The enemy in the mirror: self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder
Open accessAbstract
Background: Patients suffering from dissociative disorders (DD) are characterized by an avoidance of aversive stimuli. Clinical experience has shown that DD patients typically avoid the confrontation with their own faces in a mirror (CFM).Objective: To investigate potential CFM-associated self-reported and psychophysiological stress reactions of DD patients, which most likely inform on the still unknown pathophysiology of dysfunctional self-perception in DD.Method: Eighteen DD patients and 18 healthy controls (HCs) underwent CFM. They were assessed for CFM-induced subjective self-reported stress, acute dissociative symptoms and sympathetic and parasympathetic drive using impedance cardiography.Results: DD patients experienced more subjective stress and acute dissociation than HCs upon CFM. Their psychological stress response did not activate the sympathetic and parasympathetic nervous system.Conclusions: In DD patients, CFM constitutes serious self-reported stress and is associated with a blunted autonomic reactivity. Therapeutic approaches promoting self-perception and self-compassion, in particular by using CFM, might serve as goal-oriented diagnostic and therapeutic tools in DD.
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The remaining studies reported no significant change in heart rate to mirror confrontation, white noise, or fear-potentiated startle.
“The remaining studies reported no significant change in HR to mirror confrontation (Schäflein et al., 2018), white noise (Schalinski et al., 2013), or fear-potentiated startle (Seligowski et al., 2019).”
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 Schäflein et al., 2018
For the mirror-confrontation citation, Table 4 (Results, “Sympathetic and parasympathetic tone during CFM assessed by impedance cardiography”) shows no significant change in heart period when participants moved from relaxation to mirror confrontation. But the Discussion (“Psychophysiology”) reports one significant within-patient change during mirror confrontation: heart rate dropped when the accompanying cognition changed from negative to positive. The unqualified claim of no significant heart-rate change therefore overstates the result; white noise and startle are attributed to other sources. (LLM, conf=0.87)
Experimental — accuracy not yet measuredNone of the other studies found correlations between heart rate variability and trait dissociation after exposure to trauma-related material or general stress stimuli.
“None of the other studies found correlations between HRV and trait dissociation after exposure to trauma related material (Hauschildt et al., 2011) or general stress stimuli (Powers et al., 2021; Schäflein et al., 2018).”
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 Schäflein et al., 2018
The Methods (Instruments and Data analysis; page unavailable) say the study measured trait dissociation with the Dissociative Experiences Scale and HRV with RMSSD, but describe mixed-model comparisons rather than correlations between them. The Results (Sympathetic and parasympathetic tone during CFM; page unavailable) report HRV changes during mirror-confrontation, not whether HRV correlated with trait dissociation. I found no reported test of the claimed correlation. (LLM, conf=0.76)
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Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Eysenck, H. J. (1985) · Behaviour Research and Therapy · doi:10.1016/0005-7967(85)90087-7 · Cited by 32,026 · see citing works
“Stress: appraisal and coping,”
Folkman, S. (2013) · Encyclopedia of Behavioral Medicine · doi:10.1007/978-1-4419-1005-9_215 · Cited by 27,833 · see citing works
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289 · see citing works
Impact of Event Scale: A Measure of Subjective Stress
Horowitz, M., Wilner, N., & Alvarez, W. (1979) · Psychosomatic Medicine · doi:10.1097/00006842-197905000-00004 · Cited by 7,813 · see citing works
The brief symptom inventory: an introductory report.
Derogatis, L. R., & Melisaratos, N. (1983) · Psychological Medicine · doi:10.1017/s0033291700048017 · Cited by 6,650 · see citing works
The Development and Validation of a Scale to Measure Self-Compassion
NEFF, K. D. (2003) · Self and Identity · doi:10.1080/15298860309027 · Cited by 6,436 · cited 1× · see citing works
“To estimate self-compassion, we asked participants to complete the Self-Compassion Scale (SCS; Neff, 2003).”
MethodAffective Neuroscience: The Foundations of Human and Animal Emotions
Panksepp, J. (1998) · doi:10.1093/oso/9780195096736.001.0001 · Cited by 4,428 · see citing works
(1998) · Cited by 4,012 · see citing works
Development, reliability, and validity of a dissociation scale
BERNSTEIN, E. M., & PUTNAM, F. W. (1986) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198612000-00004 · Cited by 3,793 · cited 1× · see citing works
“To evaluate trait dissociation, we used the Dissociative Experiences Scale (Bernstein & Putnam, 1986).”
MethodHayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.6.1152 · Cited by 3,595 · see citing works
Thayer, J. F., Åhs, F., Fredrikson, M., Sollers, J. J., & Wager, T. D. (2012) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2011.11.009 · Cited by 3,224 · see citing works
The practice of behavior therapy
Wolpe, J. (1969) · Cited by 2,343 · see citing works
Laborde, S., Mosley, E., & Thayer, J. F. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00213 · Cited by 2,336 · see citing works
A pilot study and randomized controlled trial of the mindful self-compassion program
Neff, K. D., & Germer, C. K. (2013) · Journal of Clinical Psychology · doi:10.1002/jclp.21923 · Cited by 2,253 · see citing works
Measuring experiential avoidance: A preliminary test of a working model
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., Polusny, M. A., Dykstra, T. A., Batten, S. V., Bergan, J., et al. (2004) · The Psychological Record · doi:10.1007/bf03395492 · Cited by 2,140 · see citing works
Ellsworth, P. D. (1980) · American Journal of Occupational Therapy · doi:10.5014/ajot.34.12.819a · Cited by 1,712 · see citing works
Using SAS PROC MIXED to Fit Multilevel Models, Hierarchical Models, and Individual Growth Models
Singer, J. D. (1998) · Journal of Educational and Behavioral Statistics · doi:10.2307/1165280 · Cited by 1,092 · see citing works
Demmel, R. (1999) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026//0084-5345.28.1.68 · Cited by 1,010 · see citing works
(2006) · Cited by 900 · see citing works
The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization
van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006) · Medical Entomology and Zoology · Cited by 632 · see citing works
Are there two qualitatively distinct forms of dissociation? A review and some clinical implications
Holmes, E. A., Brown, R. J., Mansell, W., Fearon, R. P., Hunter, E. C. M., Frasquilho, F., & Oakley, D. A. (2005) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.08.006 · Cited by 619 · see citing works
The Practice of Behavior Therapy.
Moss, M. G. R. (1970) · Archives of General Psychiatry · doi:10.1001/archpsyc.1970.01750060095013 · Cited by 600 · see citing works
Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M., Neufeld, R. W. J., Gati, J. S., & Menon, R. S. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01367-7 · Cited by 505 · cited 1× · see citing works
“…psychophysiological hyperarousal under stressful conditions, exhibit blunted autonomic reactivity and are thus classified as ‘physiological nonresponders’ (Orr, Metzger, & Pitman, 2002; Orr & Roth, 2000) or ‘dissociative subtype’ of PTSD (Lanius, Bluhm, Lanius, & Pain, 2006; Lanius et al., 2002).”
BackgroundAlvares, G. A., Quintana, D. S., Hickie, I. B., & Guastella, A. J. (2016) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.140217 · Cited by 503 · see citing works
Dissociation Following Traumatic Stress: Etiology and Treatment
Schauer, M., & Elbert, T. (2010) · Zeitschrift für Psychologie / Journal of Psychology · doi:10.1027/0044-3409/a000018 · Cited by 462 · see citing works
Quintana, D. S., Alvares, G. A., & Heathers, J. A. J. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.73 · Cited by 420 · see citing works
Depersonalization: neurobiological perspectives.
Sierra, M., & Berrios, G. E. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00015-8 · Cited by 394 · see citing works
Cacioppo, J. T., Berntson, G. G., Binkley, P. F., Quigley, K. S., Uchino, B. N., & Fieldstone, A. (1994) · Psychophysiology · doi:10.1111/j.1469-8986.1994.tb02351.x · Cited by 388 · see citing works
A review of neuroimaging studies in PTSD: heterogeneity of response to symptom provocation
Lanius, R. A., Bluhm, R., Lanius, U., & Pain, C. (2006) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2005.07.007 · Cited by 380 · see citing works
Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
International Society for the Study of Trauma and Dissociati (2011) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2011.537247 · Cited by 374 · see citing works
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997) · Medical Entomology and Zoology · Cited by 367 · see citing works
Dissociation in Trauma: A New Definition and Comparison with Previous Formulations
Nijenhuis, E. R. S., & van der Hart, O. (2011) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2011.570592 · Cited by 364 · see citing works
Ambulatory measurement of respiratory sinus arrhythmia and respiration rate
de Geus, E. J. C., Willemsen, G. A. H. M., Klaver, C. H. A. M., & van Doornen, L. J. P. (1995) · Biological Psychology · doi:10.1016/0301-0511(95)05137-6 · Cited by 314 · see citing works
Trauma-Related Dissociation: Conceptual Clarity Lost and Found
Van Der Hart, O., Nijenhuis, E., Steele, K., & Brown, D. (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2004.01480.x · Cited by 308 · see citing works
Pre‐ejection Period: Measuring Beta‐adrenergic Influences Upon the Heart
Newlin, D. B., & Levenson, R. W. (1979) · Psychophysiology · doi:10.1111/j.1469-8986.1979.tb01519.x · Cited by 275 · see citing works
Bosch, J. A., de Geus, E. J. C., Veerman, E. C. I., Hoogstraten, J., & Amerongen, A. V. N. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000058376.50240.2d · Cited by 249 · see citing works
The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization
Harris, M. (2007) · Psychiatric Services · doi:10.1176/appi.ps.58.9.1232 · Cited by 231 · see citing works
Psychophysiological assessment: clinical applications for PTSD
Orr, S. P., & Roth, W. T. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00340-2 · Cited by 229 · see citing works
Autonomic Response in Depersonalization Disorder
Sierra, M., Senior, C., Dalton, J., McDonough, M., Bond, A., Phillips, M. L., O'Dwyer, A. M., & David, A. S. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.9.833 · Cited by 225 · see citing works
Ambulatory monitoring of the impedance cardiogram
Willemsen, G. A. H. M., de Geus, E. J. C., Klaver, C. H. A. M., VanDoornen, L. J. P., & Carrofl, D. (1996) · Psychophysiology · doi:10.1111/j.1469-8986.1996.tb02122.x · Cited by 222 · see citing works
Epidemiology of dissociative disorders: An overview
Sar, V. (2011) · Epidemiology Research International · doi:10.1155/2011/404538 · Cited by 212 · see citing works
A Review of Dissociative Disorders Treatment Studies
Brand, B. L., Classen, C. C., McNary, S. W., & Zaveri, P. (2009) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e3181b3afaa · Cited by 209 · see citing works
Berntson, G. G., Lozano, D. L., Chen, Y., & Cacioppo, J. T. (2004) · Psychophysiology · doi:10.1111/j.1469-8986.2004.00156.x · Cited by 206 · see citing works
Psychobiological characteristics of dissociative identity disorder: a symptom provocation study
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. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.12.019 · Cited by 196 · see citing works
Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma
Corrigan, F., Fisher, J., & Nutt, D. (2011) · Journal of Psychopharmacology · doi:10.1177/0269881109354930 · Cited by 195 · see citing works
Psychophysiology of post-traumatic stress disorder
Orr, S. P., Metzger, L. J., & Pitman, R. K. (2002) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(01)00007-7 · Cited by 187 · see citing works
Emotion regulation in action: emotional reactivity in experiential avoidance
Sloan, D. M. (2003) · Behaviour Research and Therapy · doi:10.1016/j.brat.2003.08.006 · Cited by 186 · see citing works
Ebner‐Priemer, U., Badeck, S., Beckmann, C., Wagner, A. W., Feige, B., Weiss, I. C., Lieb, K., & Bohus, M. (2004) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2004.05.001 · Cited by 178 · see citing works
Cardiovascular Indices of Peripheral and Central Sympathetic Activation
Schächinger, H., Weinbacher, M., Kiss, A., Ritz, R., & Langewitz, W. A. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200109000-00012 · Cited by 176 · see citing works
What happens in the course of body exposure?
Vocks, S., Legenbauer, T., Wächter, A., Wucherer, M., & Kosfelder, J. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.08.007 · Cited by 174 · see citing works
Kleindienst, N., Limberger, M. F., Ebner-Priemer, U. W., Keibel-Mauchnik, J., Dyer, A., Berger, M., Schmahl, C., & Bohus, M. (2011) · Journal of Personality Disorders · doi:10.1521/pedi.2011.25.4.432 · Cited by 171 · see citing works
Brindle, R. C., Ginty, A. T., Phillips, A. C., & Carroll, D. (2014) · Psychophysiology · doi:10.1111/psyp.12248 · Cited by 135 · see citing works
Rufer, M., Held, D., Cremer, J., Fricke, S., Moritz, S., Peter, H., & Hand, I. (2006) · Psychotherapy and Psychosomatics · doi:10.1159/000089225 · Cited by 134 · see citing works
Dissociation Predicts Symptom-Related Treatment Outcome in Short-Term Inpatient Psychotherapy
Spitzer, C., Barnow, S., Freyberger, H. J., & Joergen Grabe, H. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670701449146 · Cited by 129 · see citing works
PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie
Strauß, B. (2026) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/s-00000060 · Cited by 128 · see citing works
Lanius, R. A. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.27905 · Cited by 127 · cited 1× · see citing works
“Research on the potential causes of the poor therapeutic outcome of these patients is thus urgently needed (Lanius, 2015).”
BackgroundBrand, B. L., Lanius, R. A., Vermetten, E. H. G. J. M., Loewenstein, R. J., & Spiegel, D. (2012) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2011.620687 · Cited by 114 · see citing works
Differential effects of active versus passive coping on secretory immunity
Bosch, J. A., de Geus, E. J. C., Kelder, A., Veerman, E. C. I., Hoogstraten, J., & Amerongen, A. V. N. (2001) · Psychophysiology · doi:10.1111/1469-8986.3850836 · Cited by 109 · see citing works
Zaba, M., Kirmeier, T., Ionescu, I. A., Wollweber, B., Buell, D. R., Gall-Kleebach, D. J., Schubert, C. F., Novak, B., Huber, C., Köhler, K., et al. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.02.005 · Cited by 101 · see citing works
Self-citationMichelson, L., June, K., Vives, A., Testa, S., & Marchione, N. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00073-4 · Cited by 98 · see citing works
Large-scale ensemble averaging of ambulatory impedance cardiograms
Riese, H., Groot, P. F. C., van den Berg, M., Kupper, N. H. M., Magnee, E. H. B., Rohaan, E. J., Vrijkotte, T. G. M., Willemsen, G. A. H. M., & de Geus, E. J. C. (2003) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03195525 · Cited by 94 · see citing works
Gillie, B. L., & Thayer, J. F. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00758 · Cited by 92 · see citing works
Brand, B. L., Myrick, A. C., Loewenstein, R. J., Classen, C. C., Lanius, R. A., McNary, S. W., Pain, C., & Putnam, F. W. (2011) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0026487 · Cited by 90 · see citing works
Hopper, J. W., Frewen, P. A., Sack, M., Lanius, R. A., & van der Kolk, B. A. (2007) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-007-9046-0 · Cited by 86 · see citing works
Self-citationThe Neurophysiology of Dissociation and Chronic Disease
Scaer, R. C. (2001) · Applied Psychophysiology and Biofeedback · doi:10.1023/a:1009571806136 · Cited by 81 · see citing works
van Dijke, A., van der Hart, O., Ford, J. D., van Son, M. J. M., van der Heijden, P. G. M., & Bühring, M. E. F. (2010) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2010.496140 · Cited by 70 · see citing works
Trauma-Related Altered States of Consciousness: Exploring the 4-D Model
Frewen, P., & Lanius, R. A. (2014) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2013.873377 · Cited by 63 · see citing works
Recognizing Traumatic Dissociation
Spiegel, D. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.4.566 · Cited by 59 · see citing works
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 · see citing works
Dissociative Disorders: Pathways to Diagnosis, Clinician Attitudes and Their Impact
Leonard, D., Brann, S., & Tiller, J. W. G. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01700.x · Cited by 53 · see citing works
Acute dissociation and cardiac reactivity to script-driven imagery in trauma-related disorders
Sack, M., Cillien, M., & Hopper, J. W. (2012) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v3i0.17419 · Cited by 46 · see citing works
Self-citationLanius, R. A., Brewin, C. R., Bremner, J. D., Daniels, J. K., Friedman, M. J., Liberzon, I., McFARLANE, A. C., Schnurr, P. P., Shin, L. M., Stein, M. B., et al. (2010) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.090047 · Cited by 46 · see citing works
Clandestine Psychopathology: Unrecognized Dissociative Disorders in Inpatient Psychiatry
Ginzburg, K., Somer, E., Tamarkin, G., & Kramer, L. (2010) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181da4d65 · Cited by 37 · see citing works
Self-referential processing in women with PTSD: Affective and neural response.
Frewen, P., Dozois, D. J. A., Neufeld, R. W. J., Densmore, M., Stevens, T. K., & Lanius, R. A. (2011) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0021264 · Cited by 33 · see citing works
Dysfunctional affect regulation in borderline personality disorder and in somatoform disorder
van Dijke, A. (2012) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v3i0.19566 · Cited by 27 · see citing works
Can’t stand the look in the mirror? Self-awareness avoidance in borderline personality disorder
Winter, D., Koplin, K., & Lis, S. (2015) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-015-0034-9 · Cited by 23 · see citing works
Servián-Franco, F., Moreno‐Domínguez, S., & del Paso, G. A. R. (2015) · PLoS ONE · doi:10.1371/journal.pone.0122737 · Cited by 22 · see citing works
Individual differences in psychophysiological reactivity in adults with childhood abuse
Schmahl, C. G., Elzinga, B. M., & Bremner, J. D. (2002) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.325 · Cited by 22 · see citing works
Borgmann, E., Kleindienst, N., Vocks, S., & Dyer, A. S. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-10 · Cited by 21 · see citing works
Spaans, J., Veselka, L., Luyten, P., & Bühring, M. E. F. (2009) · PubMed · Cited by 19 · see citing works
Freyberger, H. J., & Spitzer, C. (2005) · Der Nervenarzt · doi:10.1007/s00115-005-1956-z · Cited by 17 · see citing works
An Excellent Definition of Structural Dissociation and a Dogmatic Rejection of All Other Models
Dell, P. F. (2011) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2011.570236 · Cited by 15 · see citing works
Jäger, B., Schmid-Ott, G., Ernst, G., Dölle-Lange, E., & Sack, M. (2012) · Fortschritte der Neurologie · Psychiatrie · doi:10.1055/s-0031-1282071 · Cited by 10 · see citing works
Self-citationKörperexposition bei Essstörungen: Durchführung und Bedeutung für den Therapieerfolg
Voßbeck-Elsebusch, A. N., Vocks, S., & Legenbauer, T. (2013) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/s-0032-1331171 · Cited by 10 · see citing works
Blom, R. M. (2017) · Data Archiving and Networked Services (DANS) · Cited by 1 · see citing works
Schore, A. N. (2001) · Infant Mental Health Journal · doi:10.1002/1097-0355(200101/04)22:1
Flagged first, then by citations
2 of the 91 references couldn’t be matched to a known paper.
Research works printed but not linked: 7
- Bernstein D. P., & Fink L. (1998). Childhood trauma questionnaire: A retrospective self-report; Manual. St. Antonio, Texas: Pearson.
- De Geus E. J. C., & van Doornen L. J. P. (1996). Ambulatory assessment of parasympathetic/sympathetic balance by impedance cardiography In Fahrenberg J. & Myrtek M. (Eds.), Ambulatory assessment: Computer-assisted psychological and psychophysiological methods in monitoring and field studies (pp. 141– 163). Göttingen: Hogrefe & Huber.
- Hütter B. O., & Fischer G. (1997). Clinimetric evaluation of the German version of the Impact of Event Scale. Presented at the 2nd European Conference on Traumatic Stress Maastricht, The Netherlands.
- Jäger B., Schmid-Ott G., Dölle-Lange E., & Sack M. (2012). Development and validation of an inventory of ego functions and self-regulation (Hannover self-regulation inventory, HSRI) (in German). Fortschritte Der Neurologie · Psychiatrie, 80, 336– 343. 22431127
- Shapiro F. (2001). EMDR. Basic principles, protocols, and procedures (2nd ed.). New York: Guilford Publications.
- Steinberg M. (1994). Structured clinical interview for DSM-IV dissociative disorders (SCID-D) (revised). Washington, Wash.: American Psychiatric Press.
- Wirtz G., & Frommberger U. (2013). Diagnostik Dissoziativer Störungen in der ambulanten und stationären Behandlung. Theorie und Praxis [Diagnosing dissociative disorders in inpatient and outpatient settings – theory and practice]. Trauma & Gewalt, 7(3), 182– 191.
Cited by
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“, 2022), as well as in individuals with psychiatric conditions highly associated with severe early life traumatization including dissociative disorder (DD) (Schäflein et al., 2018), borderline personality disorder (BPD) (Ebner-Priemer et al.”
BackgroundDi Bello, M., Carnevali, L., Petrocchi, N., Thayer, J. F., Gilbert, P., & Ottaviani, C. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.06.016 · Cited by 154 · see citing works
Biomarkers of Pathological Dissociation: A Systematic Review
Roydeva, M. I., & Reinders, A. A. T. S. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.11.019 · Cited by 116 · see citing works
Beutler, 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 · see citing works
“Regarding general stress stimuli, Schäflein et al. (2018) found no correlation between acute dissociation and RMSSD in the mirror confrontation task.”
BackgroundInfluentialSchäflein, E., Sattel, H. C., Pollatos, O., & Sack, M. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00897 · Cited by 41 · see citing works
Self-citationStress response in dissociation and conversion disorders: A systematic review
Boulet, C., López‐Castromán, J., Mouchabac, S., Olié, É., Courtet, P., Thouvenot, É., Abbar, M., & Conejero, I. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.10.049 · Cited by 33 · see citing works
Evidence for subjective emotional numbing following induced acute dissociation
Shin, G. I., Goldstein, L. H., & Pick, S. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.05.004 · Cited by 21 · see citing works
Complementary and integrative interventions for PTSD
Niles, B. L., Lang, A. J., & Olff, M. (2023) · European Journal of Psychotraumatology · doi:10.1080/20008066.2023.2247888 · Cited by 19 · see citing works
Subjectifying the Personality State: Theoretical Underpinnings and an Empirical Example
Lazarus, G., Sened, H., & Rafaeli, E. (2020) · European Journal of Personality · doi:10.1002/per.2278 · Cited by 19 · see citing works
Demartini, B., Nisticò, V., Tedesco, R., Marzorati, A., Ferrucci, R., Priori, A., Gambini, O., & Caputo, G. (2020) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-020-00977-6 · Cited by 15 · see citing works
Kotwas, I., Micoulaud‐Franchi, J., Khalfa, S., McGonigal, A., Bastien‐Toniazzo, M., & Bartoloméi, F. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.10.004 · Cited by 13 · see citing works
Impact of dissociative experiences in migraine and its close relationship with osmophobia
Saçmacı, H., Cengiz, G. F., & Aktürk, T. (2020) · Neurological Research · doi:10.1080/01616412.2020.1753417 · Cited by 10 · see citing works
Schäflein, E., Mertens, Y. L., Lejko, N., Beutler, S., Sattel, H. C., & Sack, M. (2022) · BJPsych Open · doi:10.1192/bjo.2022.593 · Cited by 7 · see citing works
Self-citationCaputo, G. (2023) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2023.2195394 · Cited by 7 · see citing works
Monéger, J., Chatard, A., & Selimbegović, L. (2022) · Self and Identity · doi:10.1080/15298868.2022.2099454 · Cited by 4 · see citing works
Philipps, A., Silbermann, A., Morawa, E., Schäflein, E., Stemmler, M., & Erim, Y. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1152486 · Cited by 6 · see citing works
Self-citationMorioka, H., Ijichi, S., Ijichi, N., Ijichi, Y., & King, B. H. (2019) · Medical Hypotheses · doi:10.1016/j.mehy.2019.03.015 · Cited by 5 · see citing works
How-To Study Dissociative Symptoms in a Broad Range of Mental Disorders: A Methodological Primer
Danböck, S. K., Mertens, Y. L., Kulla, P., Seitz, K. I., & Schalinski, I. (2025) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2025.2481474 · Cited by 4 · see citing works
Pape, V. R., Sammer, G., Hanewald, B., Schäflein, E., Rauschenbach, F., & Stingl, M. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1406180 · Cited by 3 · see citing works
Self-citationStief, L., Sattel, H. C., Paschinger, K., Sack, M., & Schäflein, E. (2025) · BJPsych Open · doi:10.1192/bjo.2025.10072 · Cited by 3 · see citing works
Self-citationDoes Dissociation Have an Emotion-Regulation Function? Evidence From Daily Life and the Laboratory
Heekerens, J. B., Gross, J. J., Kreibig, S. D., Ober, H., Eichentopf, R., Dittrich, T., Lebovitz, J. G., Hellmann‐Regen, J., Wingenfeld, K., & Roepke, S. (2026) · Clinical Psychological Science · doi:10.1177/21677026251396803 · Cited by 2 · see citing works
Bettess, Z., Albertella, L., Destrée, L., do Rosário, M. C., Ferrão, Y. A., Miguel, E. C., & Fontenelle, L. F. (2022) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674221084241 · Cited by 2 · see citing works
Danböck, S. K., Hettegger, S. E., Franke, L. K., Hillemeyer, K., Liedlgruber, M., Miedl, S. F., Alpers, G. W., & Wilhelm, F. H. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2563482 · Cited by 1 · see citing works
Schäflein, E., Sattel, H. C., & Sack, M. (2019) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2019.1675223 · Cited by 1 · see citing works
Self-citationTreatment of Trauma: Imaginative Minds of Dissociative Identify Disorder
Rinker, K. (2019) · Journal of Humanistic Psychology · doi:10.1177/0022167819877038
Subjectifying the personality state: Theoretical underpinnings and an empirical examplePreprint
Lab, A. A. R. (2020) · doi:10.31234/osf.io/ywm57
A Neural Substrate for Mirror Agnosia and Mirror Image Agnosia – Is it a Network disorder?
Chandra, S. R., Sivaram, S., Venkatasubramanian, G., Holla, B., & Bhat, M. D. (2021) · Neurology India · doi:10.4103/0028-3886.325339
„Mein Körper gehört nicht mir“: Zur Rolle des Körpers in der traumafokussierten Psychotherapie
Donat, S., Eckenberger, C., Preyer, S., & Kratzer, L. (2026) · Psychotherapie Forum · doi:10.1007/s00729-026-00308-7
- Authors
- Schäflein, E., Sattel, H., Schmidt, U., & Sack, M.
- Affiliations
- TUM Klinikum (DE)
- Universitätsmedizin Göttingen (DE)
- Corresponding author
- Schäflein, Eva
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2018-06-18
- Volume
- 9
- Issue
- sup3
- Pages
- 1472991-1472991
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC6008582
- OpenAlex
- W2809487647
- Cited by
- 28
- References
- 91
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 5 · 2021: 2 · 2020: 6 · 2019: 4 · 2018: 2
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (Technical University of Munich Open Access Publishing Program)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- dissociative disorders, self-perception, stress response, dissociation, autonomic nervous system, self-compassion, psychophysiology
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