The Biopsychosocial Model of Depersonalisation

人格解体和非现实化是痛苦的症状，尽管它们在临床和一般人群中很突出，但研究却明显不足（Aderibigbe et al，2001; Ross，Joshi & Currie，1991）。人格解体和非现实化的特征是强烈的脱离一个人的身体和自我（人格解体）和一个人的环境（非现实化）的感觉，这可能是非常痛苦的个人（亨特等人，2017年）的报告。这些症状在急性压力期间或之后很常见，例如在灾难发生后感到“时间变慢”或“在梦中”。患有慢性人格解体的人正在经历同样的现象，只是他们不是短暂的状态，而是经历很长一段时间，有时是几周，几个月或几年，这取决于个人情况。人格解体和非现实化通常一起讨论，然而，非现实化只是人格解体的一个特征，还有非人格化的感觉，情绪麻木和异常的主观回忆（萨拉米，Andreu-Perez和Gillmeister，2020）。就本提案而言，所有非个性化特征将仅用术语非个性化来描述。人格解体被认为是第三大最常见的心理健康症状（马尔多纳多，2007; Simeon et al，1997; Stewart et al，1964），是短暂的经历，被认为是人类经历的正常特征（Hunter，Sierra和大卫，2004）。存在于一系列严重程度上，随着症状变得更加强烈和规律，它们变得有问题。这可以被比作从一个低情绪的过渡，以响应一个悲伤的事件，一个持续的低情绪表示严重抑郁症。与抑郁症类似，人格解体是“不可见的”，这意味着人格解体的人可以保持外表（例如，保住一份工作，与朋友交往），但他们的内部体验是充满的（例如，感觉与世界/他们的身体脱节，无法将他们的经历转化为语言）。人格解体的终生患病率在26%至74%之间，在创伤事件发生时在31%至66%之间。在临床样本中，患病率在患有PTSD的退伍军人的30%和抑郁症的60%之间变化。惊恐障碍的患病率最高，高达82.6%（Hunter，Sierra和大卫，2004）。当症状随着时间的推移变得更加频繁和持续时，人格解体成为慢性的，直到这种经历是“普遍和持续的”（Medford等人，2005）。准确诊断慢性人格解体平均需要7-12年（Baker等人，2003; Michal等人，2016）。当我们评估新冠肺炎疫情对我们人口的影响时，进一步的去个人化研究非常重要，因为在封锁期间增加使用数字媒体以及封锁导致的主观痛苦与更高的去个人化感受相关（Ciaunica et al，2022）。个人因新冠肺炎而失去个性的经历是自助团体的共同特征。

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.