The Biopsychosocial Model of Depersonalisation

人格解体的生物心理社会模型

• 批准号: 2604212
• 金额: --
• 依托单位: University of Essex
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2604212
• 关键词: Biopsychosocial; Model; Depersonalisation

Depersonalisation and derealisation are symptoms of distress that are strikingly under researched despite their prominence in clinical and general populations (Aderibigbe et al, 2001; Ross, Joshi & Currie, 1991). Depersonalisation and derealisation are characterised by strong feelings of detachment from one's body and self (depersonalisation) and from one's environment (derealisation), which can be extremely distressing to individuals (Hunter et al., 2017). These symptoms are common during or following acute stress, for example feeling 'time slowing down' or 'in a dream' after a moment of calamity. Individuals suffering from chronic depersonalisation are experiencing that same phenomena, only instead of fleeting states, they are experiencing it for long periods of time, sometimes weeks, months or years, depending on the individual circumstances. Depersonalisation and derealisation are usually discussed together, however derealisation is simply a feature of depersonalisation, alongside disembodiment feeling, emotional numbing and anomalous subjective recall (Salami, Andreu-Perez and Gillmeister, 2020). For the purpose of this proposal, all features of depersonalisation will be described by the term depersonalisation only. Considered the third most common mental health symptom (Maldonado, 2007; Simeon et al, 1997; Stewart et al, 1964), depersonalisation is experienced transiently and is considered a normal feature of human experience (Hunter, Sierra and David, 2004). Existing on a spectrum of severity, as the symptoms become more intense and regular, they become problematic. This could be likened to the transition from a low mood in response to a sad event, to a consistently low mood indicative of major depression. Similar to depression, depersonalisation is 'invisible', meaning that depersonalised individuals can maintain external appearances (e.g. hold down a job, socialise with friends), yet their internal experience is fraught (e.g. feeling disconnected from the world/their body, inability to put their experiences into words). Depersonalisation holds a lifetime prevalence rate of between 26 and 74%, and between 31 and 66% at the time of a traumatic event. In clinical samples, prevalence rates vary between 30% in war veterans with PTSD and 60% in depression. The highest prevalence is seen in panic disorder, with rates up to 82.6% (Hunter, Sierra and David, 2004). Depersonalisation becomes chronic when symptoms are more frequent and persistent over time, until the experience is "pervasive and unremitting" (Medford et al, 2005). It takes an average of 7-12 years to accurately diagnose chronic depersonalisation (Baker et al, 2003; Michal et al., 2016). As we assess the impact of the Covid-19 pandemic on our population, further depersonalisation research is important, as increased use of digital media during lockdown and subjective distress as a result of lockdown correlate with higher feelings of depersonalisation (Ciaunica et al, 2022). Individual experiences of depersonalisation as a result of the Covid-19 are a common feature of self-help groups.

去人格化和去世俗化是痛苦的症状，尽管它们在临床和普通人群中很突出，但研究明显不足(Arigigbe等人，2001；Ross，Joshi&Currie，1991)。去人格化和去人格化的特征是对一个人的身体和自我(去人格化)和一个人的环境(去人格化)的强烈感觉，这对个人来说可能是非常痛苦的(Hunter等人，2017年)。这些症状在急性应激期间或之后很常见，例如，在经历了片刻的灾难后，会感到“时间放慢”或“在梦中”。患有慢性去人格化的人正在经历同样的现象，只是他们不是短暂的状态，而是经历了很长一段时间，有时是几周、几个月或几年，这取决于个人的情况。去人格化和去人格化通常是一起讨论的，然而去人格化只是去人格化的一个特征，与去人格化的感觉、情感麻木和异常的主观回忆一起(Salami，Andreu-Perez和Gillmeister，2020)。就本建议而言，非人格化的所有特征将仅用非人格化一词来描述。被认为是第三种最常见的心理健康症状(Maldonado，2007；Simeon等人，1997；Stewart等人，1964)，去人格化是短暂经历的，被认为是人类经验的正常特征(Hunter，Sierra and David，2004)。存在于一系列严重程度上，随着症状变得更加强烈和规则，它们变得有问题。这可以被比作从对悲伤事件的低落情绪到表明严重抑郁的持续低落情绪的转变。与抑郁症类似，去人格化是“看不见的”，这意味着去人格化的人可以保持外表(例如，保住工作，与朋友交往)，但他们的内在体验是令人担忧的(例如，感觉与世界/他们的身体脱节，无法将他们的经历用语言表达)。去人格化的终生患病率在26%到74%之间，在创伤事件发生时在31%到66%之间。在临床样本中，患有创伤后应激障碍的退伍军人的患病率从30%到抑郁症的60%不等。恐慌症的患病率最高，高达82.6%(Hunter，Sierra和David，2004年)。当症状随着时间的推移变得更加频繁和持续时，去人格化就变成了慢性的，直到这种经历“无处不在且坚持不懈”(Medford et al，2005)。准确诊断慢性去人格化平均需要7-12年(Baker等人，2003年；Michal等人，2016年)。在我们评估新冠肺炎疫情对我们人群的影响时，进一步的去人格化研究是重要的，因为封锁期间数字媒体的更多使用以及封锁所导致的主观痛苦与更高的去人格化感觉相关(Ciaunica等人，2022年)。个人因新冠肺炎而去人格化的经历是自助团体的一个共同特征。