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Depersonalization disorder (DPD), is an often debilitating DSM V psychiatric disorder characterized by feelings of detachment from the self or others as well as emotional blunting or numbness. Subjective and physiological evidence of decreased emotional arousal may suggest impaired emotion regulation abilities. Deficits in emotional processing of DPD may be the result of dysregulated cortisol and oxytocin levels, however oxytocin levels have never been assessed in DPD. In this series of studies, we aimed to investigate the physiological correlates of emotion regulation in depersonalization disorder. In experiment 1, DPD patients and a normal control group subjectively enhanced and suppressed emotion to affective pictures. Compared to the control group, the DPD group tended to be better at suppressing emotion to unpleasant pictures and tended to modulate subjective arousal less effectively. In experiment 2, we measured heart rate and skin conductance response while DPD patients and a healthy control group enhanced and suppressed emotion to affective stimuli. DPD patients were better able to suppress and less able to enhance emotion (heart rate). In experiment 3, we investigated the relationship between cortisol and oxytocin responsivity during the Trier Social Stress Test (TSST) in DPD. The TSST induced subjective stress in the normal control group but not in the DPD group. The control group also demonstrated a positive association between post-stress cortisol and decrease in oxytocin during the 20 minute stress recovery period, an association not found for the DPD group. However, the DPD group had higher overall cortisol levels and tended toward higher oxytocin levels. In experiment 4, we explored the relationship between cortisol, oxytocin, and depersonalization during recall of a personally relevant stressful event by Psychology 100 course students. Consistent with experiment 4, post-stress cortisol was associated with a decrease in oxytocin during stress recovery. However, depersonalization was associated with less decrease in oxytocin during stress recovery. Taken together, these results suggest emotional blunting in DPD is accompanied by a superior ability to suppress emotion and dysregulated hormonal responses. DPD patients may benefit from pharmacological interventions that regulate cortisol and oxytocin levels and therapeutic interventions that support enhancing emotion subjectively and physiologically.
Monde, Kai-Mosadi, "Physiological Correlates of Emotion Regulation in Depersonalization Disorder" (2014). CUNY Academic Works.