Neurodevelopmental origins of abnormal cortical morphology in dissociative identity disorder
Open accessAbstract
Objective: To examine the two constitutes of cortical volume (CV), that is, cortical thickness (CT) and surface area (SA), in individuals with dissociative identity disorder (DID) with the view of gaining important novel insights into the underlying neurobiological mechanisms mediating DID. Methods: This study included 32 female patients with DID and 43 matched healthy controls. Between‐group differences in CV, thickness, and SA, the degree of spatial overlap between differences in CT and SA, and their relative contribution to differences in regional CV were assessed using a novel spatially unbiased vertex‐wise approach. Whole‐brain correlation analyses were performed between measures of cortical anatomy and dissociative symptoms and traumatization. Results: Individuals with DID differed from controls in CV, CT, and SA, with significantly decreased CT in the insula, anterior cingulate, and parietal regions and reduced cortical SA in temporal and orbitofrontal cortices. Abnormalities in CT and SA shared only about 3% of all significantly different cerebral surface locations and involved distinct contributions to the abnormality of CV in DID. Significant negative associations between abnormal brain morphology (SA and CV) and dissociative symptoms and early childhood traumatization (0 and 3 years of age) were found. Conclusions: In DID, neuroanatomical areas with decreased CT and SA are in different locations in the brain. As CT and SA have distinct genetic and developmental origins, our findings may indicate that different neurobiological mechanisms and environmental factors impact on cortical morphology in DID, such as early childhood traumatization.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
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
Cortical Surface-Based Analysis
Dale, A. M., Fischl, B., & Sereno, M. I. (1999) · NeuroImage · doi:10.1006/nimg.1998.0395 · Cited by 10,910 · see citing works
Cortical Surface-Based Analysis
Fischl, B., Sereno, M. I., & Dale, A. M. (1999) · NeuroImage · doi:10.1006/nimg.1998.0396 · Cited by 6,147 · see citing works
Measuring the thickness of the human cerebral cortex from magnetic resonance images
Fischl, B. R., & Dale, A. M. (2000) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.200033797 · Cited by 5,789 · 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 · see citing works
Specification of Cerebral Cortical Areas
Rakic, P. (1988) · Science · doi:10.1126/science.3291116 · Cited by 3,127 · see citing works
A hybrid approach to the skull stripping problem in MRI
Ségonne, F., Dale, A. M., Busa, E., Glessner, M., Salat, D. H., Hahn, H., & Fischl, B. R. (2004) · NeuroImage · doi:10.1016/j.neuroimage.2004.03.032 · Cited by 2,227 · see citing works
for the ENIGMA-Major Depressive Disorder Working Group, Schmaal, L., Hibar, D. P., Sämann, P. G., Hall, G. B., Baune, B. T., Jahanshad, N., Cheung, J. W., van Erp, T. G. M., Bos, D., et al. (2017) · Molecular Psychiatry · doi:10.1038/mp.2016.60 · Cited by 1,330 · see citing works
Self-citationDistinct Genetic Influences on Cortical Surface Area and Cortical Thickness
Panizzon, M. S., Fennema-Notestine, C., Eyler, L. T., Jernigan, T. L., Prom-Wormley, E., Neale, M., Jacobson, K., Lyons, M. J., Grant, M. D., Franz, C. E., et al. (2009) · Cerebral Cortex · doi:10.1093/cercor/bhp026 · Cited by 1,304 · see citing works
Lasting epigenetic influence of early-life adversity on the BDNF gene
Roth, T. L., Lubin, F. D., Funk, A. J., & Sweatt, J. D. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.11.028 · Cited by 1,273 · see citing works
Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype
Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09081168 · Cited by 1,123 · cited 14× · see citing works
“However, in the latter study, the dACC thickness did not differ between patients and controls, and only 16 patients with PTSD were included.”
BackgroundInfluentialRakic, P. (1995) · Trends in Neurosciences · doi:10.1016/0166-2236(95)93934-p · Cited by 1,047 · see citing works
Evaluation of the evidence for the trauma and fantasy models of dissociation.
Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardeña, E., Frewen, P. A., Carlson, E. B., & Spiegel, D. (2012) · Psychological Bulletin · doi:10.1037/a0027447 · Cited by 667 · cited 2× · see citing works
“The clusters included (1) the left insular cortex, extending into the dorsolateral orbitofrontal cortex [Brodmann area (BA) 44/45/ 47], (2) the cingulate cortex, (3) the left temporoparietal junction (BA 19/39), (4 & 5) the left pre/ postcentral gyrus, and (6) the right temporal lobe.”
BackgroundMethodNijenhuis, E. R. S., Spinhoven, P., van Dyck, R., van der Hart, O., & Vanderlinden, J. (1996) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199611000-00006 · Cited by 567 · see citing works
Self-citationCortical Evolution: Judge the Brain by Its Cover
Geschwind, D. H., & Rakic, P. (2013) · Neuron · doi:10.1016/j.neuron.2013.10.045 · Cited by 519 · see citing works
Hazlett, H. C., Poe, M. D., Gerig, G., Styner, M., Chappell, C., Smith, R. G., Vachet, C., & Piven, J. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.39 · Cited by 481 · see citing works
The Cambridge Depersonalisation Scale: a new instrument for the measurement of depersonalisation
Sierra, M., & Berrios, G. E. (2000) · Psychiatry Research · doi:10.1016/s0165-1781(00)00100-1 · Cited by 467 · see citing works
Nijenhuis, E. R. S., van der Hart, O., & Kruger, K. (2002) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.332 · Cited by 387 · see citing works
Self-citationHippocampal and Amygdalar Volumes in Dissociative Identity Disorder
Vermetten, E., Schmahl, C., Lindner, S., Loewenstein, R. J., & Bremner, J. D. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.4.630 · Cited by 296 · see citing works
Prevalence of Dissociative Disorders in Psychiatric Outpatients
Foote, B., Smolin, Y., Kaplan, M., Legatt, M. E., & Lipschitz, D. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.4.623 · Cited by 277 · see citing works
Lanius, R. A., Bluhm, R. L., Coupland, N. J., Hegadoren, K. M., Rowe, B., Théberge, J., Neufeld, R. W. J., Williamson, P. C., & Brimson, M. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2009.01391.x · Cited by 273 · see citing works
Gray Matter Correlates of Posttraumatic Stress Disorder: A Quantitative Meta-Analysis
Kühn, S., & Gallinat, J. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2012.06.029 · Cited by 259 · see citing works
Houtepen, L. C., Vinkers, C. H., Carrillo-Roa, T., Hiemstra, M., van Lier, P. A., Meeus, W., Branje, S., Heim, C. M., Nemeroff, C. B., Mill, J., et al. (2016) · Nature Communications · doi:10.1038/ncomms10967 · Cited by 242 · see citing works
Affect Regulation and the Origin of the Self
Schore, A. N. (2012) · Psychology Press eBooks · doi:10.4324/9781410604163 · Cited by 237 · see citing works
Prevalence of dissociative disorders among women in the general population
Şar, V., Akyüz, G., & Doğan, O. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2006.01.005 · Cited by 236 · see citing works
Brain Surface Anatomy in Adults With Autism
Ecker, C., Ginestet, C. E., Feng, Y., Johnston, P., Lombardo, M. V., Lai, M., John Suckling, A., Palaniyappan, L. K., Daly, E., Murphy, C. M., et al. (2012) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.265 · Cited by 226 · see citing works
Self-citationMultiple personality disorder in The Netherlands: a clinical investigation of 71 patients
Boon, S., & Draijer, N. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.3.489 · Cited by 198 · 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
Self-citationReinders, A. A. T. S. (2003) · NeuroImage · doi:10.1016/j.neuroimage.2003.08.021 · Cited by 181 · see citing works
Self-citationMeasuring and comparing brain cortical surface area and other areal quantities
Winkler, A. M., Sabuncu, M. R., Yeo, B. T. T., Fischl, B. R., Greve, D. N., Kochunov, P., Nichols, T. E., Blangero, J., & Glahn, D. C. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2012.03.026 · Cited by 176 · see citing works
Nardo, D., Högberg, G., Looi, J. C., Larsson, S., Hällström, T., & Pagani, M. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.10.014 · Cited by 135 · see citing works
Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States
Reinders, A. A. T. S., Willemsen, A. T. M., Vos, H. P. J., den Boer, J. A., & Nijenhuis, E. R. S. (2012) · PLoS ONE · doi:10.1371/journal.pone.0039279 · Cited by 120 · see citing works
Self-citationTrauma 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 101 · see citing works
Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R. S., Draijer, N., Cole, J. H., Dazzan, P., Pariante, C. M., Madsen, S. K., Rajagopalan, P., et al. (2015) · Human Brain Mapping · doi:10.1002/hbm.22730 · Cited by 100 · see citing works
Self-citationMeng, Y., Qiu, C., Zhu, H., Lama, S., Lui, S., Gong, Q., & Zhang, W. (2014) · Behavioural Brain Research · doi:10.1016/j.bbr.2014.05.021 · Cited by 96 · see citing works
Reinders, 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 · see citing works
Self-citationThe co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD
Armour, C., Karstoft, K.-I., & Richardson, J. D. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0819-y · Cited by 90 · see citing works
Tsoory, M., Guterman, A., & Richter‐Levin, G. (2007) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301397 · Cited by 88 · see citing works
Schlumpf, 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 · see citing works
Self-citationDissociative depression among women in the community
Sar, V., Akyüz, G., Öztürk, E., & Alioğlu, F. (2013) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2012.753654 · Cited by 86 · see citing works
Schlumpf, 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 85 · see citing works
Self-citationVissia, E. M., Giesen, M. E., Chalavi, S., Nijenhuis, E. R. S., Draijer, N., Brand, B. L., & Reinders, A. A. T. S. (2016) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12590 · Cited by 85 · see citing works
Self-citationToward an etiology of dissociative identity disorder: a neurodevelopmental approach.
Forrest, K. A. (2001) · Consciousness and Cognition · doi:10.1006/ccog.2001.0493 · Cited by 71 · see citing works
Ecker, C., Shahidiani, A., Feng, Y., Daly, E., Murphy, C., D’Almeida, V., Deoni, S., Williams, S., Gillan, N., Gudbrandsen, M., et al. (2014) · Journal of Neural Transmission · doi:10.1007/s00702-014-1207-1 · Cited by 65 · see citing works
Self-citationTsai, G. E., Condie, D., Wu, M.-T., & Chang, I.-W. (1999) · Harvard Review of Psychiatry · doi:10.1093/hrp/7.2.119 · Cited by 64 · see citing works
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. (2015) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2015.01.014 · Cited by 63 · see citing works
Self-citationChanges in brain anatomy during the course of posttraumatic stress disorder
Cardenas, V. A., Samuelson, K. W., Lenoci, M., Studholme, C., Neylan, T. C., Marmar, C. R., Schuff, N. W., & Weiner, M. W. (2011) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2011.01.013 · Cited by 62 · see citing works
Volume of discrete brain structures in complex dissociative disorders: preliminary findings
Ehling, T., Nijenhuis, E. R. S., & Krikke, A. P. (2007) · Progress in Brain Research · doi:10.1016/s0079-6123(07)67029-0 · Cited by 52 · see citing works
Self-citationChalavi, S., Simmons, A., Dijkstra, H., Barker, G. J., & Reinders, A. A. T. S. (2012) · BMC Medical Imaging · doi:10.1186/1471-2342-12-27 · Cited by 51 · see citing works
Self-citationThe Psychobiology of Authentic and Simulated Dissociative Personality States: The Full Monty
Reinders, A. A. T. S., Willemsen, A. T. M., Vissia, E. M., Vos, H. P. J., den Boer, J. A., & Nijenhuis, E. R. S. (2016) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000522 · Cited by 51 · see citing works
Self-citationTsai, G. E., Condie, D., Wu, M.-T., et al. (1999) · Harvard Review of Psychiatry · doi:10.3109/hrp.7.2.119 · Cited by 51 · see citing works
Daniels, J. K., Frewen, P., Theberge, J., & Lanius, R. A. (2016) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12464 · Cited by 40 · cited 1× · see citing works
“A voxel-based morphometry (VBM) study reported a significant positive correlation between dissociation severity [depersonalization/derealization as measured by items 29 and 30 of the Clinician Administered PTSD Scale (CAPS)] and gray matter volume in the right middle frontal gyrus but did not report any significant ne…”
MethodDorsal Anterior Cingulate Thickness Is Related to Alexithymia in Childhood Trauma-Related PTSD
Demers, L. A., Olson, E. A., Crowley, D. J., Rauch, S. L., & Rosso, I. M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0139807 · Cited by 29 · see citing works
Nijenhuis, E. R. S. (2015) · Cited by 28 · see citing works
Self-citationCortical morphology and early adverse birth events in men with first-episode psychosis
Smith, G. N., Thornton, A. E., Lang, D. J., MacEwan, G. W., Kopala, L. C., Su, W., & Honer, W. G. (2014) · Psychological Medicine · doi:10.1017/s003329171400292x · Cited by 27 · see citing works
Parlar, M. E., Densmore, M., Hall, G. B., Lanius, R. A., & McKinnon, M. C. (2017) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2017.07.004 · Cited by 22 · see citing works
DID is trauma based: further evidence supporting the trauma model of DID
Brand, B. L., Vissia, E. M., Chalavi, S., Nijenhuis, E. R. S., Webermann, A. R., Draijer, N., & Reinders, A. A. T. S. (2016) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12653 · Cited by 18 · see citing works
Self-citationXiong (1999) · doi:10.1002/(sici)1097-0193(1999)8:2/3
Flagged first, then by citations
Research works printed but not linked: 2
- STEINBERG M. Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID- D). Washington DC: American Psychiatric Press, 1993
- WORSLEY KJ, ANDERMANN M, KOULIS T, MACDONALD D, EVANS AC. Detecting changes in nonisotropic images. Hum Brain Mapp 1999;8:98-101.
Cited by
Sorted by citations
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
Self-citationReinders, A. A. T. S., Marquand, A. F., Schlumpf, Y. R., Chalavi, S., Vissia, E. M., Nijenhuis, E. R. S., Dazzan, P., Jäncke, L., & Veltman, D. J. (2019) · British Journal of Psychiatry · doi:10.1192/bjp.2018.255 · Cited by 73 · see citing works
Self-citationLotfinia, S., Soorgi, Z., Mertens, Y., & Daniels, J. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.05.006 · Cited by 53 · see citing works
Treatment of dissociative identity disorder: leveraging neurobiology to optimize success
Purcell, J. B., Brand, B., Browne, H. A., Chefetz, R. A., Shanahan, M., Bair, Z. A., Baranowski, K. A., Davis, V., Mangones, P., Modell, R. L., et al. (2024) · Expert review of neurotherapeutics · doi:10.1080/14737175.2024.2316153 · Cited by 17 · see citing works
- Authors
- Reinders, A. A. T. S., Chalavi, S., Schlumpf, Y. R., Vissia, E. M., Nijenhuis, E. R. S., Jäncke, L., Veltman, D. J., & Ecker, C.
- Affiliations
- University Medical Center Groningen (NL)
- University of Zurich (CH)
- Clienia AG (CH)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Goethe University Frankfurt (DE)
- Corresponding author
- Reinders, A. A. T. S.
- ORCID
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2017-12-27
- Volume
- 137
- Issue
- 2
- Pages
- 157-170
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2776423230
- Cited by
- 52
- References
- 58
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 9 · 2023: 5 · 2022: 12 · 2021: 4 · 2020: 8 · 2019: 1 · 2018: 3
- FWCI
- 2.69
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Netherlands Organization for Scientific Research (451-07-009)
- David Caul graduate research grant from the International Society for the Study of Trauma and Dissociation (ISSTD)
- Forschungskredit UZH
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- dissociative identity disorder, cortical thickness, cortical surface area, cortical volume, cortical morphology, early childhood trauma, dissociative symptoms, insula, anterior cingulate cortex, orbitofrontal cortex, temporal cortex, brain development
- MeSH terms
- Adult Survivors of Child Adverse Events, Adverse Childhood Experiences, Adult, Cerebral Cortex, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Middle Aged, Dissociative Identity Disorder, Stress Disorders, Post-Traumatic, Comorbidity, Case-Control Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
