Adolescents Suspended in the Space-Time: Problematic Use of Smartphone between Dissociative Symptoms and Flow Experiences

Based on current digital culture, this chapter aims to provide an updated view of dissociative experiences as no-psychopathological symptoms of flow experiences. It has been hypothesized that prolonged exposures to smartphone screens could be a predictor of altered states of consciousness (flow) and that sometimes these prolonged exposures could degenerate into dissociative phenomena. Participants were 643 high school students aged between 13 and 23 years (M = 16.08; SD = 1.79). They were asked to answer four self-report questionnaires about the habits of smartphone usage, the perception of problematic smartphone use, and the assessment of dissociative symptoms and experiences (e.g., bizarre sensory experiences, absorption and imaginative involvement [AII], depersonalization and derealization). Gender differences emerged both in smartphone usage habits and some dissociative scales. Two gender-specific stepwise linear regressions showed that problematic smartphone use is one of the stronger predictors of dissociative symptoms. Results support the idea that in an adolescents’ community sample prolonged exposition to smartphone screens plays a role in the manifestation of dissociative symptoms. This is closely connected with experiences of AII, which could reinforce the use of devices contributing significantly to establishing a causal circularity between smartphone prolonged usage and AII phenomena.

The antecedents and consequences of disorganised attachment and dissociation

Attachment researchers theorise that the primary antecedent of dissociation is disorganised attachment. However, the family and social contexts of this parent–child relationship are frequently ignored even though they play an important role in determining whether the unresolved attachment of the parent actually leads to the role confusion characteristic of disorganised attachment and dissociation in the child. This article will address first how the dynamics leading to disorganised attachment and dissociation are dependent on the larger family and social contexts; and second how both unresolved attachment and dissociation in the adolescent or adult are often maintained through the choice of a partner, the dissociative symptoms themselves and other social conditions to which these individuals are frequently exposed. Two case studies will illustrate this thesis. Finally, implications for treatment will be explored.

Signs of dissociation and symptoms of post-traumatic stress disorder in inflammatory bowel disease. A case-control study

Background. Several psychological disorders have been described in patients affected by Inflammatory Bowel Disease (IBD). Few studies have focused on the relationship between IBD and Post-Traumatic Stress Disorder (PTSD) symptoms, and no data are available on the relationship between IBD and dissociative symptoms. Aim of the present study was to evaluate the prevalence of PTSD and dissociative symptoms in a sample of IBD patients compared to healthy controls. A possible relationship with disease activity was also investigated. Methods: A total of 112 IBD patients, 55 Crohn’s disease (CD) and 57 Ulcerative Colitis (UC), and 114 healthy individuals were evaluated. IBD patients were divided into three subgroups according to disease activity (remission, mild, moderate). The revised version of the Impact of Event Scale (IES-R) and the Dissociative Experience Scale (DES) were administered to patients and controls. Results: IBD patients showed significantly higher rates of PTSD and dissociative symptoms compared to healthy controls. No differences were found between CD and UC patients. PTSD and dissociative symptoms were higher among CD patients with mild to moderate-severe activity compared to the remission group. No differences were found among UC patients with different activity levels. Conclusion: IBD patients show a high prevalence of dissociative and traumatic affective disorders. Future studies are needed to investigate the role of these disorders in the clinical course and management of IBD patients according to different disease activity phase.

Duration of Untreated Disorder and Cannabis Use: An Observational Study on a Cohort of Young Italian Patients Experiencing Psychotic Experiences and Dissociative Symptoms

Background: The Duration of Untreated Psychosis (DUP) is the time between the first-episode psychosis (FEP) and the initiation of antipsychotic treatment. It is an important predictor of several disease-related outcomes in psychotic disorders. The aim of this manuscript is investigating the influence of cannabis on the DUP and its clinical correlates. Methods: During years 2014–2019, sixty-two FEP patients with and without cannabis use disorder (CUD) were recruited from several Italian psychiatric hospitals. The subjects were then divided into two groups based on the duration of the DUP and assessed at the beginning of the antipsychotic treatment and after 3 and 6 months, using the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale, and the Dissociative Experiences Scale (DES-II). Results: As expected, a longer DUP was associated with worse symptoms and cannabis use did not seem to affect the DUP, but both were related with more dissociative symptoms at onset and over time. Discussion: According to our study, cannabis use can be a predictor of FEP and DUP, and of disease outcome. However, several factors might influence the relationship between cannabis use and DUP. Preventing cannabis use and early diagnosis of psychotic disorders might impact the disease by reducing the persistence of symptoms and limiting dissociative experiences.

Dissociative-Traumatic Dimension and Triple Network: An EEG Functional Connectivity Study in a Sample of University Students

<b><i>Aims:</i></b> We investigated the association among triple network electroencephalographic (EEG) functional connectivity, dissociative symptoms, and childhood trauma (CT) in a sample of university students. <b><i>Sampling and Methods:</i></b> Seventy-six participants (30 males and 46 females; mean age 22.12 ± 2.35) completed self-report measures investigating dissociative symptoms, CT, and depressive symptoms. Participants also performed an eyes-closed resting-state EEG recording. EEG analyses were conducted through the exact low-resolution electromagnetic tomography (eLORETA) software. <b><i>Results:</i></b> A 2-step cluster analysis revealed 2 groups: participants (<i>N</i> = 23) with high dissociative-traumatic dimension symptoms (DTD+) and participants (<i>N</i> = 53) with low DTD symptoms (DTD−). Compared to DTD− subjects, DTD+ participants showed decreased theta connectivity between the salience network (SN) and central executive network (CEN), specifically between the right anterior insula and the left posterior parietal cortex. No significant correlation was detected between EEG data and clinical variables. <b><i>Conclusion:</i></b> Our results raise the possibility of a dysfunctional connectivity pattern occurring between the SN and CEN in individuals with high DTD symptoms. Such connectivity pattern might reflect the neuropsychophysiological disintegration related to pathological dissociation.

The effects of subliminal or supraliminal sadness induction on the sense of body ownership and the role of dissociative symptoms

Previous research has shown that emotions can alter our sense of ownership. Whether this relationship is modulated by differences in emotion experience and awareness, however, remains unclear. We investigated this by comparing the susceptibility to the rubber hand illusion (RHI) between participants who were either exposed to a low-arousing emotion induction (sadness) or placed in a neutral control group. Several factors that might influence this relationship were considered: dissociative symptoms were included to observe if a sadness induction led to a higher RHI score in participants scoring high in dissociation, as a result of detached emotion experience. Whether the level of awareness of the emotion mattered was also tested, as subliminal processing was shown to require less focal attention. Therefore, our sample (N = 122) was divided into three experimental groups: Sad pictures were presented to two of the three groups differing in presentation mode (subliminal: n = 40, supraliminal: n = 41), neutral pictures were presented supraliminally to the control group (n = 41). Additionally, the effects of slow (3 cm/s) and fast (30 cm/s) stroking, applied either synchronously or asynchronously, were examined as the comforting effects of stroking might interfere with the emotion induction. Results showed that the supraliminal sadness induction was associated with a stronger subjective illusion, but not with a higher proprioceptive drift compared to the subliminal induction. In addition, a stronger subjective illusion after fast and synchronous stroking was found compared to slow and asynchronous stroking. A significant proprioceptive drift was detected independent of group and stroking style. Both slow and synchronous stroking were perceived as more comforting than their respective counterparts. Participants with higher dissociative symptoms were more susceptible to the subjective illusion, especially in the supraliminal group in the synchronous condition. We concluded that individual differences in emotion experience are likely to play a role in body ownership. However, we cannot clarify at this stage whether differences in proprioception and the subjective illusion depend on the type of emotion experienced (e.g. different levels of arousal) and on concomitant changes in multisensory integration processes.

Dissociation in SLE: A part of lupus fog?

Introduction Lupus fog is ill-defined. We aimed to study whether lupus fog is the result of dissociation by studying the prevalence of dissociation and dissociative fog in patients with SLE and neuropsychiatric manifestations of inflammatory and non-inflammatory origin. Methods Patients visiting the tertiary referral center for neuropsychiatric systemic lupus erythematosus (NPSLE) of the LUMC between 2007–2019 were included. Patients were classified as having neuropsychiatric symptoms of inflammatory or non-inflammatory origin. Dissociation was studied using the Dissociative Experience Scale-II (DES), in which the presence of 28 dissociative symptoms is rated (0–100% of the time), of which one question assesses the presence of a dissociative fog directly. Average scores are calculated and scores ≥ 25 are considered indicative of a dissociative disorder. A score of ≥ 30 on question 28 (dissociative fog) was considered indicative for the presence of a fog. Summary scores in the general adult population range from 4.4 to 14. Multiple regression analysis (MRA) was performed to study the association between inflammatory neuropsychiatric symptoms and dissociation. DES results are presented as median (range) and MRA as B and 95% confidence interval (CI). Results DES questionnaires were available for 337 patients, of which 69 had an inflammatory NPSLE phenotype (20%). Mean age in the total study population was 43 ± 14 years and the majority was female (87%). The median dissociation score was 7.1 (0–75) and did not differ between patients with neuropsychiatric symptoms of inflammatory or non-inflammatory origin (B: −0.04 (95% CI: −0.17; 0.09)). 35 patients (10%) had a score indicative of a dissociative disorder. The most common type of dissociation was absorption/imagination. 43 patients (13%) reported a dissociative fog. Discussion In most patients with SLE and neuropsychiatric symptoms, dissociative symptoms are within normal range, regardless of underlying etiology. Dissociative fog is present, but uncommon. Lupus fog is most likely not associated with dissociation.