Are There Any Neuroscientists Here That Have An Understanding Of The Dissociation Phenomenon?

[Peatogenic]

Dissociation is a mysterious and complex symptom of trauma disorders. And I'm curious of resources to better understand what it is on a physiological level. It's often described as being in an alternate reality where you lose track of time, even lose your five senses in varying degrees, sometimes out of body.

 

[DaveFoster]

Dissociation is a mysterious and complex symptom of trauma disorders. And I'm curious of resources to better understand what it is on a physiological level. It's often described as being in an alternate reality where you lose track of time, even lose your five senses in varying degrees, sometimes out of body.

Dissociative symptoms often appear alongside post-traumatic stress disorder (PTSD). The endorphinergic (that is endorphin-producing) system of the body regulates the "freeze" response to a threat, such as with trauma or shock. Compared against those without the disorder, those with PTSD feature an elevated and prolonged release of endorphins following exercise. Those with either PTSD or borderline personality disorder (BPD) experience a decrease in dissociative symptoms following treatment with naltrexone, which suggests a contributory role of elevated endogenous endorphins to the symptom of disassociation.

References

"RESULTS:
The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group.

CONCLUSIONS:
In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group."

Link: https://www.ncbi.nlm.nih.gov/pubmed/24445579

"4 Endogenous opiate reward systems very likely contribute to th e establishment of conditioned procedural memory in trauma. Researchers have known for decades that exposure to overwhelming trauma in combat often results in a sustained period of analgesia. Soldiers wounded in battle freque ntly require much lower doses of morphine than in other types of incidental injury (Beecher, 1946). Stress-induced analgesia is a well-documented phenomenon in many forms of traumatic stress (van der Kolk, Greenberg, Orr & Pittman, 1989). Release of endorphins at the time of acute stress has a distinct survival benef it. An animal ministering to his wounds due to pain at the time of aggressive, life-threatening injury would su ffer significant compromise of his defensive capabilities. Endorphins also persist dur ing freeze/immobility, rendering the animal analgesic in the face of the injury from the a ttack. This also has potential survival value, since the persistence of immobility in the face of painful injury might serve to end the predator’s attack behavior. In the event of lack of completion of the freeze/immobility response, however, persistent recurrent dissociation with associated endophinergic reward might well potentiate the kindled trau ma reflex. Endorphinerg ic influences might also contribute to the phenomenon of com pulsive trauma reenactment (van der Kolk, 1989)."

Link: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.489.692&rep=rep1&type=pdf

"Treatment with low-dose naltrexone may be a helpful element in the treatment of patients with complex posttraumatic stress disorder. However, it has to be realized that the decrease of dissociation may lead patients to a not yet resolvable challenge, in as much as dissociation had previously been a necessary mechanism of self-protection."

Link: [Low dose naltrexone in the treatment of dissociative symptoms]. - PubMed - NCBI

"Post-traumatic stress disorder (PTSD) may be associated with changes in endogenous opioid peptide function. To test this hypothesis, 10 male Vietnam combat veterans with PTSD and 8 age-matched male controls underwent a standard grade-incremented exercise treadmill stress test. Plasma beta-endorphin measurements were obtained at rest and following maximal exercise. Resting plasma beta-endorphin levels were comparable between groups. Post-exercise plasma beta-endorphin levels were significantly higher than resting levels in the PTSD patients only (P less than 0.05). These pilot data suggest a differential alteration in plasma beta-endorphin response to exercise in PTSD."

Link: Plasma beta-endorphin levels in post-traumatic stress disorder: a preliminary report on response to exercise-induced stress. - PubMed - NCBI

"RESULTS:
The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group.

CONCLUSIONS:
In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group."

Link: [Low dose naltrexone in the treatment of dissociative symptoms]. - PubMed - NCBI

"RESULTS: DAISS scores reflected a highly significant reduction of the duration and the intensity of dissociative phenomena and tonic immobility as well as a marked reduction in analgesia during treatment with naltrexone. Six of 9 patients reported a decrease in the mean number of flashbacks per day.
CONCLUSION: These observations support the hypothesis that an increased activity of the opioid system contributes to dissociative symptoms, including flashbacks, in borderline personality disorder and suggest that these symptoms may respond to treatment with opiate antagonists. In view of these results, a placebo-controlled, double-blind study to assess the potential benefit of naltrexone in a more rigorous way appears justified."

Link: Naltrexone in the treatment of dissociative symptoms in patients with borderline personality disorder: an open-label trial. - PubMed - NCBI

 

[Peatogenic]

Thanks! In prolonged stress (PTSD/CPTSD) you would have elevated cortisol, obviously. It turns out that with elevated cortisol (such as in endurance exercise), you also experience an elevation in endorphins.

 

[jonnybgoode84]

Following.