Neurobiological and Genetic Correlates of the Dissociative Subtype of PTSD
E. Wolf, Sage E. Hawn, Danielle R. Sullivan, Mark Miller, Victoria Sanborn, Emma M. Brown, Zoe Neale, Dana Fein-Schaffer, Xiang Zhao, M. Logue, C. Fortier, R. McGlinchey, W. Milberg
Journal of Psychopathology and Clinical Science April 6, 2023 DOI: 10.1037/abn0000795 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 374 |
| Population | Young, primarily male post-9/11-era Veterans with PTSD |
| Duration | 1.5-year follow-up |
| Topics | PTSD |
| Key findings | A dissociative class comprising 7.5% of the sample fit the data better than dimensional or hybrid models and was stable over 1.5 years. Derealization/depersonalization severity was associated with decreased default mode network connectivity, increased hippocampal subfield volumes, worse self-monitoring, and a variant in the adenylyl cyclase 8 gene, suggesting mechanisms related to sensory integration and spatial awareness. |
Abstract
Approximately 10–30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization and derealization. This study examined the psychometric evidence for the dissociative subtype of PTSD in a sample of young, primarily male post-9/11-era Veterans (n = 374 at baseline and n = 163 at follow-up) and evaluated its biological correlates with respect to resting state functional connectivity (default mode network; DMN; n = 275), brain morphology (hippocampal subfield volume and cortical thickness; n = 280), neurocognitive functioning (n = 337), and genetic variation (n = 193). Multivariate analyses of PTSD and dissociation items suggested a class structure was superior to dimensional and hybrid ones, with 7.5% of the sample comprising the dissociative class; this group showed stability over 1.5 years. Covarying for age, sex, and PTSD severity, linear regression models revealed that derealization/depersonalization severity was associated with: decreased DMN connectivity between bilateral posterior cingulate cortex and right isthmus (p = .015; adjusted-p [padj] = .097); increased bilateral whole hippocampal, hippocampal head, and molecular layer head volume (p = .010 - .034; padj = .032 - .053); worse self-monitoring (p = .018; padj = .079); and a candidate genetic variant (rs263232) in the adenylyl cyclase 8 gene (p = .026), previously associated with dissociation. Results converged on biological structures and systems implicated in sensory integration, the neural representation of spatial awareness, and stress-related spatial learning and memory, suggesting possible mechanisms underlying the dissociative subtype of PTSD.
Comparable studies
Other observational and cohort studies on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| MDMA-Assisted Psychotherapy Using Low Doses in a Small Sample of Women with Chronic Posttraumatic Stress Disorder Women with chronic PTSD secondary to sexual assault | 2008 | Observational cohort | n = 6 |
| An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder Treatment-seeking veterans, current serving military members, and emergency service... | 2017 | Observational study using ambulatory polysomnography | n = 35 |
| Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD. Female sexual assault survivors with chronic nightmares | 2004 | Observational cohort | n = 44 |
| Posttraumatic stress symptoms following near-death experiences. Persons who report near-death experiences and those who came close to death without NDEs | 2001 | Observational study | |
| Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Outpatients with treatment-resistant depression and PTSD | 2018 | Retrospective review | n = 37 |
Citations in the library
Cited by 7
- Post-traumatic stress disorder: evolving conceptualization and evidence, and future research directions. World Psychiatry February 1, 2025
- Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study. Psychopharmacology October 23, 2023
- The pattern of dissociative symptoms differs between post-traumatic stress disorder and first esketamine administration for treatment-resistant depression. Journal of Affective Disorders June 12, 2025
- MDMA-Assisted Therapy May Decrease PTSD Symptoms, Dissociation, Depression, and Functional Disability: A Systematic Review and Meta-Analysis Harvard Review of Psychiatry September 8, 2026
- Brain Network Convergence of Abnormal Gray Matter and Functional Activity of Pathological Dissociative Symptoms. Psychiatry and Clinical Neurosciences August 29, 2026
and 2 more in the library
Cites 13
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- Measurement of dissociative states with the Clinician‐Administered Dissociative States Scale (CADSS) Journal of Traumatic Stress 1998
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
- A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder. American Journal of Psychiatry January 5, 2021
and 8 more in the library