Citation

Wolf EJ, Hawn SE, Sullivan DR, Miller MW, Sanborn V, Brown E, Neale Z, Fein-Schaffer D, Zhao X, Logue MW, Fortier CB, McGlinchey RE, Milberg WP. J. Psychopathol. Clin. Sci. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Psychological Association)

DOI

10.1037/abn0000795

PMID

37023279

Abstract

Approximately 10%-30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization and derealization. This study examined the psychometric evidence for the dissociative subtype of PTSD in a sample of young, primarily male post-9/11-era Veterans (n = 374 at baseline and n = 163 at follow-up) and evaluated its biological correlates with respect to resting state functional connectivity (default mode network [DMN]; n = 275), brain morphology (hippocampal subfield volume and cortical thickness; n = 280), neurocognitive functioning (n = 337), and genetic variation (n = 193). Multivariate analyses of PTSD and dissociation items suggested a class structure was superior to dimensional and hybrid ones, with 7.5% of the sample comprising the dissociative class; this group showed stability over 1.5 years. Covarying for age, sex, and PTSD severity, linear regression models revealed that derealization/depersonalization severity was associated with: decreased DMN connectivity between bilateral posterior cingulate cortex and right isthmus (p =.015; adjusted-p [p(adj)] =.097); increased bilateral whole hippocampal, hippocampal head, and molecular layer head volume (p =.010-.034; p(adj) =.032-.053); worse self-monitoring (p =.018; p(adj) =.079); and a candidate genetic variant (rs263232) in the adenylyl cyclase 8 gene (p =.026), previously associated with dissociation.

RESULTS converged on biological structures and systems implicated in sensory integration, the neural representation of spatial awareness, and stress-related spatial learning and memory, suggesting possible mechanisms underlying the dissociative subtype of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Language: en