RESUMEN

Depersonalization/derealization disorder (DPD) is a prevalent yet inadequately understood clinical condition characterized by a recurrent or persistent sense of unreality. This study aims to provide insight into DPD through descriptive and comparative analyses involving a large group of Chinese participants. The socio-demographic details (age, gender proportion, education, occupational status, marital status), depersonalized and dissociative symptom characteristics (symptomatic factors or subscales of the Cambridge Depersonalization Scale and the Dissociative Experiences Scale), development trajectory (age of onset, potential precipitating factors, course characteristics), treatment history (duration of delayed healthcare attendance, duration of delayed diagnosis, previous diagnoses), and adverse childhood experiences of the DPD patients are presented. Comparisons of anxiety and depressive symptoms, alongside psychosocial functioning, between DPD participants and those diagnosed with generalized anxiety disorder, bipolar disorders, and major depressive disorder were conducted. The analysis highlights a higher male preponderance and early onset of DPD, symptomatology marked by derealization, notable impairment in psychosocial functioning, and prolonged periods of delayed healthcare attendance and diagnosis associated with symptom severity. Furthermore, noteworthy relationships between adverse childhood experiences and symptom levels were identified. The findings substantiate the view that DPD is a serious but neglected mental disorder, urging initiatives to improve the current condition of DPD patients.

Asunto(s)

RESUMEN

Purpose: Dissociation is a necessary part of our threat response system, common to all animal species, normally temporarily activated under conditions of extreme or inescapable threat. Pathological dissociation, however, continues to occur after the initial threat has passed, in response to reminders or inaccessibility of safety and security. Present across the spectrum of psychiatric diagnoses, recurrent dissociative symptoms are linked to severe trauma exposure, insecure attachment, treatment non-response, and maladaptive coping behaviors such as substance use, suicidality, and self-harm. However, empirical studies testing treatments specific to dissociative processes remain scarce. This narrative review summarizes existing studies and provides theoretical, neurobiological, and evolutionary perspectives on dissociative processes and treatments for pathological dissociation. Methods: A systematic search of five databases (MEDLINE, EMBASE, APA PsycINFO, CINAHL plus, Scopus) was conducted on April 13, 2023. Peer-reviewed clinical studies with adult participants, assessing intervention effects on dissociative symptoms, were included. Results were thematically analyzed and summarized. Results: Sixty-nine studies were identified, mainly focused on posttraumatic stress disorder, trauma-exposed populations, and borderline personality disorder. Psychotherapy was studied in 72.5% of studies; other interventions included medications and neurostimulation. The majority reported positive outcomes, despite the heterogeneous spectrum of interventions. However, treatment of dissociative symptoms was the primary objective in only a minority. Conclusion: Pathological dissociation is a complex phenomenon involving brain and body systems designed for perceiving and responding to severe threats, requiring an individualized approach. A literature is emerging regarding potentially evidence-based treatments to help those impacted by recurrent dissociative symptoms. When contextualized within a neurobiological and evolutionary perspective, these treatments can be understood as facilitating an internal and/or relational sense of safety, resulting in symptom reduction. Further studies are needed to explore effective treatments for dissociative symptoms.

RESUMEN

Background: While several studies documented a positive correlation between childhood maltreatment severity and dissociation severity, it is currently unknown whether specific dissociative symptoms cluster together among individuals with childhood trauma histories ranging from none to severe.Objective: We aimed to explore symptom constellations across the whole spectrum of dissociative processing from patients with severe dissociative disorders to healthy controls and relate these to maltreatment severity and sociodemographic characteristics.Methods: We employed latent profile analysis to explore symptom profiles based on five subscales, measuring absorption, depersonalization, derealization, somatoform and identity alteration, based on the 20 items of the German short version of the Dissociative Experiences Scale-II (Fragebogen zu Dissoziativen Symptomen-20) in a large aggregate sample (n = 3,128) overrepresenting patients with trauma-related disorders. We then related these profiles to maltreatment severity as measured by the five subscales of the Childhood Trauma Questionnaire as well as sociodemographic characteristics.Results: Based on the five FDS subscales, six clusters differentiated by symptom severity, but not symptom constellations, were identified. Somatoform dissociation varied in accordance with the remaining symptom clusters. The cluster with the highest overall symptom severity entailed nearly all subjects diagnosed with Dissociative Identity Disorder and was characterized by extreme levels of childhood maltreatment. Both abuse and neglect were predictive of cluster membership throughout.Conclusions: The higher the severity of dissociative processing in a cluster, the more subjects reported high severity and multiplicity of childhood maltreatment. However, some subjects remain resilient to the development of dissociative processing although they experience extreme childhood maltreatment.

Dissociative symptoms, including identity alterations, are closely related to the severity of experienced childhood abuse.Somatoform dissociation occurs on all levels of overall dissociation severity.Some subjects with a history extreme childhood maltreatment do not develop dissociative symptoms, while some subjects with extreme dissociative symptoms do not report any childhood maltreatment.

Asunto(s)

RESUMEN

OBJECTIVES: Depersonalisation-derealization disorder (DPD) is a dissociative disorder that impairs cognitive function and occupational performance. Emerging evidence indicate the levels of tumour necrosis factor-α and interleukin associated with the dissociative symptoms. In this study, we aimed to explore the role of the immune system in the pathology of DPD. METHODS: We screened the protein expression in serum samples of 30 DPD patients and 32 healthy controls. Using a mass spectrometry-based proteomic approach, we identified differential proteins that were verified in another group of 25 DPD patients and 30 healthy controls using immune assays. Finally, we performed a correlation analysis between the expression of differential proteins and clinical symptoms of patients with DPD. RESULTS: We identified several dysregulated proteins in patients with DPD compared to HCs, including decreased levels of C-reactive protein (CRP), complement C1q subcomponent subunit B, apolipoprotein A-IV, and increased levels of alpha-1-antichymotrypsin (SERPINA3). Moreover, the expression of CRP was positively correlated with visuospatial memory and the ability to inhibit cognitive interference of DPD. The expression of SERPINA3 was positively correlated with the ability to inhibit cognitive interference and negatively correlated with the perceptual alterations of DPD. CONCLUSIONS: The dysregulation of the immune system may be the underlying biological mechanism in DPD. And the expressions of CRP and SERPINA3 can be the potential predictors for the cognitive performance of DPD.

Asunto(s)

RESUMEN

Depersonalization and derealization symptoms are often transient. Recurrent and persistent symptoms can result in a diagnosis of depersonalization/derealization disorder (DDD). Here, we reported a case of a 24-year-old adult male whose presentation was consistent with primary derealization disorder only. He was referred with his consent by an ophthalmologist and neurologist for psychiatric opinion for the complaints of blackish discoloration of his vision for the last two years and feeling of unreality towards his surroundings for the last one and a half years in the absence of any comorbid physical illness and mental disorder. The patient was treated with fluoxetine, Lamotrigine, and psychotherapy, but there was only some improvement reported in his distress; however, primary complaints remained unchanged.

RESUMEN

BACKGROUND: Symptoms of depersonalization (DP) and derealization (DR) are a risk factor for more severe impairment, non-response to various treatments, and a chronic course. In this study, we investigated the effects of DP/DR symptoms in patients with clinically significant depressive symptoms on clinical characteristics and various outcomes in a representative population-based sample with a 5-year follow-up. METHODS: The middle-aged sample comprised n = 10,422 persons at baseline, of whom n = 9,301 were free from depressive and DP/DR symptoms. N = 522 persons had clinically significant depression (PHQ-9 ≥ 10) and co-occurring DP/DR symptoms, and n = 599 persons had clinically significant depression (PHQ-9 ≥ 10) without DP/DR symptoms. RESULTS: There were substantial health disparities between persons with and without depression. These disparities concerned a wide range of life domains, including lower quality of the recalled early life experiences with the parents, current socioeconomic status, social integration (partnership, loneliness), current social and interpersonal stressors (family, work), functional bodily complaints (e.g., tinnitus, migraine, chest pain), unhealthy lifestyle, and the prevalence of already developed physical diseases. These disparities persisted to the 5-year follow-up and were exceptionally severe for depressed persons with co-occurring DP/DR symptoms. Among the depressed persons, the co-occurrence of DP/DR symptoms more than doubled the risk for recurrence or persistence of depression. Only 6.9% of depressed persons with DP/DR symptoms achieved remission at the 5-year follow-up (PHQ-9 < 5). Depression with and without co-occurring DP/DR worsened self-rated physical health significantly. The impact of depression with co-occurring DP/DR on the worsening of the self-rated physical health status was stronger than those of age and major medical diseases (e.g., heart failure). However, only depression without DP/DR was associated with mortality in a hazard regression analysis adjusted for age, sex, and lifestyle. CONCLUSIONS: The results demonstrated that DP/DR symptoms represent an important and easily assessable prognostic factor for the course of depression and health outcomes. Given the low remission rates for depression in general and depression with DP/DR in particular, efforts should be made to identify and better support this group, which is disadvantaged in many aspects of life.

Asunto(s)

RESUMEN

BACKGROUND: Depersonalization and derealization can occur not just from psychiatric causes but also from various organic etiologies, such as seizures and intracerebral structural abnormalities. However, there have been no previous reported cases to the authors' knowledge detailing isolated depersonalization and derealization in the absence of clinical seizure activity or other psychiatric pathology, as sequelae of structural intracerebral lesions. CASE PRESENTATION: In this case report, we detail the unique presentation of a 68-year-old woman under the care of palliative medicine who experienced depersonalization and derealization secondary to a metastatic lesion in her temporal lobe, in the parahippocampal gyrus to medial occipitotemporal gyrus region. These symptoms were present in the absence of any clinical seizure activity or other psychiatric symptomatology and largely resolved with the use of steroidal therapy, before returning secondary to disease progression. CONCLUSIONS: We discuss the relationship among isolated depersonalization and derealization with pathology of the left posterior temporal lobe in the context of this interesting case. This case expands our knowledge of the neurobiology of these phenomena, given the specific localization of the intracerebral pathology and temporal specificity of symptoms relative to tumor growth and treatment course.

Asunto(s)

RESUMEN

BACKGROUND: Dissociation is a ubiquitous clinical phenomenon. Dissociative disorders (DD) are primarily characterized by dissociation, and dissociative states are also a criterion for borderline personality disorder (BPD) and the dissociative subtype of post-traumatic stress disorder (PTSD). Dissociative reactions (e.g., depersonalization/derealization or gaps in awareness/memory) across diagnostic categories are believed to be affect contingent and theorized to serve affect regulation functions. What is not clear, however, is how self-reported affect and physiological reactivity unfold within dissociative episodes. To address this issue, the present project aims to investigate the hypothesis (1) whether self-reported distress (as indicated by arousal, e.g., feeling tense/agitated, and/or valence, e.g., feeling discontent/unwell) and physiological reactivity increase before dissociative episodes and (2) whether self-reported distress and physiological reactivity decrease during and after dissociative episodes in a transdiagnostic sample of patients with DD, BPD, and/or PTSD. METHODS: We will use a smartphone application to assess affect and dissociation 12 times per day over the course of one week in everyday life. During this time, heart and respiratory rates will be remotely monitored. Afterwards, participants will report affect and dissociative states eight times in the laboratory before, during, and after the Trier Social Stress Test. During the laboratory task, we will continuously record heart rate, electrodermal activity, and respiratory rate, as well as measure blood pressure and take salivary samples to determine cortisol levels. Our hypotheses will be tested using multilevel structural equation models. Power analyses determined a sample size of 85. DISCUSSION: The project will test key predictions of a transdiagnostic model of dissociation based on the idea that dissociative reactions are affect contingent and serve affect regulation functions. This project will not include non-clinical control participants. In addition, the assessment of dissociation is limited to pathological phenomena.

Asunto(s)

RESUMEN

To probe the causal importance of the human posteromedial cortex (PMC) in processing the sense of self, we studied a rare cohort of nine patients with electrodes implanted bilaterally in the precuneus, posterior cingulate, and retrosplenial regions with a combination of neuroimaging, intracranial recordings, and direct cortical stimulations. In all participants, the stimulation of specific sites within the anterior precuneus (aPCu) caused dissociative changes in physical and spatial domains. Using single-pulse electrical stimulations and neuroimaging, we present effective and resting-state connectivity of aPCu hot zone with the rest of the brain and show that they are located outside the boundaries of the default mode network (DMN) but connected reciprocally with it. We propose that the function of this subregion of the PMC is integral to a range of cognitive processes that require the self's physical point of reference, given its location within a spatial environment.

Asunto(s)

RESUMEN

BACKGROUND: Dissociative and posttraumatic stress disorder (PTSD) symptoms are commonly co-occurring responses to psychological trauma. Yet, these two groups of symptoms appear to be related to diverging patterns of physiological response. To date, few studies have examined how specific dissociative symptoms, namely, depersonalization and derealization, relate to skin conductance response (SCR), a marker of autonomic function, within the context of PTSD symptoms. We examined associations among depersonalization, derealization, and SCR during two conditions - resting control and breath-focused mindfulness - in the context of current PTSD symptoms. METHODS: Sixty-eight trauma-exposed women (82.4% Black; Mage = 42.5, SDage = 12.1) were recruited from the community for a breath-focused mindfulness study. SCR data were collected during alternating resting control and breath-focused mindfulness conditions. Moderation analyses were conducted to examine relations among dissociative symptoms, SCR, and PTSD for these different conditions. RESULTS: Moderation analyses revealed that depersonalization was linked to lower SCR during resting control, B = 0.0005, SE = 0.0002, p = .006, in participants low-to-moderate PTSD symptoms; however, depersonalization was associated with higher SCR during breath-focused mindfulness, B = -0.0006, SE = 0.0003, p = .029, in individuals with similar levels of PTSD symptoms. No significant interaction between derealization and PTSD symptoms on SCR was observed. CONCLUSIONS: Depersonalization symptoms may associate with physiological withdrawal during rest, but greater physiological arousal during effortful emotion regulation in individuals with low-to moderate levels of PTSD, which has significant implications for barriers to treatment engagement as well as treatment selection in this population.

Asunto(s)

RESUMEN

Depersonalization and derealization refer to an estranged state of mind that involves a profound feeling of detachment from one's sense of self and the surrounding environment, respectively. The phenomena co-occur on a continuum of severity, ranging from a transient experience as a normal reaction to a traumatic event to a highly debilitating condition with persistent symptoms, formally described as depersonalization/derealization disorder (DPDR). Lack of awareness of DPDR is partly due to a limited neurobiological framework, and there remains a significant risk of misdiagnosis in clinical practice. Earlier literature has focused on several brain regions involved in the experience of depersonalization and derealization, including adaptive responses to stress via defense cascades comprising autonomic functioning, the hypothalamic-pituitary-adrenal (HPA) axis, and various other neurocircuits. Recent evidence has also demonstrated the role of more complex mechanisms that are bolstered by dissociative features, such as emotional dysregulation and disintegration of the body schema. This review intends to abridge the prevailing knowledge regarding structural and functional brain alterations associated with DPDR with that of its heterogenic manifestations. DPDR is not merely the disruption of various sensory integrations, but also of several large-scale brain networks. Although a comprehensive antidote is not available for DPDR, a holistic route to the neurobiological context in DPDR may improve general understanding of the disorder and help afflicted individuals re-establish their sense of personal identity. Such information may also be useful in the development of novel pharmacological agents and targeted psychological interventions.

RESUMEN

BACKGROUND: Depersonalization-derealization disorder (DDD) is a dissociative disorder encompassing pronounced disconnections from the self and from external reality. As DDD is inherently tied to a detachment from the body, dance/movement therapy could provide an innovative treatment approach. MATERIALS AND METHODS: We developed two online dance tasks to reduce detachment either by training body awareness (BA task) or enhancing the salience of bodily signals through dance exercise (DE task). Individuals with DDD (n = 31) and healthy controls (n = 29) performed both tasks individually in a cross-over design. We assessed symptom severity (Cambridge Depersonalization Scale), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness - II), mindfulness (Five Facet Mindfulness Questionnaire), and body vigilance (Body Vigilance Scale) before, during and after the tasks. RESULTS: At baseline, individuals with DDD exhibited elevated depersonalization-derealization symptoms alongside lower levels of interoceptive awareness and mindfulness compared to controls. Both tasks reduced symptoms in the DDD group, though dance exercise was perceived as easier. The DE task increased mindfulness in those with DDD more than the BA task, whereas controls showed the opposite pattern. In the DDD group, within-subject correlations showed that lower levels of symptoms were associated with task-specific elevations in interoceptive awareness and mindfulness. CONCLUSION: Individual and structured dance/movement practice, performed at home without an instructor present, offers an effective tool to reduce symptoms in DDD and can be tailored to address specific cognitive components of a mindful engagement with the body.

Asunto(s)

Asunto(s)

RESUMEN

Dissociation in child sexual abuse (CSA) survivors remains under-recognized and diagnosed, partly because of the difficulties involved in identifying dissociative symptoms. Qualitative research can contribute to a better understanding of the lived experiences of dissociation. This study focused on the experiences of dissociation in the context of CSA. In all, 22 female incest survivors, all diagnosed with different dissociative disorders, provided narratives about their experiences of dissociation. The narratives were analyzed using interpretative phenomenological analysis. The narrative analysis revealed four central themes. The first theme deals with reliving the experience of the abuse. The second theme refers to the experience of disconnection from the body, the self, and the surroundings. The third theme covers the lack of coherence in the narrative, and the fourth theme describes the bridge between voluntary controlled and nonvoluntary uncontrolled use of dissociation. The data are discussed in light of several traumagenic constructs, including a lack of self-sense, being entrapped in a victim-aggressor relationship, and distorted time perception. It is suggested that the extent to which participants can control their dissociation and the coherency of their narratives reflects the severity of their dissociation. Clinicians can consider helping clients use dissociation as an adaptive defense mechanism.

Asunto(s)

RESUMEN

Previous research shows that virtual reality (VR) users may experience symptoms of depersonalization/derealization (DPDR) immediately after use. However, the impact of long-term VR use on these symptoms has not been analyzed so far. In a preregistered study, we conducted an online survey among a bigger sample of VR users (N = 754) to investigate the relationship between time of use during the past 6 months and the presence of DPDR symptoms. The results support the absence of a linear association between time of VR use and the presence of symptoms, when controlling for other factors. DPDR symptoms are more frequent among younger female users and in those who experience higher levels of embodiment during use. Secondary analyses show that symptoms are more common among newer users and among those who engage in longer sessions. These findings suggest that current common VR experiences are not a cause of long-term DPDR symptoms for the majority of users, yet also encourage further research about specific cases where VR use might trigger DPDR experiences in the long term.

Asunto(s)

RESUMEN

There exists some evidence for a link between dissociation and emotionally avoidant information processing, yet studies to date have been contradictory. Our goal was to investigate emotionally avoidant processing in Depersonalization Disorder (DDD) using a directed forgetting (DF) paradigm. Thirty-two participants with DSM-IV DDD and 40 healthy controls performed an item-method DF task using positive, negative, and neutral words. Participants were also administered the Dissociative Experiences Scale (DES) and the Childhood Trauma Questionnaire (CTQ). The DDD group demonstrated significantly lower directed forgetting for negative, but not positive or neutral, words compared to controls. In the combined sample, DES total, depersonalization/derealization, and amnesia scores significantly inversely predicted explicit cued recall for to-be-forgotten negative words (higher dissociation, lower forgetting), while the CTQ was not predictive. The findings do not support emotionally avoidant processing in this paradigm; rather, DDD may be characterized by a diminished capacity to actively control attention and direct it away from emotionally disturbing material when instructed to do so.

Asunto(s)

RESUMEN

The Multidimensional Inventory of Dissociation (MID) was administered to 23 participants diagnosed with DSM-IV-TR Depersonalization Disorder (DDD) by structured interview. The MID has not been previously examined in DDD and does not generate a diagnostic formula for the disorder. Mean MID score for the sample was modestly elevated at 18.54, and was significantly correlated with Dissociative Experiences Scale, Cambridge Depersonalization Scale, and Childhood Trauma Questionnaire scores. Criterion A (General Dissociation) Depersonalization and Depersonalization scale scores were markedly elevated (41.70 and 40.98 respectively), followed by moderate elevations in the Identity Confusion (36.01), Trance (25.44), and Memory Problems (23.30) scales. Criterion B (Intrusions from partly dissociated self-states) mean score was modestly elevated (19.13) and declined to 13.67 once items overlapping with the Depersonalization and Identity Confusion scales were excluded. Criterion C (fully dissociated manifestations of other self-states) mean score was minimally elevated (6.57). Of the 168 pathological dissociation items, 55 were clinically elevated in DDD. Closer examination of the Intrusions and Amnesia items that were modestly elevated in DDD revealed that these items did not reflect the presence of alters, but rather represented known depersonalization-related phenomena. We propose a preliminary formula, based on cutoff scores for Criterion A Depersonalization and/or Derealization, Criterion B, and Criterion C (≥20, ≤28, ≤11) for the sensitive diagnosis of DDD (82.6% of participants), which would require future investigation for replication and determination of specificity vis-à-vis the other dissociative disorders.

Asunto(s)

RESUMEN

BACKGROUND: Psychiatric Depersonalization/Derealization (DPDR) symptoms were demonstrated in patients with peripheral vestibular disorders. However, only semicircular canals (SCCs) dysfunction was evaluated, therefore, otoliths' contribution to DPDR is unknown. Also, DPDR symptoms in patients with central vestibular dysfunction are presently unknown. DPDR was also studied in the context of spatial disorientation and anxiety, but the relation of these cognitive and emotional functions to vestibular dysfunction requires clarification. METHODS: We tested patients with peripheral Bilateral Vestibular Hypofunction (pBVH), Machado Joseph Disease (MJD) with cerebellar and central bilateral vestibular hypofunction, and healthy controls. Participants completed the video Head Impulse Test (vHIT) for SCCs function, cervical Vestibular Evoked Myogenic Potentials test (cVEMPt) for sacculi function, Body Sensation Questionnaire (BSQ) for panic anxiety, Object Perspective-Taking test (OPTt) for spatial orientation and Cox & Swinson DPDR inventory for DPDR symptoms. RESULTS: pBVH patients showed significant SCCs and sacculi dysfunction, spatial disorientation, elevated panic anxiety, and DPDR symptoms. MJD patients showed significant SCCs hypofunction but preserved sacculi function, spatial disorientation but normal levels of panic anxiety and DPDR symptoms. Only pBVH patients demonstrated a positive correlation between the severity of the DPDR and spatial disorientation and panic anxiety. CONCLUSIONS: DPDR develops in association with sacculi dysfunction, either with or without SSCs dysfunction. Spatial disorientation and anxiety seem to mediate the transformation of vestibular dysfunction into DPDR symptoms. DPDR does not develop in MJD with central vestibular hypofunction but a normal saccular response. We propose a three-step model that describes the development of DPDR symptoms in vestibular patients.

Asunto(s)

RESUMEN

Objective: Dissociation is a conscious state characterized by alterations in sensation and perception and is thought to arise from traumatic life experiences. Previous research has demonstrated that individuals with high levels of dissociation show impairments in cognitive-emotional processes. Therefore, using the Competing Neurobehavioral Decisions System (CNDS) theory, we used statistical modeling to examine whether dissociative experience and trauma symptoms are independently predicted by impulsivity, risk-seeking, affective state (i.e., anxiety, depression, stress, and negative affect), and trauma history. Method: In this cross-sectional study design, data were collected via Amazon Mechanical Turk from a total of n = 557 English-speaking participants in the United States. Using Qualtrics, participants answered a series of self-reported questionnaires and completed several neurocognitive tasks. Three independent multiple linear regression models were conducted to assess whether impulsivity, risk seeking, affective state, and trauma history predict depersonalization, trauma symptoms, and PTSD symptoms. Results: As hypothesized, we found that depersonalization and other trauma symptoms are associated with heightened impulsivity, increased risk-seeking, impaired affective states, and a history of traumatic experiences. Conclusion: We demonstrate that an imbalanced CNDS (i.e., hyperimpulsive/hypoexecutive), as evidenced by decreased future valuation, increased risk seeking, and impaired affective states, predicts heightened depersonalization and other trauma and PTSD symptomatology. This is the first time that dissociation has been connected to delay discounting (i.e., the tendency to place more value on rewards received immediately compared to farther in the future). Interventions that positively impact areas of the CNDS, such as episodic future thinking or mindfulness meditation, may be a target to help decrease dissociative symptoms.

RESUMEN

The self-perception or self-experience of patients with depersonalization/derealization disorder (DPD) is altered, leading to a profound disruption in self-awareness. The main aim of the study is to explore the characteristics of subliminal self-face processing in DPD patients. To our knowledge, this is the first experimental study that has measured and evaluated subliminal self-processing in DPD. To better understand this, we examined the ability of patients with DPD and healthy controls (HC) to identify pictures of faces using an experimental paradigm of breaking continuous flash suppression. There were 23 DPD outpatients from Beijing Anding Hospital, Capital Medical University and 23 matched HC who participated in this experiment. The time needed for a face to break into awareness was taken as the measure of participants' subliminal processing of that face. The results indicated that there were significant differences between the DPD patients and HC in subliminal reaction times to different faces. Under experimental conditions, the average reaction response of self-face recognition in the HC group was significantly faster than for a famous face. However, this difference was not observed in DPD patients, which means that DPD patients did not show the processing advantage of their own faces as did the HC. The results suggest a deficit in subliminal self-face processing in DPD.