Feelings of detachment predict worse mental health outcomes
Study participants provided self-report data about persistent derealization (N=1,464), a severe type of dissociation, and completed a functional MRI emotion reactivity task and resting-state scan 2 weeks posttrauma (N=145). Derealization was associated with increased ventromedial prefrontal cortex (vmPFC) activation in the emotional reactivity task and decreased resting-state vmPFC connectivity with the cerebellum and orbitofrontal cortex. In separate analyses, brain-based and self-report measures of persistent derealization at 2 weeks predicted worse 3-month posttraumatic stress symptoms, distinct from the effects of childhood maltreatment history and current posttraumatic stress symptoms. The findings suggest that persistent derealization is both an early psychological and biological marker of worse later psychiatric outcomes.

Source: https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.21090911