Derealization: Difference between revisions
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: Abnormal fronto-limbic connectivity; hypo-activity of the [[amygdala]] and [[insula]]; disturbances in predictive-coding networks.<ref>Gatus, A., Jamieson, G., & Stevenson, B. (2022). Past and future explanations for DPDR: a role for predictive coding. ''Frontiers in Human Neuroscience'', 16, 813300.</ref> | : Abnormal fronto-limbic connectivity; hypo-activity of the [[amygdala]] and [[insula]]; disturbances in predictive-coding networks.<ref>Gatus, A., Jamieson, G., & Stevenson, B. (2022). Past and future explanations for DPDR: a role for predictive coding. ''Frontiers in Human Neuroscience'', 16, 813300.</ref> | ||
;Substance-related | ;Substance-related | ||
: Cannabis, hallucinogens ( | : Cannabis, hallucinogens (for example LSD, psilocybin), [[ketamine]], MDMA, stimulant intoxication, or benzodiazepine withdrawal can precipitate DR.<ref>Simeon, D., Kozin, D., Segal, K., & Lerch, B. (2009). Is depersonalization disorder initiated by illicit drug use any different? ''Journal of Clinical Psychiatry'', 70 (10), 1358-1364.</ref> | ||
==Neurological mechanisms== | ==Neurological mechanisms== | ||
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===Proposed mechanisms=== | ===Proposed mechanisms=== | ||
* '''[[Sensory conflict]]''' between visual and vestibular/proprioceptive inputs.<ref>Keshavarz, B. et al. (2014). Vection and motion sickness: higher susceptibility in women. ''Perception'', 43 (ECVP Suppl.), 107.</ref> | * '''[[Sensory conflict]]''' between visual and vestibular/proprioceptive inputs.<ref>Keshavarz, B. et al. (2014). Vection and motion sickness: higher susceptibility in women. ''Perception'', 43 (ECVP Suppl.), 107.</ref> | ||
* High '''immersion / presence shift''', producing a temporary imbalance favouring virtual over physical cues.<ref>Slater, M., & Sanchez-Vives, M. V. (2016). Enhancing our lives with immersive VR. ''Frontiers in Robotics & AI'', 3, 74.</ref> | * High '''[[immersion]] / [[presence shift]]''', producing a temporary imbalance favouring virtual over physical cues.<ref>Slater, M., & Sanchez-Vives, M. V. (2016). Enhancing our lives with immersive VR. ''Frontiers in Robotics & AI'', 3, 74.</ref> | ||
* '''Boundary blurring''' when hyper-realistic graphics or prolonged sessions weaken reality markers.<ref name="Madary2016">Madary, M., & Metzinger, T. (2016). Real virtuality: a code of ethical conduct. ''Frontiers in Robotics & AI'', 3, 3.</ref> | * '''Boundary blurring''' when hyper-realistic graphics or prolonged sessions weaken reality markers.<ref name="Madary2016">Madary, M., & Metzinger, T. (2016). Real virtuality: a code of ethical conduct. ''Frontiers in Robotics & AI'', 3, 3.</ref> | ||
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===Prevention and management strategies=== | ===Prevention and management strategies=== | ||
*'''Session design:''' build-in breaks every | *'''Session design:''' build-in breaks every 20-30 min; gradual onboarding for new users. | ||
*'''Grounding techniques:''' post-VR mindfulness, tactile engagement, or brief exercise help re-establish physical-world presence. | *'''Grounding techniques:''' post-VR mindfulness, tactile engagement, or brief exercise help re-establish physical-world presence. | ||
*'''User warnings:''' advise individuals with DPDR, severe [[anxiety]], or trauma histories to proceed cautiously.<ref name="Madary2016" /> | *'''User warnings:''' advise individuals with DPDR, severe [[anxiety]], or trauma histories to proceed cautiously.<ref name="Madary2016" /> | ||
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===Therapeutic applications=== | ===Therapeutic applications=== | ||
Paradoxically, controlled VR has been investigated to '''treat''' dissociative conditions, | Paradoxically, controlled VR has been investigated to '''treat''' dissociative conditions, for example reality, discrimination training or interoceptive biofeedback to enhance bodily awareness.<ref>Opriş, D. et al. (2012). VR exposure therapy in anxiety disorders: a meta-analysis. ''Depression & Anxiety'', 29 (2), 85-93.</ref> | ||
===Ethical considerations=== | ===Ethical considerations=== | ||