Feelings of detachment may signal worse mental health in PTSD

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Scientists from McLean Hospital found that for people who experience trauma, the presence of dissociation—a profound feeling of detachment from one’s sense of self or surroundings—may indicate a high risk of later developing severe post-traumatic stress, depression, anxiety, physical pain, and social impairment.

The research is published in the American Journal of Psychiatry and was conducted by Lauren A. M. Lebois et al.

Dissociation may help someone cope in the aftermath of trauma by providing some psychological distance from the experience, but at a high cost—dissociation is often linked with more severe psychiatric symptoms.

Despite this, dissociative symptoms remain under-studied and under-diagnosed due to a relative lack of understanding in medical and clinical practice.

In the study, the team examined data from 1,464 adults treated at 22 different emergency departments across the United States who reported whether they experienced a severe type of dissociation called derealization.

They found that patients who reported experiencing derealization tended to have higher levels of post-traumatic stress, anxiety, depression, pain, and functional impairment at the 3-month follow-up.

In addition, both self-reported survey results and brain imaging results that were indicative of derealization predicted worse post-traumatic stress symptoms at the follow-up exam—even after accounting for post-traumatic stress symptoms at the start of the study and histories of childhood trauma.

The results point to the importance of screening patients for dissociation-related symptoms following trauma to identify at-risk individuals who could benefit from early interventions.

The scientists discovered that derealization was linked to altered activity in certain brain regions detected through brain imaging.

The team says persistent derealization is both an early psychological marker and a biological marker of worse psychiatric outcomes later, and its neural correlates in the brain may serve as potential future targets for treatments to prevent PTSD

They hope that their findings will increase awareness of these symptoms and their potential aftereffects.

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