Dissociative and Somatoform Disorders 343
can also lead to further depersonalization or derealization symptoms. Patients then
become extremely sensitive to and hypervigilant for possible symptoms of “unreal-
ity” and come to fear that the symptoms indicate that they are going “round the
bend.” They may also avoid situations likely to elicit the symptoms.
Why might some people be more likely to interpret depersonalization symptoms
as indicating that they are veering toward insanity? Perhaps because they had a
family member with a major mental illness (social factor) (Hunter et al., 2003): When
these people experience symptoms of depersonalization or derealization, rather than
attributing such symptoms to external events, as normal responses to a stressor, they
view the symptoms as confi rming their mental illness. Figure 8.1 illustrates the three
types of factors that arise in depersonalization disorder and their feedback loops.
Figure 8.1
8.1 • Feedback Loops in Action: Depersonalization Disorder
g
ddbb kk ll dd
Affect Behavior
Brain Systems
Neural Communication Genetics
NeuroPsychoSocial
NeuroPsychoSocial
Anxiety
Frontal lobes
Parietal lobes
Temporal lobes
Limbic system
Norepinephrine No known major
contribution
Mental Processes and
Mental Contents
Problems With the Types
short-term memory,
attention, spatial
reasoning
Incorrect catastrophic
attributions of
depersonalization
symptoms
Hypervigilance
Stressful Life Events
Gender/Culture
Family
Family members
may have been
abusers
NeuroPsychoSocial
Severe chronic emotional
abuse during childhood
Stressors may exacerbate
symptoms
No known major
contribution
No known major
contribution