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Emotional Experience and Awareness of Self: Functional MRI Studies of Depersonalization Disorder

Medford, N; Sierra, M; Stringaris, A; Giampietro, V; Brammer, MJ; David, AS; (2016) Emotional Experience and Awareness of Self: Functional MRI Studies of Depersonalization Disorder. Frontiers in Psychology , 7 , Article 432. 10.3389/fpsyg.2016.00432. Green open access

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Abstract

This paper presents functional MRI work on emotional processing in depersonalization disorder (DPD). This relatively neglected disorder is hallmarked by a disturbing change in the quality of first-person experience, almost invariably encompassing a diminished sense of self and an alteration in emotional experience such that the sufferer feels less emotionally reactive, with emotions experienced as decreased or “damped down,” so that emotional life seems to lack spontaneity and subjective validity. Here we explored responses to emotive visual stimuli to examine the functional neuroanatomy of emotional processing in DPD before and after pharmacological treatment. We also employed concurrent skin conductance measurement as an index of autonomic arousal. In common with previous studies we demonstrated that in DPD, there is attenuated psychophysiological response to emotional material, reflected in altered patterns of (i) regional brain response, (ii) autonomic responses. By scanning participants before and after treatment we were able to build on previous findings by examining the changes in functional MRI response in patients whose symptoms had improved at time 2. The attenuation of emotional experience was associated with reduced activity of the insula, whereas clinical improvement in DPD symptoms was associated with increased insula activity. The insula is known to be implicated in interoceptive awareness and the generation of feeling states. In addition an area of right ventrolateral prefrontal cortex emerged as particularly implicated in what may be “top-down” inhibition of emotional responses. The relevance of these findings to the wider study of emotion, self-related processes, and interoception is discussed.

Type: Article
Title: Emotional Experience and Awareness of Self: Functional MRI Studies of Depersonalization Disorder
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fpsyg.2016.00432
Publisher version: https://doi.org/10.3389/fpsyg.2016.00432
Language: English
Additional information: © 2016 Medford, Sierra, Stringaris, Giampietro, Brammer and David. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (http://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: depersonalization, insula, interoception, self-awareness, fMRI
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10063530
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