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{{see also|Terms|Non-technical Terms}}
[[Derealization]] also known as '''DR''' is the feeling that the real world or [[objective reality]] is not ''real''. Individuals suffering from derealization feel that their real life external surroundings are lacking in depths, colors or vibrancy. Derealization is often associated with [[depersonalization]], the feeling that one self is not real.  
[[Derealization]] ('''DR''') is a form of [[dissociation]] in which the '''external world feels unreal, dream-like, foggy, artificial, distant, or visually distorted'''.<ref name="DSM5">American Psychiatric Association. (2013). ''Diagnostic and Statistical Manual of Mental Disorders'' (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref>  Although surroundings may appear "flat", "cartoonish", or "as if seen through glass", '''reality-testing remains intact''': the sufferer knows the environment itself has not actually changed. Derealization often co-occurs with [[depersonalization]] (detachment from one’s self); persistent or recurrent episodes of either, when clinically distressing, are diagnosed as [[Depersonalization/Derealization Disorder]] (DPDR).<ref name="Simeon2004">Simeon, D. (2004). Depersonalisation disorder: a contemporary overview. ''CNS Drugs'', 18 (6), 343-354. https://doi.org/10.2165/00023210-200418060-00002</ref>


Researchers have theorized that the rise of [[virtual reality]] can lead to increased instances of derealization.<ref name="Research_Gate">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>
==Clinical definition and overview==
*'''Core symptoms''' include a sense that people or objects are artificial, colour-less, two-dimensional, or remote; time may seem sped up or slowed; familiar places can appear strangely foreign.<ref name="Hunter2004">Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation. ''Social Psychiatry & Psychiatric Epidemiology'', 39 (1), 9-18. https://doi.org/10.1007/s00127-004-0701-4</ref>
*'''Prevalence.''' Transient DR/DP episodes occur in '''26-74 %''' of the general population, but chronic DPDR affects roughly '''1-2 %'''.<ref name="Hunter2004" /><ref>Y, J., Millman, L. S., David, A. S., & Hunter, E. (2023). The prevalence of depersonalization-derealization disorder: a systematic review. ''Journal of Trauma & Dissociation'', 24 (1), 8-41. https://doi.org/10.1080/15299732.2022.2079796</ref>


==Derealization and Virtual Reality==
===Symptoms and characteristics===
Researchers from Fernand-Seguin Research Center in Montréal, Québec, Canada found that being [[immersed]] in an [[VR]] environment increases the feelings of derealization and other associative experiences and reduces the sense of [[presence]] in objective reality.<ref name="Research_Gate">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>  
{| class="wikitable"
! Domain !! Examples
|-
| Perceptual || The world seems foggy, muted, too sharp, [[macropsia]]/[[micropsia]], muted or echoing sounds
|-
| Cognitive || Feeling "in a film", heightened [[self-observation]], doubts about the reality of memories
|-
| Affective || Emotional numbing (“de-affectualisation”), blunted responses to normally salient stimuli
|}
 
==Etiology and triggers==
;Psychological
: Acute [[stress]], [[panic attacks]], trauma, severe [[sleep deprivation]], or sensory overload.<ref name="Medford2005">Medford, N., Sierra, M., Baker, D., & David, A. S. (2005). Understanding and treating depersonalisation disorder. ''Advances in Psychiatric Treatment'', 11 (2), 92-100. https://doi.org/10.1192/apt.11.2.92</ref> 
;Neurobiological 
: 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 
: 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==
Neuro-imaging studies reveal a '''fronto-limbic "decoupling"''': hyper-activation of pre-frontal regions suppresses limbic emotional circuits, yielding detachment from affective salience.<ref>Sierra, M. & David, A. S. (2011). Depersonalization: a selective impairment of self-awareness. ''Consciousness & Cognition'', 20 (1), 99-108.</ref>  Reduced insular activity may underlie impaired [[interoception]], while alterations in visual association cortices correlate with perceptual distortions.<ref>Adler, J. et al. (2014). Altered orientation of spatial attention in DPDR. ''Psychiatry Research: Neuroimaging'', 216 (2), 230-235.</ref>
 
==Derealization and immersive technology (VR/AR)==
Immersive [[virtual reality]] (VR) and [[augmented reality]] (AR) deliberately alter multisensory input, raising concern that they may '''induce transient or persistent DR/DP symptoms'''.
 
===Induced dissociative symptoms===
A pivotal study from the Fernand-Seguin Research Center reported significant increases in DR/DP and reduced sense of [[presence]] after VR exposure.<ref name="Aardema2010">Aardema, F., O'Connor, K., Côté, S., & Taillon, A. (2010). Virtual reality induces dissociation and lowers sense of presence in objective reality. ''Cyberpsychology, Behavior, & Social Networking'', 13 (4), 429-435. https://doi.org/10.1089/cyber.2009.0164</ref>  More recent RCTs and surveys confirm that '''VR can acutely elevate DR scores''', yet effects typically resolve within minutes to hours and rarely persist.<ref>Braun, N. et al. (2022). Virtual reality induces depersonalization and derealization: a longitudinal RCT. ''Computers in Human Behavior'', 131, 107233.</ref><ref>Barreda-Ángeles, M., & Hartmann, T. (2023). Experiences of DP/DR among users of VR applications: a cross-sectional survey. ''Cyberpsychology, Behavior, & Social Networking'', 26 (1), 22-27.</ref>
 
===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>
* 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>
 
===Risk factors===
{| class="wikitable"
! Factor !! Evidence
|-
| High baseline dissociation || Greater symptom spike post-VR in high-trait individuals.<ref name="Aardema2010" />
|-
| New users / long sessions || Larger DR reports among novices and marathon users.<ref>Barreda-Ángeles & Hartmann (2023).</ref>
|-
| High [[embodiment]] || Feeling “inside” an avatar predicts stronger after-effects.<ref>Peckmann, C. et al. (2023). Experiences of DP/DR among VR gamers. ''Cyberpsychology, Behavior, & Social Networking'', 26 (1), 55-63.</ref>
|}
 
===Prevention and management strategies===
*'''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. 
*'''User warnings:''' advise individuals with DPDR, severe [[anxiety]], or trauma histories to proceed cautiously.<ref name="Madary2016" /> 
*'''Clinical monitoring:''' therapists using VR exposure should screen for dissociative side-effects.<ref>Maples-Keller, J. L. et al. (2017). The use of VR in treatment of anxiety & psychiatric disorders. ''Harvard Review of Psychiatry'', 25 (3), 103-113.</ref>
 
===Therapeutic applications===
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===
Developers and researchers are urged to supply informed consent, protect vulnerable users, and pursue longitudinal studies on cumulative exposure.<ref name="Madary2016" /><ref>Brey, P. (1999). The ethics of representation and action in virtual reality. ''Ethics & Information Technology'', 1 (1), 5-14.</ref>
 
==Historical background==
Derealization-like phenomena have been documented since the 19th century; Mayer-Gross (1935) distinguished “allopsychic depersonalization” (unreality of environment) from “autopsychic” depersonalization (unreality of self).<ref>Mayer-Gross, W. (1935). On depersonalization. ''British Journal of Medical Psychology'', 15, 103-126.</ref> DSM-III (1980) first codified Depersonalization Disorder; DSM-5 renamed it DPDR to equalize derealization.<ref name="DSM5" />
 
==Future research directions==
# Neuro-imaging comparing spontaneous DR episodes with VR-induced DR 
# Standardized assessment tools for technology-induced dissociation 
# Longitudinal studies on heavy VR/AR users 
# Tailored VR therapeutics balancing presence and grounding 
# Predictive-coding models of derealization across clinical and technological contexts


==References==
==References==
<references />
<references />


[[Category:Terms]]
[[Category:Terms]]
[[Category:Non-technical Terms]]
[[Category:Mental Health]]
[[Category:Dissociative Disorders]]
[[Category:Psychological Effects]]
[[Category:Virtual Reality]]
[[Category:Augmented Reality]]
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