Sierra Mauricio, Senior Carl, Dalton Jeffrey, McDonough Michael, Bond Alison, Phillips Mary L, O'Dwyer Anne M, David Anthony S
Institute of Psychiatry, 103 Denmark Hill, London SE5 8AZ, England.
Arch Gen Psychiatry. 2002 Sep;59(9):833-8. doi: 10.1001/archpsyc.59.9.833.
Emotional-processing inhibition has been suggested as a mechanism underlying some of the clinical features of depersonalization and/or derealization. In this study, we tested the prediction that autonomic response to emotional stimuli would be reduced in patients with depersonalization disorder.
The skin conductance responses of 15 patients with chronic depersonalization disorder according to DSM-IV, 15 controls, and 11 individuals with anxiety disorders according to DSM-IV, were recorded in response to nonspecific elicitors (an unexpected clap and taking a sigh) and in response to 15 randomized pictures with different emotional valences: 5 unpleasant, 5 pleasant, and 5 neutral.
The skin conductance response to unpleasant pictures was significantly reduced in patients with depersonalization disorder (magnitude of 0.017 micro siemens in controls and 0.103 micro siemens in patients with anxiety disorders; P =.01). Also, the latency of response to these stimuli was significantly prolonged in the group with depersonalization disorder (3.01 seconds compared with 2.5 and 2.1 seconds in the control and anxiety groups, respectively; P =.02). In contrast, latency to nonspecific stimuli (clap and sigh) was significantly shorter in the depersonalization and anxiety groups (1.6 seconds) than in controls (2.3 seconds) (P =.03).
In depersonalization disorder, autonomic response to unpleasant stimuli is reduced. The fact that patients with depersonalization disorder respond earlier to a startling noise suggests that they are in a heightened state of alertness and that the reduced response to unpleasant stimuli is caused by a selective inhibitory mechanism on emotional processing.
情绪加工抑制被认为是人格解体和/或现实解体某些临床特征的潜在机制。在本研究中，我们检验了以下预测：人格解体障碍患者对情绪刺激的自主反应会降低。
记录了15名符合《精神疾病诊断与统计手册》第四版（DSM-IV）标准的慢性人格解体障碍患者、15名对照者以及11名符合DSM-IV标准的焦虑症患者对非特异性刺激（意外的拍手声和叹气声）以及15张随机呈现的具有不同情绪效价图片（5张不愉快的、5张愉快的和5张中性的）的皮肤电反应。
人格解体障碍患者对不愉快图片的皮肤电反应显著降低（对照组为0.017微西门子，焦虑症患者为0.103微西门子；P = 0.01）。此外，人格解体障碍组对这些刺激的反应潜伏期显著延长（分别为3.01秒，而对照组和焦虑症组分别为2.5秒和2.1秒；P = 0.02）。相比之下，人格解体组和焦虑症组对非特异性刺激（拍手声和叹气声）的潜伏期（1.6秒）显著短于对照组（2.3秒）（P = 0.03）。
在人格解体障碍中，对不愉快刺激的自主反应降低。人格解体障碍患者对突发噪声反应更早这一事实表明他们处于高度警觉状态，且对不愉快刺激反应降低是由情绪加工的选择性抑制机制所致。
