Dissociative identity state-dependent working memory in dissociative identity disorder: a controlled functional magnetic resonance imaging study.

cognitive neuroscience dissociative disorders post-traumatic stress disorder simulation trauma

Journal

BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931

Informations de publication

Date de publication:
11 Apr 2022
Historique:
entrez: 11 4 2022
pubmed: 12 4 2022
medline: 12 4 2022
Statut: epublish

Résumé

Memory function is at the core of the psychopathology of dissociative identity disorder (DID), but little is known about its psychobiological correlates. This study aims to investigate whether memory function in DID differs between dissociative identity states. Behavioural data and neural activation patterns were assessed in 92 sessions during an n-back working memory task. Participants were people with genuine diagnosed DID (n = 14), DID-simulating controls (n = 16) and a paired control group (post-traumatic stress disorder (n = 16), healthy controls (n = 16)). Both DID groups participated as authentic or simulated neutral and trauma-related identity states. Reaction times and errors of omission were analysed with repeated measures ANOVA. Working memory neural activation (main working memory and linear load) was investigated for effects of identity state, participant group and their interaction. Identity state-dependent behavioural performance and neural activation was found. DID simulators made fewer errors of omission than those with genuine DID. Regarding the prefrontal parietal network, main working memory in the left frontal pole and ventrolateral prefrontal cortex (Brodmann area 44) was activated in all three simulated neutral states, and in trauma-related identity states of DID simulators, but not those with genuine DID or post-traumatic stress disorder; for linear load, trauma-related identity states of those with genuine DID did not engage the parietal regions. Behavioural performance and neural activation patterns related to working memory in DID are dependent on the dissociative identities involved. The narrowed consciousness of trauma-related identity states, with a proneness to re-experiencing traumatising events, may relate to poorer working memory functioning.

Sections du résumé

BACKGROUND BACKGROUND
Memory function is at the core of the psychopathology of dissociative identity disorder (DID), but little is known about its psychobiological correlates.
AIMS OBJECTIVE
This study aims to investigate whether memory function in DID differs between dissociative identity states.
METHOD METHODS
Behavioural data and neural activation patterns were assessed in 92 sessions during an n-back working memory task. Participants were people with genuine diagnosed DID (n = 14), DID-simulating controls (n = 16) and a paired control group (post-traumatic stress disorder (n = 16), healthy controls (n = 16)). Both DID groups participated as authentic or simulated neutral and trauma-related identity states. Reaction times and errors of omission were analysed with repeated measures ANOVA. Working memory neural activation (main working memory and linear load) was investigated for effects of identity state, participant group and their interaction.
RESULTS RESULTS
Identity state-dependent behavioural performance and neural activation was found. DID simulators made fewer errors of omission than those with genuine DID. Regarding the prefrontal parietal network, main working memory in the left frontal pole and ventrolateral prefrontal cortex (Brodmann area 44) was activated in all three simulated neutral states, and in trauma-related identity states of DID simulators, but not those with genuine DID or post-traumatic stress disorder; for linear load, trauma-related identity states of those with genuine DID did not engage the parietal regions.
CONCLUSIONS CONCLUSIONS
Behavioural performance and neural activation patterns related to working memory in DID are dependent on the dissociative identities involved. The narrowed consciousness of trauma-related identity states, with a proneness to re-experiencing traumatising events, may relate to poorer working memory functioning.

Identifiants

pubmed: 35403592
doi: 10.1192/bjo.2022.22
pii: S2056472422000229
pmc: PMC9059616
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e82

Subventions

Organisme : International Society for the Study of Trauma and Dissociation (www.isst-d.org) National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London Netherlands Organization for Scientific Research (www.nwo.nl)

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Auteurs

Eline M Vissia (EM)

Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands; and Centre for Psychotrauma, Heelzorg, The Netherlands.

Andrew J Lawrence (AJ)

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Sima Chalavi (S)

Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands; and Research Centre for Movement Control and Neuroplasticity, Department of Movement Sciences, Katholieke Universiteit Leuven, Belgium.

Mechteld E Giesen (ME)

Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands.

Nel Draijer (N)

Department of Psychiatry, VU University Medical Center, Amsterdam University Medical Center, The Netherlands.

Ellert R S Nijenhuis (ERS)

Clienia Littenheid AG, Switzerland.

André Aleman (A)

Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands.

Dick J Veltman (DJ)

Department of Psychiatry, VU University Medical Center, Amsterdam University Medical Center, The Netherlands.

Antje A T S Reinders (AATS)

Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands; and Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Classifications MeSH