Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: A PET study and neurobiological model

Reinders, A. A. T. S., Willemsen, A. T. M., den Boer, J. A., Vos, H. P. J., Veltman, D. J. & Loewenstein, R. J., 30-Sep-2014, In : Psychiatry research-Neuroimaging. 223, 3, p. 236-243 8 p.

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  • Opposite brain emotion-regulation patterns in identity states of dissociative identity

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Imaging studies in posttraumatic stress disorder (PTSD) have shown differing neural network patterns between hypo-aroused/dissociative and hyper-aroused subtypes. Since dissociative identity disorder (DID) involves different emotional states, this study tests whether DID fits aspects of the differing brain-activation patterns in PTSD. While brain activation was monitored using positron emission tomography, DID individuals (n=11) and matched DID-simulating healthy controls (n=16) underwent an autobiographic script-driven imagery paradigm in a hypo-aroused and a hyper-aroused identity state. Results were consistent with those previously found in the two PTSD subtypes for the rostral/dorsal anterior cingulate, the prefrontal cortex, and the amygdala and insula, respectively. Furthermore, the dissociative identity state uniquely activated the posterior association areas and the parahippocampal gyri, whereas the hyper-aroused identity state uniquely activated the caudate nucleus. Therefore, we proposed an extended PTSD-based neurobiological model for emotion modulation in DID: the hypo-aroused identity state activates the prefrontal cortex, cingulate, posterior association areas and parahippocampal gyri, thereby overmodulating emotion regulation; the hyper-aroused identity state activates the amygdala and insula as well as the dorsal striatum, thereby undermodulating emotion regulation. This confirms the notion that DID is related to PTSD as hypo-aroused and hyper-arousal states in DID and PTSD are similar. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)236-243
Number of pages8
JournalPsychiatry research-Neuroimaging
Issue number3
Publication statusPublished - 30-Sep-2014


  • Dissociative identity disorder (DID), Posttraumatic stress disorder (PTSD), Neuroimaging, Emotional undermodulation, Emotional overmodulation, Etiology, POSTTRAUMATIC-STRESS-DISORDER, PSYCHOMETRIC CHARACTERISTICS, MEMORY CONSOLIDATION, DORSAL STRIATUM, TRAUMA, PTSD, PERSONALITY, RESPONSES, SUBTYPE, DYSREGULATION

ID: 15991925