Neuroreport
May 28, 2008
Robyn L. Bluhm, Elizabeth A. Osuch, Ruth A. Lanius et al.
229 citations
The default mode network, a set of brain regions active during rest, can be identified by both region of interest-based correlation analyses and independent component analysis. In a study of 40 participants, both methods successfully identified the network. Age and sex differences in the network were small, and the two analytic techniques agreed less on these differences than on the network's structure.
European Journal of Psychotraumatology
May 19, 2015
Ruth A. Lanius
126 citations
A recently proposed four-dimensional model categorizes trauma-related psychopathology into symptoms occurring within normal waking consciousness and those that are dissociative, associated with trauma-related altered states of consciousness (TRASC). The dimensions are time, thought, body, and emotion. Clinical applications and future research directions for each dimension are discussed. This model has transdiagnostic implications for trauma-related disorders in both the DSM and ICD. It provides a framework, guided by existing dissociation models, for future research on the phenomenological, neurobiological, and physiological underpinnings of trauma-related dissociation.
Neuropsychologia
November 1, 2017
Sherain Harricharan, Andrew A Nicholson, Maria Densmore et al.
64 citations
People with posttraumatic stress disorder (PTSD) and its dissociative subtype show altered brain connectivity between the vestibular system—which integrates sensory information about body orientation—and cortical regions involved in self-awareness. Using resting-state fMRI, researchers compared 60 people with PTSD, 41 with the dissociative subtype, and 40 healthy controls. The PTSD and control groups had stronger connectivity between the vestibular nuclei and the parieto-insular vestibular cortex and dorsolateral prefrontal cortex than the dissociative subtype group. Greater depersonalization and derealization symptoms correlated with weaker connectivity in the right supramarginal gyrus. These findings suggest that disrupted vestibular multisensory integration may contribute to distinct symptom profiles in PTSD and its dissociative subtype.
Journal of Trauma & Dissociation
March 20, 2014
Paul Frewen, Ruth A. Lanius
59 citations
A 4-D model classifies posttraumatic stress symptoms into those occurring in normal waking consciousness versus those representing dissociative altered states of consciousness. Across four dimensions—time-memory, thought, body, and emotion—the model predicts that dissociative symptoms are less frequent, less intercorrelated as momentary states, more common in people with high dissociative symptoms, and more frequent after repeated trauma, especially early developmental trauma. In a sample of 74 women with PTSD primarily from childhood trauma and 504 undergraduates, the first two predictions were supported; the third held in the PTSD sample. However, childhood trauma severity was not strongly linked to dissociative symptoms, indicating further research is needed.
Mindfulness
April 8, 2015
Paul Frewen, Nicholas M. Rogers, Les Flodrowski et al.
31 citations
An internet-based mindfulness and metta-based trauma therapy (MMTT) website was developed and tested in a proof-of-concept study with 177 online participants. Regardless of their psychiatric history or PTSD symptom severity, participants rated the website as a credible and helpful intervention for improving self-regulation and well-being and for reducing PTSD, anxiety, depression, and dissociation. Guided and non-guided meditation practices were rated as more helpful than a journaling exercise. Participants with higher PTSD symptoms showed less preference for metta (lovingkindness) meditations. The authors conclude MMTT should be piloted in clinical trials as an adjunctive treatment.
European Journal of Psychotraumatology
January 1, 2016
Daniela Rabellino, Sherain Harricharan, Paul Frewen et al.
25 citations
In individuals with the dissociative subtype of posttraumatic stress disorder (PTSD), the rubber hand illusion (RHI) provokes complex and differentiated responses, including subjective distress, depersonalization, derealization, tonic immobility, increased physiological arousal, and flashbacks. The illusion was induced after both synchronous and asynchronous brushing. These findings suggest that the RHI acts as a strong provocation stimulus, eliciting individual patterns of symptom presentation related to body misrepresentation and altered body ownership. The paradigm may be useful for studying the neurophenomenology of body distortion in trauma-related altered states of consciousness.
Psychiatry and Clinical Psychopharmacology
August 11, 2025
Reinhard Janssen-Aguilar, Shakila Meshkat, Huda Al-Shamali et al.
4 citations
Posttraumatic stress disorder (PTSD) is a severe condition that can be difficult to treat, prompting interest in innovative therapies. This systematic review of 94 studies evaluated interventional treatments including neuromodulation, rapid-acting pharmacotherapies like intravenous ketamine and esketamine, and psychedelic-assisted psychotherapies. Randomized controlled trials showed response rates ranging from 12.5% to 80% for transcranial magnetic stimulation, 17% to 67% for intravenous ketamine, and 50% to 87% for MDMA-assisted therapy. Most treatments were well tolerated with only mild, transient adverse effects. The review highlights variability in efficacy, safety, and tolerability across treatments, reflecting differences in patient populations, protocols, and comorbidities. While symptom improvement is observed, sustained efficacy varies, underscoring the need for maintenance strategies.
Journal of Jungian Scholarly Studies
May 16, 2026
Ruth A. Lanius
Trauma, dissociation, and bodily disconnection are central clinical concerns, and insight alone is insufficient for healing—there is a difference between knowing one is safe and actually feeling safe in the body. The book integrates Jungian depth psychology with somatic practices like Authentic Movement, demonstrating that somatic experience can be a precise, symbol-bearing dimension of analytic process rather than a deviation from it. A case example of "Lydia," a sexual abuse survivor, illustrates a phased approach that first emphasizes boundaries, grounding, and orienting through structured movement and sensory awareness to build bodily safety and agency before moving into more imaginal and expressive work. This approach aligns with contemporary trauma neuroscience showing that early overwhelming experiences are encoded in subcortical networks.
Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)
January 1, 2022
Paul Frewen, Bethany L Brand, Hugo J Schielke et al.
Trauma-related dissociation can be understood through a 4-dimensional model that distinguishes altered states of consciousness from distress symptoms across time, thought, body, and emotions. In 111 people with trauma-related dissociative disorders receiving in-person psychotherapy plus an online psychoeducational program, intrusive memories were more common than flashbacks, and emotional numbing was more common than other forms of affect dysregulation. Negative thoughts and emotion dysregulation correlated more strongly than did voice hearing and emotional numbing. Distress symptoms were more tied to PTSD symptoms and emotion regulation difficulties, while depersonalization was more linked to dissociative self-states. Distress symptoms also reduced more than altered states during treatment. Results support distinguishing distress from dissociation, though findings varied across dimensions.
Psychological trauma : theory, research, practice and policy
November 1, 2020
Divya Mistry, Jenney Zhu, Paul Tremblay et al.
Practicing meditation with virtual reality (VR) guidance boosted positive affect and perceived satisfaction-credibility more than non-VR guided meditation, but only when the VR session came first. Negative affect during meditation was rare overall, though people with more PTSD symptoms reported greater distress in both VR and non-VR conditions. The findings suggest VR could aid meditation practice, especially for those with PTSD symptoms, but more research is needed.