The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index.
Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype
Open accessAbstract
In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.
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“Specifically, when the prefrontal cortex is shutdown among individuals with classic PTSD, it can propagate an emotion under-modulation symptom profile, which includes hypervigilance and hyperarousal symptoms.”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Lanius et al., 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“In response to trauma scripts, patients with the reexperiencing/hyperarousal response—as in PTSD—show decreased activation in anterior brain regions implicated in regulating arousal and emotion (ventromedial prefrontal cortex and rostral anterior cingulate cortex), decreased activation in the thalamus and occipital cortices, and increased activity in the amygdala and insula.53–58”
From Fear and the Defense Cascade (2015) · cites this paper as [56]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Building on this seminal work, Lanius et al. (2010) proposed a neurobiological model of PTSD-DS, characterized primarily by symptoms of derealization, depersonalization, and tonic hypoarousal that contrasted with the more typical symptoms of re-experiencing and hyperarousal that feature predominately in the majority of cases of PTSD.”
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., 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Ultimately, this undermines the proposed neurobiological basis (e.g. Lanius et al., 2010; Terpou et al., 2019) of the defense cascade model and the dissociative subtype as a whole.”
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., 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“In addition to these core cognitive and affective symptoms, individuals with PTSD have shown unique neural signatures that overlap with key brain regions involved in the sensory transmission of incoming interoceptive and exteroceptive sensations, including the brainstem, the insula, and the prefrontal cortex (Lanius et al., 2010; Nicholson et al., 2015, 2017; Daniels et al., 2016; Sierk et al., 2”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Lanius et al., 2010
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“Moreover, in patients with the PTSD dissociative subtype, the prefrontal cortex is thought to play an inhibitory role on subcortical structures identified in the innate alarm system, including the amygdala and the periaqueductal gray, which contributes to an emotion over-modulation symptom profile, including depersonalization/derealization and emotional detachment behaviors (Lanius et al., 2010; N”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Lanius et al., 2010
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“Here, we propose that sensory-based treatments may be an alternative mechanism that can bring online the prefrontal cortex, a key brain region for multisensory integration, emotion regulation and social cognition, which may be offline under certain conditions (Lanius et al., 2010; Aupperle et al., 2013).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Lanius et al., 2010
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“Lanius and colleagues have proposed a model of heightened prefrontal recruitment with associated dampening of amygdala-based threat responding [64].”
From Trauma, PTSD, and the Developing Brain (2017) · cites this paper as [64]
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“Similarly, greater activity in prefrontal cortex was associated with subjective feelings of dissociation (e.g., depersonalization/derealization) across various emotionally provocative tasks [147–149].”
From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [147]
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“prior work indicates that individuals with the dissociative subtype of PTSD have greater activity in regions associated with “top-down” regulation (e.g., prefrontal cortex) and diminished activity in limbic regions (e.g., amygdala) when presented with emotionally provocative autobiographical trauma-related scripts [147,148].”
From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [147]
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“Thereby, dissociation can become maladaptive [10] and possibly interfere with treatment [46–50].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [10]
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“Dissociation can also develop in the aftermath of trauma and generalize across situations”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [10]
The cited source says what the claim attributes to it.
In the citing paper
“Based on more recent neuroimaging findings in PTSD [10], Lanius and colleagues (2010) proposed a neurobiological model that distinguishes between two types of responses to traumatic reminders or other stressors: patients with a dissociative response type (D-PTSD) are thought to “over-modulate” their emotions, as opposed to patients who primarily suffer from re-experiencing symptoms”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [10]
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“Patients who reported a stronger increase of state dissociation (DSS) showed significantly lower amygdala reactivity to negative distractors [139], in line with aforementioned findings by Hazlett and colleagues [135] and theoretical models [10].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [10]
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“Dissociation may be a protective strategy to cope with overwhelming emotions in traumatic/stressful situations [1, 3, 10].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [10]
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In the citing paper
“Pathological dissociation is a complex and heterogeneous phenomenon [2–4, 153], which has been closely linked to traumatic stress [1, 10].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [10]
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“Neurobiological studies of PTSD-DS continue to underscore the observation that depersonalization and derealization represent distinct responses from re-experiencing/hyperarousal reactivity in persons with PTSD (Lanius et al., 2010(Lanius et al., , 2012(Lanius et al., , 2006;;Nicholson et al., 2015).”
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., 2010
The cited source says what the claim attributes to it.
In the citing paper
“Specifically, whereas reliving responses are thought to be mediated by a failure of prefrontal inhibition or top-down control of limbic regions, depersonalization and derealization responses are thought to be mediated by increased prefrontal inhibition of limbic regions.”
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., 2010
The cited source says what the claim attributes to it.
In the citing paper
“this pattern of brain activity is similar to that seen in patients with the PTSD-DS during presentation of trauma-related scripts (Lanius et al., 2010(Lanius et al., , 2012(Lanius et al., , 2006)).”
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., 2010
The cited source says what the claim attributes to it.
In the citing paper
“Evidence of distinct patterns of neural activity (Frewen and Lanius, 2006;Lanius et al., 2010Lanius et al., , 2012) )”
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., 2010
The cited source says what the claim attributes to it.
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“Lanius et al. (2010) postulated that among individuals with the PTSD dissociative subtype, overactivation in the prefrontal cortex exerts top-down inhibitory effects on the amygdala, which is a key structure for emotion processing.”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Lanius et al. (2010)
The cited source says what the claim attributes to it.
In the citing paper
“Interestingly, these patterns differ from previous studies conducted by our research group that suggest among individuals with the PTSD dissociative subtype, the prefrontal cortex exerts top-down inhibitory effects on emotional reactivity structures (Lanius et al., 2010; Nicholson et al., 2017).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Lanius et al., 2010
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Integrating NIMH Research Domain Criteria (RDoC) into PTSD Research
Schmidt, U., & Vermetten, E. H. G. J. M. (2017) · Current topics in behavioral neurosciences · doi:10.1007/7854_2017_1 · Cited by 49
“Lanius and colleagues state that only patients suffering from the dissociative subtype of PTSD show a frequent and severe overactivity of the prefrontal area with consecutive hypersuppression of limbic regions upon exposure to trauma-narrative scripts (emotional overmodulation) [138].”
InfluentialSelf-citationRisk and Resilience Factors of Post-Traumatic Stress Disorder: A Review of Current Research
Lauth, G. (2016) · Clinical and Experimental Psychology · doi:10.4172/2471-2701.1000120 · Cited by 21
Childhood trauma, PTSD/CPTSD and chronic pain: A systematic review
Karimov-Zwienenberg, M., Symphor, W., Peraud, W., & Décamps, G. (2024) · PLoS ONE · doi:10.1371/journal.pone.0309332 · Cited by 45
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“An alternative dysregulation model, whereby hyperactive medial prefrontal regions overmodulate fear networks, has also been proposed for a dissociative subtype of PTSD (Lanius et al., 2010).”
BackgroundImperatori, C., Mazzotti, E., Farina, B., Mansutti, F., Prunetti, E., Speranza, A. M., & Barbaranelli, C. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s105110 · Cited by 49
“37 Moreover, as stated by Brown, 6 different forms of dissociative problems require different types of treatment and the “one-size-fits-all” approach implied by the unitary model of dissociation could be clinically misleading.”
Olivé, I., Densmore, M., Harricharan, S., Théberge, J., McKinnon, M. C., & Lanius, R. A. (2017) · Human Brain Mapping · doi:10.1002/hbm.23865 · Cited by 42
“Nevertheless, in light of evidence demonstrating the involvement of the medial prefrontral cortex (mPFC) in emotion regulation associated with PTSD [Kozlowska et al., 2015; Lanius et al., 2010], it was hypothesized that the role of the bilateral DLPFC in emotional anticipation of negative images would reflect the enga…”
BackgroundSelf-citationGómez, J. M. (2018) · Violence Against Women · doi:10.1177/1077801218811682 · Cited by 50
Gandubert, C., Scali, J., Ancelin, M., Carrière, I., Dupuy, A., Bagnolini, G., Ritchie, K. A., Sebanne, M., Martrille, L., Baccino, É., et al. (2016) · Neurobiology of Stress · doi:10.1016/j.ynstr.2016.02.002 · Cited by 44
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“Dissociative subtypes of posttraumatic stress disorder and schizophrenic disorder are increasingly accepted by clinicians and researchers as valid constructs (Lanius et al., 2010; Ross, 1997; Sar et al., 2010).”
BackgroundConsiderations of Dissociation, Betrayal Trauma, and Complex Trauma in the Treatment of Incest
Lawson, D. M., & Akay, S. (2020) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2020.1751369 · Cited by 60
“Some studies note that DD interfere with engagement in treatment, especially if strong emotions are involved (Lanius et al., 2010).”
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“In the context of these earlier findings, our results suggest that dissociation may underlie attempts of increasing ER, possibly at the cost of other mental processes that are crucial to goaldirected behavior (Lanius et al., 2010).”
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“These conflicting findings in the literature point to the need to take into account the heterogeneity in symptomatology between anxiety disorders, including PTSD subtypes (Lanius et al., 2010), when investigating psychophysiological responses to threat cues in trauma-exposed populations.”
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“Based on the evidence for dissociation-related symptom and response variations (e.g., Lanius et al., 2010), a dissociative subtype of PTSD has been introduced into the latest version of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5: APA, 2013).”
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“The second proposed approach to addressing posttraumatic dissociation in diagnostic nosology is to create a dissociative subtype of PTSD (PTSD-D; Lanius et al., 2010; Lanius, Brand, Vermetten, Frewen, & Spiegel, 2012).”
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“Many clinical and neurobiological factors have also been identified that differentiate this subtype from “pure” PTSD and non-PTSD populations (Lanius et al., 2010; Wolf et al., 2012).”
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“stress disorder (PTSD) [100, 101] and depersonalization disorder [102], highlighting their trans-diagnostic rele-”
BackgroundInfluentialComplex posttraumatic stress disorder and survivors of human rights violations
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Miles, S. R., Sharp, C., Tharp, A. T., Stanford, M. S., Stanley, M. A., Thompson, K. E., & Kent, T. A. (2017) · Aggression and Violent Behavior · doi:10.1016/j.avb.2017.01.017 · Cited by 38
“PTSD involves both under-regulation of fear and other emotions (hyperarousal symptoms) and over-regulation through avoidance and dissociation (Lanius et al., 2010).”
BackgroundKizilhan, J. I., Steger, F., & Noll‐Hussong, M. (2020) · The British Journal of Psychiatry · doi:10.1192/bjp.2020.2 · Cited by 37
“39,40 Furthermore, this study has revealed that the percentage of prior sexual and physical abuse is significantly higher in the investigation group than in the control group.”
Autonomic Reactivity to Infant Crying in Maltreating Mothers
Reijman, S., Alink, L. R. A., Block, L. C.-D., Werner, C. D., Maras, A., Rijnberk, C., van IJzendoorn, M. H., & Bakermans‐Kranenburg, M. J. (2014) · Child Maltreatment · doi:10.1177/1077559514538115 · Cited by 36
“A dissociative subtype of posttraumatic stress disorder has been distinguished from the reexperiencing/hyperaroused subtype and is marked by neurological overregulation of affect and arousal, accompanied by a lack of autonomic arousal in response to traumatic stimuli (Lanius et al., 2010).”
BackgroundMyrick, A. C., Chasson, G. S., Lanius, R. A., Leventhal, B., & Brand, B. L. (2014) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2014.949020 · Cited by 38
Self-citationResting‐state pulvinar‐posterior parietal decoupling in PTSD and its dissociative subtype
Terpou, B. A., Densmore, M., Théberge, J., Frewen, P., McKinnon, M. C., & Lanius, R. A. (2018) · Human Brain Mapping · doi:10.1002/hbm.24242 · Cited by 39
“Dysfunction of these large-scale networks relate directly to observed impairments in PTSD, which include alterations in attention (Block et al., 2017; Hart et al., 2017; Shalev et al., 1998), awareness (Craig, 2009), and emotion regulation (Etkin & Wagner, 2007; Lanius et al., 2010).”
BackgroundInfluentialSelf-citationShu, I.-W., Onton, J., O’Connell, R. M., Simmons, A. N., & Matthews, S. C. (2014) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2014.07.010 · Cited by 35
“Since patients with PTSD commonly report difficulties controlling ongoing brain processes, including trauma-related thoughts and feelings (Lanius et al., 2010), abnormal inhibitory processing by the ACC may play a role in the pathophysiology of PTSD.”
BackgroundExome sequencing of healthy phenotypic extremes links TROVE2 to emotional memory and PTSD
Heck, A., Milnik, A., Vukojević, V., Petrovska, J., Egli, T., Singer, J., Escobar, P., Sengstag, T., Coynel, D., Freytag, V., et al. (2017) · Nature Human Behaviour · doi:10.1038/s41562-017-0081 · Cited by 37
Burton, M. S., Feeny, N. C., Connell, A. M., & Zoellner, L. A. (2018) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000297 · Cited by 38
“A theory derived from brain imaging studies suggests those with PTSD who dissociate show distinct neural processes reflective of an emotion regulation deficit, where the prefrontal cortex overmodulates the limbic system (for a review, see Lanius et al., 2010).”
Chiba, T., Ide, K., Taylor, J. E., Boku, S., Toda, H., Kanazawa, T., Kato, S., Horiuchi, Y., Hishimoto, A., Maruyama, T., et al. (2020) · Molecular Psychiatry · doi:10.1038/s41380-020-0827-0 · Cited by 41
Salami, A., Andreu-Pérez, J., & Gillmeister, H. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.08.011 · Cited by 37
Shame on the brain: Neural correlates of moral injury event recall in posttraumatic stress disorder
Lloyd, C. S., Nicholson, A. A., Densmore, M., Théberge, J., Neufeld, R. W. J., Jetly, R., McKinnon, M. C., & Lanius, R. A. (2021) · Depression and Anxiety · doi:10.1002/da.23128 · Cited by 35
“Finally, significant functional disruption of CEN regions (e.g., dlPFC) has been observed in PTSD samples relative to controls, revealing a bias toward either under‐ or overmodulation of limbic activity (Lanius et al., 2010, 2015; Nicholson et al., 2020).”
BackgroundMethodSelf-citationDissociative Depression Among Women with Fibromyalgia or Rheumatoid Arthritis
Kılıç, Ö., Şar, V., Taycan, O., Poyraz, C. A., Turgut Can, E. R. O. L., Tecer, Ö., Emül, M., & Özmen, M. (2013) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2013.844218 · Cited by 37
Habenula volume in post-traumatic stress disorder measured with high-resolution MRI
Savitz, J. B., Bonne, O. B., Nugent, A. C., Vythilingam, M., Bogers, W., Charney, D. S., & Drevets, W. C. (2011) · Biology of Mood & Anxiety Disorders · doi:10.1186/2045-5380-1-7 · Cited by 35
“This deficit attributed is hypothesized to reflect deficient inhibition of the amygdala by the ventromedial prefrontal cortex (vmPFC) [1-3].”
BackgroundWhite matter network alterations in patients with depersonalization/derealization disorder
Sierk, A., Daniels, J. K., Manthey, A., Kok, J. G., Leemans, A., Gaebler, M., Lamke, J.-P., Kruschwitz, J., & Walter, H. (2018) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.170110 · Cited by 36
Stress 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
Rudstam, G., Elofsson, U. O. E., Söndergaard, H. P., Bonde, L. O., & Beck, B. D. (2017) · Approaches An Interdisciplinary Journal of Music Therapy · doi:10.56883/aijmt.2017.287 · Cited by 33
“CPTSD may also be diagnosed with PTSD plus a dissociative diagnosis: “dissociative subtype of PTSD” (Lanius et al. 2010).”
BackgroundPabst, A., Schauer, M., Bernhardt, K., Ruf, M., Göder, R., Rosentraeger, R., Elbert, T. R., Aldenhoff, J. B., & Seeck-Hirschner, M. (2011) · Psychotherapy and Psychosomatics · doi:10.1159/000329548 · Cited by 33
Mazza, M., Catalucci, A., Mariano, M., Pino, M. C., Tripaldi, S., Roncone, R., & Gallucci, M. (2012) · Brain Imaging and Behavior · doi:10.1007/s11682-012-9151-x · Cited by 36
Current Understanding of the Neural Mechanisms of Dissociation in Borderline Personality Disorder
Krause-Utz, A., & Elzinga, B. M. (2018) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-018-0146-9 · Cited by 36
“survival or the coping with extreme threat [22, 25, 26, 38, 44, 51].”
BackgroundResultInfluentialdel Río-Casanova, L., González, A., Páramo, M., Van Dijke, A., & Brenlla, J. (2016) · Reviews in the Neurosciences · doi:10.1515/revneuro-2015-0045 · Cited by 32
“…characterized either by a predominant hyperactivation (recall, flashbacks, nightmares, intrusive images or thoughts and a high autonomic arousal level) or by dissociative symptoms linked to emotional distance and lower autonomic activation (Griffin et al., 1997; Lanius et al., 2010a,b).”
BackgroundPowers, A., Fani, N., Murphy, L., Briscione, M., Bradley, B., Tone, E. B., Norrholm, S. D., & Jovanovic, T. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1568133 · Cited by 38
“Re- experiencing symptoms (in addition to hyperarousal symptoms) may also represent particular difficulty with emotional undermodulation, or failure of prefrontal inhibition of limbic regions in the face of trauma reminders (or negative emotional cues) (Lanius et al., 2010).”
BackgroundOprel, D. A. C., Hoeboer, C. M., Schoorl, M., de Kleine, R. A., Wigard, I. G., Cloître, M., van Minnen, A., & van der Does, W. A. J. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1967-5 · Cited by 36
Kimonis, E. R. (2023) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-023-00455-2 · Cited by 44
“…emotions, as in dissociation, involves overmodulation of emotions and is characteristic of one PTSD subtype linked to trauma occurring within close interpersonal relationships, relative to an undermodulation subtype that conversely shows hyperarousal and emotional reactivity (Lanius et al., 2010).”
BackgroundKeeshin, B. R., Strawn, J. R., Out, D., Granger, D. A., & Putnam, F. W. (2015) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2014.0034 · Cited by 35
“(DSM-V), based on the evidence that PTSD with dissociation is not only clinically different than nondissociative PTSD, but also has different underlying biological features (Lanius et al. 2010; American Psychiatric Association 2013).”
BackgroundAlterations in positive affect: Relationship to symptoms, traumatic experiences, and affect ratings.
DePierro, J. M., D'Andrea, W. M., Frewen, P., & Todman, M. (2017) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000317 · Cited by 32
Hodgdon, H., Liebman, R. E., Martin, L., Suvak, M. K., Beserra, K., Rosenblum, W., & Spinazzola, J. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22267 · Cited by 32
“Overmodulation of affect among traumatized individuals has been associated with a distinct neurological profile that reflects increased activation of some of the brain areas involved in EF (i.e., the medial prefrontal cortex; Lanius et al., 2010).”
BackgroundtDCS-Augmented in vivo exposure therapy for specific fears: A randomized clinical trial
Cobb, A. R., O’Connor, P., Zaizar, E. D., Caulfield, K. A., Gonzalez-Lima, F., & Telch, M. J. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102344 · Cited by 34
A machine learning approach to modeling PTSD and difficulties in emotion regulation
Christ, N. M., Elhai, J. D., Forbes, C. N., Gratz, K. L., & Tull, M. T. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113712 · Cited by 37
Hawn, S. E., Wolf, E. J., Neale, Z. E., & Miller, M. W. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102177 · Cited by 37
Ten reasons for conceiving and classifying posttraumatic stress disorder as a dissociative disorder
Nijenhuis, E. R. S. (2017) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2017.01.001 · Cited by 37
“These alternations are clinically observed (Lanius et al. 2010) and theoretically formulated in TSDP.”
BackgroundNeuroimaging genetic approaches to Posttraumatic Stress Disorder
Lebois, L. A. M., Wolff, J. D., & Ressler, K. J. (2016) · Experimental Neurology · doi:10.1016/j.expneurol.2016.04.019 · Cited by 31
“Recent research suggests that the reexperiencing subtype of PTSD shows classic amygdala hyper-activity and vmPFC hypo-activity, and in contrast, the dissociative subtype of PTSD shows the opposite pattern (Lanius et al., 2010).”
BackgroundGonçalves, R., Rodrigues, H., Novaes, F. C., Árbol, J. R., Volchan, E., Coutinho, E. S. F., Figueira, I. L. D. V., & Ventura, P. R. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.09.058 · Cited by 30
Tylee, D. S., Gray, R. M., Glatt, S. J., & Bourke, F. (2017) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh.4120 · Cited by 32
Assessing the structure and meaningfulness of the dissociative subtype of PTSD
Ross, J., Baník, G., Dědová, M., Mikulášková, G., & Armour, C. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1445-2 · Cited by 38
“More specifically, individuals with PTSD and symptoms of depersonalization or derealization show abnormally high activation in the medial prefrontal cortex and the anterior cingulate cortex and hyper-inhibition of the limbic system [16].”
BackgroundA structural MRI study of cortical thickness in depersonalisation disorder
Sierra, M., Nestler, S., Jay, E.-L., Ecker, C., Feng, Y., & David, A. S. (2014) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2014.06.007 · Cited by 30
“, 2002a) showed increased activation in the vmPFC, together with decreased activation in limbic areas (Lanius et al., 2010).”
BackgroundWidyatmoko, C. S., Tan, E. T., Seyle, D. C., Mayawati, E. H., & Silver, R. C. (2011) · School Psychology International · doi:10.1177/0143034311402919 · Cited by 31
Autonomic Changes in Psychogenic Nonepileptic Seizures
Reinsberger, C., Sarkis, R. A., Papadelis, C. L., Doshi, C., Perez, D. L., Baslet, G. C., Loddenkemper, T., & Dworetzky, B. A. (2015) · Clinical EEG and Neuroscience · doi:10.1177/1550059414567739 · Cited by 31
“This hyperarousability may be indicative of functional and structural alterations in brain networks mediating ANS control.(32,33)”
BackgroundGrey matter alterations in patients with depersonalization disorder: a voxel-based morphometry study
Daniels, J. K., Gaebler, M., Lamke, J.-P., & Walter, H. (2015) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.130284 · Cited by 37
Jerud, A. B., Zoellner, L. A., Pruitt, L. D., & Feeny, N. C. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0036520 · Cited by 31
“First, given that impaired emotion regulation has been associated not only with CA but also with PTSD (Boden, Bonn-Miller, Kashdan, Alvarez, & Gross, 2012; Eftekhari, Zoellner, & Vigil, 2009; Lanius, Bluhm, & Frewen, 2011; Lanius et al., 2010; Tull, Barrett, McMillan, & Roemer, 2007), we hypothesized that those with a…”
Dysfunctional Pain Modulation in Torture Survivors: The Mediating Effect of PTSD
Defrin, R., Lahav, Y., & Solomon, Z. (2016) · Journal of Pain · doi:10.1016/j.jpain.2016.09.005 · Cited by 31
Classification of Posttraumatic Stress Disorder
Ball, T. M., & Stein, M. B. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195399066.013.0004 · Cited by 31
Nazarov, A., Frewen, P., Oremus, C., Schellenberg, E. G., McKinnon, M. C., & Lanius, R. (2015) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12364 · Cited by 30
Self-citationFunctional Neuroimaging in Dissociative Disorders: A Systematic Review
Modesti, M. N., Rapisarda, L., Capriotti, G., & CASALE, A. D. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12091405 · Cited by 38
“Established models have linked dissociation with increased recruitment in regions involved in executive control [16,17], such as the ventromedial prefrontal cortex, anterior cingulate cortex, and inferior frontal gyri, resulting in dampened activation of the amygdala.”
BackgroundMelara, R. D., Ruglass, L. M., Fertuck, E. A., & Hien, D. A. (2018) · Biological Psychology · doi:10.1016/j.biopsycho.2018.01.017 · Cited by 33
Insight and Dissociation in Lucid Dreaming and Psychosis
Voss, U., D’Agostino, A., Kolibius, L. D., Klimke, A., Scarone, S., & Hobson, J. A. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02164 · Cited by 33
Terpou, B. A., Densmore, M., Théberge, J., Frewen, P., McKinnon, M. C., Nicholson, A. A., & Lanius, R. A. (2020) · NeuroImage Clinical · doi:10.1016/j.nicl.2020.102345 · Cited by 35
Self-citationStructure of ICD-11 complex PTSD and relationship with psychoform and somatoform dissociation
Møller, L., Bach, B., Augsburger, M., Elklit, A., Søgaard, U., & Simonsen, E. H. (2021) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2021.100233 · Cited by 35
Terpou, B. A., Lloyd, C. S., Densmore, M., McKinnon, M. C., Théberge, J., Neufeld, R. W. J., Jetly, R., & Lanius, R. A. (2022) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.210117 · Cited by 30
Self-citationCraske, M. G., Herzallah, M. M., Nusslock, R., & Patel, V. (2023) · Nature Mental Health · doi:10.1038/s44220-022-00012-w · Cited by 31
“…post-traumatic stress disorder exhibit amygdala hyperactivation and prefrontal cortex hypoactivation in response to trauma reminders, whereas others show the reverse pattern, and these neural differences have been linked to symptom profiles of emotional reactivity versus numbing and avoidance 81 .”
Reconsidering the autohypnotic model of the dissociative disorders
Dell, P. F. (2019) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2018.1451806 · Cited by 29
“For a different approach to evolution-prepared defenses, see the symptom-provocation studies of dissociative PTSD patients (Frewen & Lanius, 2006; Lanius et al., 2010) and their use-dependent consequences for resting functional connectivity in PTSD (Nicholson et al., 2015, 2016).”
BackgroundKilpatrick, D. G., Friedman, M. J., & Gilmore, A. K. (2020) · doi:10.1093/med/9780198713005.003.0078 · Cited by 29
A Functional Magnetic Resonance Imaging Meta-Analysis of Childhood Trauma
Ireton, R., Hughes, A. E., & Klabunde, M. (2024) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2024.01.009 · Cited by 36
Measuring Trauma: Considerations for Assessing Complex and Non-PTSD Criterion A Childhood Trauma
McDonald, M. K., Borntrager, C. F., & Rostad, W. L. (2014) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2014.867577 · Cited by 29
Rowland, G. E., Mekawi, Y., Michopoulos, V., Powers, A. D., Fani, N., Bradley, B., Ressler, K. J., Jovanović, T., & Stevens, J. S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.08.099 · Cited by 34
Gore-Felton, C. E., Ginzburg, K., Chartier, M., Gardner, W., Agnew‐Blais, J. C., McGarvey, E. L., Weiss, E., & Koopman, C. (2012) · Journal of Behavioral Medicine · doi:10.1007/s10865-012-9400-x · Cited by 29
“Emotion-focused coping has been strongly and consistently associated with PTSD (Brown et al., 2003), which is not surprising given a hallmark feature of PTSD is lack of emotion regulation which is linked to neurobiological factors (Lanius et al., 2010).”
Cadamuro, A., Versari, A., Vezzali, L., Giovannini, D., & Trifiletti, E. (2014) · Child & Youth Care Forum · doi:10.1007/s10566-014-9272-z · Cited by 30
Ben‐Zion, Z., Fine, N. B., Keynan, J. N., Admon, R., Halpern, P., Liberzon, I., Hendler, T., & Shalev, A. Y. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1683941 · Cited by 31
“Although dissociative PTSD subtype was previously associated with altered neural mechanisms (Lanius et al., 2010), it was most common among PTSD stemming from childhood trauma (De Bellis, Woolley, & Hooper, 2013; Rivera-Vélez, González-Viruet, Martínez-Taboas, & Pérez-Mojica, 2014).”
BackgroundWabnitz, P., Gast, U., & Catani, C. (2013) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v4i0.21452 · Cited by 28
“This view of different reaction tendencies to trauma reminders in PTSD is consistent with the notion of separated neural manifestations of dissociative and hyperarousal subtypes of PTSD put forward by Lanius and colleagues (Lanius et al., 2010).”
BackgroundResultDissociative Depression is Resistant to Treatment-As-Usual
Şar, V. (2015) · Journal of Psychology & Clinical Psychiatry · doi:10.15406/jpcpy.2015.03.00128 · Cited by 28
“Recently, a dissociative subtype of PTSD has been introduced [1,22] which may also overlap with the mentioned syndromes in some cases.”
Background
Metadata
- Authors
- Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D.
- Affiliations
- Western University (CA)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2010-06-01
- Volume
- 167
- Issue
- 6
- Pages
- 640-647
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3226703
- OpenAlex
- W2124556602
- Cited by
- 1,123
- References
- 53
- Citations by year
- 2026: 61 · 2025: 74 · 2024: 64 · 2023: 67 · 2022: 69 · 2021: 74 · 2020: 71 · 2019: 61 · 2018: 84 · 2017: 84 · 2016: 71 · 2015: 66 · 2014: 86 · 2013: 57 · 2012: 74
- FWCI
- 8.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- AstraZeneca
- H. Lundbeck A/S
- National Institutes of Health (UL1TR000454)
- National Institute on Aging (P01AG018784)
- National Heart, Lung, and Blood Institute (R01HL088726)
- National Institute of Mental Health (R21MH080208, R01MH056120, R01MH047226, K24MH076955, T32MH067547, R01MH060556)
- National Cancer Institute (R01CA118567, R01CA061309, U01CA197282)
- National Center for Research Resources (S10RR016917)
- National Center for Advancing Translational Sciences
- National Center for Complementary and Integrative Health (RC1AT005733, P30AT005886)
- 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, emotional dysregulation, re-experiencing, hyperarousal, limbic regions, dissociation, trauma treatment, symptom profiles
- MeSH terms
- Affect, Amygdala, Cerebral Cortex, Chronic Disease, Dissociative Disorders, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Memory Disorders, Neural Inhibition, Stress Disorders, Post-Traumatic
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