Derealization - Revision history

Xinreality at 06:46, 29 April 2025

2025-04-29T06:46:27Z

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	===Prevention and management strategies===		===Prevention and management strategies===
	*'''Session design:''' build-in breaks every ~~20–30~~ min; gradual onboarding for new users.		*'''Session design:''' build-in breaks every 20-30 min; gradual onboarding for new users.
	*'''Grounding techniques:''' post-VR mindfulness, tactile engagement, or brief exercise help re-establish physical-world presence.		*'''Grounding techniques:''' post-VR mindfulness, tactile engagement, or brief exercise help re-establish physical-world presence.
	*'''User warnings:''' advise individuals with DPDR, severe [[anxiety]], or trauma histories to proceed cautiously.<ref name="Madary2016" />		*'''User warnings:''' advise individuals with DPDR, severe [[anxiety]], or trauma histories to proceed cautiously.<ref name="Madary2016" />

Xinreality: Text replacement - "e.g.," to "for example"

2025-04-29T04:23:18Z

Text replacement - "e.g.," to "for example"

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	: Abnormal fronto-limbic connectivity; hypo-activity of the [[amygdala]] and [[insula]]; disturbances in predictive-coding networks.<ref>Gatus, A., Jamieson, G., & Stevenson, B. (2022). Past and future explanations for DPDR: a role for predictive coding. ''Frontiers in Human Neuroscience'', 16, 813300.</ref>		: Abnormal fronto-limbic connectivity; hypo-activity of the [[amygdala]] and [[insula]]; disturbances in predictive-coding networks.<ref>Gatus, A., Jamieson, G., & Stevenson, B. (2022). Past and future explanations for DPDR: a role for predictive coding. ''Frontiers in Human Neuroscience'', 16, 813300.</ref>
	;Substance-related		;Substance-related
	: Cannabis, hallucinogens (~~e.g.,~~ LSD, psilocybin), [[ketamine]], MDMA, stimulant intoxication, or benzodiazepine withdrawal can precipitate DR.<ref>Simeon, D., Kozin, D., Segal, K., & Lerch, B. (2009). Is depersonalization disorder initiated by illicit drug use any different? ''Journal of Clinical Psychiatry'', 70 (10), 1358-1364.</ref>		: Cannabis, hallucinogens (for example LSD, psilocybin), [[ketamine]], MDMA, stimulant intoxication, or benzodiazepine withdrawal can precipitate DR.<ref>Simeon, D., Kozin, D., Segal, K., & Lerch, B. (2009). Is depersonalization disorder initiated by illicit drug use any different? ''Journal of Clinical Psychiatry'', 70 (10), 1358-1364.</ref>

	==Neurological mechanisms==		==Neurological mechanisms==
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	===Therapeutic applications===		===Therapeutic applications===
	Paradoxically, controlled VR has been investigated to '''treat''' dissociative conditions, ~~e.g.,~~ reality, discrimination training or interoceptive biofeedback to enhance bodily awareness.<ref>Opriş, D. et al. (2012). VR exposure therapy in anxiety disorders: a meta-analysis. ''Depression & Anxiety'', 29 (2), 85-93.</ref>		Paradoxically, controlled VR has been investigated to '''treat''' dissociative conditions, for example reality, discrimination training or interoceptive biofeedback to enhance bodily awareness.<ref>Opriş, D. et al. (2012). VR exposure therapy in anxiety disorders: a meta-analysis. ''Depression & Anxiety'', 29 (2), 85-93.</ref>

	===Ethical considerations===		===Ethical considerations===

Xinreality: /* Proposed mechanisms */

2025-04-24T21:47:56Z

Proposed mechanisms

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	===Proposed mechanisms===		===Proposed mechanisms===
	* '''[[Sensory conflict]]''' between visual and vestibular/proprioceptive inputs.<ref>Keshavarz, B. et al. (2014). Vection and motion sickness: higher susceptibility in women. ''Perception'', 43 (ECVP Suppl.), 107.</ref>		* '''[[Sensory conflict]]''' between visual and vestibular/proprioceptive inputs.<ref>Keshavarz, B. et al. (2014). Vection and motion sickness: higher susceptibility in women. ''Perception'', 43 (ECVP Suppl.), 107.</ref>
	* High '''immersion / presence shift''', producing a temporary imbalance favouring virtual over physical cues.<ref>Slater, M., & Sanchez-Vives, M. V. (2016). Enhancing our lives with immersive VR. ''Frontiers in Robotics & AI'', 3, 74.</ref>		* High '''[[immersion]] / [[presence shift]]''', producing a temporary imbalance favouring virtual over physical cues.<ref>Slater, M., & Sanchez-Vives, M. V. (2016). Enhancing our lives with immersive VR. ''Frontiers in Robotics & AI'', 3, 74.</ref>
	* '''Boundary blurring''' when hyper-realistic graphics or prolonged sessions weaken reality markers.<ref name="Madary2016">Madary, M., & Metzinger, T. (2016). Real virtuality: a code of ethical conduct. ''Frontiers in Robotics & AI'', 3, 3.</ref>		* '''Boundary blurring''' when hyper-realistic graphics or prolonged sessions weaken reality markers.<ref name="Madary2016">Madary, M., & Metzinger, T. (2016). Real virtuality: a code of ethical conduct. ''Frontiers in Robotics & AI'', 3, 3.</ref>

Xinreality at 18:29, 24 April 2025

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Xinreality at 18:21, 24 April 2025

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	{{see also\|Terms\|Non-technical Terms]]		{{see also\|Terms\|Non-technical Terms}}
	[[Derealization]] ('''DR''') is a form of [[dissociation]] in which the external world feels unreal, dream-like, foggy, artificial, distant, or visually distorted.<ref name="DSM5">American Psychiatric Association. (2013). ''Diagnostic and Statistical Manual of Mental Disorders'' (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> Although surroundings may appear “flat,” “cartoonish,” or “as if seen through glass,” reality-testing remains intact: the sufferer knows the environment itself has not actually changed. Derealization often co-occurs with [[depersonalization]] (detachment from one’s self); persistent or recurrent episodes of either — when clinically distressing — are diagnosed as [[Depersonalization/Derealization Disorder]] (DPDR).<ref name="Simeon2004">Simeon, D. (2004). Depersonalisation disorder: a contemporary overview. ''CNS Drugs'', 18 (6), 343-354. https://doi.org/10.2165/00023210-200418060-00002</ref>		[[Derealization]] ('''DR''') is a form of [[dissociation]] in which the external world feels unreal, dream-like, foggy, artificial, distant, or visually distorted.<ref name="DSM5">American Psychiatric Association. (2013). ''Diagnostic and Statistical Manual of Mental Disorders'' (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> Although surroundings may appear “flat,” “cartoonish,” or “as if seen through glass,” reality-testing remains intact: the sufferer knows the environment itself has not actually changed. Derealization often co-occurs with [[depersonalization]] (detachment from one’s self); persistent or recurrent episodes of either — when clinically distressing — are diagnosed as [[Depersonalization/Derealization Disorder]] (DPDR).<ref name="Simeon2004">Simeon, D. (2004). Depersonalisation disorder: a contemporary overview. ''CNS Drugs'', 18 (6), 343-354. https://doi.org/10.2165/00023210-200418060-00002</ref>

Xinreality at 18:20, 24 April 2025

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Show changes

Xinreality at 02:59, 27 June 2015

2015-06-27T02:59:03Z

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	[[Category:Terms]]		[[Category:Terms]]
			[[Category:Mental Health]]

Xinreality at 02:58, 27 June 2015

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	[[Derealization]] also known as '''DR''' is the feeling that the real world or [[objective reality]] is not ''real''. Individuals suffering from derealization feel that their real life external surroundings are lacking in depths, colors or vibrancy. Derealization is related to another dissociative feeling called [[depersonalization]], the feeling that one self is not real.		[[Derealization]] also known as '''DR''' is the feeling that the real world or [[objective reality]] is not ''real''. Individuals suffering from derealization feel that their real life external surroundings are lacking in depths, colors or vibrancy. Derealization is related to another dissociative feeling called [[depersonalization]], the feeling that one self is not real.

	Researchers have theorized that the rise of [[virtual reality]] can lead to increased instances of derealization and other ~~instances of~~ dissociative feelings.<ref name="Frederick_Aardema">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>		Researchers have theorized that the rise of [[virtual reality]] can lead to increased instances of derealization and other dissociative feelings.<ref name="Frederick_Aardema">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>

	==Derealization and Virtual Reality==		==Derealization and Virtual Reality==

Xinreality at 02:56, 27 June 2015

2015-06-27T02:56:41Z

← Older revision		Revision as of 02:56, 27 June 2015
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	[[Derealization]] also known as '''DR''' is the feeling that the real world or [[objective reality]] is not ''real''. Individuals suffering from derealization feel that their real life external surroundings are lacking in depths, colors or vibrancy. Derealization is related to another dissociative feeling called [[depersonalization]], the feeling that one self is not real.		[[Derealization]] also known as '''DR''' is the feeling that the real world or [[objective reality]] is not ''real''. Individuals suffering from derealization feel that their real life external surroundings are lacking in depths, colors or vibrancy. Derealization is related to another dissociative feeling called [[depersonalization]], the feeling that one self is not real.

	Researchers have theorized that the rise of [[virtual reality]] can lead to increased instances of derealization and other instances of dissociative feelings.<ref name="Frederick_Aardema,">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>		Researchers have theorized that the rise of [[virtual reality]] can lead to increased instances of derealization and other instances of dissociative feelings.<ref name="Frederick_Aardema">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>

	==Derealization and Virtual Reality==		==Derealization and Virtual Reality==

Xinreality at 02:55, 27 June 2015

2015-06-27T02:55:50Z

← Older revision		Revision as of 02:55, 27 June 2015
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	[[Derealization]] also known as '''DR''' is the feeling that the real world or [[objective reality]] is not ''real''. Individuals suffering from derealization feel that their real life external surroundings are lacking in depths, colors or vibrancy. Derealization is related to another dissociative feeling called [[depersonalization]], the feeling that one self is not real.		[[Derealization]] also known as '''DR''' is the feeling that the real world or [[objective reality]] is not ''real''. Individuals suffering from derealization feel that their real life external surroundings are lacking in depths, colors or vibrancy. Derealization is related to another dissociative feeling called [[depersonalization]], the feeling that one self is not real.

	Researchers have theorized that the rise of [[virtual reality]] can lead to increased instances of derealization and other instances of dissociative feelings.<ref name="~~Research_Gate~~">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>		Researchers have theorized that the rise of [[virtual reality]] can lead to increased instances of derealization and other instances of dissociative feelings.<ref name="Frederick_Aardema,">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>

	==Derealization and Virtual Reality==		==Derealization and Virtual Reality==
	Researchers from Fernand-Seguin Research Center in Montréal, Québec, Canada found that being [[immersed]] in an [[VR]] environment increases the feelings of derealization and depersonalization and reduces the sense of [[presence]] in objective reality.<ref name="~~Research_Gate~~">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref> When compared to individuals with no prior dissociative symptoms, individuals with pre-existing symptoms of derealization and depersonalization showed greater increase in their dissociative symptoms after exposure to VR. However they did not show greater loss of presence in objective reality than individuals with no prior symptoms.<ref name="~~Research_Gate~~">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>		Researchers from Fernand-Seguin Research Center in Montréal, Québec, Canada found that being [[immersed]] in an [[VR]] environment increases the feelings of derealization and depersonalization and reduces the sense of [[presence]] in objective reality.<ref name="Frederick_Aardema">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref> When compared to individuals with no prior dissociative symptoms, individuals with pre-existing symptoms of derealization and depersonalization showed greater increase in their dissociative symptoms after exposure to VR. However they did not show greater loss of presence in objective reality than individuals with no prior symptoms.<ref name="Frederick_Aardema">http://www.researchgate.net/publication/45658815_Virtual_Reality_Induces_Dissociation_and_Lowers_Sense_of_Presence_in_Objective_Reality</ref>

	==References==		==References==

← Older revision		Revision as of 18:29, 24 April 2025
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	{{see also\|Terms\|Non-technical Terms}}		{{see also\|Terms\|Non-technical Terms}}
	[[Derealization]] ('''DR''') is a form of [[dissociation]] in which the external world feels unreal, dream-like, foggy, artificial, distant, or visually distorted.<ref name="DSM5">American Psychiatric Association. (2013). ''Diagnostic and Statistical Manual of Mental Disorders'' (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> Although surroundings may appear ~~“flat~~,~~” “cartoonish~~,” or ~~“as~~ if seen through glass,” reality-testing remains intact: the sufferer knows the environment itself has not actually changed. Derealization often co-occurs with [[depersonalization]] (detachment from one’s self); persistent or recurrent episodes of either — when clinically distressing — are diagnosed as [[Depersonalization/Derealization Disorder]] (DPDR).<ref name="Simeon2004">Simeon, D. (2004). Depersonalisation disorder: a contemporary overview. ''CNS Drugs'', 18 (6), 343-354. https://doi.org/10.2165/00023210-200418060-00002</ref>		[[Derealization]] ('''DR''') is a form of [[dissociation]] in which the '''external world feels unreal, dream-like, foggy, artificial, distant, or visually distorted'''.<ref name="DSM5">American Psychiatric Association. (2013). ''Diagnostic and Statistical Manual of Mental Disorders'' (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> Although surroundings may appear "flat", "cartoonish", or "as if seen through glass", '''reality-testing remains intact''': the sufferer knows the environment itself has not actually changed. Derealization often co-occurs with [[depersonalization]] (detachment from one’s self); persistent or recurrent episodes of either, when clinically distressing, are diagnosed as [[Depersonalization/Derealization Disorder]] (DPDR).<ref name="Simeon2004">Simeon, D. (2004). Depersonalisation disorder: a contemporary overview. ''CNS Drugs'', 18 (6), 343-354. https://doi.org/10.2165/00023210-200418060-00002</ref>

	==Clinical definition and overview==		==Clinical definition and overview==
	* Core symptoms include a sense that people or objects are artificial, colour-less, two-dimensional, or remote; time may seem sped up or slowed; familiar places can appear strangely foreign.<ref name="Hunter2004">Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation. ''Social Psychiatry & Psychiatric Epidemiology'', 39 (1), 9-18. https://doi.org/10.1007/s00127-004-0701-4</ref>		*'''Core symptoms''' include a sense that people or objects are artificial, colour-less, two-dimensional, or remote; time may seem sped up or slowed; familiar places can appear strangely foreign.<ref name="Hunter2004">Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation. ''Social Psychiatry & Psychiatric Epidemiology'', 39 (1), 9-18. https://doi.org/10.1007/s00127-004-0701-4</ref>
	* Prevalence. Transient DR/DP episodes occur in 26-74 % of the general population, but chronic DPDR affects roughly 1-2 %.<ref name="Hunter2004" /><ref>Y, J., Millman, L. S., David, A. S., & Hunter, E. (2023). The prevalence of depersonalization-derealization disorder: a systematic review. ''Journal of Trauma & Dissociation'', 24 (1), 8-41. https://doi.org/10.1080/15299732.2022.2079796</ref>		*'''Prevalence.''' Transient DR/DP episodes occur in '''26-74 %''' of the general population, but chronic DPDR affects roughly '''1-2 %'''.<ref name="Hunter2004" /><ref>Y, J., Millman, L. S., David, A. S., & Hunter, E. (2023). The prevalence of depersonalization-derealization disorder: a systematic review. ''Journal of Trauma & Dissociation'', 24 (1), 8-41. https://doi.org/10.1080/15299732.2022.2079796</ref>

	===Symptoms and characteristics===		===Symptoms and characteristics===
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	\| Perceptual \|\| The world seems foggy, muted, too sharp, [[macropsia]]/[[micropsia]], muted or echoing sounds		\| Perceptual \|\| The world seems foggy, muted, too sharp, [[macropsia]]/[[micropsia]], muted or echoing sounds
	\|-		\|-
	\| Cognitive \|\| Feeling ~~“in~~ a film,” heightened [[self-observation]], doubts about the reality of memories		\| Cognitive \|\| Feeling "in a film", heightened [[self-observation]], doubts about the reality of memories
	\|-		\|-
	\| Affective \|\| Emotional numbing (“de-affectualisation”), blunted responses to normally salient stimuli		\| Affective \|\| Emotional numbing (“de-affectualisation”), blunted responses to normally salient stimuli
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	==Neurological mechanisms==		==Neurological mechanisms==
	Neuro-imaging studies reveal a fronto-limbic “decoupling”: hyper-activation of pre-frontal regions suppresses limbic emotional circuits, yielding detachment from affective salience.<ref>Sierra, M. & David, A. S. (2011). Depersonalization: a selective impairment of self-awareness. ''Consciousness & Cognition'', 20 (1), 99-108.</ref> Reduced insular activity may underlie impaired [[interoception]], while alterations in visual association cortices correlate with perceptual distortions.<ref>Adler, J. et al. (2014). Altered orientation of spatial attention in DPDR. ''Psychiatry Research: Neuroimaging'', 216 (2), 230-235.</ref>		Neuro-imaging studies reveal a '''fronto-limbic "decoupling"''': hyper-activation of pre-frontal regions suppresses limbic emotional circuits, yielding detachment from affective salience.<ref>Sierra, M. & David, A. S. (2011). Depersonalization: a selective impairment of self-awareness. ''Consciousness & Cognition'', 20 (1), 99-108.</ref> Reduced insular activity may underlie impaired [[interoception]], while alterations in visual association cortices correlate with perceptual distortions.<ref>Adler, J. et al. (2014). Altered orientation of spatial attention in DPDR. ''Psychiatry Research: Neuroimaging'', 216 (2), 230-235.</ref>

	==Derealization and immersive technology (VR/AR)==		==Derealization and immersive technology (VR/AR)==
	Immersive [[virtual reality]] (VR) and [[augmented reality]] (AR) deliberately alter multisensory input, raising concern that they may induce transient or persistent DR/DP symptoms.		Immersive [[virtual reality]] (VR) and [[augmented reality]] (AR) deliberately alter multisensory input, raising concern that they may '''induce transient or persistent DR/DP symptoms'''.

	===Induced dissociative symptoms===		===Induced dissociative symptoms===
	A pivotal study from the Fernand-Seguin Research Center reported significant increases in DR/DP and reduced sense of [[presence]] after VR exposure.<ref name="Aardema2010">Aardema, F., O'Connor, K., Côté, S., & Taillon, A. (2010). Virtual reality induces dissociation and lowers sense of presence in objective reality. ''Cyberpsychology, Behavior, & Social Networking'', 13 (4), 429-435. https://doi.org/10.1089/cyber.2009.0164</ref> More recent RCTs and surveys confirm that VR can acutely elevate DR scores, yet effects typically resolve within minutes to hours and rarely persist.<ref>Braun, N. et al. (2022). Virtual reality induces depersonalization and derealization: a longitudinal RCT. ''Computers in Human Behavior'', 131, 107233.</ref><ref>Barreda-Ángeles, M., & Hartmann, T. (2023). Experiences of DP/DR among users of VR applications: a cross-sectional survey. ''Cyberpsychology, Behavior, & Social Networking'', 26 (1), 22-27.</ref>		A pivotal study from the Fernand-Seguin Research Center reported significant increases in DR/DP and reduced sense of [[presence]] after VR exposure.<ref name="Aardema2010">Aardema, F., O'Connor, K., Côté, S., & Taillon, A. (2010). Virtual reality induces dissociation and lowers sense of presence in objective reality. ''Cyberpsychology, Behavior, & Social Networking'', 13 (4), 429-435. https://doi.org/10.1089/cyber.2009.0164</ref> More recent RCTs and surveys confirm that '''VR can acutely elevate DR scores''', yet effects typically resolve within minutes to hours and rarely persist.<ref>Braun, N. et al. (2022). Virtual reality induces depersonalization and derealization: a longitudinal RCT. ''Computers in Human Behavior'', 131, 107233.</ref><ref>Barreda-Ángeles, M., & Hartmann, T. (2023). Experiences of DP/DR among users of VR applications: a cross-sectional survey. ''Cyberpsychology, Behavior, & Social Networking'', 26 (1), 22-27.</ref>

	===Proposed mechanisms===		===Proposed mechanisms===
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	===Prevention and management strategies===		===Prevention and management strategies===
	* Session design: build-in breaks every 20–30 min; gradual onboarding for new users.		*'''Session design:''' build-in breaks every 20–30 min; gradual onboarding for new users.
	* Grounding techniques: post-VR mindfulness, tactile engagement, or brief exercise help re-establish physical-world presence.		*'''Grounding techniques:''' post-VR mindfulness, tactile engagement, or brief exercise help re-establish physical-world presence.
	* User warnings: advise individuals with DPDR, severe [[anxiety]], or trauma histories to proceed cautiously.<ref name="Madary2016" />		*'''User warnings:''' advise individuals with DPDR, severe [[anxiety]], or trauma histories to proceed cautiously.<ref name="Madary2016" />
	* Clinical monitoring: therapists using VR exposure should screen for dissociative side-effects.<ref>Maples-Keller, J. L. et al. (2017). The use of VR in treatment of anxiety & psychiatric disorders. ''Harvard Review of Psychiatry'', 25 (3), 103-113.</ref>		*'''Clinical monitoring:''' therapists using VR exposure should screen for dissociative side-effects.<ref>Maples-Keller, J. L. et al. (2017). The use of VR in treatment of anxiety & psychiatric disorders. ''Harvard Review of Psychiatry'', 25 (3), 103-113.</ref>

	===Therapeutic applications===		===Therapeutic applications===
	Paradoxically, controlled VR has been investigated to treat dissociative conditions — e.g., reality-discrimination training or interoceptive biofeedback to enhance bodily awareness.<ref>Opriş, D. et al. (2012). VR exposure therapy in anxiety disorders: a meta-analysis. ''Depression & Anxiety'', 29 (2), 85-93.</ref>		Paradoxically, controlled VR has been investigated to '''treat''' dissociative conditions, e.g., reality, discrimination training or interoceptive biofeedback to enhance bodily awareness.<ref>Opriş, D. et al. (2012). VR exposure therapy in anxiety disorders: a meta-analysis. ''Depression & Anxiety'', 29 (2), 85-93.</ref>

	===Ethical considerations===		===Ethical considerations===