Psychobiological characteristics of dissociative identity disorder: a symptom provocation study
Abstract
Background Dissociative identity disorder (DID) patients function as two or more identities or dissociative identity states (DIS), categorized as 'neutral identity states' (NIS) and 'traumatic identity states' (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. We tested whether these DIS show different psychobiological reactions to trauma-related memory. Methods A symptom provocation paradigm with 11 DID patients was used in a two-by-two factorial design setting. Both NIS and TIS were exposed to a neutral and a trauma-related memory script. Three psychobiological parameters were tested: subjective ratings (emotional and sensori-motor), cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with H(2)(15)O positron emission tomography. Results Psychobiological differences were found for the different DIS. Subjective and cardiovascular reactions revealed significant main and interactions effects. Regional cerebral blood flow data revealed different neural networks to be associated with different processing of the neutral and trauma-related memory script by NIS and TIS. Conclusions Patients with DID encompass at least two different DIS. These identities involve different subjective reactions, cardiovascular responses and cerebral activation patterns to a trauma-related memory script.
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In comparison to the TIS, the NIS is thought to act as a protective state, avoiding access or response to traumatic memories, a process that may render the NIS amnesic for these memories.
“In comparison to the TIS, the NIS is thought to act as a protective state, avoiding access or response to traumatic memories (Reinders et al., 2006), a process that may render the NIS amnesic for these memories.”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Reinders et al., 2006
Reinders et al. (2006) reported increased activation of brain areas involved in somatosensory processes and negative emotional states (e.g., insular cortex) when the trauma identity state was presented with a traumatic memory script as compared to a neutral memory script; no such difference was reported for the neutral identity state.
“Reinders et al. (2006) reported increased activation of brain areas involved in somatosensory processes and negative emotional states (e.g., insular cortex) when the trauma identity state was presented with a traumatic memory script as compared to a neutral memory script; no such difference was reported for the neutral identity state.”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Reinders et al., 2006
Differences in psychophysiological and neural functioning between states when processing traumatic or emotional stimuli support the authenticity of DID patients' subjective reports of autobiographical memory deficits.
“differences in psychophysiological and neural functioning between states when processing traumatic or emotional stimuli (e.g., Reinders et al., 2006Reinders et al., , 2014) ) support the authenticity of DID patients' subjective reports of autobiographical memory deficits.”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Reinders et al., 2006
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References 89 · Cited by 196
- Authors
- Reinders, A. A. T. S., Nijenhuis, E. R. S., Quak, J., Korf, J., Haaksma, J., Paans, A. M. J., Willemsen, A. T. M., & den Boer, J. A.
- Affiliations
- University Medical Center Groningen (NL)
- GGZ Drenthe (NL)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2006-10
- Volume
- 60
- Issue
- 7
- Pages
- 730-740
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2076940039
- Cited by
- 196
- References
- 89
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 9 · 2023: 8 · 2022: 8 · 2021: 4 · 2020: 4 · 2019: 8 · 2018: 13 · 2017: 13 · 2016: 12 · 2015: 14 · 2014: 20 · 2013: 12 · 2012: 13
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
- Keywords
- dissociative identity disorder, symptom provocation, heart rate, blood pressure, heart rate variability, regional cerebral blood flow, emotional reactivity, artificial neural networks
- MeSH terms
- Adult, Brain Mapping, Cerebral Cortex, Cerebrovascular Circulation, Female, Humans, Imagination, Memory, Middle Aged, Dissociative Identity Disorder, Radionuclide Imaging, Mental Recall, Repression, Psychology, Principal Component Analysis
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