Pathological dissociation is a severe, debilitating and transdiagnostic psychiatric symptom. This presentation aims to inform on biomarkers of pathological dissociation in a transdiagnostic manner in support of the precision medicine framework (part 1) and on the basis of a brain imaging study in individuals with DID (part 2).
In part 1 a systematic review will present a systematic review that includes a total of 205 unique studies. The terms ‘biomarker’ and ‘precision medicine’ will be explained. Studies that met inclusion criteria were divided into four biomarker categories, namely neuroimaging, psychobiological, psychophysiological and genetic biomarkers. Two tables per category were created, namely one to list the studies by biomarker measure and first author, and a second one listing the biomarker findings and the directionality of response. For every biomarker finding, e.g. the hippocampus, a counter was created to calculate the frequency of this biomarker finding across studies. Bar graphs were created on the basis of these counters. A biomarker finding that was most frequent was proposed as an important biomarker for pathological dissociation. The dorsomedial and dorsolateral prefrontal cortex, bilateral superior frontal regions, (anterior) cingulate, posterior association areas and basal ganglia are identified as neurofunctional biomarkers of pathological dissociation and decreased hippocampal, basal ganglia and thalamic volumes as neurostructural biomarkers. Increased oxytocin and prolactin and decreased tumor necrosis factor alpha (TNF-α) are identified as psychobiological markers. Psychophysiological biomarkers, including blood pressure, heart rate and skin conductance, were inconclusive. For the genetic biomarker category studies related to dissociation were limited and no clear directionality of effect was found to warrant identification of a genetic biomarker. Recommendations for future research pathways and possible clinical applicability are provided.
Part 2 presents a novel study in individuals with DID and reveals a hippocampal subfield as neurostructural biomarker of dissociative amnesia.
This course is based on the recorded webinar, Biomarkers of Pathological Dissociation created by Simone Reinders, PhD and Lora Dimitrova, MSC, AKC in 2021.