervention to understand its effect on brain dynamics, evidenced by Functional Magnetic Resonance Imaging (fMRI) scans. Our data preprocessing and analysis employed techniques such as Independent Component Analysis (ICA) and Dynamic Functional Network Connectivity (dFNC) to establish a comprehensive disease atlas for DPD. We compared the brain's dynamic states between DPDs and HCs using ANACOVA tests, assessed correlations with patient experiences and symptomatology through Spearman correlation analysis, and examined the tDCS effect via paired t-tests.ResultsWe identified distinct brain networks corresponding to the Frontoparietal Network (FPN), the Sensorimotor Network (SMN), and the Default Mode Network (DMN) in DPD using group Independent Component Analysis (ICA). Additionally, we discovered four distinct dFNC states, with State-1 displaying significant differences between DPD and HC groups (F = 4.10, P = 0.045). Correlation analysis revealed negative associations between the dwell time of State-2 and various clinical assessment factors. Post-tDCS analysis showed a significant change in the mean dwell time for State-2 in responders (t-statistic = 4.506, P = 0.046), consistent with previous clinical assessments.ConclusionsOur study suggests the brain dynamics of DPD could be a potential biomarker for diagnosis and symptom analysis, which potentially leads to more personalized and effective treatment strategies for DPD patients.Trial registrationsThe trial was registered at the Chinese Clinical Trial Registry on 03/01/2021 (Registration number: ChiCTR2100041741, https://www.chictr.org.cn/showproj.html?proj=66731) before the trial.

Clinical characteristics of 217 Chinese cases with depersonalization/derealization disorder

Depersonalization/derealization disorder (DPD) is a prevalent yet inadequately understood clinical condition characterized by a recurrent or persistent sense of unreality. This study aims to provide insight into DPD through descriptive and comparative analyses involving a large group of Chinese participants. The socio-demographic details (age, gender proportion, education, occupational status, marital status), depersonalized and dissociative symptom characteristics (symptomatic factors or subscales of the Cambridge Depersonalization Scale and the Dissociative Experiences Scale), development trajectory (age of onset, potential precipitating factors, course characteristics), treatment history (duration of delayed healthcare attendance, duration of delayed diagnosis, previous diagnoses), and adverse childhood experiences of the DPD patients are presented. Comparisons of anxiety and depressive symptoms, alongside psychosocial functioning, between DPD participants and those diagnosed with generalized anxiety disorder, bipolar disorders, and major depressive disorder were conducted. The analysis highlights a higher male preponderance and early onset of DPD, symptomatology marked by derealization, notable impairment in psychosocial functioning, and prolonged periods of delayed healthcare attendance and diagnosis associated with symptom severity. Furthermore, noteworthy relationships between adverse childhood experiences and symptom levels were identified. The findings substantiate the view that DPD is a serious but neglected mental disorder, urging initiatives to improve the current condition of DPD patients.

Treatment outcomes in the inpatient management of severe functional neurological disorder: a retrospective cohort study

BackgroundFunctional neurological disorder (FND) is a heterogeneous condition; severe forms can be disabling. Multidisciplinary treatment and rehabilitation are recommended for severe FND, but there remains a lack of evidence for...

Psychotic-like anomalous self-experiences in feeding and eating disorders: Their role in eating psychopathology through the mediation of body uneasiness and embodiment and identity disorders.

Psychotic-like anomalous self-experiences (ASEs) are core and early features of schizophrenia spectrum disorders, which have been recently also postulated to underlie embodiment disturbance in feeding and eating disorders (FEDs). The present study was aimed at investigating the interplay between ASEs and specific psychopathology in FED. Ninety persons with Anorexia Nervosa and 41 with Bulimia Nervosa were evaluated with the inventory of psychotic-like anomalous self-experiences (IPASE), identity and eating disorders (IDEA), body uneasiness test (BUT), and eating disorder examination questionnaire (EDE-Q). The same assessment was performed for 92 subjects recruited from the general population. Structural equation modelling was employed to test the role of embodiment/identity disorders in mediating the relationship between ASEs and ED psychopathology. Patients with FED displayed high scores on IPASE, comparable with people with schizophrenia spectrum disorders. A significant correlation was also demonstrated between IPASE, BUT and EDE-Q. All IPASE domains were strongly related to feeling extraneous from one's own body by IDEA. All IPASE domains demonstrated a high relationship with BUT Depersonalization scale. A strong correlation was also reported between total scores of IPASE and IDEA. The mediation model confirmed that ASEs impact on FED symptomatology through the mediation of both embodiment/identity disorders and body image. Anomalous interoceptive processes may represent the first step of a maladaptive process-impairing embodiment, selfhood, and identity in FED. Assessment of ASEs might be a valid tool to identify an early-shared vulnerability of severe disorders characterized by embodiment alterations.

Examining the association between depersonalisation traits and the bodily self in waking and dreaming

Depersonalisation (DP) is characterized by fundamental alterations to the sense of self that include feelings of detachment and estrangement from one’s body. We conducted an online study in healthy participants (n = 514) with DP traits to investigate and quantify the subjective experience of body and self during waking and dreaming, as the vast majority of previous studies focussed on waking experience only. Investigating dreams in people experiencing DP symptoms may help us understand whether the dream state is a ‘spared space’ where people can temporarily ‘retrieve’ their sense of self and sense of bodily presence. We found that higher DP traits—i.e. higher scores on the Cambridge Depersonalisation Scale (CDS)—were associated with more frequent dream experiences from an outside observer perspective (r = 0.28) and more frequent dream experiences of distinct bodily sensations (r = 0.23). We also found that people with higher CDS scores had more frequent dream experiences of altered bodily perception (r = 0.24), more frequent nightmares (r = 0.33) and higher dream recall (r = 0.17). CDS scores were negatively correlated with body boundary scores (r = − 0.31) in waking states and there was a negative association between CDS scores and the degree of trust in interoceptive signals (r = − 0.52). Our study elucidates the complex phenomenology of DP in relation to bodily selfhood during waking and dreaming and suggests avenues for potential therapeutic interventions in people with chronic depersonalisation (depersonalisation -derealisation disorder).

Unraveling the Complexity: Exploring the Intersection of Panic Disorder, Dissociation, and Complex Post-Traumatic Stress Disorder.

Patients with panic disorder (PD) may experience increased vulnerability to dissociative and anxious phenomena in the presence of repeated traumatic events, and these may be risk factors for the development of complex post-traumatic stress disorder (cPTSD). The present study aims to find out whether the presence of cPTSD exacerbates anxiety symptoms in patients suffering from panic disorder and whether this is specifically associated with the occurrence of dissociative symptoms. One-hundred-and-seventy-three patients diagnosed with PD were recruited and divided into two groups based on the presence (or absence) of cPTSD using the International Trauma Questionnaire (ITQ) scale. Dissociative and anxious symptoms were assessed using the Cambridge Depersonalization Scale (CDS) and Hamilton Anxiety Scale (HAM-A), respectively. Significant differences in re-experienced PTSD (p < 0.001), PTSD avoidance (p < 0.001), PTSD hyperarousal (p < 0.001), and DSO dysregulation (p < 0.001) were found between the cPTSD-positive and cPTSD-negative groups. A statistically significant association between the presence of cPTSD and total scores on the HAM-A (p < 0.001) and CDS (p < 0.001) scales was found using regression analysis. This study highlights the potential link between dissociative symptoms and a more severe clinical course of anxiety-related conditions in patients with PD. Early intervention programs and prevention strategies are needed.

MENTAL HEALTH SUPPORT FOR HIGHER EDUCATION STAFF IN TIMES OF CRISIS

The COVID-19 pandemic affected the mental health of higher education staff. Purpose: The aim of this study is to examine the impact of COVID-19 on the mental health of higher education staff. Materials and methods: The survey subjects were 165 university teachers of the Medical University in Varna. The following tools were used: a questionnaire to explore some aspects of the respondent's quality of life before and during the COVID-19 pandemic, HADS and the Maslach Burnout Inventory. Descriptive statistical methods, a t-test, correlation analysis, χ2 test and a multiple linear regression model were applied. SPSS version v.24.0 was used to process the survey data. The survey took place between October and December 2022. Results: The mean value on the anxiety scale was 5.61, SD = 4.027 and 3.62, SD = 3.39 on the depression scale. The mean score on the emotional exhaustion scale (ЕЕ) was 27.67. The mean in the depersonalization scale was 9.10, SD = 5.494. The personal accomplishment mean value was 44.78, SD = 8.006. The results from HADS depression and HADS anxiety showed a statistical significance for predicting the scores on the EE scale (β = 1.158, p = 0.0001 and β = 0.573, p = 0.021). The levels of stress before and during the pandemic had a statistically significant weak correlation with the EE scale. Conclusions: activities for general and selective prevention of occupational stress and burnout, based on stress-coping strategies, can be introduced in higher education.

Finding neural correlates of depersonalisation/derealisation disorder via explainable CNN-based analysis guided by clinical assessment scores

Mental health disorders are typically diagnosed based on subjective reports (e.g., through questionnaires) followed by clinical interviews to evaluate the self-reported symptoms. Therefore, considering the interconnected nature of psychiatric disorders, their accurate diagnosis is a real challenge without indicators of underlying physiological dysfunction. Depersonalisation/derealisation disorder (DPD) is an example of dissociative disorder affecting 1–2 % of the population. DPD is characterised mainly by persistent disembodiment, detachment from surroundings, and feelings of emotional numbness, which can significantly impact patients' quality of life. The underlying neural correlates of DPD have been investigated for years to understand and help with a more accurate and in-time diagnosis of the disorder. However, in terms of EEG studies, which hold great importance due to their convenient and inexpensive nature, the literature has often been based on hypotheses proposed by experts in the field, which require prior knowledge of the disorder. In addition, participants' labelling in research experiments is often derived from the outcome of the Cambridge Depersonalisation Scale (CDS), a subjective assessment to quantify the level of depersonalisation/derealisation, the threshold and reliability of which might be challenged. As a result, we aimed to propose a novel end-to-end EEG processing pipeline based on deep neural networks for DPD biomarker discovery, which requires no prior handcrafted labelled data. Alternatively, it can assimilate knowledge from clinical outcomes like CDS as well as data-driven patterns that differentiate individual brain responses. In addition, the structure of the proposed model targets the uncertainty in CDS scores by using them as prior information only to guide the unsupervised learning task in a multi-task learning scenario. A comprehensive evaluation has been done to confirm the significance of the proposed deep structure, including new ways of network visualisation to investigate spectral, spatial, and temporal information derived in the learning process. We argued that the proposed EEG analytics could also be applied to investigate other psychological and mental disorders currently indicated on the basis of clinical assessment scores. The code to reproduce the results presented in this paper is openly accessible at https://github.com/AbbasSalami/DPD_Analysis.

Cognitive Behaviour Therapy for Depersonalisation Derealisation Disorder (CBT-f-DDD): Study protocol for a randomised controlled feasibility trial.

Depersonalisation-Derealisation Disorder (DDD) is a distressing mental health condition which causes individuals to have a sense of 'unreality' or detachment about themselves and/or the world around them. DDD is chronically under-researched, and as a result, under-diagnosed, with a population prevalence of about 1%. In systematic reviews, Cognitive Behavioural Therapy (CBT) has been found to be the only intervention with significant clinical impact on alleviating the symptoms of DDD. However, previous studies have suffered from small sample sizes, reliance on expert clinicians to provide therapy and narrow population demographics. This feasibility randomised controlled trial aims to provide more robust evidence for the treatment efficacy of CBT in DDD. The study aims to recruit 40 participants from two NHS trusts, 20 per arm from two community Mental Health NHS services in London. The intervention group will receive 12-24 individual CBT sessions over a 6-month period from CBT therapists following specialist training for DDD. The control group will receive Treatment as Usual. We will assess the feasibility of a future RCT through measuring the acceptability of the intervention, and assessing our ability to recruit, retain and randomise participants. We will calculate the correlation of scores on the Cambridge Depersonalisation Scale, its baseline standard deviation, assess the magnitude/direction of change and characterise the uncertainty in the outcome scores and the probability that the results have been obtained by chance. The outputs of this trial will guide whether a definite RCT is feasible and acceptable, for both the clinician and participant. The ISRCTN registration number is ISRCTN97686121(https://doi.org/10.1186/ISRCTN97686121).

Optimised Multi-Channel Transcranial Direct Current Stimulation (MtDCS) Reveals Differential Involvement of the Right-Ventrolateral Prefrontal Cortex (rVLPFC) and Insular Complex in those Predisposed to Aberrant Experiences

Research has shown a prominent role for cortical hyperexcitability underlying aberrant perceptions, hallucinations, and distortions in human conscious experience – even in neurotypical groups. The rVLPFC has been identified as an important structure in mediating cognitive affective states / feeling conscious states. The current study examined the involvement of the rVLPFC in mediating cognitive affective states in those predisposed to aberrant experiences in the neurotypical population. Participants completed two trait-based measures: (i) the Cortical Hyperexcitability Index_II (CHi_II, a proxy measure of cortical hyperexcitability) and (ii) two factors from the Cambridge Depersonalisation Scale (CDS). An optimised 7-channel MtDCS montage for stimulation conditions (Anodal, Cathodal and Sham) was created targeting the rVLPFC in a single-blind study. At the end of each stimulation session, participants completed a body-threat task (BTAB) while skin conductance responses (SCRs) and psychological responses were recorded. Participants with signs of increasing cortical hyperexcitability showed significant suppression of SCRs in the Cathodal stimulation relative to the Anodal and sSham conditions. Those high on the trait-based measures of depersonalisation-like experiences failed to show reliable effects. Collectively, the findings suggest that baseline brain states can mediate the effects of neurostimulation which would be missed via sample level averaging and without appropriate measures for stratifying individual differences.

Assessment of Occupational Burnout And Its Determinants, Causes of Occupational Stress, And Its Coping Strategies Among Nurses Working In The Psychiatric Wards: A mixed-method study

Aims: This study assessed occupational burnout and its determinants, causes of occupational stress, and its coping strategies amongst 13 nurses working in the psychiatry wards in India. Methods: This was a longitudinal mixed-method study. The qualitative component comprised interviewing each participant under the steps of “free listing” and “pile sorting” to assess the causes of occupational stress and its coping strategies. The occupational burnout experiences were assessed using the Maslach Burnout Inventory. Results: Low-level depersonalization scores were present among six (46.1%) participants. Scores under this component of burnout were negatively correlated with years of work experience in providing nursing care for admitted psychiatric patients (rs = -0.548, p=0.05). Median scores of the emotional exhaustion scale (p=0.047) and of the depersonalization scale (p=0.016) were significantly higher among participants working at the government hospital. The major cause of occupational stress was poor infrastructure and treatment facilities with a salience score of 0.154. The most adopted strategies to tide over occupational stress were reading books and meditation with a salience score of 0.128 and 0.109 respectively. Conclusion: Extended work experience of participants was associated with their better ability to understand and empathize more with the patients as reflected by the low depersonalization scores. Two components of occupational burnout were found to be higher among nurses working in the government hospital. Organizational relationships were a more common cause of occupational stress than client-related matters among the participants. Recreational activities were the most common coping strategies adopted by the participants to deal with stress.

Cognitive Behaviour Therapy (CBT) for Depersonalization Derealization Disorder (DDD): a self-controlled cross-over study of waiting list vs. active treatment

ABSTRACT Depersonalisation-Derealisation Disorder (DDD) has a prevalence of around 1% but is under-recognised and often does not respond to medical intervention. We report on a clinical audit of 36 participants with a diagnosis of chronic DDD who were sequentially recruited from a specialist DDD National Health Service clinic in London, United Kingdom, and who completed Cognitive Behavioural Therapy specifically adapted for DDD. The sample population had a mean age of 38.7 years (s.d. = 13.4), 61% were male and 69% were of White ethnicity. Three outcomes were assessed (Cambridge Depersonalisation Scale [CDS], Beck Depression Inventory [BDI], and the Beck Anxiety Inventory [BAI]) at three time points in a naturalistic, self-controlled, cross-over design. Hierarchical longitudinal analyses for outcome response clustered by patient were performed using scores from baseline, beginning, and end of therapy. All scores showed improvement during the treatment period, with medium effect sizes. CBT may be an effective treatment for DDD. However, treatment was not randomly assigned, and the sample was small. More research is needed, including the use of randomisation to assess the efficacy of CBT for DDD.

Определение группы риска профессионального выгорания для преподавателей высшей школы

The level of professional emotional burnout of teachers of higher education was studied to identify those most at risk. The technique of K. Maslach and S. Jackson was used, as well as an integral indicator — a systemic index of burnout syndrome. Statistical methods for processing the observation results were used. The sample consisted of 60 people (teachers from two universities in Smolensk: Smolensk State University — 30 people and Smolensk State Medical University — 30 people). The samples of the two universities did not differ significantly in terms of age, length of service, and gender. The study period is April–July 2022. As a result of the study, it was found that, in general, the level of professional burnout of city teachers is average. According to the scales of professional burnout (emotional exhaustion, depersonalization, reduction of personal achievements), there are some differences between universities. So the level of depersonalization of the teaching staff of the medical university is low. A correlation analysis of the levels of professional burnout scales based on the signs: gender, age and length of service were carried out. It has been established that the level of emotional exhaustion of higher school teachers depends on gender: men are more likely to have high and medium levels compared to women. Models for determining risk groups for professional burnout have been developed. The risk of professional burnout according to the depersonalization scale is characteristic of men under the age of 50 and less than 10 years of work experience. This category of faculty is recommended to be allocated to the risk group of professional burnout in order to carry out further measures to prevent and reduce it.

Online structured dance/movement therapy reduces bodily detachment in depersonalization-derealization disorder

BackgroundDepersonalization-derealization disorder (DDD) is a dissociative disorder encompassing pronounced disconnections from the self and from external reality. As DDD is inherently tied to a detachment from the body, dance/movement therapy could provide an innovative treatment approach. Materials and methodsWe developed two online dance tasks to reduce detachment either by training body awareness (BA task) or enhancing the salience of bodily signals through dance exercise (DE task). Individuals with DDD (n = 31) and healthy controls (n = 29) performed both tasks individually in a cross-over design. We assessed symptom severity (Cambridge Depersonalization Scale), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness – II), mindfulness (Five Facet Mindfulness Questionnaire), and body vigilance (Body Vigilance Scale) before, during and after the tasks. ResultsAt baseline, individuals with DDD exhibited elevated depersonalization-derealization symptoms alongside lower levels of interoceptive awareness and mindfulness compared to controls. Both tasks reduced symptoms in the DDD group, though dance exercise was perceived as easier. The DE task increased mindfulness in those with DDD more than the BA task, whereas controls showed the opposite pattern. In the DDD group, within-subject correlations showed that lower levels of symptoms were associated with task-specific elevations in interoceptive awareness and mindfulness. ConclusionIndividual and structured dance/movement practice, performed at home without an instructor present, offers an effective tool to reduce symptoms in DDD and can be tailored to address specific cognitive components of a mindful engagement with the body.

Burnout levels of the intensive care unit team during extended COVID-19 outbreak and affecting factors

Introduction: This study aimed to determine how intensive care workers are affected by the pandemic period and the factors affecting burnout.&#x0D; Methods: 45assistants, 76nurses and 40specialists working in a tertiary intensive care unit(ICU) with 70 covid-beds participated in the study. Responses were collected through a website(www.surveymonkey.com).&#x0D; Results:&#x0D; The mean age of the respondents was 34.4±8.6 years, and the mean years of experience were 9.4±8.2. The general Emotional Exhaustion(EE), Depersonalization(DP), Reduced Personal Achievement(RPA) scores of the ICU workers were calculated as 20.7, 8.4 and 20.1 and the general arithmetic mean of the burnout scores was 49.1. It was found that the assistant doctors(AD) group had a statistically significantly higher risk in the EE and DP scales. (p=0,016 p&lt;0,001). It was found that the risk of EE was higher in AD Group without child.&#x0D; Considering the satisfaction correlation of the scales, The rate of dissatisfaction was found statistically significantly higher in the intensive care nurses(ICN) group than AD and specialist doctors(SD) groups (p&lt;0,001).&#x0D; Considering the factors affecting burnout, a statistically significant negative correlation was found between EE and ‘Appreciation at work during the pandemic period’ and ‘Adequacy of physical conditions’ in the SD group (p=0,005 p=0,044). There was a statistically significant negative correlation between RPA and being married in the AD group (p=0,023). A statistically significant negative correlation was found between DP and having a child in the ICN group (p=0,032).&#x0D; Conclusion: It is of importance to reveal the causes of burnout during the pandemic, and to make arrangements&#x0D; Keywords: COVID-19, Intensive Care Unit, Assistant Doctor, Specialist Doctor, Burnout Burnout

OCCUPATIONAL BURNOUT SYNDROME AMONG COMMUNITY PHARMACISTS DURING COVID-19 PANDEMIC

Introduction: The community pharmacy is the most accessible medical facility in the current healthcare system. Therefore, the expectations from pharmacists as the most accessible healthcare professionals are constantly rising. However, various studies indicate that pharmacists are subject to very high levels of occupational stress and professional burnout is common.&#x0D; The COVID-19 pandemic has posed new challenges to the work organisation in pharmacies and demand for an adequate reorganisation. In addition, it forced pharmacists to quickly adapt to the new circumstances and requirements and further increased occupational stress. &#x0D; Objective: To establish the level of occupational burnout among community pharmacists during COVID-19.&#x0D; Materials and Methods: An anonymous questionnaire survey was conducted among 127 pharmacists working in community pharmacies in Varna, Bulgaria. The study period was from March 2021 to October 2021. The questionnaire consisted of two parts; the first one was based on the specialised Maslach Burnout Inventory (MBI-HSS) tool, assessing professional burnout in terms of emotional exhaustion, depersonalisation, and personal accomplishment; the second one collected data about the demographic characteristics of the respondents, including their job position, pharmacy type (an independent pharmacy or a pharmacy chain) and information on specific problems during COVID-19.&#x0D; Results: The identified mean values in the group of respondents were as follows: emotional exhaustion M=23.39 (SD 9,298), depersonalisation M=12.37 (SD 6,426), professional achievements M=31.25 (SD 7,531). The sample mean values that stood out were in the depersonalisation scale М=12.37, which is considered a high value. A statistically significant difference was found in the different age groups on the depersonalisation scale (F=3,957, p=0,022). There was a statistically significant difference between the arithmetic mean values for the age groups 25-40 years (M=13.75) and over 55 years (M=9.86).&#x0D; Conclusion: Based on the statistical differences for depersonalisation among pharmacists in different age groups, it can be concluded that young pharmacists do not express empathy while providing pharmaceutical care services.

The Multidimensional Inventory of Dissociation (MID) in Depersonalization Disorder: General Findings with a Clinical Emphasis on Memory and Identity Disturbances

ABSTRACT The Multidimensional Inventory of Dissociation (MID) was administered to 23 participants diagnosed with DSM-IV-TR Depersonalization Disorder (DDD) by structured interview. The MID has not been previously examined in DDD and does not generate a diagnostic formula for the disorder. Mean MID score for the sample was modestly elevated at 18.54, and was significantly correlated with Dissociative Experiences Scale, Cambridge Depersonalization Scale, and Childhood Trauma Questionnaire scores. Criterion A (General Dissociation) Depersonalization and Depersonalization scale scores were markedly elevated (41.70 and 40.98 respectively), followed by moderate elevations in the Identity Confusion (36.01), Trance (25.44), and Memory Problems (23.30) scales. Criterion B (Intrusions from partly dissociated self-states) mean score was modestly elevated (19.13) and declined to 13.67 once items overlapping with the Depersonalization and Identity Confusion scales were excluded. Criterion C (fully dissociated manifestations of other self-states) mean score was minimally elevated (6.57). Of the 168 pathological dissociation items, 55 were clinically elevated in DDD. Closer examination of the Intrusions and Amnesia items that were modestly elevated in DDD revealed that these items did not reflect the presence of alters, but rather represented known depersonalization-related phenomena. We propose a preliminary formula, based on cutoff scores for Criterion A Depersonalization and/or Derealization, Criterion B, and Criterion C (≥20, ≤28, ≤11) for the sensitive diagnosis of DDD (82.6% of participants), which would require future investigation for replication and determination of specificity vis-à-vis the other dissociative disorders.

Top-Down Influence Leads to a Reduced Sense of Body Ownership in Individuals With Depersonalization Tendencies: A Focus on Full Body Illusion.

Sense of body ownership, that is, the feeling that “my body belongs to me,” has been examined by both the rubber hand illusion (RHI) and full body illusion (FBI). In a study that examined the relationship between RHI and depersonalization, a symptom in which people experience a lower sense of body ownership, people with a high depersonalization tendency experienced RHI through the bottom-up process of visual-tactile integration. Why is it that people with depersonalization feel a lower sense of body ownership over their bodies? Case studies of depersonalization suggest that the top-down cognition in people with depersonalization may make them less likely to feel a sense of body ownership. However, the top-down influence on the sense of body ownership in depersonalization has not yet been experimentally demonstrated. By incorporating top-down manipulation (e.g., instructing participants to regard a fake body as their own) into the FBI procedure, we aimed to clarify the cause of the reduced sense of body ownership in people with a high depersonalization tendency. The FBI procedure was conducted in a virtual reality environment using an avatar as a fake body. The avatar was presented from a third-person perspective, and visual-tactile stimuli were presented to create an illusion. To examine the degree of illusion, we measured the skin conductance responses to the fear stimulus presented after the visual-tactile stimuli presentation. The degree of depersonalization was measured using the Japanese version of the Cambridge Depersonalization Scale. To manipulate the top-down influence, we provided self-association instructions before the presentation of the visual-tactile stimuli. We predicted that the higher the degree of depersonalization, the lower the degree of illusion in the self-association instruction. The results showed that participants with a higher depersonalization tendency had a lower degree of illusion (rho = −0.424, p = 0.035) in the self-association condition. This indicates that in people with a high depersonalization tendency, top-down cognition of the body as their own leads to a decrease in the sense of body ownership.

Psychological aspects of body perception in depression with non-suicidal self-injury

IntroductionEmotional regulation appears to be a key factor in self-injury. But body image also may play an important role in self-harming.ObjectivesAnalysis of the relationship between non-suicidal self-injurious behavior and various aspects of body representation and body perception in adolescents and young women suffering from depression.MethodsThe study involved 85 women with endogenous depression. The answer to the question “Sometimes I purposely injure myself” was used as an indicator of self-harm. The methods include: SCL-90-R, Body Investment Scale (BIS), Physical Appearance Comparison Scale-Revised (PACS-R), Body Satisfaction Scale (BSS), Cambridge Depersonalization Scale (CDS).ResultsThe relationship between self-injurious behavior and emotional, cognitive and behavioral characteristics of the self-body perception was revealed: more negative body image - dissatisfaction with its parts and the whole body (correlation with BSS_head ,238*, BSS_body ,472**, BSS_total_score ,453**), which is accompanied by behavioral manifestations - reduced “Protection” (correlation with BIS -,281**), higher rates of self-surveillance and comparisons of the self-body with others (PACS-R ,323**), depersonalization (CDS ,301**), body dissociation (CDS ABE ,346**), somatization (SCL-90-R ,226*).ConclusionsFor young women with depression, it has been shown that when self-harming, the self-body is “devalued”, perceived as “bad,” and the need to protect it is ignored. The severity of self-harm directly correlates with the phenomena of somatopsychic depersonalization. The results obtained may indicate that rejection of the self-body, “alienated” attitude and deprivation of the body of “subjectivity” can contribute to its use as a tool for solving psychological problems, which is a risk factor for the development, consolidation and aggravation of self-injurious behavior.DisclosureNo significant relationships.

Burnout among early career psychiatrists in Russia – results of a cross-sectional study

IntroductionDespite the long history of burnout studies, the problem of burnout among psychiatric specialists in Russia is insufficiently studied. The risk of burnout is the highest among psychiatrists in the first 10 years of their career.ObjectivesTo assess the prevalence and severity of burnout in early career psychiatrists (ECPs) in Russia.MethodsAn anonymous online survey of ECPs in Russia was conducted in July-August 2019 with a screening for burnout using the Maslach Burnout Inventory (MBI). The final sample consisted of 165 people (61.2% women; mean age 31.05±3.88). 95.2% of respondents lived in urban areas.ResultsA high level of burnout according to at least one of the MBI scales was revealed in 71.5% of ECPs: in 79 (78.2%) women and 39 (60.9%) men (χ2(1)=5.74; p=0.017). Mean values of the MBI Emotional Exhaustion scale corresponded to 23.33±8.97 and 17.97±8.49 (U=1999.5; p=0.003), the MBI Depersonalization scale – 10.46±4.81 and 9.16±4.22 (U=2598.5; p=0.083), and the MBI Personal Accomplishment scale – 33.02±5.98 and 35.32±5.75 (U=2409.5; p=0.026) for women and men, respectively. The following risk factors for professional burnout were identified: female sex (OR=3.54 [95% CI: 1.96; 6.39], p&lt;0.001), overlapping of several working positions (OR=2.44 [95% CI: 1.36; 4.37], p=0.003), difficulties in work due to changes in documentation requirements introduced since the start of career (OR=2.32 [95% CI: 1.31; 4.11], p=0.004).ConclusionsA high frequency of burnout among ECPs in Russia was revealed which suggests the urgent need for studies assessing the ways to prevent burnout in psychiatrists in Russia.DisclosureNo significant relationships.