Cited by 116Psychosomatic Disorders and Their TreatmentsPsychoanalysis and Psychopathology ResearchMental Health and Psychiatry

Biomarkers of Pathological Dissociation: A Systematic Review

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Roydeva, Monika I., Reinders, Antje A.T.S.·2021·Neuroscience & Biobehavioral Reviews

Abstract

Pathological dissociation is a severe, debilitating and transdiagnostic psychiatric symptom. This review identifies biomarkers of pathological dissociation in a transdiagnostic manner to recommend the most promising research and treatment pathways in support of the precision medicine framework. A total of 205 unique studies that met inclusion criteria were included. Studies were divided into four biomarker categories, namely neuroimaging, psychobiological, psychophysiological and genetic biomarkers. The dorsomedial and dorsolateral prefrontal cortex, bilateral superior frontal regions, (anterior) cingulate, posterior association areas and basal ganglia are identified as neurofunctional biomarkers of pathological dissociation and decreased hippocampal, basal ganglia and thalamic volumes as neurostructural biomarkers. Increased oxytocin and prolactin and decreased tumor necrosis factor alpha (TNF-α) are identified as psychobiological markers. Psychophysiological biomarkers, including blood pressure, heart rate and skin conductance, were inconclusive. For the genetic biomarker category studies related to dissociation were limited and no clear directionality of effect was found to warrant identification of a genetic biomarker. Recommendations for future research pathways and possible clinical applicability are provided.

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Crossref · 10.1016/j.neubiorev.2020.11.019

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  • Three neuromodulatory and neurotransmitter systems may play a role in generating dissociative experiences.

    “In this section, we briefly overview three neuromodulatory and neurotransmitter systems that may play a role in generating dissociative experiences (see [105–107] for reviews, and [108] for recent discussion).”

    From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [106]

    Section 4.5.1 (page unavailable) reviews associations between dissociative symptoms and several neurochemical measures, including oxytocin, norepinephrine, and glutamate. That supports a possible neurochemical role, but the review does not identify three neuromodulatory or neurotransmitter systems as generating dissociative experiences; its findings concern biomarkers and associations. (LLM, conf=0.77)

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  • A recent extensive systematic review confirmed the present findings, citing inconclusive results due to most studies reporting no effects.

    “This review confirmed our findings, citing inconclusive results due to most studies reporting no effects.”

    From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Roydeva & Reinders, 2021

    Section 4.5 (page not available) reports mixed findings and says most studies found no correlation between psychophysiological responses and dissociative symptoms; null findings were also most frequent in the genetic studies. But this does not establish that most studies across the entire review found no effects. Section 4.6.2 says the authors found some convergence and proposed diagnostic biomarkers, so the claim overgeneralizes the review’s conclusions. (LLM, conf=0.84)

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  • The authors of that review concluded that none of the reviewed physiological measures could be recommended as a biomarker of pathological dissociation.

    “The authors further concluded that none of the reviewed physiological measures could be recommended as a biomarker of pathological dissociation (Roydeva & Reinders, 2021).”

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1 retracted

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1 of the 350 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Farina, B., Liotti, G., 2013. Does a dissociative psychopathological dimension exist? A review on dissociative processes and symptoms in developmental trauma spectrum disorders. Clin. Neuropsychiatry 10, 11-18.

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Authors
Roydeva, M. I., & Reinders, A. A. T. S.
Affiliations
King's College London (GB)
Corresponding author
Reinders, Antje A.T.S.
Venue
Neuroscience & Biobehavioral Reviews
Publisher
Elsevier BV
Published
2021-04
Volume
123
Pages
120-202
ISSN
0149-7634 (ISSN-L)
OpenAlex
W3107607617
Cited by
116
References
350
Citations by year
2026: 12 · 2025: 25 · 2024: 31 · 2023: 25 · 2022: 19 · 2021: 4
FWCI
1.98
Type
journal article
Language
en
Open access
Locations
  • Neuroscience & Biobehavioral Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion, other-oa)
Funders
  • National Institute for Health Research
  • King's College London
  • King’s College London
  • South London and Maudsley NHS Foundation Trust
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
pathological dissociation, transdiagnostic psychiatry, neuroimaging biomarkers, oxytocin, prolactin, TNF-α, genetic biomarkers, prefrontal cortex, hippocampus, basal ganglia, thalamus, precision medicine
MeSH terms
Mental Disorders, Frontal Lobe, Hippocampus, Humans, Biomarkers, Neuroimaging

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