Depersonalization disorder: thinking without feeling

Area of Science:

• Neuroscience
• Psychiatry
• Psychology

Background:

• Depersonalization disorder (DP) is characterized by a persistent feeling of detachment from oneself and surroundings.
• Emotional detachment is a common symptom, impacting patients' subjective experience of emotions.
• Understanding the neural underpinnings of this emotional detachment is crucial for developing effective treatments.

Purpose of the Study:

• To investigate the neural correlates of emotional processing in patients with depersonalization disorder.
• To compare brain activity in DP patients versus psychiatric (OCD) and healthy controls when viewing emotionally salient stimuli.
• To identify brain regions associated with the absent subjective experience of emotion in DP.

Main Methods:

• Functional magnetic resonance imaging (fMRI) was used to measure brain activity.
• Participants included patients with DP, patients with obsessive-compulsive disorder (OCD), and healthy controls.
• Standardized aversive and neutral scene images were presented, followed by subjective emotional ratings.

Main Results:

• DP patients exhibited significantly reduced activation in emotion-sensitive regions (insula, occipito-temporal cortex) compared to controls when viewing aversive scenes.
• In DP patients, aversive scenes activated the right ventral prefrontal cortex, a region associated with emotion regulation.
• The insula, crucial for disgust perception, was activated only by neutral scenes in DP patients, unlike in control groups.

Conclusions:

• The absent subjective experience of emotion in depersonalization disorder is associated with diminished neural responses in key emotion-processing areas.
• Increased activation in emotion regulation regions suggests a compensatory mechanism in DP patients.
• These findings highlight altered neural processing of emotional stimuli as a core feature of depersonalization disorder.