Depersonalization in individuals of the community and individuals with anxiety disorders: the role of catastrophic interpretations and experiential avoidance
Abstract
This study explored the relación among catastrophic interpretations, experiential avoidance and different subtypes of depersonalization (DP) in 70 individuals of the community and 70 individuals with anxiety disorders. Patients answered questionnaires that measured catastropihc interpretations, experiential avoidance and DP. Catastrophic interpretations predicted the global intensity of DP and also the subtypes anomalous corporal experiences, anomalous recall experiencies and derealization. On the opposite, experiential avoidance was not a predictor of DP. Results are commented in light of the progress in the conceptualization of DP.
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Abramowitz, J. S., Lackey, G. R., & Wheaton, M. G. (2009). Obsessive– compulsive symptoms: The contribution of obsessional beliefs and experiential avoidance. Journal of Anxiety Disorders, 23(2), 160-166.
http://dx.doi.org/10.1016/j.janxdis.2008.06.003
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author.
Baker, D., Earle, M., Medford, N., Sierra, M., Towell, A., & David, A. (2007). Illness perceptions in depersonalization disorder: testing an illness attribution model. Clinical Psychology & Psychotherapy, 14(2), 105-116. http://dx.doi.org/10.1002/cpp.518
Baker, D., Hunter, E., Lawrence, E., Medford, N., Patel, M., Senior., & David, A. S. (2003). Depersonalisation disorder: clinical features of 204 cases. The British Journal of Psychiatry, 182(5), 428-433. http://dx.doi.org/10.1192/bjp.182.5.428
Barlow, D. H., Vermilyea, J., Blanchard, E. B., Vermilyea, B. B., Di Nardo, P. A., & Cerny, J. A. (1985). The phenomenon of panic. Journal of Abnormal Psychology, 94(3), 320. http://dx.doi.org/10.1037/0021-843X.94.3.320
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory – Manual. San Antonio, TX: The Psychological Corporation.
Berman, N. C., Wheaton, M. G., McGrath, P., & Abramowitz, J. S. (2010). Predicting anxiety: The role of experiential avoidance and anxiety sensitivity. Journal of Anxiety Disorders, 24(1), 109-113. http://dx.doi.org/10.1016/j.janxdis.2009.09.005
Block-Lerner, J., Salters-Pedneault, K., & Tull, M. T. (2005). Assessing mindfulness and experiential acceptance. En S. M. Orsillo & L. Roemer (Eds). Acceptance and mindfulness-based approaches to anxiety (pp. 71-99). Springer US. http://dx.doi.org/10.1007/0-387-25989-9_3
Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of consulting and clinical psychology, 52(6), 1090. http://dx.doi.org/10.1037/0022-006X.52.6.1090
Cohen, J., Cohen, P., & Stephen, G. West, and Leona S. Aiken. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah: Erlbaum.
Cox, B. J., & Swinson, R. P. (2002). Instrument to assess depersonalization‐ derealization in panic disorder. Depression and anxiety, 15(4), 172-175. http://dx.doi.org/10.1002/da.10051
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). User’s guide for the Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version. New York: Biometrics Research, New York State Psychiatric Institute.
First, M. B., Spitzer, R. L., Gibbon, M. & Williams, J. B. W. (1998). Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Patient Edition with Psychotic Screen (SCID-I/P W/PSY SCREEN). New York: Biometrics Research, New York State Psychiatric Institute.
Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences. Oxford: Oxford University Press.
Foa, E. B., Riggs, D., & Gershuny, B. (1995). Arousal, numbing, and intrusion. American Journal of Psychiatry, 152, 116-120. http://dx.doi.org/10.1176/ajp.152.1.116
Goff, D. C., Olin, J. A., Jenike, M. A., Baer, L., & Buttolph, M. L. (1992). Dissociative symptoms in patients with obsessive-compulsive disorder. The Journal of nervous and mental disease, 180(5), 332-337. http://dx.doi.org/10.1097/00005053-199205000-00008
Graves, R. E. (2000). Accuracy of regression equation prediction across the range of estimated premorbid IQ. Journal of clinical and experimental neuropsychology, 22(3), 316-324. http://dx.doi.org/10.1076/1380-3395(200006)22:3;1-V;FT316
Harvey, A. G., & Bryant, R. A. (1999). Dissociative symptoms in acute stress disorder. Journal of traumatic stress, 12(4), 673-680. http://dx.doi.org/10.1023/A:1024773202939
Hayes, S. C. (2004). Acceptance and Commitment Therapy and the New Behavior Therapies: Mindfulness, Acceptance, and Relationship. En S. C. Hayes, V. M. Follete, & M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive behavioral tradition (pp. 1-29). New York: Guilford. http://dx.doi.org/10.1016/S0005-7894(04)80013-3
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of consulting and clinical psychology, 64(6), 1152. http://dx.doi.org/10.1037/0022-006X.64.6.1152
Holmes, E. A., Brown, R. J., Mansell, W., Fearon, R. P., Hunter, E. C., Frasquilho, F., & Oakley, D. A. (2005). Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clinical psychology review, 25(1), 1-23. http://dx.doi.org/10.1016/j.cpr.2004.08.006
Hoyer, J., Braeuer, D., Crawcour, S., Klumbies, E., & Kirschbaum, C. (2013). Depersonalization/derealization during acute social st ress in social phobia. Journal of anxiety disorders, 27(2), 178-187. http://dx.doi.org/10.1016/j.janxdis.2013.01.002
Hunter, E. C. M., Phillips, M. L., Chalder, T., Sierra, M., & David, A. S. (2003). Depersonalisation disorder: a cognitive–behavioural conceptualisation. Behaviour Research and Therapy, 41(12), 1451-1467. http://dx.doi.org/10.1016/S0005-7967(03)00066-4
Hunter, E. C., Salkovskis, P. M., & David, A. S. (2014). Attributions, appraisals and attention for symptoms in depersonalisation disorder. Behaviour research and therapy, 53, 20-29. http://dx.doi.org/10.1016/j.brat.2013.11.005
Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation. Social psychiatry and psychiatric epidemiology, 39(1), 9-18. http://dx.doi.org/10.1007/s00127-004-0701-4
Jaycox, L. H., & Foa, E. B. (1999). Obstacles in implementing exposure therapy for PTSD: Case discussions and practical solution. Clinical psychology and Psychotherapy, 3, 176-184.
Lickel, J., Nelson, E., Hayes, A., & Deacon, B. (2008). Interoceptive exposure exercises for evoking depersonalization and derealization: A pilot study. Journal of Cognitive Psychotherapy, 22, 321-330. http://dx.doi.org/10.1891/0889-8391.22.4.321
Litz, B. T., Litz, B. T., & Gray, M. J. (2002). Emotional numbing in posttraumatic stress disorder: Current and future research directions. Australian and New Zealand Journal of Psychiatry, 36(2), 198-204. http://dx.doi.org/10.1046/j.1440-1614.2002.01002.x
Mahaffey, B. L., Wheaton, M. G., Fabricant, L. E., Berman, N. C., & Abramowitz, J. S. (2013). The contribution of experiential avoidance and social cognitions in the prediction of social anxiety. Behavioural and cognitive psychotherapy, 41(01), 52-65. http://dx.doi.org/10.1017/S1352465812000367
Manos, R. C., Cahill, S. P., Wetterneck, C. T., Conelea, C. A., Ross, A. R., & Riemann, B. C. (2010). The impact of experiential avoidance and obsessive beliefs on obsessive-compulsive symptoms in a severe clinical sample. Journal of anxiety disorders, 24(7), 700-708. http://dx.doi.org/10.1016/j.janxdis.2010.05.001
Michal, M., Beutel, M. E., Jordan, J., Zimmermann, M., Wolters, S., & Heidenreich, T. (2007). Depersonalization, mindfulness, and childhood trauma. The Journal of nervous and mental disease, 195(8), 693-696. http://dx.doi.org/10.1097/NMD.0b013e31811f4492
Michal, M., Glaesmer, H., Zwerenz, R., Knebel, A., Wiltink, J., Brähler, E., & Beutel, M. E. (2011). Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population. Journal of affective disorders, 128(1), 106-111. http://dx.doi.org/10.1016/j.jad.2010.06.033
Molina Castillo, F., Molina Castillo, J. J., Martínez de la Iglesia, J., Albert Colomer, C., Berrios, G., Luque Luque, R., & Sierra, A. M. (2006). Adaptación y validación al castellano de la Escala de Despersonalización de Cambridge. Actas Españolas de Psiquiatría, 34(3), 185-192.
Neziroglu, F. & Donnelly, K. (2010). Overcoming Depersonalization Disorder: A mindfulness and acceptance guide to conquering feelings of numbness and unreality. Oakland: New Harbinger Publications.
Noyes, R., & Kletti, R. (1977). Depersonalization in response to life-threatening danger. Comprehensive psychiatry, 18(4), 375-384. http://dx.doi.org/10.1016/0010-440X(77)90010-4
Noyes, R., Woodman, C., Garvey, M. J., Cook, B. L., Suelzer, M., Clancy, J., & Anderson, D. J. (1992). Generalized anxiety disorder vs. panic disorder: Distinguishing characteristics and patterns of comorbidity. The Journal of nervous and mental disease, 180(6), 369-379.
Sanderson, W. C., Rapee, R. M., & Barlow, D. H. (1989). The influence of an illusion of control on panic attacks induced via inhalation of 5.5% carbon dioxide-enriched air. Archives of General Psychiatry, 46(2), 157-162. http://dx.doi.org/10.1001/archpsyc.1989.01810020059010
Sierra, M., Baker, D., Medford, N., & David, A. S. (2005). Unpacking the depersonalization syndrome: an exploratory factor analysis on the Cambridge Depersonalization Scale. Psychological medicine, 35(10), 1523-1532. http://dx.doi.org/10.1017/S0033291705005325
Sierra, M., & Berrios, G. E. (1998). Depersonalization: Neurobiological perspectives. Biological Psychiatry, 44, 898-908. http://dx.doi.org/10.1016/S0006-3223(98)00015-8
Sierra, M., & Berrios, G. E. (2000). The Cambridge Depersonalisation Scale: a new instrument for the measurement of depersonalisation. Psychiatry research,93(2), 153-164. http://dx.doi.org/10.1016/S0165-1781(00)00100-1
Sierra, M., & David, A. S. (2007). Depersonalization and individualism: the effect of culture on symptom profiles in panic disorder. The Journal of nervous and mental disease, 195(12), 989-995. http://dx.doi.org/10.1097/NMD.0b013e31815c19f7
Sierra, M., Medford, N., Wyatt, G., & David, A. S. (2012). Depersonalization disorder and anxiety: a special relationship?. Psychiatry research, 197(1), 123- 127. http://dx.doi.org/10.1016/j.psychres.2011.12.017
Simeon, D. S. & Abugel, J. (2008). Feeling unreal: Depersonalization disorder and the loss of the self. Oxford: Oxford University Press.
Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory STAI. Mountain View, CA: Consulting Psychologists Press.
Stevens, J. P. (1984). Outliers and influential data points in regression analysis. Psychological Bulletin, 95, 334-344. http://dx.doi.org/10.1037/0033-2909.95.2.334
Trueman, D. (1984a). Depersonalization in a nonclinical population. The Journal of psychology, 116(1), 107-112.
Trueman, D. (1984b). Anxiety and depersonalization and derealization experiences. Psychological reports, 54(1), 91-96.
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