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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.
In the citing paper
“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.
In the citing paper
“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.
In the citing paper
“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
Experimental — accuracy not yet measured
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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
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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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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In the citing paper
“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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In the citing paper
“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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In the citing paper
“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]
The cited source says what the claim attributes to it.
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]
The cited source says what the claim attributes to it.
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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.
In the citing paper
“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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“In this context, it is interesting to note that traumatized individuals are thought to alternate between states of emotional under- and overarousal, which have also been linked to insular hypo- or hyperactivation (Frewen and Lanius, 2006; Lanius et al., 2010).”
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“In addition, imaging studies similar to those done in dissociative subtype of PTSD might be beneficial to illuminate the pathological mechanisms of emotional abnormality in dissociative depression (Lanius et al., 2010).”
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ЭНЦИКЛОПЕДИЯ МАГИИ КАК КОГНИТИВНОЙ ДИСЦИПЛИНЫ
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“A person struggling with these impairments may be diagnosed with a condition of depersonalization or dissociation, Dissociative Identity Disorder, (Lanius et al., 2010), Borderline Personality Disorder, or even psychosis (Schore, 2003; Fonagy and Luyten, 2015).”
BackgroundTomán, E., Pintér, J. N., & Hargitai, R. (2022) · Psychiatry Research Communications · doi:10.1016/j.psycom.2022.100101 · Cited by 8
“According to Lewis et al. (2014) the uncertainty of COPD patients arising from their illness fundamentally affects their lived experiences of their illness right from diagnosis, This uncertainty related to their lived experience temporally – related to their past, present and future experiences.”
BackgroundPredicting Fear Extinction in Posttraumatic Stress Disorder
Lewis, M. W., Webb, C. A., Kuhn, M., Akman, E., Jobson, S. A., & Rosso, I. (2023) · Brain Science · doi:10.3390/brainsci13081131 · Cited by 6
Tannura, T. A. (2014) · American Journal of Sexuality Education · doi:10.1080/15546128.2014.883267 · Cited by 7
“PTSD is an anxiety disorder that can develop when an individual experiences a terrifying or traumatic event (Lanius et al., 2010).”
BackgroundThe Neural Correlates of Vertical Splitting in a Single Case Study
Wolk, P. C., Savoy, R. L., & Frederick, B. B. (2012) · Neuropsychoanalysis · doi:10.1080/15294145.2012.10773699 · Cited by 7
Juggling-Exposure Therapy: An Innovation in Trauma Treatment
Welburn, K. R. (2014) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2014.949019 · Cited by 7
“The two types of defensive strategies are associated with the hyperaroused and dissociative subtypes of PTSD (Lanius et al., 2010).”
BackgroundWegen, K. S., van Dijke, A., Aalbers, A., & Zedlitz, A. M. E. E. (2017) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2017.06.001 · Cited by 7
“Introduction Affect dysregulation plays a critical role in posttraumatic stress disorder (PTSD) and in substance use disorders (SUD) (Berking et al., 2011; Coffey, Saladin, Drobes, Brady, & Kilpatrick, 2002; Ford & Smith, 2008; Lanius et al., 2010; Yael Dvir, Ford, Hill, & Frazier, 2014).”
BackgroundResultInfluentialTreating Complex Trauma Survivors
Loewenstein, R. J., Brand, B. L., Gilbert, L. E., Ma, Dressel, C. E., Camins, J. S., & Pyne, Z. J. (2014) · Cited by 7
Self-citationPsychophysiological Reactivity and PTSD Symptom Severity among Young Women.
Malcolm, L. R., Kibler, J. L., Ma, M., Tursich, M., Augustin, D., Greenbarg, R., & Gold, S. N. (2016) · PubMed · Cited by 7
Nicholson, A. A., McKinnon, M. C., Jetly, R., & Lanius, R. A. (2020) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh.2019-0031 · Cited by 7
Self-citationProtopopescu, A., O’Connor, C., Cameron, D. H., Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2022) · Brain Sciences · doi:10.3390/brainsci12030377 · Cited by 11
“Dissociative symptoms have been proposed as an ER strategy during and following traumatic events [15], as they allow individuals to detach from intense and distressing emotions.”
BackgroundInfluentialSelf-citationStein, D. J., & Ipser, J. (2011) · Wiley eBooks · doi:10.1002/9781119998471.ch4 · Cited by 7
Zhao, J., Guo, Y., Tan, Y., Zhang, Y., Liu, S., Liu, Y., Li, J., Ruan, J., Liu, L., & Ren, Z. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.12.058 · Cited by 6
Memory and identity processes in ICD-11 complex posttraumatic stress disorder: Tests of a new theory
Hyland, P., Broughill, M., Shevlin, M. E., & Brewin, C. R. (2025) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2025.103055 · Cited by 6
“…parallels with brain imaging findings suggestive of disturbances to a coherent and embodied sense of self in the dissociative subtype of DSM-5 PTSD (APA, 2022), which is characterized by over-modulation of affect, depersonalization, and derealization (Lanius et al., 2010; Rabellino et al., 2023).”
D’Alessandro-Lowe, A. M., Scott, A. M., Patel, H., Easterbrook, B., Ritchie, K., Brown, A., Pichtikova, M., Karram, M., Sullo, E., Mirabelli, J., et al. (2024) · Journal of Traumatic Stress · doi:10.1002/jts.23122 · Cited by 7
“This addition to the DSM-5 is consistent with neurobiological research on distinct profiles of individuals with a prototypical presentation of PTSD and those with the dissociative subtype (Lanius et al., 2010, 2012; Shaw et al., 2022).”
Self-citationAarts, I., Vriend, C., Snoek, A., van den End, A., Blankers, M., Beekman, A. T. F., Dekker, J., van den Heuvel, O. A., & Thomaes, K. (2021) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-021-00156-8 · Cited by 7
“Possible predictors for treatment success in PTSD include clinical features such as the severity of dissociative symptoms [39], baseline PTSD severity and presence of comorbid depressive disorder (see [40, 41] for recent systematic reviews).”
BackgroundCorrea, R., Rodriguez, N., & Bortolaso, M. (2021) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2021.100227 · Cited by 4
Mertens, Y. L., Manthey, A., Sierk, A., de Jong, P. J., Walter, H., & Daniels, J. K. (2023) · BJPsych Open · doi:10.1192/bjo.2023.34 · Cited by 6
Danböck, S. K., Hettegger, S. E., Anders, S., Franke, L. K., Liedlgruber, M., Miedl, S. F., Gashi, A., Kurapov, A., Weber, R.-C., Ehring, T. W., et al. (2023) · European Journal of Psychotraumatology · doi:10.1080/20008066.2023.2238492 · Cited by 6
“…risk factors, neurobiological alterations, elevated symptom severity, comorbidity, chronicity and functional impairment as well as di ff erential treatment outcomes (for reviews see Atchley & Bedford, 2021; Beutler et al., 2022; Lanius et al., 2010; Roydeva & Reinders, 2021; Schiavone et al., 2018).”
Sigurvinsdóttir, R., Skúladóttir, H., Antonsdóttir, H. F., Cardenas, P., Georgsdóttir, M. T., Þórisdóttir, M. Í., Jónsdóttir, E. K., Konop, M. A., Valdimarsdóttir, H. B., Vilhjálmsson, H. H., et al. (2023) · Violence Against Women · doi:10.1177/10778012231205589 · Cited by 8
Aarts, I., Thorsen, A. L., Vriend, C., Planting, C. H. M., van den Heuvel, O. A., & Thomaes, K. (2023) · Brain Imaging and Behavior · doi:10.1007/s11682-023-00831-0 · Cited by 11
“Lanius et al. (2010) later described two subtypes of PTSD with their own model of emotion dysregulation.”
InfluentialBorderline personality disorder and sexuality: causes and consequences of dissociative symptoms
Mazinan, R. G., Dudek, C., Warkentin, H. F., Finkenstaedt, M., Schröder, J., Musil, R., Kratzer, L., Fuß, J., & Biedermann, S. V. (2024) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-024-00251-6 · Cited by 6
“…environment (derealization), can be understood as a form of protective mechanism in overwhelming situations to create an inner distance, which can be helpful in inescapable threatening situations such as childhood abuse, but can also interfere with safety judgements in social situations [10, 11].”
BackgroundRoss, C. A., Goode, C., & Schroeder, E. C. (2015) · The Open Psychiatry Journal · Cited by 6
From the Neuropsychiatric to the Analytic
Biswas, J., Chu, J. A., Perez, D. L., & Gutheil, T. G. (2013) · Harvard Review of Psychiatry · doi:10.1097/hrp.0b013e31827fd7c8 · Cited by 6
Using New Approaches in Neurobiology to Rethink Stress-Induced Amnesia
Radulović, J. (2017) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-017-0109-6 · Cited by 6
Dissociative Tendencies and Alcohol Use Disorder
Noël, X., Saeremans, M., Kornreich, C., & Jaafari, N. (2018) · Current Addiction Reports · doi:10.1007/s40429-018-0225-8 · Cited by 6
A Social–Cognitive–Neuroscience Approach to PTSD: Clinical and Research Perspectives
Lanius, R. A., Paul, F. S., Nazarov, A., & Margaret, C. M. (2014) · Springer Publishing Company eBooks · doi:10.1891/9780826106322.0004 · Cited by 6
Self-citationWoods-Jaeger, B. A., Briggs, E. C., Vivrette, R. L., Lee, R. C., Suárez, L., & Belcher, H. M. E. (2019) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-019-00251-7 · Cited by 6
Carvalho, T., Pinto‐Gouveia, J., Cunha, M. I. V. A., & da Motta, C. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23303 · Cited by 7
Psychophysiological predictors of change in emotion dysregulation 6 months after traumatic injury
Fitzgerald, J. M., Timmer‐Murillo, S. C., Sheeran, C., Begg, H., Christoph, M., deRoon‐Cassini, T. A., & Larson, C. L. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.01.005 · Cited by 6
Geng, F., Liang, Y., Zhan, N., & Wang, J. (2022) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2022.2079797 · Cited by 6
“Specifically, patients with D-PTSD are characterized by increased activation in medial prefrontal structures (Lanius et al., 2010), which may constitute the neural basis of emotional dysregulation and abnormal emotional experience.”
BackgroundNestler, S., Jay, E.-L., Sierra, M., & David, A. S. (2014) · Psychopathology · doi:10.1159/000367600 · Cited by 6
Tschöke, S., Uhlmann, C., & Steinert, T. (2011) · Neuropsychiatry · doi:10.2217/npy.11.27 · Cited by 6
The Tri-Modal Reaction (T-MR) Model of Complex Trauma and Dissociation: A Proposal
Şar, V. (2019) · QUADERNI DI PSICOTERAPIA COGNITIVA · doi:10.3280/qpc44-2019oa8149 · Cited by 6
Proposition of Two Subtypes of Patients at Risk of Suicide: Pain Hypersensitive Vs. Dissociative
Bianco, F., Courtet, P., Olié, É., López‐Castromán, J., Madeddu, F., & Calati, R. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01600-0 · Cited by 7
“This conceptualization aligns with the two stress-response patterns observed in PTSD [91, 98] and shares conceptual similarities with SI patterns described by Oquendo and colleagues [ 51 , 124 ].”
InfluentialReduced cerebello-thalamo-cortical functional connectivity during traumatic memory retrieval in PTSD
Kearney, B. E., Densmore, M., Théberge, J., Jetly, R., McKinnon, M. C., Shaw, S. B., & Lanius, R. A. (2025) · Nature Mental Health · doi:10.1038/s44220-025-00476-6 · Cited by 8
“…33–35 , those with PTSD + DS had significantly higher CTQ and MDI total scores and a higher representation of individuals with recurrent major depressive disorder (MDD) relative to PTSD and controls. detachment from the body in depersonalization or from the environment in derealization 8 .”
Self-citationGrzesińska, A. D. (2025) · Current Issues in Molecular Biology · doi:10.3390/cimb47100814 · Cited by 5
Gargiulo, Á. J. M., Colombini, A. P., Trovato, A., Gargiulo, A. P. Í., & D’Alessio, L. (2022) · Psychiatry Research Communications · doi:10.1016/j.psycom.2022.100071 · Cited by 5
Affective Matter: designing human-material interactions to enhance health and wellbeing
Papadopoulou, A. (2024) · Design Science · doi:10.1017/dsj.2024.40 · Cited by 5
“Traumatic experiences can cause somatic sensory processing dysfunction resulting in emotional and bodily detachment (Gottfredson & Becker 2023; Lanius et al. 2010; Van Der Kolk 2015).”
Anatomie et physiologie du stress traumatique
Verney, C., Gressèns, P., & Vitalis, T. (2021) · médecine/sciences · doi:10.1051/medsci/2021165 · Cited by 7
Neurostructural brain imaging study of trait dissociation in healthy children
Badura-Brack, A. S., Marklin, M., Embury, C. M., Picci, G., Frenzel, M. R., Klanecky, A. K., Stephen, J. M., Wang, Y., Calhoun, V. D., & Wilson, T. W. (2022) · BJPsych Open · doi:10.1192/bjo.2022.576 · Cited by 6
“20,21 Roydeva & Reinders ’ review 11 supported the involvement of frontal and limbic regions in pathological dissociation – specifically the dorsomedial and dorsolateral prefrontal cortex, superior frontal regions, anterior cingulate and basal ganglia – as functional biomarkers of pathological…”
Iffland, B., Eilers, R., Rosner, R., Renneberg, B., Steil, R., & Neuner, F. (2023) · Brain and Behavior · doi:10.1002/brb3.2904 · Cited by 4
Zukerman, G., Pinhas, M., & Icht, M. (2023) · Experimental Brain Research · doi:10.1007/s00221-023-06578-w · Cited by 5
Lathan, E. C., Guelfo, A., Barrie, D. L. L., Teer, A. P., Powers, A. D., Siegle, G. J., & Fani, N. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.05.028 · Cited by 5
Liotti, G., & Farina, B. (2013) · Rivista internazionale di filosofia e psicologia · doi:10.4453/rifp.2013.0033 · Cited by 5
Tzannidakis, N. C. A., & Frewen, P. (2015) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2015.1024059 · Cited by 5
“…Fifth Edition (DSM–5), based specifically on the endorsement of experiences of depersonalization and derealization (e.g., Carlson, Dalenberg, & McDade-Montez, 2012; Dalenberg & Carlson, 2012; Lanius, Brand, Vermetten, Frewen, & Spiegel, 2012; Lanius et al., 2010, 2014; Spiegel et al., 2011, 2013).”
BackgroundResultDissociation and the Dissociative Disorders ☆
Cardeña, E. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809324-5.06401-4 · Cited by 5
Goetzmann, L., Siegel, A. M., & Ruettner, B. (2018) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2018.08.001 · Cited by 6
A Neurobiological Perspective of Mental Health Following Torture Trauma
Liddell, B. J., & Bryant, R. A. (2018) · Springer eBooks · doi:10.1007/978-3-319-97046-2_7 · Cited by 5
PTSD in paramedics: history, conceptual issues and psychometric measures
Baqai, K. (2020) · Journal of Paramedic Practice · doi:10.12968/jpar.2020.12.12.495 · Cited by 5
Brantbjerg, M. H. (2021) · Body Movement and Dance in Psychotherapy · doi:10.1080/17432979.2021.1876768 · Cited by 5
“Lanius et al. (2010) differentiate hyper-aroused reactivity – connected to emotional under-modulation – from hypo-aroused over-modulation – emotional numbing, shut-down, immobility.”
Brueggemann, A., & Ekwonye, A. U. (2023) · Healthcare · doi:10.3390/healthcare11233087 · Cited by 5
Suvak, M. K., Musicaro, R. M., & Hodgdon, H. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816022-0.00013-2 · Cited by 6
Tseng, H., Chiu, C., Chen, K. C., Lee, I. H., Chen, P. S., & Yang, Y. K. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.04.017 · Cited by 6
Smith, G. P., & Hartelius, G. (2020) · Military Psychology · doi:10.1080/08995605.2019.1654292 · Cited by 7
“Mindfulness is in some senses the diametrical opposite of certain PTSD symptoms; for example, flashbacks reflect a dissociation from present time, often to a timeframe associated with an initial trauma event (Carlson et al., 2012; Lanius et al., 2010).”
BackgroundPosttraumatic Stress Disorder (PTSD)
Brewin, C. R. (2012) · Oxford University Press eBooks · doi:10.1093/obo/9780199828340-0094 · Cited by 5
Bidirectional modulation of human emotional conflict resolution using intracranial stimulationPreprint
Paulk, A. C., Yousefi, A., Ellard, K. K., Farnes, K., Peled, N., Crocker, B., Zelmann, R., Vallejo-Lopez, D. I., Belok, G., Zorowitz, S., et al. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/825893 · Cited by 4
Impact of post-traumatic stress disorder on epileptogenic networks: a functional connectivity study
Soncin, L., Simula, S., Hemmer, N., Mourre, H., Arthuis, M., Makhalova, J., Bénar, C., Faure, S., & Bartoloméi, F. (2024) · Scientific Reports · doi:10.1038/s41598-024-81164-w · Cited by 4
Harris, H. W. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1630858 · Cited by 8
“PTSD has been associated with dysregulation in the medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), hippocampus, and anterior insula — regions implicated in both interoceptive inference and self-referential processing (63, 64).”
Göhre, I., Back, S. N., Schütz‐Bosbach, S., Ren, Q., Wolkenstein, L., Rupp, A., & Bertsch, K. (2025) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-025-00313-3 · Cited by 4
“Neurocircuitry models have supported both an under-modulation of the prefrontal cortex (PFC) resulting in a hyperreactivity of the amygdala to trauma cues as well as an over-modulation of the PFC as dissociative shutdown of trauma-unrelated emotion processing in PTSD [91].”
Lennie, S., Crozier, S. E., & Sutton, A. (2025) · International journal of law, crime and justice · doi:10.1016/j.ijlcj.2025.100787 · Cited by 4
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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