From brooding to detachment: Rumination longitudinally predicts an increase in depersonalization and derealisation

Abstract

Objectives. Depersonalization-derealization (DEP-DER) is a dissociative experience which is related to psychopathology and distress. Yet, the aetiological factors leading to DEP-DER are not sufficiently clear. In this study, we suggest rumination as one possible antecedent. Thus, the goal of the study was to explore the longitudinal relationship between rumination and DEP-DER.Design. Longitudinal self-report study; mixed clinical and community sample.Methods. The study was conducted on 98 participants, 49 of them were diagnosed with depression, anxiety disorders, or obsessive-compulsive disorder, and the other 49 were healthy, matched community controls. The participants underwent a structured clinical interview and completed a battery of questionnaires. Then, the participants completed the same battery again once a month, for five additional assessment points (6 months in total). The data were analysed using multilevel linear modelling with time-lag analysis.Results. We found that levels of rumination and DEP-DER increased and decreased simultaneously, meaning that on assessments in which people reported that they tended to ruminate, they also reported higher levels of DEP-DER symptoms. In addition, we found support for a unidirectional association, consistent with our theoretical hypothesis. Specifically, rumination levels on a certain month longitudinally predicted a higher likeliness for reporting DEP-DER on the following month, even when controlling for the contemporaneous relationship. Conversely, DEP-DER symptoms did not longitudinally predict increased rumination.Conclusions. These findings suggest that rumination may be an antecedent of DEP-DER, but not vice versa. Possible mechanisms to explain this link are discussed. Practitioner pointsRumination and DEP-DER oscillate together over time; additionally, rumination predicts a longitudinal increase in DEP-DER.

The path to dissociative experiences: A direct comparison of different etiological models

“…Moreover, while depersonalization‐derealization symptoms are central in PTSD, they are also central in panic disorder, meaning that they may represent a response to over‐whelming negative emotion in general, rather than only to traumatic stress (Soffer‐Dudek, 2014). Relatedly, we have recently shown that increased rumination predicts a long‐term increase in depersonalization‐derealization symptoms (Vannikov‐Lugassi et al, 2020). Similar to depersonalization‐derealization, dissociative absorption is also elevated in PTSD (Armour et al, 2014; Özdemir et al, 2015) but unrelated to childhood trauma (Irwin, 1999; Somer & Herscu, 2017).…”

“…The sample included 98 participants (49 clinical and 49 community participants, see Table 1). This sample's data were also used for another publication exploring the directionality of the relationship between depersonalization‐derealization and rumination (Vannikov‐Lugassi et al, 2020). That paper does not include data on sleep quality, SREs, or psychological distress included here.…”

“…Importantly, the present study was part of a project attempting to better understand common dissociative experiences in widespread disorders such as depression, anxiety, and OCD (Soffer‐Dudek, 2014, 2017b; Vannikov‐Lugassi et al, 2020; Vannikov‐Lugassi & Soffer‐Dudek, 2018), and as such it focused on an anxiety and depression sample rather than one of dissociative and trauma disorders, which is why it cannot be considered a direct test of the trauma model. We hypothesized that: (H1) Individuals with higher psychological distress will demonstrate higher dissociative experiences (between‐subjects hypothesis, DM).…”

No evidence for selective serotonin reuptake inhibitors (SSRIs) use as explaining the relationship between sleep experiences and psychopathological distress.

“…This study is part of a larger study assessing dissociative experiences in depression and anxiety (Buchnik-Daniely et al, 2021; Vannikov-Lugassi et al, 2020). These other publications did not explore medication use and its relation to dreaming.…”

Features of depersonalization: An examination and expansion of the cognitive-behavioral model.

“…Last, perseverative negative thinking appears to be a prominent feature of both disorders, with obsessive thoughts in OCD and perseveration on catastrophic appraisals and anxiety-provoking existential thoughts in DDD (Ehring & Watkins, 2008; Torch, 1978). In support of the link between perseverative thinking and depersonalization, one study found a longitudinal association between rumination and DDD symptoms, such that increases in rumination preceded increases in symptoms (Vannikov-Lugassi et al, 2021).…”