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Biomarkers of Pathological Dissociation: A Systematic Review
Open accessAbstract
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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“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]
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“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
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“The authors further concluded that none of the reviewed physiological measures could be recommended as a biomarker of pathological dissociation (Roydeva & Reinders, 2021).”
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
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“As recommended by Roydeva and Reinders (2021), future research should aim to increase the specificity of biomarkers to PTSD-related dissociation, for instance by testing the robustness of these psychophysiological correlates across other psychopathologies (e.g. depression or anxiety).”
BackgroundInfluentialKrause-Utz, A., Frost, R., Chatzaki, E., Winter, D., Schmahl, C. G., & Elzinga, B. M. (2021) · Current Psychiatry Reports · doi:10.1007/s11920-021-01246-8 · Cited by 67
Persistent Dissociation and Its Neural Correlates in Predicting Outcomes After Trauma Exposure
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Metadata
- 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
- green
- kclpure.kcl.ac.uk
- Licence
- 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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