The link between dissociative tendencies and hyperassociativity.

BACKGROUND AND OBJECTIVES: Anecdotal and research evidence suggests that individuals with dissociative symptoms exhibit hyperassociativity, which might explain several key features of their condition. The aim of our study was to investigate the link between dissociative tendencies and hyperassociativity among college students. METHODS: The study (n = 118) entailed various measures of hyperassociativity, measures of dissociative tendencies, depressive experiences, unusual sleep experiences, cognitive failures, and alexithymia. RESULTS: We found a positive association between dissociative experiences (i.e., depersonalization) and hyperassociativity specific for associative fluency and associative flexibility tasks (including neutral and valenced material), but not for a remote association task. We also found tentative evidence for cognitive failures and alexithymia explaining the link between hyperassociativity and daytime dissociation and nighttime unusual sleep experiences. LIMITATIONS: Limitations include the use of hyperassociation tasks limited to verbal associations vs. imagistic associations, the lack of a measure of trauma history, and a sample limited to college students. CONCLUSION: Our study reports a link between depersonalization and hyperassociativity on tasks that allow for free associations across different semantic domains, potentially explained by alexithymia and cognitive failures. This finding may, with replication, open the pathway to applied intervention studies.

[Psychopathological significance of fantasy proneness as measured by the Creative Experiences Questionnaire: a meta-analysis]. / Psychopathologische betekenis van fantasiegeneigdheid gemeten met de Creatieve Ervaringen-Vragenlijst: een meta-analyse.

BACKGROUND: Fantasy proneness has been linked to dissociative symptoms and adverse childhood experiences.
AIM: To review and meta-analyze the empirical literature on fantasy proneness (as indexed by the Creative Experiences Questionnaire) that appeared between 2000 and 2018.
METHOD: We searched Google Scholar to identify relevant papers and subjected them to inspection. In doing so, we specifically looked at correlations between fantasy proneness, on the one hand, and dissociative symptoms, magical ideation, depression, anxiety, trauma, and susceptibility to false memories, on the other hand. Correlations were weighted using the Hunter-Schmidt approach.
RESULTS: We identified 97 studies that together included 16.999 research participants. Fantasy proneness strongly correlated with both dissociative symptoms and magical ideation. The association of fantasy proneness with depression and anomalistic was moderate. Its association with trauma and anxiety was small, albeit significant, and much the same was true for false memories.
CONCLUSION: The psychopathological relevance of fantasy proneness is broader than just dissociative symptoms. The modest correlation between trauma and fantasy proneness suggests that, apart from trauma, other causal antecedents of fantasy proneness exist. What fantasy proneness, dissociation, and magical ideation have in common is that they are manifestations of apophenia, i.e., the tendency to overinterpret reality.

[Tranylcypromine and khat: a potentially fatal combination]. / Tranylcypromine en khat: een potentieel fatale combinatie.

It is well known that the use of tranylcypromine in combination with amphetamines may induce a potentially lethal hypertensive crisis. That such a complication may also occur when tranylcypromine is combined with khat, however, is less known. We describe the case of a young patient who received a low dose of tranylcypromine combined with a small amount of khat, subsequently developing a subarachnoid hemorrhage.

Symptom overreporting and dissociative experiences: A qualitative review.

We discuss a phenomenon that has received little attention to date in research on dissociative phenomena, namely that self-reports of these phenomena overlap with the tendency to overendorse eccentric items. We review the literature documenting the dissociation-overreporting link and then briefly discuss various interpretations of this link: (1) overreporting is an artifact of measuring dissociative symptoms; (2) dissociative psychopathology engenders overreporting of eccentric symptoms through fantasy proneness or impairments in internal monitoring; (3) an overreporting response style as is evident in malingerers, for example, promotes reports of dissociative symptoms. These three interpretations are not mutually exclusive. Also, the dissociation-overreporting link may have different origins among different samples. Because overreporting may introduce noise in datasets, we need more research specifically aimed at disentangling the dissociation-overreporting link. We suggest various avenues to accomplish this goal.

The validity of individual frontal alpha asymmetry EEG neurofeedback.

Frontal asymmetry in alpha oscillations is assumed to be associated with psychopathology and individual differences in emotional responding. Brain-activity-based feedback is a promising tool for the modulation of cortical activity. Here, we validated a neurofeedback protocol designed to change relative frontal asymmetry based on individual alpha peak frequencies, including real-time average referencing and eye-correction. Participants (N = 60) were randomly assigned to a right, left or placebo neurofeedback group. Results show a difference in trainability between groups, with a linear change in frontal alpha asymmetry over time for the right neurofeedback group during rest. Moreover, the asymmetry changes in the right group were frequency and location specific, even though trainability did not persist at 1 week and 1 month follow-ups. On the behavioral level, subjective stress on the second test day was reduced in the left and placebo neurofeedback groups, but not in the right neurofeedback group. We found individual differences in trainability that were dependent on training group, with participants in the right neurofeedback group being more likely to change their frontal asymmetry in the desired direction. Individual differences in trainability were also reflected in the ability to change frontal asymmetry during the feedback.

Temporal dynamics of stress-induced alternations of intrinsic amygdala connectivity and neuroendocrine levels.

Stress-induced changes in functional brain connectivity have been linked to the etiology of stress-related disorders. Resting state functional connectivity (rsFC) is especially informative in characterizing the temporal trajectory of glucocorticoids during stress adaptation. Using the imaging Maastricht Acute Stress Test (iMAST), we induced acute stress in 39 healthy volunteers and monitored the neuroendocrine stress levels during three runs of resting state functional magnetic resonance imaging (rs-fMRI): before (run 1), immediately following (run 2), and 30 min after acute stress (run 3). The iMAST resulted in strong increases in cortisol levels. Whole-brain analysis revealed that acute stress (run 2 - 1) was characterized by changes in connectivity of the amygdala with the ventrolateral prefrontal cortex (vlPFC), ventral posterior cingulate cortex (PCC), cuneus, parahippocampal gyrus, and culmen. Additionally, cortisol responders were characterized by enhanced amygdala - medial prefrontal cortex (mPFC) connectivity. Stress recovery (run 3 - 2) was characterized by altered amygdala connectivity with the dorsolateral prefrontal cortex (dlPFC), ventral and dorsal anterior cingulate cortex (ACC), anterior hippocampal complex, cuneus, and presupplementary motor area (preSMA). Opposite to non-responders, cortisol responders were characterized by enhanced amygdala connectivity with the anterior hippocampal complex and parahippocampal gyrus, and reduced connectivity with left dlPFC, dACC, and culmen during early recovery. Acute stress responding and recovery are thus associated with changes in the functional connectivity of the amygdala network. Our findings show that these changes may be regulated via stress-induced neuroendocrine levels. Defining stress-induced neuronal network changes is pertinent to developing treatments that target abnormal neuronal activity.

[Crime-related amnesia: real or feigned?]. / Tatbezogene Amnesien - authentisch oder vorgetäuscht?

In the context of criminal forensic evaluations, experts are often confronted with the problem of offenders' claims of crime-related amnesia. Because of the far-reaching legal consequences of the expert opinion, the nature of the suspected memory disorder has to be investigated with special care and due consideration of differential diagnoses. While the diagnosis of organic amnesia is comparatively easy to make, the same is not true for dissociative amnesia. Despite existing theoretical explanations such as stress, peritraumatic dissociation or repression, to date there is no sound, scientifically based and empirically supported explanation for the occurrence of genuine, non-organic crime-related amnesia. In the criminal context of claimed amnesia, secondary gain is usually obvious; thus, possible malingering of memory loss has to be carefully investigated by the forensic expert. To test this hypothesis, the expert has to resort to methods based on a high methodological level. The diagnosis of dissociative amnesia cannot be made by mere exclusion of evidence for organic amnesia; instead, malingering has to be ruled out on an explicit basis.

[Sleepiness predicts an increase in dissociative symptoms: a field study]. / Slaperigheid voorspelt toename van dissociatieve symptomen: een veldstudie.

BACKGROUND: In laboratory studies, sleepiness has been found to increase dissociative symptoms. AIM: To explore the link between sleepiness and dissociation in a natural setting. METHOD: A longitudinal study was performed among volunteers at a pop festival. Information was collected via self-report scales at four successive test moments spread over a 12-hour period. RESULTS: Sleepiness was the only variable that could predict the increase in dissociative symptoms. This result was not mediated by a deteriorated mood. CONCLUSION: Our data suggest that sleepiness intensifies dissociative symptoms, even if it occurs outside a laboratory environment. Studies focusing on sleep normalisation may provide insights into new ways of treating dissociative symptoms.

[The problem of careless respondents in surveys]. / Kretenzers in surveys: het probleem van onzorgvuldige respondenten.

BACKGROUND: A substantial proportion of psychiatric research is based on surveys that rely on self-report scales. Little is known about careless respondents in such surveys. AIM: To explore to what extent careless respondents may bias the outcomes of surveys. METHOD: Three surveys were conducted among paid volunteers (undergraduates). RESULTS: A small but non-trivial proportion of undergraduates admitted that they often intentionally gave wrong answers in surveys. These respondents also exhibited overendorsement of nonsensical items on the Infrequency Scale. In addition, many of them seemed to show a preference for reporting low prevalence symptoms (e.g. amnesia and derealisation). CONCLUSION: Should we take careless respondents seriously? Our results demonstrate that researchers and readers of their articles are well advised to do so, at least when research reports concern rare symptoms and experiences.

Acute consolidation stress enhances reality monitoring in healthy young adults.

Source monitoring refers to cognitive processes involved in making attributions about the origins of memories, knowledge, and beliefs. One particular type of source monitoring with ample practical significance is reality monitoring, i.e., the ability to discriminate between internally vs. externally generated memories. Abundant evidence indicates that exposure to acute stress enhances declarative memory consolidation. To date, no study has looked at whether exposure to acute stress during the consolidation phase may promote reality monitoring performance. The authors examined this by administering cold pressor stress (CPS) or a control procedure to participants (N = 80) after they had either performed or only imagined performing simple motor acts, and assessing reality monitoring 24 h later. When compared with the control condition, CPS significantly elevated salivary free cortisol concentrations and enhanced reality monitoring. Stress-induced cortisol responses, however, were found not to be related to improved reality monitoring performance. Our findings are consistent with the view that post-learning stress hormone-related activity may modulate source memory consolidation.

Context-dependent enhancement of declarative memory performance following acute psychosocial stress.

Studies on how acute stress affects learning and memory have yielded inconsistent findings, with some studies reporting enhancing effects while others report impairing effects. Recently, Joëls et al. [Joëls, M., Pu, Z., Wiegert, O., Oitzl, M.S., Krugers, H.J., 2006. Learning under stress: how does it work? Trends in Cognitive Sciences, 10, 152-158] argued that stress will enhance memory only when the memory acquisition phase and stressor share the same spatiotemporal context (i.e., context-congruency). The current study tested this hypothesis by looking at whether context-congruent stress enhances declarative memory performance. Undergraduates were assigned to a personality stress group (n=16), a memory stress group (n=18), or a no-stress control group (n=18). While being exposed to the acute stressor or a control task, participants encoded personality- and memory-related words and were tested for free recall 24h later. Relative to controls, stress significantly enhanced recall of context-congruent words, but only for personality words. This suggests that acute stress may strengthen the consolidation of memory material when the stressor matches the to-be-remembered information in place and time.

It was not me: attribution of blame for criminal acts in psychiatric offenders.

The current article addresses the psychometric qualities of the German Version of Gudjonsson's Blame Attribution Inventory (GBAI), a self-report scale for measuring attribution of blame for crime. The GBAI was administered to a criminal sample of forensic and criminal inmates (n=107). Findings indicate that the German version of the Gudjonsson Blame Attribution Inventory possesses acceptable test-retest stability and good internal consistency. Factor analysis reproduced the three basic dimensions of the GBAI: external attribution, mental-element attribution, and guilt-feeling attribution. Forensic patients had higher mental-element attribution and guilt-feeling attribution scores than the prison inmates. Interestingly, sexual offenders who were prisoners, showed the lowest guilt-feeling attribution, while sexual offenders who were forensic patients had the highest guilt-feeling attribution scores. Since earlier research reported a tendency of faking good in sexual offenders, we suggest that the forensic sexual offenders may demonstrate a social desirable response tendency in an attempt to gain sympathy and/or earlier parole. All in all, our data show that the German version of the GBAI is a valuable tool for measuring attributional styles of offenders.

[Dissociative symptoms and sleep]. / Dissociatieve symptomen en slaap.

There is a widespread view among psychiatrists that dissociative experiences such as depersonalisation, derealisation, absorption, and psychogenic amnesia have a traumatic etiology. This view is subjected to a critical evaluation. We also discuss an alternative interpretation namely that dissociative experiences are caused by a labile sleep-wake rhythm. We evaluated this alternative view in two exploratory studies. In study 1 we looked at the relationship between the Dissociative Experience Scale (DES) and the Iowa Sleep Experiences Survey (ISES) and in study 2, we checked this relationship when the response bias was controlled for. Dissociative experiences (measured with the DES) correlated with the ISES. The correlation between DES and ISES remained completely intact even when we controlledfor response bias. Our findings show that dissociative symptoms are associated with typical sleep experiences such as nightmares and strange dreams. The association is not the by-product of the positive response bias which generally characterises persons with dissociative symptoms.

Enhanced memory performance on an internal-internal source monitoring test following acute psychosocial stress.

Research on the effect of acute stress and high levels of glucocorticoids on memory has largely focused on memory tasks involving the medial temporal lobe (e.g., declarative memory). Less is known, however, about the effects of stress and glucocorticoids on more strategic memory processes regulated by the prefrontal cortex (e.g., source monitoring). In the current study, the authors investigated whether exposure to acute psychosocial stress would result in altered source monitoring performance relative to the performance of a nonstressed control group. To this end, the authors assigned nonsmoking, healthy, young men to either a stress (n = 22) or a control (n = 18) condition, after which the men were given an internal source monitoring test. Results show that relative to control participants, stressed participants made fewer source monitoring errors. This study suggests that stress may have differential effects on memory, depending on whether the memory test is regulated by the prefrontal cortex or the medial temporal lobe.

[The causal relationship between dissociation and trauma. A critical review]. / Uber die kausale Beziehung zwischen Dissoziation und Trauma. Ein kritischer Uberblick.

This article discusses the accepted view that trauma causes dissociation. We critically evaluate studies that explored this relationship and discuss their shortcomings. In addition, individual differences related to dissociative experiences are discussed. In doing so, we focus on their potential to create pseudo-correlations between dissociative symptoms and self-reports of childhood trauma. After concluding that the causal link between trauma and dissociation is far from self-evident or empirically substantiated, we suggest some avenues for further research.

Psychological characteristics of patients with newly developed psychogenic seizures.

OBJECTIVES: To assess psychopathological symptoms and history of childhood trauma in patients with newly developed psychogenic seizures. METHODS: Using validated scales, 178 patients from the general population diagnosed with newly developed seizures were assessed, at a point in time when the nature of their seizures was yet unknown to either doctors or patients. After standardised neurological examination, 138 patients were diagnosed with non-psychogenic seizures (NPS), while 40 patients were found to have psychogenic seizures (PS). To evaluate possible differences between the genders and the diagnostic groups, univariate analyses of variance were done. RESULTS: PS patients reported significantly more comorbid psychopathological complaints, dissociative experiences, anxiety, and self-reported childhood trauma than NPS patients. In addition, PS patients had lower quality of life ratings than NPS patients. These effects were not modulated by gender. CONCLUSIONS: The results of the present study indicate that patients with newly developed PS constitute a group with complex psychopathological features that warrant early detection and treatment.

[The connection between trauma and dissociation: a critical evaluation]. / Der Zusammenhang zwischen Trauma und Dissoziation: Eine kritische Betrachtung.

Dissociation is often considered to be a psychological defense mechanism used by victims of traumatic events (e. g., sexual abuse, physical punishment, or emotional abuse). Evidence for this view comes from studies that found a connection between self-reported traumatic childhood experiences and high levels of dissociation. However, there are some problems with this causal interpretation. The aim of this review is to summarize evidence that casts doubts on the commonly voiced view that the connection between self-reported trauma and dissociation is a simple and robust one. First, we briefly summarize studies that looked at the link between trauma and dissociation as well as studies that identified factors that may modulate this link. Second, we review studies that explored the psychological correlates of dissociation. Over the past few years, our knowledge of these correlates has increased considerably. Some of these correlates (e. g., fantasy proneness, suggestibility, and frontal lobe dysfunction) are especially relevant because they may undermine the accuracy of retrospective self-reports of trauma. Finally, we conclude that the link between trauma and dissociation is more complex than many clinicians seem to assume. In particular, the possibility that dissociation acts as an antecedent of self-reported trauma warrants serious attention.