title: Striking discrepancy of anomalous body experiences with normal interoceptive accuracy in depersonalization-derealization disorder.
abstract: BACKGROUND
  Disembodiment is a core feature of depersonalization disorder (DPD). Given the narratives of DPD patients about their disembodiment and emotional numbing and neurobiological findings of an inhibition of insular activity, DPD may be considered as a mental disorder with specific impairments of interoceptive awareness and body perception.
  
  
  METHODS
  We investigated cardioceptive accuracy (CA) of DPD patients (n=24) as compared to healthy controls (n=26) with two different heartbeat detection tasks ("Schandry heartbeat counting task" and "Whitehead heartbeat discrimination task"). Self-rated clearness of body perception was measured by questionnaire.
  
  
  RESULTS
  Contrary to our hypothesis, DPD patients performed similarly to healthy controls on the two different heartbeat detection tasks, and they had equal scores regarding their self-rated clearness of body perception. There was no correlation of the severity of "anomalous body experiences" and depersonalization with measures of interoceptive accuracy. Only among healthy controls CA in the Schandry task was positively correlated with self-rated clearness of body perception. Depersonalization was unrelated to severity of depression or anxiety, while depression and anxiety were highly correlated. Anxiety and depression did not modify the associations of depersonalization with interoceptive accuracy.
  
  
  CONCLUSIONS
  Our main findings highlight a striking discrepancy of normal interoception with overwhelming experiences of disembodiment in DPD. This may reflect difficulties of DPD patients to integrate their visceral and bodily perceptions into a sense of their selves. This problem may be considered an important target for psychotherapeutic treatment approaches.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Michal
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Reuchlein
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Adler
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors.forename: Iris
authors.initials: I
authors.lastname: Reiner
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.affiliation: Research Unit INSIDE, Research Group Self-Regulation and Health, University of Luxembourg, Walferdange, Luxembourg.
authors.forename: Claus
authors.initials: C
authors.lastname: Vögele
authors.affiliation: Department of Clinical Psychophysiology, Institute of Psychobiology, University of Trier, Trier, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Schächinger
authors.affiliation: Research Unit INSIDE, Research Group Self-Regulation and Health, University of Luxembourg, Walferdange, Luxembourg.
authors.forename: André
authors.initials: A
authors.lastname: Schulz
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003861:Depersonalization / Q000175:diagnosis* / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D010465:Perception; D011594:Psychometrics; D011597:Psychomotor Performance; D055815:Young Adult