Psychobiological characteristics of dissociative identity disorder: A symptom provocation study
Psychobiological characteristics of dissociative identity disorder: A symptom provocation study
复制标题
DOI：
10.1016/j.biopsych.2005.12.019
复制
发表时间：
2006-10-01
影响因子：
10.6
通讯作者：
den Boer, Johan A.
中科院分区：
文献类型：
--
作者：
Reinders, A. A. T. Simone;Nijenhuis, Ellert R. S.;den Boer, Johan A.
背景：分离性认同障碍(DID)患者表现为两个或两个以上的认同或分离性认同状态(DIS)，分为中性认同状态(NIS)和创伤性认同状态(TIS)。NIS抑制对创伤性记忆的获取，从而使日常生活功能得以发挥。他们对这些记忆有访问和反应能力。我们测试了这些DIS对创伤相关记忆是否表现出不同的心理生物学反应。方法：采用2×2析因设计，对11名DID患者采用症状激发范式。NIS和TIS都被暴露在中性和创伤相关的记忆脚本中。测试3个心理生物学参数：主观评分(情绪和感觉-运动)、心血管反应(心率、血压、心率变异性)和(H2O)-O-15正电子发射计算机断层扫描测定局部脑血流量。主观反应和心血管反应表现出显著的主效应和交互效应。局部脑血流数据显示不同的神经网络与NIS和TIS对中性和创伤相关记忆脚本的不同加工有关。结论：DID患者至少包含两种不同的DIS。这些身份涉及对创伤相关记忆脚本的不同主观反应、心血管反应和大脑激活模式。
Background: Dissociative identity disorder (DID) patients function as two or more identities or dissociative identity states (DIS), categorized as 'neutral identity states' (NIS) and 'traumatic identity states' (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. Wee tested whether these DIS show different psychobiological reactions to trauma-related memory.Methods: A symptom provocation paradigm with 11 DID patients was used in a two-by-two factorial design setting. Both NIS and TIS were exposed to a neutral and a trauma-related memory script. Three psychobiological parameters were tested: subjective ratings (emotional and sensori-motor), cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with (H2O)-O-15 positron emission tomography.Results: Psychobiological differences were found for the different DIS. Subjective and cardiovascular reactions revealed significant main and interactions effects. Regional cerebral blood flow data revealed different neural networks to be associated with different processing of the neutral and trauma-related memory script by NIS and TIS.Conclusions: Patients with DID encompass at least two different DIS. These identities involve different subjective reactions, cardiovascular responses and cerebral activation patterns to a trauma-related memory script.