The exact cause of<unk>  is unknown, although biopsychosocial correlations and triggers have been identified. It has been thought that<unk>  can be caused by a biological response to dangerous or life-threatening situations which causes heightened senses and emotional numbing. Psychosocial There is growing evidence linking physical and sexual abuse in childhood with the development of dissociative<unk> s. Childhood interpersonal trauma – emotional abuse in particular – is a significant predictor of a diagnosis of DPDR. Compared to other types of childhood trauma, emotional abuse has been found to be the most significant predictor both of a diagnosis of<unk><unk>  and of<unk>  scores, but not of general dissociation scores. Some studies suggest that greater emotional abuse and lower physical abuse predict<unk>  in adult women with post-traumatic stress<unk>  (PTSD). Patients with high interpersonal abuse histories (HIA) show significantly higher scores on the Cambridge<unk>  Scale, when compared to a control group. Earlier age of abuse, increased duration and parental abuse tend to correlate with severity of dissociative symptoms. Besides traumatic experiences, other common precipitators of the<unk>  include severe stress, major depressive<unk> , panic attacks, and psychoactive substances. People who live in highly individualistic cultures may be more vulnerable to<unk> , due to threat hypersensitivity and an external locus of control. Neurobiology Animated image showing prefrontal cortex, which is thought to play a role in DPDR There is converging evidence that the prefrontal cortex may inhibit neural circuits that normally form the basis of emotional experience. In an fMRI study of DPD patients, emotionally aversive scenes activated the right ventral prefrontal cortex. Participants demonstrated a reduced neural response in emotion-sensitive regions, as well as an increased response in regions associated with emotional regulation. In a similar test of emotional memory,<unk><unk>  patients did not process emotionally salient material in the same way as did healthy controls. In a test of skin conductance responses to unpleasant stimuli, the subjects showed a selective inhibitory mechanism on emotional processing. Studies are beginning to show that the temporoparietal junction has a role in multisensory integration, embodiment, and self-other distinction. Several studies analyzing brain MRI findings from DPDR patients found decreased cortical thickness in the right middle temporal gyrus, reduction in grey matter volume in the right caudate, thalamus, and occipital gyri, as well as lower white matter integrity in the left temporal and right temporoparietal regions. However, no structural changes in the amygdala were observed. A PET scan found functional abnormalities in the visual, auditory, and somatosensory cortex, as well as in areas responsible for an integrated body schema. One study examining EEG readings found frontal alpha wave overactivation and increased theta activity waves in the temporal region of the left hemisphere. Image showing temporoparietal junction, a portion of the brain also thought to play a role in DPDR It is unclear whether genetics plays a role; however, there are many neurochemical and hormonal changes in individuals with<unk><unk> . DPDR may be associated with dysregulation of the hypothalamic-pituitary-adrenal axis, the area of the brain involved in the "fight-or-flight" response. Patients demonstrate abnormal cortisol levels and basal activity. Studies found that patients with DPD could be distinguished from patients with clinical depression and posttraumatic stress<unk> . The vestibular system may also play a role in DPDR. The vestibular system helps control balance, spatial orientation, motor coordination, but also plays a role in self-awareness. Disruption to this system can potentially cause a feeling of detachment from surroundings. Several studies have shown that patients with peripheral vestibular disease are also more likely to have dissociative symptoms when compared to healthy individuals. Dissociative symptoms are sometimes described by those with neurological diseases, such as amyotrophic lateral sclerosis, Alzheimer's, multiple sclerosis (MS), etc., that directly affect brain tissue.
Depersonalization-derealization disorder
Transference neurosis
Psychopathy
Dissociative identity disorder
Dissociative disorder
Gemütlose psychopathy
Other specified dissociative disorder
Unitary psychosis