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Introduction Depersonalization/derealization disorder (DPD) is a dissociative disorder (1) estimated to affect 1%-2% of the general population. (2) However, a German study found a 12-month prevalence of 0.007 based on [...], Background: Depersonalization/derealization disorder (DPD) is a chronic and distressing condition characterized by detachment from oneself and/or the external world. Neuroimaging studies have associated DPD with structural and functional alterations in a variety of distinct brain regions. Such local neuronal changes might be mediated by altered interregional white matter connections. However, to our knowledge, no research on network characteristics in this patient population exists to date. Methods: We explored the structural connectome in 23 individuals with DPD and 23 matched, healthy controls by applying graph theory to diffusion tensor imaging data. Mean interregional fractional anisotropy (FA) was used to define the network weights. Group differences were assessed using network-based statistics and a link-based controlling procedure. Results: Our main finding refers to lower FA values within left temporal and right temporoparietal regions in individuals with DPD than in healthy controls when using a link-based controlling procedure. These links were also associated with dissociative symptom severity and could not be explained by anxiety or depression scores. Using network-based statistics, no significant results emerged. However, we found a trend for 1 subnetwork that may support the model of frontolimbic dysbalance suggested to underlie DPD symptomatology. Limitations: To ensure ecological validity, patients with certain comorbidities or psychotropic medication were included in the study. Confirmatory replications are necessary to corroborate the results of this explorative investigation. Conclusion: In patients with DPD, the structural connectivity between brain regions crucial for multimodal integration and emotion regulation may be altered. Aberrations in fibre tract communication seem to be not solely a secondary effect of local grey matter volume loss, but may present a primary pathophysiology in patients with DPD.

Introduction Depersonalization disorder (DPD), classified as a dissociative disorder in DSM-5, is characterized by symptoms of detachment from one's mental processes, disembodiment, emotional numbing and derealization. Reality testing remains intact, [...], Background: To our knowledge, no whole brain investigation of morphological aberrations in dissociative disorder is available to date. Previous region-of-interest studies focused exclusively on amygdalar, hippocampal and parahippocampal grey matter volumes and did not include patients with depersonalization disorder (DPD). We therefore carried out an explorative whole brain study on structural brain aberrations in patients with DPD. Methods: We acquired whole brain, structural MRI data for patients with DPD and healthy controls. Voxel-based morphometry was carried out to test for group differences, and correlations with symptom severity scores were computed for grey matter volume. Results: Our study included 25 patients with DPD and 23 controls. Patients exhibited volume reductions in the right caudate, right thalamus and right cuneus as well as volume increases in the left dorsomedial prefrontal cortex and right somatosensory region that are not a direct function of anxiety or depression symptoms. Limitations: To ensure ecological validity, we included patients with comorbid disorders and patients taking psychotropic medication. Conclusion: The results of this first whole brain investigation of grey matter volume in patients with a dissociative disorder indentified structural alterations in regions subserving the emergence of conscious perception. It remains unknown if these alterations are best understood as risk factors for or results of the disorder.

Introduction Emotions are proposed to involve a 'person-situation interaction that engages attention, has meaning to an individual, and causes a coordinated yet malleable multisystem response to the interaction,' (1) including [...], Background: In healthy individuals, voluntary modification of self-relevance has proven effective in regulating subjective emotional experience as well as physiologic responses evoked by emotive stimuli. As social anxiety disorder (SAD) is characterized by both altered emotional and self-related processing, we tested if emotion regulation through self-focused reappraisal is effective in individuals with SAD. Methods: While undergoing 3 T functional magnetic resonance imaging, individuals with SAD and matched healthy controls either passively viewed neutral and aversive pictures or actively increased or decreased their negative emotional experience through the modification of self-relevance or personal distance to aversive pictures. Participants rated all pictures with regard to the intensity of elicited emotions and self-relatedness. Results: We included 21 individuals with SAD and 23 controls in our study. Individuals with SAD reported significantly stronger emotional intensity across conditions and showed a nonsignificant tendency to judge pictures as more self-related than controls. Compared with controls, individuals with SAD showed an overactivation in bilateral temporoparietal regions and in the posterior midcingulate cortex during the passive viewing of aversive compared with neutral pictures. During instructed emotion regulation, activation patterns normalized and no significant group differences were detected. Limitations: As no positive pictures were presented, results might be limited to the regulation of negative emotion. Conclusion: During passive viewing of aversive images, individuals with SAD showed evidence of neural hyperreactivity that may be interpreted as increased bodily self-consciousness and heightened perspective-taking. During voluntary increase and decrease of negative emotional intensity, group differences disappeared, suggesting self-focused reappraisal as a successful emotion regulation strategy for individuals with SAD.

Describing, understanding, and explaining subjective experience in depression is a great challenge for psychopathology. Attempts to uncover neurobiological mechanisms of those experiences are in need of theoretical concepts that are able to bridge phenomenological descriptions and neurocognitive approaches, which allow us to measure indicators of those experiences in quantitative terms. Based on our own ongoing work with patients who sufferfrom depersonalization disorder (DPD) and describe their experience as flat and detached from self body, and world, we introduce the idea of phenomenal depth as such a concept. Phenomenal depth is conceptualized as a dimension inherent to all experiences, describing the relatedness of one's self with one's mental processes, body, and the world. More precisely, ii captures the experience of this relatedness and embeddedness of one's experiences, and it is thus a metaor secondorder experience. The psychopathology of DPD patients can be understood very generally as an instance of reduced phenomenal depth. We will argue that similar experiences in depression can also be understood as a reduction in phenomenal depth. We relate those ideas to neurocognitive studies of perception, emotion regulation, and the idea ofpredictive coding. Finally, we will speculate about possible neurobiological underpinnings of the dimension of phenomenal depth. [ABSTRACT FROM AUTHOR]