Understanding the brain correlates of dissociative disorders

Understanding the brain correlates of dissociative disorders

Trauma can cause dissociative symptoms – such as: Some symptoms, such as an out-of-body experience or emotional numbness, may help a person cope in the short term, but can have negative effects if symptoms persist over a longer period of time.

In a new study published recently in Neuropsychopharmacology, a team led by researchers at McLean Hospital, the largest psychiatric affiliate of Harvard Medical School and a member of Mass General Brigham, identified regions within brain networks that communicate with each other when people experience different types of dissociative symptoms.

Dissociation and severe dissociative disorders such as dissociative identity disorder or ‘DID’ are underestimated at best and often undiagnosed or misdiagnosed at worst.”

Lauren AM Lebois, PhD, Co-Lead Author, Director, Dissociative Disorders and Trauma Research Program

"The costs of this stigma and misdiagnosis are high - they have prevented people from accessing appropriate and effective treatment, caused prolonged suffering, and inhibited research into dissociation. Additionally, because DID disproportionately affects women, gender inequality is an important issue in this context."

The study by Lebois and her colleagues included 91 women with and without a history of childhood trauma, current post-traumatic stress disorder and with a variety of dissociative symptoms. The participants completed a functional magnetic resonance imaging scan so researchers could gain insight into their brain activity.

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“The novel methods we used to study brain connectivity are critical to understanding the role these network disruptions play in dissociative disorders,” said co-senior author Lisa D. Nickerson, PhD, director of the Applied Neuroimaging Statistics Lab at McLean Hospital.

The scientists found that various dissociative symptoms are clearly associated with connections between areas in brain networks responsible for cognition and emotion processes. “We found that dissociation, which is typical of post-traumatic stress disorder, and dissociation, which is central to DID, are each associated with unique brain signatures,” Lebois said.

The team hopes that a better understanding of the brain correlates of dissociation will help correct historical misconceptions about dissociation and DID, destigmatize these experiences and help reduce gender health disparities.

“We also hope that it will increase awareness of dissociative symptoms – and that clinicians will ultimately be more likely to pay attention to and consider these symptoms and connect patients with timely and appropriate treatment,” said co-senior author Milissa Kaufman. MD, PhD, Director of the Dissociative Disorders and Trauma Research Program.

It's important to note that the unique brain signatures of different dissociative symptoms may point to new therapies, the study authors said. “In the future, we may target brain activity associated with dissociation as a standalone treatment,” said co-author Kerry J. Ressler, MD, PhD, McLean’s chief scientific officer.

Source:

McLean Hospital

Reference:

Lebois, L.A.M. et al. (2022) Deconstructing dissociation: a triple network model of trauma-related dissociation and its subtypes. Neuropsychopharmacology. doi.org/10.1038/s41386-022-01468-1.

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