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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 related to another dissociative feeling called [[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 and other dissociative feelings.<ref name="Frederick_Aardema">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 depersonalization and reduces the sense of [[presence]] in objective reality.<ref name="Frederick_Aardema">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref> When compared to individuals with no prior dissociative symptoms, individuals with pre-existing symptoms of derealization and depersonalization showed greater increase in their dissociative symptoms after exposure to VR. However they did not show greater loss of presence in objective reality than individuals with no prior symptoms.<ref name="Frederick_Aardema">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]]

Latest revision as of 06:46, 29 April 2025

See also: Terms and Non-technical Terms

Derealization (DR) is a form of dissociation in which the external world feels unreal, dream-like, foggy, artificial, distant, or visually distorted.[1] 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).[2]

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.[3]
  • Prevalence. Transient DR/DP episodes occur in 26-74 % of the general population, but chronic DPDR affects roughly 1-2 %.[3][4]

Symptoms and characteristics

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.[5]
Neurobiological
Abnormal fronto-limbic connectivity; hypo-activity of the amygdala and insula; disturbances in predictive-coding networks.[6]
Substance-related
Cannabis, hallucinogens (for example LSD, psilocybin), ketamine, MDMA, stimulant intoxication, or benzodiazepine withdrawal can precipitate DR.[7]

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.[8] Reduced insular activity may underlie impaired interoception, while alterations in visual association cortices correlate with perceptual distortions.[9]

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.[10] More recent RCTs and surveys confirm that VR can acutely elevate DR scores, yet effects typically resolve within minutes to hours and rarely persist.[11][12]

Proposed mechanisms

  • Sensory conflict between visual and vestibular/proprioceptive inputs.[13]
  • High immersion / presence shift, producing a temporary imbalance favouring virtual over physical cues.[14]
  • Boundary blurring when hyper-realistic graphics or prolonged sessions weaken reality markers.[15]

Risk factors

Factor Evidence
High baseline dissociation Greater symptom spike post-VR in high-trait individuals.[10]
New users / long sessions Larger DR reports among novices and marathon users.[16]
High embodiment Feeling “inside” an avatar predicts stronger after-effects.[17]

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.[15]
  • Clinical monitoring: therapists using VR exposure should screen for dissociative side-effects.[18]

Therapeutic applications

Paradoxically, controlled VR has been investigated to treat dissociative conditions, for example reality, discrimination training or interoceptive biofeedback to enhance bodily awareness.[19]

Ethical considerations

Developers and researchers are urged to supply informed consent, protect vulnerable users, and pursue longitudinal studies on cumulative exposure.[15][20]

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).[21] DSM-III (1980) first codified Depersonalization Disorder; DSM-5 renamed it DPDR to equalize derealization.[1]

Future research directions

  1. Neuro-imaging comparing spontaneous DR episodes with VR-induced DR
  2. Standardized assessment tools for technology-induced dissociation
  3. Longitudinal studies on heavy VR/AR users
  4. Tailored VR therapeutics balancing presence and grounding
  5. Predictive-coding models of derealization across clinical and technological contexts

References

  1. ↑ Jump up to: 1.0 1.1 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. ↑ Simeon, D. (2004). Depersonalisation disorder: a contemporary overview. CNS Drugs, 18 (6), 343-354. https://doi.org/10.2165/00023210-200418060-00002
  3. ↑ Jump up to: 3.0 3.1 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
  4. ↑ 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
  5. ↑ 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
  6. ↑ Gatus, A., Jamieson, G., & Stevenson, B. (2022). Past and future explanations for DPDR: a role for predictive coding. Frontiers in Human Neuroscience, 16, 813300.
  7. ↑ 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.
  8. ↑ Sierra, M. & David, A. S. (2011). Depersonalization: a selective impairment of self-awareness. Consciousness & Cognition, 20 (1), 99-108.
  9. ↑ Adler, J. et al. (2014). Altered orientation of spatial attention in DPDR. Psychiatry Research: Neuroimaging, 216 (2), 230-235.
  10. ↑ Jump up to: 10.0 10.1 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
  11. ↑ Braun, N. et al. (2022). Virtual reality induces depersonalization and derealization: a longitudinal RCT. Computers in Human Behavior, 131, 107233.
  12. ↑ 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.
  13. ↑ Keshavarz, B. et al. (2014). Vection and motion sickness: higher susceptibility in women. Perception, 43 (ECVP Suppl.), 107.
  14. ↑ Slater, M., & Sanchez-Vives, M. V. (2016). Enhancing our lives with immersive VR. Frontiers in Robotics & AI, 3, 74.
  15. ↑ Jump up to: 15.0 15.1 15.2 Madary, M., & Metzinger, T. (2016). Real virtuality: a code of ethical conduct. Frontiers in Robotics & AI, 3, 3.
  16. ↑ Barreda-Ángeles & Hartmann (2023).
  17. ↑ Peckmann, C. et al. (2023). Experiences of DP/DR among VR gamers. Cyberpsychology, Behavior, & Social Networking, 26 (1), 55-63.
  18. ↑ 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.
  19. ↑ Opriş, D. et al. (2012). VR exposure therapy in anxiety disorders: a meta-analysis. Depression & Anxiety, 29 (2), 85-93.
  20. ↑ Brey, P. (1999). The ethics of representation and action in virtual reality. Ethics & Information Technology, 1 (1), 5-14.
  21. ↑ Mayer-Gross, W. (1935). On depersonalization. British Journal of Medical Psychology, 15, 103-126.
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