Lauren A M Lebois1, Cori A Palermo2, Luke S Scheuer2, Evan P Lebois3, Sherry R Winternitz4, Laura Germine4, Milissa L Kaufman4. 1. McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA. Electronic address: llebois@mclean.harvard.edu. 2. McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA. 3. Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, 415 Main St, Cambridge, MA, 02142, USA. 4. McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
Abstract
BACKGROUND: Recovery from dissociative identity disorder (DID) is associated with the process of integration, which includes an increasing sense of self-cohesion and ownership over one's own emotions. Emotion perception is a construction based on interplay between stored knowledge (past experience), and incoming sensory inputs, suggesting changes in emotion perception might occur at different levels of integration - but this remains unexplored. Therefore, we examined the association between integration, psychiatric symptoms, and facial emotion perception. We hypothesized higher integration would be associated with fewer psychiatric symptoms, and differences in the perception of emotions. METHODS: Participants were 82 respondents to a cross-sectional web-based study. All participants met self-report cutoff scores for posttraumatic stress disorder (PTSD) and DID using the PTSD Checklist for DSM-5 and Multiscale Dissociation Inventory, respectively. Participants completed a psychometrically-matched test of facial emotion perception for anger, fear, and happiness called the Belmont Emotion Sensitivity Test. Participants also completed the Beck Depression Inventory II, Childhood Trauma Questionnaire, and Integration Measure, a validated measure of self-cohesion. RESULTS: Higher integration scores were associated with lower depression, PTSD, and autobiographical memory disturbance scores. Repeated-measures ANCOVA confirmed integration significantly interacted with emotion category on the facial emotion perception task. Specifically, higher integration scores were associated with greater accuracy to fearful and angry faces. CONCLUSIONS: While acknowledging the limitations of a cross-sectional design, our results suggest that the process of integration is associated with fewer psychiatric symptoms, and more accurate facial emotion perception. This supports treatment guidelines regarding integration as a therapeutic goal for DID.
BACKGROUND: Recovery from dissociative identity disorder (DID) is associated with the process of integration, which includes an increasing sense of self-cohesion and ownership over one's own emotions. Emotion perception is a construction based on interplay between stored knowledge (past experience), and incoming sensory inputs, suggesting changes in emotion perception might occur at different levels of integration - but this remains unexplored. Therefore, we examined the association between integration, psychiatric symptoms, and facial emotion perception. We hypothesized higher integration would be associated with fewer psychiatric symptoms, and differences in the perception of emotions. METHODS:Participants were 82 respondents to a cross-sectional web-based study. All participants met self-report cutoff scores for posttraumatic stress disorder (PTSD) and DID using the PTSD Checklist for DSM-5 and Multiscale Dissociation Inventory, respectively. Participants completed a psychometrically-matched test of facial emotion perception for anger, fear, and happiness called the Belmont Emotion Sensitivity Test. Participants also completed the Beck Depression Inventory II, Childhood Trauma Questionnaire, and Integration Measure, a validated measure of self-cohesion. RESULTS: Higher integration scores were associated with lower depression, PTSD, and autobiographical memory disturbance scores. Repeated-measures ANCOVA confirmed integration significantly interacted with emotion category on the facial emotion perception task. Specifically, higher integration scores were associated with greater accuracy to fearful and angry faces. CONCLUSIONS: While acknowledging the limitations of a cross-sectional design, our results suggest that the process of integration is associated with fewer psychiatric symptoms, and more accurate facial emotion perception. This supports treatment guidelines regarding integration as a therapeutic goal for DID.
Authors: Constance J Dalenberg; Bethany L Brand; David H Gleaves; Martin J Dorahy; Richard J Loewenstein; Etzel Cardeña; Paul A Frewen; Eve B Carlson; David Spiegel Journal: Psychol Bull Date: 2012-03-12 Impact factor: 17.737
Authors: Martin J Dorahy; Bethany L Brand; Vedat Sar; Christa Krüger; Pam Stavropoulos; Alfonso Martínez-Taboas; Roberto Lewis-Fernández; Warwick Middleton Journal: Aust N Z J Psychiatry Date: 2014-05 Impact factor: 5.744