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The article presents a unique clinical case of a twenty-year-old patient, Iskander, whose clinical picture of the disease combined mutism and functional tetraparesis. The disease developed acutely, manifested itself with a “panic attack” and subsequently throughout the year the condition remained unchanged – he could not move independently (only in a wheelchair), there was no speech. All attempts to identify traumatic events or traumatic experiences have failed. Based on a review of the literature, the article analyzes the possibility of the formation of dissociative (functional) disorders without connection with psychological tramatization. It is noted that, in accordance with modern scientific views, the relationship between dissociative disorders and mental trauma is not proven and obvious. However, it remains unclear – if not psychological trauma, then what in this case causes functional (dissociative, conversion) disorders?

The issues related to Dissociative Disorder of Identity in Polish legal science have not been raised in principle. Few studies in this field emphasize its controversial nature, both in the psychiatric and criminal law aspects. This applies to the criminal liability of the perpetrator of the prohibited act, including his / her sanity, and consequently also to issues related to his rehabilitation or treatment. This disorder causes significant diagnostic difficulties, much greater than the relatively exhaustively described dissocial disorder (the so-called psychopathy), from which it is absolutely necessary to distinguish DID. Thus, the views on “psychopathy”, established in the literature and judicature of criminal law, do not find an adequate reference to Dissociative Identity Disorder. At the same time, the nature and manner of committing the act by perpetrators with this disorder justify a thorough analysis of the subject using a specific case. The practical dimension of this issue also includes forensic-psychiatric and psychological issues. The criminological point of view suggests that the phenomenon itself is underestimated. The aim of the study is to show the signaled problems and to try to answer the questions posed in the study. The most important of them is related to the possibility of recognizing the title disorders as the cause of insanity, referred to in Article 31 1 of the CC, and consequently the legitimacy of applying an appropriate precautionary measure to the perpetrator.

Functional seizures (FS) are classified as conversion disorders in the DSM-5 and dissociative disorders in the ICD-11, showing a multifactorial psychopathology with various psychiatric comorbidities, such as depression and anxiety. Several studies have found a correlation between FS and personality disorders, mainly those in cluster B. Within this cluster, borderline personality disorder (BPD) or borderline personality traits are the most prevalent in FS. Emotion dysregulation is a hallmark of BPD and is commonly reported in individuals with FS. Cluster C personality disorders, such as avoidant or obsessive-compulsive disorders, have also been reported in FS. In this review, we aim to evaluate the relationship between FS and personality disorders. Assessing personality disorders in the context of FS is relevant for determining the most appropriate intervention. Cognitive-behavioral therapy (CBT) is considered the first-line approach to treating FS. Among various CBT strategies, dialectical behavior therapy, which specifically targets emotion dysregulation, may be helpful for individuals with BPD. Future research should assess the advantages of systematically evaluating personality disorders in FS to address specific treatment planning and evaluate its effectiveness on seizure recurrence, psychological comorbidities, and quality of life. [ABSTRACT FROM AUTHOR]

The unique health-related traditions, perceptions, and communication patterns of Ethiopian immigrants are challenging to Israeli healthcare providers who are trained in western medicine. The aim of this review was to conduct a survey of traditions, beliefs, and symptom reporting by Ethiopian immigrants and culturally oriented interventions to improve the care of Ethiopian immigrants. We used the keywords "Ethiopian immigrants Israel" and "Ethiopian Jews." Of 418 articles initially retrieved, 35 satisfied the inclusion and exclusion criteria. We described health-related traditions and their possible complications. Possession syndrome was frequently misdiagnosed as a neurological or psychiatric disorder. The medical staff was unfamiliar with these health and illness beliefs, somatization patterns, and the communication style of Ethiopian immigrants. There were successful interventions that involved liaisons from the Ethiopian community and community-based educational activities. Medical professionals working with African immigrants worldwide can use the Israeli experience to develop effective, culturally oriented interventions to optimize the health care for these immigrants. [ABSTRACT FROM AUTHOR]

Betrayal trauma theory suggests betrayal from a trusted person affects how an event is remembered and processed. Few studies have looked at differences in psychological symptoms due to the severity and timing of betrayal trauma (BT). This study examined whether psychological symptoms, specifically, sleep disturbance, dissociation, and anxiety, differ depending on the severity and timing of BT. Participants (N = 270; 67.8% female) with at least one trauma completed online questionnaires measuring BT severity (low-medium, high), timing (childhood trauma, adulthood trauma), and frequency of psychological symptoms. A two-way between-subjects multivariate analysis of variance (MANOVA) was conducted. BT was prevalent in the sample, with 202 participants (74.8%) reporting a history of high BT. The MANOVA revealed a significant interaction between BT severity and BT timing on all outcome variables [p =.007, η2p =.05]. Childhood BT participants with low-medium BT history had significantly greater sleep disturbance [p =.008, η2p =.03], than participants with adulthood BT participants with low-medium BT history. Furthermore, adulthood BT participants with a history of high BT had significantly more dissociation [p =.003, η2p =.01] and anxiety [p <.001, η2p =.04] symptoms than childhood BT participants with a history of high BT. The research provides a novel insight into how different psychological symptoms manifest according to BT severity and timing, and the possibility of "rotating betrayal blindness" in which trauma awareness shifts in varying contexts. [ABSTRACT FROM AUTHOR]

The paper examined how dissociation is experienced and manifested in the drawings and narratives of female survivors of childhood sexual abuse (CSA) diagnosed with dissociative identity disorder. Fifteen Israeli women filled out a self-report questionnaire consisting of demographics, traumatic events, and dissociation severity. Then, they were asked to draw a dissociation experience and provide a narrative. The results indicated that experiencing CSA was highly correlated with indicators such as the level of fragmentation, the figurative style, as well as with the narrative. Two main themes emerged: a constant movement between internal and external worlds, and distorted perceptions of time and space. [ABSTRACT FROM AUTHOR]

Research on male survivors of childhood sexual abuse is notably deficient when it comes to addressing their sexual concerns, such as experiences of sexual distress, negative thoughts, and feelings related to their sexuality. Dissociation, a known consequence of childhood sexual abuse, could be associated with higher sexual concerns through identity cohesion. Precisely, dissociation can potentially be related to lower identity cohesion (e.g., not knowing what you want or need). In return, lower identity cohesion may be related to higher sexual concerns by impeding the capacity to know and accept oneself, which tends to promote a positive and healthy sexuality. This study aimed to examine the role of identity cohesion in the link between dissociation and sexual concerns in 105 men consulting for their history of childhood sexual abuse. Men completed questionnaires assessing dissociation, sexual concerns, and identity cohesion at admission in a community setting. Results of a path analysis revealed an indirect association between dissociation and higher sexual concerns through lower identity cohesion. The model explained 27.6% of the variance in sexual concerns. This study highlights the relevance of interventions targeting dissociative symptoms to improve identity cohesion and sexual health in male survivors of childhood sexual abuse. [ABSTRACT FROM AUTHOR]

The Detachment and Compartmentalization Inventory (DCI) is a valid and reliable self-report instrument that assesses these two distinct forms of dissociative symptoms. However, there is limited research on the cross-cultural validation of the DCI. Therefore, this study aimed to develop an Italian translation of the DCI and examine its internal structure and psychometric properties (including internal consistency, convergent validity, and test-retest reliability) within an Italian-speaking community sample. The sample consisted of 1276 adults (887 females; mean age: 29.57 ± 10.96 years), who completed the DCI and other self-report measures evaluating dissociative experiences and childhood trauma. Confirmatory factor analyses supported the original two-factor model (χ2169 = 1312.80, RMSEA = 0.073, 95%CI 0.069–0.077; CFI = 0.94; TLI = 0.94; SRMR = 0.04). Additionally, the DCI exhibited good internal consistency, test-retest reliability, and convergent validity with another measure of dissociation. The study also confirmed the association between DCI scores and the severity of childhood trauma. Finally, a Receiver Operating Characteristic (ROC) curve analysis demonstrated that the DCI effectively distinguishes individuals who screened positively for dissociative disorders. Overall, these findings indicate that the Italian translation of the DCI possesses satisfactory psychometric properties, suggesting its utility as a screening tool for assessing detachment and compartmentalization experiences. [ABSTRACT FROM AUTHOR]

Identifying and contrasting different patterns of intimate partner violence (IPV) (e.g. situational couple violence, coercive controlling violence) is useful for understanding IPV and its connections with health. Applying this approach to dissociation may be fruitful, given theoretical perspectives that predict a specific connection between coercive controlling violence and dissociative symptoms. To address this, community women with divorce histories (N = 188) completed measures to identify patterns of IPV victimization in prior relationships (no direct violence, situational couple violence, coercive controlling violence), and to quantify recent dissociative symptoms and number of depressed days, for comparison. Contrary to predictions, the predicted odds of recent dissociative symptoms did not differ between women who experienced situational couple violence versus coercive controlling violence. However, the latter group had greater odds of recent dissociative symptoms, but not depressed days, compared to women with no histories of direct violence. Further, a continuous measure of coercive control was uniquely associated with increased odds of dissociative symptoms. This study provides preliminary empirical support for a connection between coercive controlling violence and dissociative symptoms, compared to women without histories of direct violence. This deserves further attention given the strong theoretical rationale for this link, and the importance of dissociation for mental health. [ABSTRACT FROM AUTHOR]

Dissociation is a multifaceted phenomenon that occurs in various mental disorders, including borderline personality disorder (BPD), but also in non-clinical populations. Severity of childhood trauma (abuse, neglect) plays an important role in the development of dissociation and BPD. However, the complex interplay of different dissociative symptoms, BPD features, and self-reported childhood trauma experiences is not yet fully understood. Graph-theoretical network analysis can help to better understand such multivariate interrelations. Objective: This study aimed to investigate associations between self-reported dissociation, BPD features, and childhood trauma experiences using a graph-theoretical approach. Data was collected online via international mental health platforms and research sites. N = 921 individuals (77.4% female) were included; 40% reported pathological levels of dissociation. Variables were assessed with established psychometric scales (Dissociative Experiences Scale; Personality Assessment Inventory Borderline Features Scale; Childhood Trauma Questionnaire) and analyzed within a partial correlation network. Positive bivariate correlations between all variables were found. When accounting for their mutual influence on each other, dissociation was predominantly connected to BPD features with effect sizes between rp =.028 and rp =.126, while still showing a slight unique relationship with physical neglect (rp =.044). Findings suggest close associations between dissociative experiences and BPD features. While childhood trauma plays an important role in the development of dissociation and BPD, its recall may not fully explain their current co-occurrence. Prospective studies are needed to shed more light on causal pathways to better understand which factors contribute to dissociation and its link to BPD (features). [ABSTRACT FROM AUTHOR]

The dissociative motor disorder is one of the most commonly diagnosed forms of dissociative disorder in the Indian population, especially among adolescents. However, there is a dearth of literature on effective psychotherapy practices in the Indian setting. This article details the unique process of employing an integrative psychotherapy approach with a 16-year-old adolescent girl diagnosed with dissociative motor disorder who presented with complaints of headache, deviation of mouth, multiple somatic complaints, inability to move her legs, episodes of loss of consciousness with jerking of upper limbs and a non-pervasive low mood. A detailed evaluation highlighted significant disruptions in attachment with caregivers, complicated grief, significant anger towards her family which did not find a space for expression, unhealthy coping mechanisms in the background of a slow-to-warm-up temperament and sociocultural stressors. The case formulation drew elements from the psychodynamic perspective, family systems approach, biosocial theory and the cognitive behavioural perspective. The intervention from the first session until termination is delineated in different phases which outline the significant themes that emerged along with the techniques used, challenges faced and therapist reflections. The role of the therapeutic alliance, working through transference, systemic work, primary and secondary gains and the importance of defences along with the aftermath of losing them becomes especially salient as the psychotherapy progresses in this case. The implications of the therapy process that can hold relevance to the management of dissociation disorder in the clinical setting are also discussed. [ABSTRACT FROM AUTHOR]

Child maltreatment and removal from home have been increasingly examined among marginalized groups but less so among multiracial youth. The present study examined 99 multiracial youth aged 11–17 (M = 14.18, SD = 1.79) years. Classification and regression tree analysis was conducted on demographic (age, gender, family religion, self-identified religious, English first language), type of maltreatment, and psychological (depression, dissociation, anger, post-traumatic cognitions) variables for three post-traumatic symptom clusters. Pathways of low and high risk were identified for reexperiencing symptoms, avoidance, and hyperarousal. The findings have implications for tailoring assessment and intervention processes for this highly vulnerable population. [ABSTRACT FROM AUTHOR]

Esketamine nasal spray (ESK-NS) is a new drug for treatment-resistant depression, and we aimed to detect and characterize the adverse events (AEs) of ESK-NS using the Food and Drug Administration (FDA) adverse event reporting system (FAERS) database between 2019 Q1 and 2023 Q4. Reporting odds ratio (ROR), proportional reporting ratio (PRR), and multi-item gamma Poisson shrinker (MGPS) were performed to detect risk signals from the FAERS data to identify potential ESK-NS-AEs associations. A total of 14,606 reports on AEs with ESK-NS as the primary suspected drug were analyzed. A total of 518 preferred terms signals and 25 system organ classes mainly concentrated in psychiatric disorders (33.20%), nervous system disorders (16.67%), general disorders and administration site conditions (14.21%), and others were obtained. Notably, dissociation (n = 1,093, ROR 2,257.80, PRR 899.64, EBGM 876.86) exhibited highest occurrence rates and signal intensity. Moreover, uncommon but significantly strong AEs signals, such as hand-eye coordination impaired, feeling guilty, and feelings of worthlessness, were observed. Additionally, dissociative disorder (n = 57, ROR 510.92, PRR 506.70, EBGM 386.60) and sedation (n = 688, ROR 172.68, PRR 155.53, and EBGM 142.05) both presented strong AE signals, and the former is not recorded in the Summary of Product Characteristics (SmPC). In clinical applications, close attention should be paid to the psychiatric disorders and nervous system disorders, especially dissociation. Meanwhile, clinical professionals should be alert for the occurrence of AEs signals not mentioned in the SmPC and take preventive measures to ensure the safety of clinical use. [ABSTRACT FROM AUTHOR]

PTSD treatment that focused on a sensory symptoms is increasing. The study aimed to explore symptoms and abnormalities in the five senses exhibited by persons with PTSD and to examine whether there are any differences depending on type of traumatic experience. Questionnaire was followed by interviews to clinical psychologists involved in the treatment of PTSD. 249 PTSD symptoms exhibited in the sensory organs were collected. Sensory symptoms were classified into three categories according to the type of symptoms and the type of traumatic events. Cluster 1 is a group formed by child abuse and violence together with audition, tactile, and hyperarousal. Cluster 2 is made up of natural disaster, accident, and sexual assault together with vision, olfaction and intrusion. Cluster 3 is made up of multiple traumas together with gustation and dissociation. It is speculated that the survivors of Child abuse and violence are hypersensitive to sounds, the presence of others, and physical contact because they try to quickly sense when a perpetrator is approaching. Natural disasters, accidents, and sexual assault are events with strong smell and severe visual impact, it is possible that they may easily cause reliving of the event in the form of shocking visual images and smells in flashbacks. Dissociation symptoms were related with complex trauma and taste. The mouth is the site of first contact between mother and child, and it is possible that gustatory dissociation may occur mainly in cases of severe and repeated trauma since early childhood. [ABSTRACT FROM AUTHOR]

Purpose: Insecure attachment may constitute a vulnerability factor for psychosis, and dissociation may be a key mechanism in the development of auditory hallucinations specifically. While there is good evidence for the role of these processes in isolation, it is unclear whether dissociation accounts for the association between insecure attachment and psychosis. This systematic review takes a theory‐driven approach to examine proposed causal relationships across the clinical and nonclinical literature. Methods: We searched five databases (PubMeD, Web of Science, PsycINFO, CINAHL and ETHOS) for published and unpublished research examining attachment, dissociation and psychosis. Two independent reviewers extracted the data and assessed the quality of all included studies. Results: We identified 242 potential articles and included 13 in the final review (2096 participants). We found that (1) disorganised attachment was consistently associated with dissociation and inconsistently associated with voices and paranoia, (2) dissociation was associated with voices and paranoia, and these links were stronger in clinical samples, and (3) dissociation played a role in the impact of insecure attachment on voice hearing and paranoia in clinical groups. Conclusions: This is the first review to synthesise the research examining attachment, dissociation, and psychosis. The evidence is consistent with proposed causal hypotheses and raises conceptual and measurement issues, for example, the need to clarify the relative contributions of different insecure attachment styles, and utilise behavioural/observational measures to strengthen study designs. Most importantly, we need experimental and longitudinal studies to confirm causal links and targets for treatment. [ABSTRACT FROM AUTHOR]

Childhood trauma and post-traumatic stress disorder (PTSD) are risk factors for emotional distress from trauma-related research participation. The role of dissociation, however, has not been investigated. This study examined the mediation effect of dissociation and PTSD on the relationship between childhood trauma and distress in trauma studies. Pooled data of the Childhood Trauma Questionnaire, Impact of Events Scale-Revised, Dissociative Experiences Scale-Taxon, and Trauma Antecedents Questionnaire from 231 psychiatric patients (73% diagnosed with psychotic illnesses) at a psychiatric clinic in South Korea were analysed. We performed multiple mediation effect analysis to verify a structural model for distress in trauma-related questionnaires. Thirteen percent of participants reported distress after the survey. In the structural equation, the symptoms of PTSD did not show a significant relationship (p =.064). When the two parameters were included in the model, it was found that the direct effect of childhood trauma on distress was not significant (p =.43), but dissociation showed a direct effect on distress (p <.001). Childhood trauma affects distress through the sequential mediating effect of PTSD symptoms and dissociation. Dissociation should be considered as a significant contributor to distress from trauma research participation along with childhood trauma and PTSD. [ABSTRACT FROM AUTHOR]

Depersonalisation-derealization disorder (DPD) is a dissociative disorder that impairs cognitive function and occupational performance. Emerging evidence indicate the levels of tumour necrosis factor-α and interleukin associated with the dissociative symptoms. In this study, we aimed to explore the role of the immune system in the pathology of DPD. We screened the protein expression in serum samples of 30 DPD patients and 32 healthy controls. Using a mass spectrometry-based proteomic approach, we identified differential proteins that were verified in another group of 25 DPD patients and 30 healthy controls using immune assays. Finally, we performed a correlation analysis between the expression of differential proteins and clinical symptoms of patients with DPD. We identified several dysregulated proteins in patients with DPD compared to HCs, including decreased levels of C-reactive protein (CRP), complement C1q subcomponent subunit B, apolipoprotein A-IV, and increased levels of alpha-1-antichymotrypsin (SERPINA3). Moreover, the expression of CRP was positively correlated with visuospatial memory and the ability to inhibit cognitive interference of DPD. The expression of SERPINA3 was positively correlated with the ability to inhibit cognitive interference and negatively correlated with the perceptual alterations of DPD. The dysregulation of the immune system may be the underlying biological mechanism in DPD. And the expressions of CRP and SERPINA3 can be the potential predictors for the cognitive performance of DPD. [ABSTRACT FROM AUTHOR]

Severe dissociative states involving the experience of being in parts, typically associated with diagnosis such as dissociative identity disorder and other specified dissociative disorders, continue to be a controversial and rarely studied area of research. However, because persons with severe dissociative states are at risk of being harmed instead of helped within psychiatric care, their experiences of living with such states warrant further examination, while innovative ways to include them in research remain necessary. Against that background, this study aimed to illuminate the meanings of living with severe dissociative states involving the experience of being in parts. This is a phenomenological hermeneutic study with data collected from three social media sources, one personal blog and two Instagram accounts, in February and March 2023. The results were illuminated in light of four themes; Striving to remain in the world, Balancing exposure and trust, Balancing belonging and loneliness and Owning oneselves. The interpretation of the themes suggests that living with severe dissociative states means being a human under inhuman conditions, striving for coherence and meaning in a world that is often unsupportive. This calls for a trauma-informed care to better support recovery for persons with severe dissociative states. [ABSTRACT FROM AUTHOR]

Objectives Remembering past rewarding experiences plays a crucial rule in guiding people's decision making in the future. However, as people age, they become less accurate in remembering past events and more susceptible to forming false memories. An important question is how the decline of episodic memory and the increase of false memory may affect older adults' decision-making performance. Methods The current study used a newly developed paradigm in which the Deese–Roediger–McDermott (DRM) false memory paradigm was combined with a reward learning task to create robust false memories of rewarding experiences. Participants learned that some DRM picture lists brought them a monetary reward and some DRM picture lists did not bring reward. Later, their memories were tested and decision-making preferences were measured. Results We found that older and younger adults had almost equivalent false and true memories under the rewarding context, but older adults showed significantly lower decision-making preferences for lure pictures and rewarded pictures than younger adults. Furthermore, true and false memories were a stronger predictor of decision-making preferences for younger than for older adults. Discussion These results together suggest an age-related dissociation between memory and decision making that older adults may be less efficient in using their memory to guide decision making than younger adults. Future research may further investigate its underlying mechanisms and develop potential interventions aiming at strengthening the connection between memory and decision making in older adults to help improve their decision-making performance. [ABSTRACT FROM AUTHOR]

Some researchers express caution about investigating potentially challenging topics in research, including trauma, non-suicidal self-injury (NSSI), and dissociation. While there have been studies that demonstrate people typically find participating in trauma- and NSSI-related research as more positive than negative, there have been no studies investigating how highly dissociative people react to trauma-, NSSI-, and dissociation-related research. Participants (n = 229) who self-reported dissociative symptoms and/or dissociative diagnoses completed an online survey about trauma, dissociation, and NSSI, followed by a quantitative questionnaire about their reactions to participation. Participants who endorsed unexpected emotional reactions were asked to explain their reactions and offer suggestions for improvement in a free-text qualitative question. Participants indicated the benefits of participating in the study outweighed the costs. Dissociation predicted emotional reactions but not other types of reactions (e.g. perceived drawbacks, personal benefits, global evaluation, and participation). However, when controlling for trauma history and NSSI, only trauma history predicted emotional reactions. Using codebook thematic analysis with the qualitative data, the following themes were developed to describe participants' unexpected emotional reactions and suggestions for improvement: (1) Trauma-Related Reactions (69.91%), (2) Neutral-Positive Feedback About the Study (39.82%), (3) Insight (24.78%), (4) Logistical Research Design Considerations (23.01%), and (5) Incongruence between Research Design and Lived Experience (11.50%). Research about trauma, dissociation, and NSSI was evaluated as more positive than negative and seemed to pose minimal risk to participants. It is important for researchers to not avoid studying these challenging topics yet strive to make their study design a safer and more validating experience for participants. [ABSTRACT FROM AUTHOR]

Previous research has linked self-harm to adverse childhood experiences (i.e. abuse and neglect). Despite the extensive literature on self-harm, it remains of high importance to examine psychological predictors of repetitive self-harming behaviors in those who report childhood trauma. This study explored the role of maladaptive emotion regulation strategies, dissociation proneness, and borderline personality (BP) features. An international sample with n = 374 participants (N = 287, 77%, reporting intentional use of self-harm), was recruited online via relevant mental health platforms and research sites. Within an anonymous survey, participants completed the Self-harm Inventory, Childhood Trauma Questionnaire, Dissociative Experience Scale, Cognitive Emotion Regulation Questionnaire, and Personality Assessment Inventory-Borderline Personality Features Scale. Structural equation modeling (SEM) was used to explore direct and indirect effects. Self-harm was positively correlated to severity of childhood trauma, maladaptive emotion regulation strategies, dissociation, and BP features. In the path-analytical model, independent indirect effects of childhood trauma severity via self-blame, catastrophizing, dissociation, as well as BP features on self-harm were found. Maladaptive emotion regulation, dissociation proneness, and BP features all seem to be important intermediary agents in the close association between childhood trauma and self-harm. [ABSTRACT FROM AUTHOR]

This study investigates the use of metaphor in the dissociative disorder depersonalization/derealization – the feeling of unreality or detachment from the senses or surrounding events. While the debilitating experience of depersonalization/derealization is prevalent, it is also under-acknowledged, such that it is often expressed through metaphor, with more typical metaphor described in diagnostic criteria. Using naturally occurring text from two prominent English language depersonalization/derealization support fora, in the current study a systematic survey is made of metaphor to communicate the experience of depersonalization/derealization in context. It is concluded that metaphor described in the formal diagnostic criteria for depersonalization/derealization does not completely represent metaphor use in the contexts investigated. A summary is made of metaphor for the experiences of depersonalization, and derealization, and depersonalization/derealization more generally, across both the contexts investigated, that may support vital understanding and diagnosis of this debilitating, under-recognized experience, across a wider demographic. [ABSTRACT FROM AUTHOR]

This narrative review explores Cotard’s Syndrome (CS), a rare psychiatric condition characterised by delusions of death or non-existence, originally described by Jules Cotard in 1880. The syndrome presents a complex clinical picture, encompassing grandiosity, damnation, and physical breakdown. Despite its historical origins, CS remains poorly understood and often misdiagnosed. This review elucidates the clinical complexity, diagnostic challenges, and therapeutic strategies associated with CS. It highlights the neurological aspects, such as delusional misidentification and negation, shedding light on underlying mechanisms. Treatment approaches, including pharmacotherapy, Electroconvulsive Therapy (ECT), and psychotherapy, are discussed, emphasising the importance of ongoing mental health support across the illness’s stages. The review draws from a comprehensive search methodology, encompassing diverse scholarly sources, to provide a nuanced understanding of CS. By increasing awareness among clinicians and researchers, this review aimed to improve diagnosis and treatment outcomes for individuals affected by this enigmatic syndrome.

This article summarizes the treatment and integrated traditional Chinese and western medicine nursing experience of a patient with Guillain-Barre syndrome complicated with dissociative disorder. Through syndrome differentiation and nursing, Traditional Chinese Medicine characteristic nursing methods such as bamboo cupping therapy, moxibustion and five-tone music therapy were given according to the syndrome types and clinical symptoms, combined with psychotherapy and routine nursing interventions. The combined treatment of Traditional Chinese Medicine nursing techniques are effective to improve the muscle strength and relieve the uncomfortable symptoms of patients with Guillain-Barre syndrome complicated with dissociative disorder. (本文总结1例吉兰-巴雷综合征合并分离性障碍患者的中西医结合护理经验。基于护理评估和中医辨证, 在病情观察、生活指导、饮食护理等常规护理基础上, 采取竹罐、艾灸、五音疗法等中医护理适宜技术, 有效提高患者四肢肌力, 改善了患者不适症状。)

Functional neurological disorder (FND) has been associated with predisposing psychological factors, including dysregulation of anger-related processes. This paper provides a systematic review of the literature on anger regulation in FND. We evaluated anger-related research on patient self-report, observational, and laboratory based measures in FND. The review also addresses adverse childhood experiences and their relation with anger regulation, and the effects of therapies targeting anger regulation in FND. MEDLINE, EMBASE, and PsycINFO were searched for both quantitative and qualitative research, published in a peer-reviewed journal with a sample size of at least 5 (registered under Prospero protocol CRD42022314340). A total of 2200 articles were identified. After screening, 54 studies were included in this review (k = 20 questionnaire-based studies, k = 12 laboratory studies, k = 21 using other methods, and k = 1 used both questionnaires and other methods) representing data of 2502 patients with FND. Questionnaire-based studies indicated elevated levels of state anger and trait hostility in patients with FND. Laboratory studies showed a higher tendency to avoid social threat cues, attentional bias towards angry faces, difficulties reliving anger, and preoccupation with frustrating barriers among FND patients versus controls. No specific childhood experiences were identified related to anger regulation in FND, and too few small and uncontrolled studies were available (k = 2) to assess the effects of anger-related interventions in FND. The overall quality of the studies was fair (k = 31) to poor (k = 18). Five studies (k = 5) were rated as having a good quality. This review suggests that patients with FND have maladaptive anger regulation compared to individuals without FND. The findings also highlight the need for further research on the prevalence and consequences of anger-related processes in the development, diagnosis and treatment of FND. [ABSTRACT FROM AUTHOR]

Background/Aims: Functional neurological disorder is increasingly common in paediatric neurological practice, yet the role and scope for occupational therapy and physiotherapy intervention remains unclear. The aim of this systematic review was to evaluate if occupational therapy and/or physiotherapy interventions improve activity and participation for children and adolescents with functional neurological disorder compared to usual care. Methods: CINAHL, Embase and Medline were searched until May 2023. Eligibility criteria were applied by two reviewers independently. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Data were synthesised narratively and the certainty of evidence assessed using a Grading of Recommendations, Assessment, Development and Evaluation approach. Results: A total of eight non-randomised studies (n=451 participants, mean age 13.2 years) were selected. There was very low certainty evidence that for approximately three in four participants, inpatient or outpatient multidisciplinary programmes involving physiotherapy and/or occupational therapy led to recovery at the end of the programme, with recovery and school attendance retained at 12 months. Two studies provided very low certainty evidence that two in three participants attending multidisciplinary programmes were independent on all Pediatric Functional Independence Measure items at programme discharge. Conclusions: There is insufficient evidence to suggest routine occupational therapy and/or physiotherapy interventions improve activity and participation function for children and adolescents with functional neurological disorder compared to usual care. Implications for practice: The implications for clinical practice for allied health professionals are ambiguous because of the low-quality of the available evidence. Until further research is conducted to support clinical practice, clinicians must rely on the combination of their clinical expertise and the best available evidence to guide practice. [ABSTRACT FROM AUTHOR]

A PTSD subtype with dissociative symptoms (D-PTSD) was included in the DSM-5 recognizing the existence of a more severe form of PTSD, associated to past trauma, high comorbidity, and complex clinical management. As research is rapidly growing and results are inconsistent, a better investigation of this subtype is of primary importance. We conducted a systematic review of studies using Latent Profile Analysis to investigate the existence of a D-PTSD subtype. Covariates of D-PTSD were included, to understand additional symptoms, risk factors and comorbidities. The search was performed on PubMed, EBSCOHost, and PTSDPubs according to 2020 PRISMA guidelines. Eligible articles assessed trauma exposure, PTSD symptoms and diagnosis, and dissociation, in adult samples. 13 of 165 articles met the inclusion criteria. All identified a dissociative subtype of PTSD, mainly characterized by higher levels of depersonalization and derealization. D-PTSD profile sometimes presented other dissociative symptoms, such as gaps in awareness and memory, other comorbid disorders, and a history of abuse. Despite some limitations, this review supports the existence of a dissociative subgroup of individuals among those with PTSD. More rigorous studies are needed to clarify these findings and their clinical implications. [ABSTRACT FROM AUTHOR]

Women involved in the criminal legal system report high rates of interpersonal violence, particularly sexual violence, and mental health problems. Although existing research has linked experiences of interpersonal violence to multiple negative mental health outcomes, few researchers have examined concurrent psychopathology as an outcome of child and adult sexual violence in system-involved women. The purpose of this study was to examine child sexual abuse (CSA) and adult sexual violence, while controlling for other forms of interpersonal violence, as predictors of current symptoms of posttraumatic stress disorder (PSTD), substance use disorder (SUD), and dissociation in women in jail in the Mountain West. Randomly selected participants (N = 146) completed clinician-administered measures of trauma histories and mental health symptoms. The majority of the women (73%) reported experiences of CSA and about half reported experiences of adult sexual violence. Over half of the women reported symptoms consistent with current probable PTSD, about 20% reported dissociation symptoms in a clinical range, and over 70% met criteria for a SUD in the past year. The proposed model was tested with path analysis. CSA significantly predicted current symptoms of PTSD while adult sexual violence exposure predicted symptoms of SUD and dissociation. These results illustrate the high rates of sexual violence exposure as well as the complexity of mental health needs associated with these exposures in system-involved women. Findings highlight the need to comprehensively assess incarcerated women's trauma exposure and psychological distress to better meet the needs of this population. [ABSTRACT FROM AUTHOR]

Background: Dissociation is a complex psychopathology. Symptoms of dissociation are seen in different mental disorders. It is defined as a loss of integration between memory, identity, emotion, perception, behavior, and sense of self. Aims and Objectives: The aim of the study was to study sociodemographic variables of dissociative patients and to study psychiatric morbidities and their correlates concerning dissociative semeiology. Materials and Methods: This study was conducted from June to September 2023, where 51 persons were enrolled, who visited our patient department. Ethical clearance and consent were taken for the study. All the patients were diagnosed by a consultant psychiatrist according to the International Classification of Diseases-10 criteria. Sociodemographic profile pro forma, BG Prasad scale, and Dissociation Experience Scale-II were administered. Result: The majority of patients were from the 19 to 23-year-old age group, unmarried females residing in rural areas living in nuclear families having middle economic status who achieved middle education. The majority of patients had psychogenic non-epileptic seizures as a dominant symptom with school-related issues as a precipitant factor with the majority having a major depressive disorder. The correlation was significant at the 0.005 level. A correlation of P<0.005 for anxiety, depression, obsessive-compulsive disorder, and adjustment disorder with dissociative symptoms was seen. A P<0.005 was seen for sex, education, economic status, and occupation to that of dissociative symptoms. Conclusion: Dissociation symptoms have multiple comorbid psychiatric disorders comorbidly present. Precipitating factors need to be taken care of. Intervention should be multipronged. Psychological interventions may help manage different subconscious conflicts. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to deeply examine the quality-of-life perceptions and experiences of individuals with depersonalization disorder. Material-Method: The study was conducted with 13 individuals diagnosed with depersonalization disorder using phenomenological research design, which is a qualitative research design. Interviews were conducted individually and face-to-face using semi-structured forms. The data were analyzed using Colaizzi's phenomenological analysis method. Results: In the analysis of the data, two categories, nine main themes, and twenty-one sub-themes emerged. These are the categories of "effects of depersonalization on the individual" and "quality of life perceptions". The category of the effects of depersonalization on the individual was examined under three sub-themes as mental, physical, and social effects. Individuals with depersonalization disorder experience feelings of hopelessness/despair, depression, sadness, loneliness, and dream/simulation. The diagnosis of depersonalization disorder was determined to cause many adverse conditions like internalized stigmatization and social isolation. In addition, individuals with depersonalization disorder experience problems in daily life activities, which impair their perception of quality of life. Conclusion: Individuals with depersonalization disorder experience psychosocial problems, their daily life activities are negatively affected, and their perception of quality of life is low. [ABSTRACT FROM AUTHOR]

Previous studies showed that dissociation and dissociative disorders (DDs) are prevalent and are associated with considerable individual and social consequences. There are ongoing debates regarding whether dissociation is a response to betrayal trauma across cultures and whether dissociation can be explained by maladaptive coping. Additionally, little is known about the clinical features of individuals with DDs in the Chinese context. This study aimed to investigate the relationship between trauma, emotional regulation, coping, and dissociation. We analyzed baseline data from a randomized controlled trial (N = 101). Participants with dissociative symptoms in Hong Kong completed self-report assessments. Structured interviews were also conducted subsequently. Participants with probable DDs reported more traumatic events (p = .009 to .017) and exhibited significantly higher levels of dysfunctional coping (p < .001) compared to those who reported dissociative symptoms but did not have a DD. Dissociative symptoms were more strongly associated with betrayal trauma than with non-betrayal trauma. Among different emotion regulation and coping strategies, dysfunctional coping was the only significant factor associated with dissociative symptoms (β = .309, p = .003). Dysfunctional coping was a statistically significant mediator that may explain the relationship between betrayal trauma and dissociative symptoms. Although other mediation paths are also possible and further longitudinal studies are required, our findings highlight the strong link between dysfunctional coping and dissociative symptoms and suggest that coping skills training should be incorporated into interventions for betrayal trauma survivors with dissociative symptoms. Additionally, this study provides evidence for the cross-cultural validity of the betrayal trauma theory. Further studies, however, are required. [ABSTRACT FROM AUTHOR]

Memory deficits are observed across psychiatric disorders ranging from the prodrome of psychosis to common mental disorders such as anxiety, depression, and dissociative disorders. Memory deficits among patients recovering from psychiatric disorders could be directly related to the primary illness or secondary to the adverse effect of a treatment such as Electroconvulsive Therapy (ECT). The trouble in the meaningful integration of workingmemory and episodic memory is the most commonly affected domain that requires routine assessments. An update on the recent trends of methods of assessment of memory deficits is the first step towards understanding and correcting these deficits to target optimum recovery. A systematic literature search was conducted from October 2018 to October 2022 to review the recent methods of assessment of memory deficits in psychiatric disorders. The definition of 'Memory deficit' was operationalized as 'selective processes of memory, commonly required for activities of daily living, and affected among psychiatric disorders resulting in subjective distress and dysfunction'. We included 110 studies, most of them being conducted in western countries on patients with schizophrenia. Other disorders included dementia and mild cognitive impairment. Brief Assessment of Cognition in Schizophrenia, Cambridge Automated Neuropsychological Test Battery, California Verbal Learning Test, Trail Making Test Part A and B, Rey Auditory Verbal Learning Test, Wechsler Memory Scale, Wechsler Adults Intelligence Scale-IV were the most common neuropsychological assessments used. Mini-Mental State Examination and Montreal Cognitive Assessment were the most common bedside assessment tools used while Squire Subjective Memory Questionnaire was commonly used to measure ECT-related memory deficits. The review highlights the recent developments in the field of assessment of memory deficits in psychiatric disorders. Findings recommend and emphasize routine assessment of memory deficits among psychiatric disorders in developing countries especially severe mental illnesses. It remains interesting to see the role of standardized assessments in diagnostic systems given more than a decade of research on memory deficits in psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: This study aims to conduct the first‐ever evaluation of our previously proposed behaviors of "hemomania" in individuals engaged with nonsuicidal self‐injury (NSSI). Methods: The study encompassed 130 outpatients engaged with NSSI who applied at the psychiatry outpatient clinic. NSSI behaviors were assessed using the Inventory of Statements About Self‐Injury, while psychiatric diagnoses were evaluated using the Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version. Subsequently, participants completed the Depression Anxiety Stress Scale‐21 and Short Form of Barratt Impulsiveness Scale. Results: The prevalence of at least one hemomania behavior including seeing blood, tasting blood, bloodletting, and blood‐drinking was observed to be 43.1% in individuals with NSSI. When participants were divided into two groups, individuals with hemomania exhibited: (1) a higher incidence of psychiatric comorbidities, increased suicide attempts, and more severe symptoms of depression, anxiety, stress, and impulsivity, (2) higher comorbidity rates of borderline personality disorder, body‐focused repetitive behaviors, and dissociative disorders, and (3) elevated frequencies of certain NSSI behaviors, including cutting, biting, needle‐ticking, and carving, compared to those without. Conclusion: Hemomania could be considered a specific impulse control disorder, characterized by heightened impulsivity and a persistent urge to obtain one's own blood. However, further studies are needed to validate this hypothesis. [ABSTRACT FROM AUTHOR]