Autonomic response in depersonalisation disorder

Mauricio Sierra*, Carl Senior, Jeffrey Dalton, Michael McDonough, Alison Bond, Mary L. Phillips, Anne M. O'Dwyer, Anthony S. David

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background 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. Methods 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. Results The skin conductance response to unpleasant pictures was significantly reduced in patients with depersonalization disorder (magnitude of 0.017 µsiemens in controls and 0.103 µsiemens 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). Conclusions 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.
Original languageEnglish
Pages (from-to)833-838
Number of pages6
JournalArchives of General Psychiatry
Issue number9
Publication statusPublished - Sept 2002

Bibliographical note

Publisher's version/PDF may be used, 12 months embargo. Autonomic Response in Depersonalization Disorder


  • emotional-processing inhibition
  • clinical features
  • depersonalization
  • derealization
  • autonomic response
  • emotional stimuli
  • depersonalization disorder
  • startling noise
  • state of alertness
  • unpleasant stimuli
  • selective inhibitory mechanism
  • emotional processing


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