Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder
Open accessAbstract
Neuroanatomical evidence on the relationship between posttraumatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5.
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Volumes of putamen and pallidum were negatively correlated with severity of derealization/depersonalization.
“Volumes of these regions (implicated in motor control [103–105]) were negatively correlated with severity of derealization/depersonalization [103].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [103]
Section 3.2.2 reports positive correlations between the dissociative-symptom component and bilateral putamen and right pallidum volumes; Table 4 gives positive coefficients for all three. The Discussion likewise says larger putamen and pallidum volumes were associated with more severe depersonalization/derealization symptoms, contrary to the claimed negative correlation. (LLM, conf=0.93)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredPatients with PTSD+DID, but not PTSD patients without DID, showed smaller hippocampal volumes than healthy controls.
“Patients with PTSD+DID (but not PTSD patients without DID) further showed smaller hippocampal volumes than healthy controls [103].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [103]
Patients with comorbid PTSD+DID showed significantly larger volumes of the putamen and pallidum than PTSD patients without DID.
“Patients with comorbid PTSD+DID showed significantly larger volumes of the putamen and pallidum than PTSD patients without DID [103].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [103]
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- Authors
- Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R. S., Draijer, N., Barker, G. J., Veltman, D. J., & Reinders, A. A. T. S.
- Affiliations
- University Medical Center Groningen (NL)
- GGZ Drenthe (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- King's College London (GB)
- Corresponding author
- Reinders, Antje A.T.S.
- ORCID
- Venue
- Psychiatry Research: Neuroimaging
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 231
- Issue
- 3
- Pages
- 308-319
- ISSN
- 0925-4927 (ISSN-L)
- OpenAlex
- W2005822594
- Cited by
- 63
- References
- 77
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 4 · 2023: 5 · 2022: 8 · 2021: 4 · 2020: 8 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 1
- FWCI
- 6.21
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Psychiatry Research Neuroimaging (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Research Portal (King's College London) (acceptedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Netherlands Organization for Scientific Research (451-07-009)
- International Society for the Study of Trauma and Dissociation (ISSTD)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, dissociative identity disorder, gray matter volume, hippocampal volume, putamen, globus pallidus, cortical gray matter, subcortical gray matter, depersonalization/derealization, dissociative symptoms
- MeSH terms
- Adolescent, Adult, Cerebral Cortex, Corpus Striatum, Female, Hippocampus, Humans, Life Change Events, Magnetic Resonance Imaging, Middle Aged, Dissociative Identity Disorder, Stress Disorders, Post-Traumatic, Comorbidity, Young Adult, Gray Matter
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