Emotional response in depersonalization: A systematic review of electrodermal activity studies

Depersonalization is a complex phenomenological experience initially described as a psychological disturbance of self-awareness. Among the different dimensions underlying depersonalization, emotional numbing appears to be a key symptom but remains a poorly understood phenomenon.

We conducted a systematic review, following PRISMA guidelines, of studies investigating electrodermal activity, a well-documented marker of bodily arousal expression of emotion. Studies were selected from the PubMed, Scopus, Web of Science and PsychINFO databases.

Among the 64 studies initially identified, 11 were finally included, involving 148 patients with depersonalization disorder and 173 healthy subjects for whom depersonalization symptoms were assessed. The main results of these studies suggest that depersonalization is marked by a high skin conductance level and attenuated skin conductance responses to negative stimuli.

Due to discrepancies in methodology, we were not able to conduct quantitative analyses. Moreover, the studies included had limited sample sizes, restricting the generalizability of the results.

Though further evidence is required, it appears from electrodermal studies that depersonalization is associated with hypervigilance and emotional detachment during threatening situations. However, because emotional numbing might not be restricted to negative events, we proposed perspectives for future research, stressing the need to explore emotional responses of patients with depersonalization to positive situations.