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Brain activation during script-driven imagery induced dissociative responses in PTSD: a functional magnetic resonance imaging investigation
Abstract
Background The goal of this study was to examine the neuronal circuitry underlying dissociative responses to traumatic script-driven imagery in sexual-abuse-related posttraumatic stress disorder (PTSD). Pilot studies in our laboratory have shown that PTSD patients had very different responses to traumatic script-driven imagery. Approximately 70% of patients relived their traumatic experience and showed an increase in heart rate while recalling the traumatic memory. The other 30% of patients had a dissociative response with no concomitant increase in heart rate. This article focuses on the latter group.Methods The neuronal circuitry underlying dissociative responses in PTSD was studied using the traumatic script-driven symptom provocation paradigm adapted to functional magnetic resonance imaging (fMRI) at a 4 Tesla field strength in 7 subjects with sexual-abuse-related PTSD and 10 control subjects.Results Compared with control subjects, PTSD patients in a dissociative state showed more activation in the superior and middle temporal gyri (BA 38), the inferior frontal gyrus (BA 47), the occipital lobe (BA 19), the parietal lobe (BA 7), the medial frontal gyrus (BA 10), the medial cortex (BA 9), and the anterior cingulate gyrus (BA 24 and 32).Conclusions These findings suggest that prefrontal and limbic structures underlie dissociative responses in PTSD. Differences observed clinically, psychophysiologically, and neurobiologically between patients who respond to traumatic script-driven imagery with dissociative versus nondissociative responses may suggest different neuronal mechanisms underlying these two distinct reactions.
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“The majority of patients (∼70%) reported marked re-experiencing symptoms and showed a substantial increase in heart rate during the script.”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [57]
In the citing paper
“In a smaller patient group (∼30%), however, this heart rate increase was not observed—instead, these patients showed stronger activity in the medial frontal gyrus, anterior and medial cingulate, middle temporal gyri (BA38), precuneus, occipital areas, and inferior frontal gyrus (IFG), compared to a control group of traumatized persons who had not developed PTSD [57].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [57]
In the citing paper
“The VLPAG receives signals from deep somatic (muscle, joint) or visceral tissues via the dorsal horn of the spinal cord, from the parabrachial nucleus,25,94,95 and from the vagal sensory nucleus (the solitary track nucleus).28,96”
From Fear and the Defense Cascade (2015) · cites this paper as [95]
In the citing paper
“These findings are consistent with previous reports of an absence of heart-rate increase in response to traumatic scripts among patients with PTSD and comorbid dissociative symptoms (Lanius et al., 2002), and of depressed skin conductance and heart rate when recalling a trauma among rape victims high in peri-traumatic dissociation (Griffin et al., 1997).”
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 Lanius et al., 2002
In the citing paper
“Further research by Lanius and colleagues (Lanius et al., 2002; Lanius et al., 2005; Lanius et al., 2006) employing trauma memory recall supports the idea of two different PTSD profiles”
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 Lanius et al., 2002
In the citing paper
“The initial pilot studies describing alternating physiological reactions to individualized trauma scripts in chronic PTSD patients (Lanius et al., 2001; Lanius et al., 2002) interpreted the data as supportive for two distinct subtypes ‘each representing unique pathways to chronic stress- related psychopathology’ (Lanius et al., 2006, p. 710).”
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 Lanius et al., 2002
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“Moreover, to test whether volunteers’ responses were dissociative or hypervigilant, and to ensure sample homogeneity (Griffin et al., 1997; Lanius et al., 2002, 2006), we monitored heart rate before the study and during fMRI scans, aswell as saliva cortisol expression, since its measures differed…”
BackgroundNeurocircuitry of anxiety disorders
KENT, J. M., & Rauch, S. L. (2003) · Current Psychiatry Reports · doi:10.1007/s11920-003-0055-8 · Cited by 106
“Lanius et al. [ 44 ] examined the issue of whether patients with PTSD who respond to script-driven imagery with dissociative responses (without physiologic activation) differ in patterns of brain activation from patients with PTSD with reexperiencing or anxiety responses associated with physiologic activation.”
Bovin, M. J., Jager‐Hyman, S., Gold, S. D., Marx, B. P., & Sloan, D. M. (2008) · Journal of Traumatic Stress · doi:10.1002/jts.20354 · Cited by 107
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Neural circuitry of PTSD with or without mild traumatic brain injury: a meta-analysis
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Mickleborough, M. (2010) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.080188 · Cited by 110
“26,36,38 For each script type, there were 3 warm (non-painful) and 3 hot (painful) stimulations.”
BackgroundHoerst, M., Weber-Fahr, W., Tunc-Skarka, N., Ruf, M., Bohus, M., Schmahl, C., & Ende, G. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.93 · Cited by 97
“The association of the glutamate signal and dissociation is of particular interest, since the ACC plays an important role in the mediation of dissociative symptoms.(68,69) Concordantly, N-methyl-D-aspartate neurotransmission has been also linked to dissociation.”
BackgroundGinzburg, K., Koopman, C., Butler, L. D., Palesh, O., Kraemer, H. C., Classen, C. C., & Spiegel, D. (2006) · Journal of Trauma & Dissociation · doi:10.1300/j229v07n02_02 · Cited by 101
“Similarly, Lanius et al. (2001, 2002) demonstrated that among persons with PTSD for sexual abuse or motor vehicle accidents, those who responded with high levels of dissociation to script-driven imagery showed no increase in heart rate in response to recalling a traumatic memory, whereas those with…”
BackgroundAdenauer, H., Catani, C., Gola, H., KEIL, J. E., Ruf, M., Schauer, M., & Neuner, F. (2011) · BMC Neuroscience · doi:10.1186/1471-2202-12-127 · Cited by 104
“Even though some studies point to the involvement of the parietal cortex in PTSD [33-35], until recently, no consistent theory exists about its specific role in this disorder.”
ResultSmaller Global and Regional Cortical Volume in Combat-Related Posttraumatic Stress Disorder
Woodward, S. H., Schaer, M., Kaloupek, D. G., Cediel, L., & Eliez, S. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.160 · Cited by 106
Imaging Repressed Memories in Motor Conversion Disorder
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“However, functional neuroimaging studies of dissociation, and of memory suppression, suggest these processes require prefrontal activation, presumed to reflect inhibition of memories and emotional salience as reflected in hippocampal (6) and amygdala (14) deactivation, respectively.”
BackgroundTrauma and Dissociation: Implications for Borderline Personality Disorder
Vermetten, E. H. G. J. M., & Spiegel, D. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-013-0434-8 · Cited by 106
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“A number of previous studies have identified similar decreases in participants with PTSD during symptom provocation studies (Lanius et al., 2002; Shin et al., 1999) although deficits in PTSD are more reliably found in medial rather than lateral prefrontal cortex (Milad, Rauch, Pitman, & Quirk,…”
McKinnon, M. C., Boyd, J. E., Frewen, P. A., Lanius, U. F., Jetly, R., Richardson, J. D., & Lanius, R. A. (2016) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2016.07.017 · Cited by 94
“…previous reports of an absence of heart-rate increase in response to traumatic scripts among patients with PTSD and comorbid dissociative symptoms (Lanius et al., 2002), and of depressed skin conductance and heart rate when recalling a trauma among rape victims high in peri-traumatic dissociation…”
Self-citationReinders, A. A. T. S., Willemsen, A. T. M., den Boer, J. A., Vos, H. P. J., Veltman, D. J., & Loewenstein, R. J. (2014) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2014.05.005 · Cited by 96
“The latter pattern has been termed “undermodulation” of emotional response to trauma cues (Hopper et al., 2007; Felmingham et al., 5 2008; Lanius et al., 2002, 2010, 2012) and is generally accompanied by hyper-arousal and increases in heart rate and blood pressure, consistent with the more…”
Trauma-related reactivity and regulation of emotion: Associations with posttraumatic stress symptoms
Badour, C. L., & Feldner, M. T. (2012) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2012.07.007 · Cited by 97
“…imagery with a pattern of increased subjective and physiological reactivity, the other 30% display dampened physiological arousal that is accompanied by unique patterns of brain activation consistent with self-reported feelings of depersonalization and derealization (Lanius et al., 2001, 2002).”
BackgroundHou, C., Liu, J., Wang, K., Li, L., Liang, M., He, Z., Liu, Y., Zhang, Y., Li, W., & Jiang, T. (2007) · Brain Research · doi:10.1016/j.brainres.2007.01.089 · Cited by 109
“…– see front matter © 2007 Elsevi doi:10.1016/j.brainres.2007.01.089 A B S T R A C T Article history: Accepted 23 January 2007 Available online 31 January 2007 Functional neuroimaging studies have largely been performed in patients with longstanding chronic posttraumatic stress disorder (PTSD).”
BackgroundResultInfluentialShang, J., Lui, S., Meng, Y., Zhu, H., Qiu, C., Gong, Q., Liao, W., & Zhang, W. (2014) · PLoS ONE · doi:10.1371/journal.pone.0096834 · Cited by 102
“The disrupted function of the STG observed in patients with PTSD suggests that temporal or limbic structures may contribute to the patients’ dissociative responses, which involve the fragmentation of the typically integrated function of consciousness, memory, identity, or perception of the environment [37].”
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Rüsch, N., Weber, M., Il’yasov, K. A., Lieb, K., Ebert, D., Hennig, J., & van Elst, L. T. (2007) · NeuroImage · doi:10.1016/j.neuroimage.2006.12.007 · Cited by 93
“Dissociative symptoms were less significantly associated with DTI variables probably because more extended networks involving temporal, parietal and occipital areas are relevant to dissociative symptoms (Lanius et al., 2002) that go well beyond the orbitofrontal region assessed in this study.”
BackgroundAugmentation of Extinction and Inhibitory Learning in Anxiety and Trauma-Related Disorders
Lebois, L. A. M., Seligowski, A. V., Wolff, J. D., Hill, S. B., & Ressler, K. J. (2019) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050718-095634 · Cited by 97
“Research has found that individuals who report these feelings on standardized clinician-administered dissociative symptom assessments instead have increased mPFC activation during paradigms designed to elicit PTSD symptoms (e.g., Lanius et al. 2002).”
Bohus, M., Schmahl, C. G., Fydrich, T., Steil, R., Müller‐Engelmann, M., Herzog, J., Ludäscher, P., Kleindienst, N., & Priebe, K. (2019) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-019-0099-y · Cited by 103
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“…those of Lanius and colleagues, who found that a subgroup of PTSD patients that reported dissociative symptoms while recalling a traumatic memory in the fMRI scanner had clearly distinct neuronal activation patterns compared to PTSD patients without dissociative symptoms (Lanius et al. 2002, 2005).”
ResultBrain-Imaging Studies of Posttraumatic Stress Disorder
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Magical Flight and Monstrous Stress: Technologies of Absorption and Mental Wellness in Azeroth
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“(25) investigated neural correlates of script-induced traumatic memories in patients with PTSD, but also used script-driven symptom provocation to induce dissociative states during functional imaging (26).”
BackgroundSchlumpf, Y. R., Reinders, A. A. T. S., Nijenhuis, E. R. S., Luechinger, R., van Osch, M. J. P., & Jäncke, L. (2014) · PLoS ONE · doi:10.1371/journal.pone.0098795 · Cited by 87
“In line with TSDP, as ANP, the patients had a brain activation pattern similar to patients with depersonalization disorder [23] and PTSD patients with negative dissociative symptoms to trauma-related stimuli [24,25] (i.”
A Pilot Study of Neurofeedback for Chronic PTSD
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“Studies in PTSD, Depersonalization Disorder as well as literature on temporal lobe epilepsy point to a connection between brain function in the middle temporal gyri and dissociative symptoms [54,55].”
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“Several studies by Lanius and colleagues (e.g., Lanius et al., 2001; 2002; 2010) found that PTSD patients who experienced 4 self-reported dissociative reactions in response to trauma-related imagery had a neurological and psychophysiological pattern distinct from those who self-reported…”
BackgroundSchlumpf, Y. R., Nijenhuis, E. R. S., Chalavi, S., Weder, E. V., Zimmermann, E., Luechinger, R., Marca, R. L., Reinders, A. A. T. S., & Jäncke, L. (2013) · NeuroImage Clinical · doi:10.1016/j.nicl.2013.07.002 · Cited by 91
“ANP showed a brain activation pattern similar to patients with depersonalization disorder (Simeon et al., 2000) and PTSD patients with negative dissociative symptoms to trauma-related stimuli (Lanius et al., 2002, 2006).”
Walsh, K., Galea, S., & Koenen, K. C. (2012) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12004 · Cited by 96
“…(Bremner et al., 1999), and dissociative responses to such trauma scripts have been associated with more activation in the superior and middle temporal gyri, the inferior frontal gyrus, occipital and parietal lobes, medial frontal gyrus, medial cortex, and anterior cingulate (Lanius et al., 2002).”
BackgroundInfluentialChildhood Post-Traumatic Stress Disorder: An Overview
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“Functional neuroimaging studies in adults with PTSD suggest that the medial prefrontal regions are hyporesponsive and that the amygdala is hyper-responsive [139–144].”
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Self-citationTowards a developmental trauma disorder diagnosis for childhood interpersonal trauma
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“Increased activity of the precuneus has been found in individuals with depersonalization disorder (Simeon et al., 2000) and in PTSD subjects with dissociative states (Lanius et al., 2002).”
BackgroundPTSD co-morbid with HIV: Separate but equal, or two parts of a whole?
Neigh, G. N., Rhodes, S. T., Valdez‐Sinon, A. N., & Jovanović, T. (2015) · Neurobiology of Disease · doi:10.1016/j.nbd.2015.11.012 · Cited by 81
“…of symptoms may be expected to vary over the course of time following trauma exposure, with fear and avoidance of specific trauma cues likely presenting first, followed by a more generalized avoidance and symptoms of depressed mood, which is often comorbid with PTSD symptoms (Lanius et al., 2002).”
Thome, J., Terpou, B. A., McKinnon, M. C., & Lanius, R. A. (2019) · Depression and Anxiety · doi:10.1002/da.22977 · Cited by 80
“…1999; Pissiota et al., 2002), or script‐driven imagery, which involves presenting a short, verbal description of an individual’s trauma story to facilitate the retrieval of the fuller memory (Hopper, Frewen, van der Kolk, & Lanius, 2007; Ke et al., 2015; Lanius et al., 2002; Rauch et al., 1996).”
BackgroundInfluentialSelf-citationvan Rooij, S. J. H., Rademaker, A. R., Kennis, M., Vink, M., Kahn, R. S., & Geuze, E. (2014) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.130223 · Cited by 75
Impact of early life adversities on human brain functioning: A coordinate-based meta-analysis
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Self-citationCognitive resources, valence, and memory retrieval of emotional events in older adults.
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Gray matter volume alterations related to trait dissociation in PTSD and traumatized controls
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Self-citationBeutler, S., Mertens, Y. L., Ladner, L., Schellong, J., Croy, I., & Daniels, J. K. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2132599 · Cited by 64
“Lanius et al. (2002) found no differences in HR between traumaexposed patients without PTSD and PTSD patients with comorbid Dissociative Disorder Not Otherwise Specified (DDNOS), but the authors interpreted this as the absence of an increase in HR that would be expected in PTSD patients.”
BackgroundInfluentialBasal cerebral glucose distribution in long-term post-traumatic stress disorder
Molina, M. E., Isoardi, R., Prado, M. N., & Bentolila, S. (2007) · The World Journal of Biological Psychiatry · doi:10.3109/15622970701472094 · Cited by 74
“Lanius et al. (2001, 2002) have found abnormalities in: anterior cingulate, thalamus, superior frontal gyrus, right parahippocampal gyrus, right superior occipital gyrus, right insula, left parietal lobe, right middle frontal gyrus, superior temporal gyrus and right cuneus.”
BackgroundPallanti, S., & Bernardi, S. (2009) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e32832c2639 · Cited by 71
“Although there is significant agreement on this model of interaction between mPFC and the amygdala, some studies have shown inconsistencies (Bremner et al., 1999; Rauch et al., 2000; Lanius et al., 2001, 2002, 2003; Gilboa et al., 2004; Britton et al., 2005).”
ResultMacNamara, A., Post, D., Kennedy, A. E., Rabinak, C. A., & Phan, K. L. (2013) · Biological Psychology · doi:10.1016/j.biopsycho.2013.08.009 · Cited by 72
DSM–5’s Posttraumatic Stress Disorder with Dissociative Symptoms: Challenges and Future Directions
Dorahy, M. J., & van der Hart, O. (2014) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2014.908806 · Cited by 79
“These latter participants report heightened scores on tools such as the Clinician-Administered Dissociative States Scale (Bremner et al., 1998) that have a preponderance of depersonalization and derealization items (Lanius et al., 2002, 2006).”
BackgroundRabellino, D., Densmore, M., Frewen, P. A., Théberge, J., & Lanius, R. A. (2016) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2015.12.005 · Cited by 67
Self-citationvan Huijstee, J., & Vermetten, E. H. G. J. M. (2017) · Current topics in behavioral neurosciences · doi:10.1007/7854_2017_33 · Cited by 69
Harricharan, S., Nicholson, A. A., Densmore, M., Théberge, J., McKinnon, M. C., Neufeld, R. W. J., & Lanius, R. A. (2017) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2017.09.010 · Cited by 64
“…disorder (Simeon et al., 2000), and is associated with dissociative symptoms observed in vestibular and psychiatric disorders, including dissociative PTSD (Ionta et al., 2011; Kennis et al., 2016; Lanius et al., 2005, 2002; Smith and Darlington, 2013; Steuwe et al., 2014; Voon et al., 2010).”
BackgroundSelf-citationLiu, Y., Li, Y., Luo, E., Lu, H., & Yin, H. J. (2012) · PLoS ONE · doi:10.1371/journal.pone.0039025 · Cited by 66
“It was reported that an increased [50,51] or a decreased [52] activation in right inferior frontal gyrus was identified in patients with chronic PTSD, while decreased activation in right inferior frontal gyrus was identified in patients with acute PTSD [1].”
BackgroundPerez, D. L., Matin, N., Williams, B., Tanev, K. S., Makris, N., LaFrance, W. C., Jr., & Dickerson, B. C. (2017) · Human Brain Mapping · doi:10.1002/hbm.23853 · Cited by 67
“Studies demonstrate increased task-based prefrontal/ACC activity [Lanius et al., 2002] and heightened fronto-amygdalar resting-state connectivity [Nicholson et al.”
BackgroundResultInfluentialKing, A. P., Block, S. R., Sripada, R. K., Rauch, S. A. M., Porter, K. E., Favorite, T. K., Giardino, N., & Liberzon, I. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00154 · Cited by 64
Lange, C., Kracht, L., Herholz, K., Sachsse, U., & Irle, E. (2005) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2005.05.003 · Cited by 63
“This conclusion is supported by the fact that studies performing emotion-related experiments have found predominantly right precuneus/posterior cingulate activation (Maddock, 1999; Lanius et al., 2002), whereas studies investigating non-emotional memory, personal self-reflection or states of consciousness found bilate…”
Shucard, J. L., Cox, J. L., Shucard, D. W., Fetter, H., Chung, C., Ramasamy, D. P., & Violanti, J. M. (2012) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2012.04.006 · Cited by 68
Rabellino, D., Densmore, M., Harricharan, S., Théberge, J., McKinnon, M. C., & Lanius, R. A. (2017) · Human Brain Mapping · doi:10.1002/hbm.23925 · Cited by 66
“In previous studies, the middle temporal gyrus showed reduced grey matter volumes in PTSD (K€uhn & Gallinat, 2013) and reduced activity associated with dissociative symptoms in PTSD (Lanius et al., 2002; Simeon et al., 2000).”
BackgroundSelf-citationBekrater-Bodmann, R., Chung, B. Y., Richter, I., Wicking, M., Foell, J., Mancke, F., Schmahl, C., & Flor, H. (2015) · Pain · doi:10.1097/j.pain.0000000000000275 · Cited by 61
Belleau, E. L., Ehret, L. E., Hanson, J. L., Brasel, K. J., Larson, C. L., & deRoon‐Cassini, T. A. (2020) · Neurobiology of Stress · doi:10.1016/j.ynstr.2020.100217 · Cited by 60
“Consistent with prior studies, the script driven imagery fMRI analyses focused on the 30-s guided imagery recall period (e.g., Lanius et al., 2001, 2002; 2004, 2005).”
MethodZoellner, L. A., Bedard‐Gilligan, M. A., Jun, J. J., Marks, L. H., & Garcia, N. M. (2013) · Psychological Injury and Law · doi:10.1007/s12207-013-9175-6 · Cited by 68
“, trauma narratives) for individuals with co-occurring high levels of dissociation in addition to PTSD (Felmingham et al., 2008; Hopper, Frewen, van der Kolk & Lanius, 2007; Lanius et al., 2002; Lanius et al., 2010).”
Recognizing Traumatic Dissociation
Spiegel, D. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.4.566 · Cited by 59
Autonomic response in the perception of disgust and happiness in depersonalization disorder
Sierra, M., Senior, C., Phillips, M. L., & David, A. S. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2005.05.022 · Cited by 58
“In the same vein Lanius et al. (2002) recently studied patients with sexual-abuserelated posttraumatic stress disorder and found that, while 70% of patients had increased heart rate during a traumatic script-driven symptom provocation, those patients who had a dissociative response (30”
BackgroundNeurophysiological correlates of dissociative symptoms
van der Kruijs, S. J. M., Bodde, N. M. G., Carrette, E., Lazeron, R. H. C., Vonck, K. E. J., Boon, P., Langereis, G. R., Cluitmans, P. J. M., Feijs, L. M. G., Hofman, P. A. M., et al. (2012) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-302905 · Cited by 63
Diamond, D. M., & Zoladz, P. R. (2015) · Journal of Neuroscience Research · doi:10.1002/jnr.23684 · Cited by 61
Facilitating Access to Emotions: Neural Signature of EMDR Stimulation
Herkt, D., Tumani, V., Grön, G., Kammer, T., Hofmann, A., & Abler, B. (2014) · PLoS ONE · doi:10.1371/journal.pone.0106350 · Cited by 67
“Investigations showing relatively increased activation in brain areas related to prefrontal top-down cognitive control in patients with PTSD with dissociative symptoms [56] suggest an excessive corticolimbic inhibition leading to an emotional overmodulation [26].”
BackgroundBrand, B. L., & Lanius, R. A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-13 · Cited by 64
“In contrast to the re-experiencing/hyperaroused group, the secondary dissociative group showing symptoms of depersonalization and derealization during traumatic memory recall exhibited abnormally high activation in the anterior cingulate cortex and the medial prefrontal cortex [74].”
BackgroundResultInfluentialSelf-citationTailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters
Norrholm, S., & Jovanovic, T. (2010) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s10951 · Cited by 56
“Dissociation is frequently related to avoidance and detachment symptoms; this symptom profile differs to such an extent compared with other PTSD symptom profiles that these patients are sometimes classified as a “dissociative subtype”.(103) Studies exploring the neurobiology of PTSD avoidance symptoms and related diss…”
Motor and Somatosensory Conversion Disorder: A Functional Unawareness Syndrome?
Perez, D. L., BARSKY, A. J., Daffner, K. R., & Silbersweig, D. (2012) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.11050110 · Cited by 57
Koopman, C., Carrión, V. G., Butler, L. D., Sudhakar, S., Palmer, L., & Steiner, H. (2004) · Journal of Traumatic Stress · doi:10.1023/b:jots.0000014676.83722.35 · Cited by 55
Recovered Memory and the Daubert Criteria
Dalenberg, C. J. (2006) · Trauma Violence & Abuse · doi:10.1177/1524838006294572 · Cited by 55
Winter, D., Krause-Utz, A., Lis, S., Chiu, C.-D., Lanius, R. A., Schriner, F., Bohus, M., & Schmahl, C. (2015) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2015.05.018 · Cited by 54
“Dissociation was induced through script-driven imagery (Lanius et al., 2002; Ludascher et al., 2010).”
MethodSelf-citationLong, Z., Duan, X., Xie, B., Du, H., Li, R., Xu, Q., Wei, L., Zhang, S., Wu, Y., Gao, Q. C., et al. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.03.004 · Cited by 55
“Nonetheless, the direction of ACC activation in PTSD was inconsistent across studies, some of which observed equal or greater activation (Lanius et al., 2002; Liberzon et al., 1999), while others obtained results in the opposite direction (Lanius et al.”
ResultKim, S. J., Lyoo, I. K., Lee, Y. S., Kim, J., Sim, M., Bae, S. J., Kim, H., Lee, J., & Jeong, D. ‐. (2006) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2006.00952.x · Cited by 52
“Parietal regions have been reported to be related to various clinical symptoms of PTSD (11, 35, 36).”
BackgroundRabellino, D., Burin, D., Harricharan, S., Lloyd, C., Frewen, P., McKinnon, M. C., & Lanius, R. A. (2018) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2018.00163 · Cited by 62
Self-citationWhat is it that a neurobiological model of PTSD must explain?
Brewin, C. R. (2007) · Progress in brain research · doi:10.1016/s0079-6123(07)67015-0 · Cited by 55
Neural correlates of self‐reflection in post‐traumatic stress disorder
Bluhm, R. L., Frewen, P., Coupland, N., Densmore, M., Schore, A. N., & Lanius, R. A. (2011) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2011.01773.x · Cited by 53
Self-citationEffects of post-traumatic stress disorder on occipital lobe function and structure
Chao, L. L., Lenoci, M., & Neylan, T. C. (2012) · Neuroreport · doi:10.1097/wnr.0b013e328352025e · Cited by 51
Gola, H., Engler, H., Schauer, M., Adenauer, H., Riether, C., Kolassa, S., Elbert, T., & Kolassa, I.-T. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.06.005 · Cited by 64
“Moreover, in PTSD patients, shame seems to be positively correlated with PTSD symptom severity (Leskela et al., 2002), and our two trauma groups did not differ with respect to the severity of their symptoms.”
Dahlgren, M. K., Laifer, L. M., VanElzakker, M. B., Offringa, R., Hughes, K. C., Staples-Bradley, L. K., Dubois, S. J., Lasko, N. B., Hinojosa, C. A., Orr, S. P., et al. (2018) · Psychological Medicine · doi:10.1017/s003329171700263x · Cited by 55
“Furthermore, PTSD symptom severity has been found to be inversely correlated with mPFC activation during SDI in some (Osuch et al. 2001; Shin et al. 2004), but not all (Lanius et al. 2002; Gold et al. 2011) studies.”
Humphreys, K. L., Sauder, C. L., Martin, E. K., & Marx, B. P. (2009) · Journal of Interpersonal Violence · doi:10.1177/0886260509334412 · Cited by 52
Altered amygdala activation during face processing in Iraqi and Afghanistani war veterans
Simmons, A. N., Matthews, S. C., Strigo, I. A., Baker, D. G., Donovan, H., Motezadi, A., Stein, M. B., & Paulus, M. P. (2011) · Biology of Mood & Anxiety Disorders · doi:10.1186/2045-5380-1-6 · Cited by 54
“For example, it has been shown that reduced functional connections between the amygdala and prefrontal cortex relate to increased levels of depersonalization following emotional trauma, suggesting that impaired functioning of this prefrontal modulatory network may be related to clinical symptoms in traumatized individ…”
BackgroundLazarov, A., Zhu, X., Suarez‐Jimenez, B., Rutherford, B. R., & Neria, Y. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.06.003 · Cited by 48
“Finally, decreased rs-FC of the PCC/precuneus in PTSD has also been linked to PTSD-related dissociative symptoms (Bluhm et al., 2009; Geuze et al., 2008; Lanius et al., 2002).”
BackgroundCatani, C., Adenauer, H., KEIL, J. E., Aichinger, H., & Neuner, F. (2009) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-009-0006-4 · Cited by 49
“SPC in dissociative symptoms in traumatized individuals emerged from neuroimaging studies with PTSD subjects [37, 38 ] and patients with Borderline-Personality Disorder (BPD) who had been exposed to childhood abuse [23].”
BackgroundThe neurobiology of misophonia and implications for novel, neuroscience-driven interventions
Neacsiu, A. D., Szymkiewicz, V., Galla, J. T., Li, B., Kulkarni, Y., & Spector, C. W. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.893903 · Cited by 53
“Hyperactivity of the STG during exposure to trauma has been one of the brain abnormalities distinguishing adults diagnosed with PTSD from controls (Lanius et al., 2002).”
BackgroundAttachment representations in Dutch veterans with and without deployment-related PTSD
Harari, D., Bakermans‐Kranenburg, M. J., de Kloet, C. S., Geuze, E., Vermetten, E. H. G. J. M., Westenberg, H. G. M., & van IJzendoorn, M. H. (2009) · Attachment & Human Development · doi:10.1080/14616730903282480 · Cited by 54
Theory and method at the intersection of anthropology and cultural neuroscience
Seligman, R. A., & Brown, R. A. (2009) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsp032 · Cited by 49
Brand, B. L., Schielke, H. J., Brams, J. S., & DiComo, R. A. (2017) · Psychological Injury and Law · doi:10.1007/s12207-017-9305-7 · Cited by 53
Yang, R., Gautam, A., Getnet, D., Daigle, B. J., Miller, S., Misganaw, B., Dean, K. R., Kumar, R., Muhie, S., Wang, K., et al. (2021) · Molecular Psychiatry · doi:10.1038/s41380-020-00966-2 · Cited by 48
Metadata
- Authors
- Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M., Neufeld, R. W. J., Gati, J. S., & Menon, R. S.
- Affiliations
- Western University (CA)
- Robarts Research Institute (CA)
- Corresponding author
- Lanius, Ruth A
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2002-08
- Volume
- 52
- Issue
- 4
- Pages
- 305-311
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W1966297906
- Cited by
- 505
- References
- 48
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 10 · 2023: 17 · 2022: 23 · 2021: 18 · 2020: 24 · 2019: 24 · 2018: 12 · 2017: 25 · 2016: 17 · 2015: 23 · 2014: 27 · 2013: 28 · 2012: 25
- FWCI
- 23.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- post-traumatic stress disorder, dissociation, script-driven imagery, sexual abuse, brain activation, prefrontal cortex, limbic system, anterior cingulate cortex, temporal lobe, heart rate response
- MeSH terms
- Adult, Arousal, Brain, Brain Mapping, Child, Child Abuse, Child Abuse, Sexual, Dissociative Disorders, Female, Gyrus Cinguli, Humans, Imagination, Magnetic Resonance Imaging, Nerve Net, Mental Recall, Stress Disorders, Post-Traumatic, Temporal Lobe, Prefrontal Cortex
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