[Cross-cultural adaptation and validation of the Cambridge Depersonalisation Scale].
ABSTRACT The Cambridge Depersonalisation Scale (CDS) is a self-rating questionnaire constructed to capture the frequency and duration of depersonalization symptoms over the last six months. The instrument has proved to be valid and reliable and can be useful in both clinical and neurobiological research.
This paper presents the Spanish adaptation and validation of the CDS. The study was carried out in two stages. First, we developed the Spanish version of the CDS by means of a cross-cultural adaptation methodology. Second, the CDS was tried on a sample of 130 subjects: 77 patients meeting DSM-IV-TR criteria for schizophrenia, 35 with depression disorders and 18 with anxiety disorders. Scores were compared against clinical diagnoses (gold standard). Furthermore, all the subjects of the study were administered the following: Dissociation Experiences Scale (DES), Positive and Negative Syndrome Scale (PANSS), Beck's Depression Inventory (BDI), and the Hamilton Anxiety Rating Scale (HARS).
38 patients (29.2 %) had depersonalization symptoms. The scale showed high internal consistency (Cronbach's alpha > 0.9 and split-half reliability > 0.8) and a test-retest reliability of 0.391. Convergent validity was 0.65 (p < 0.001) and discriminant validity was 0.308 (p < 0.05). The area under the ROC curve was 0.94. A cut-off of 71 appears to be most useful (sensitivity and specificity were 76.3 % and 89.1 %, respectively).
The Spanish version of the CDS has good reliability and validity, similar to the original instrument.
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ABSTRACT: Depersonalization-Derealization Disorder (DD) typically manifests as a disruption of body self-awareness. Interoception -defined as the cognitive processing of body signals- has been extensively considered as a key processing for body self-awareness. In consequence, the purpose of this study was to investigate whether there are systematic differences in interoception between a patient with DD and controls that might explain the disembodiment symptoms suffered in this disease. To assess interoception, we utilized a heartbeat detection task and measures of functional connectivity derived from fMRI networks in interoceptive/exteroceptivo/mind-wandering states. Additionally, we evaluated empathic abilities to test the association between interoception and emotional experience. The results showed patient's impaired performance in the heartbeat detection task when compared to controls. Furthermore, regarding functional connectivity, we found a lower global brain connectivity of the patient relative to controls only in the interoceptive state. He also presented a particular pattern of impairments in affective empathy. To our knowledge, this is the first experimental research that assesses the relationship between interoception and DD combining behavioral and neurobiological measures. Our results suggest that altered neural mechanisms and cognitive processes regarding body signaling might be engaged in DD phenomenology. Moreover, our study contributes experimental data to the comprehension of brain-body interactions and the emergence of self-awareness and emotional feelings.PLoS ONE 06/2014; 9(6):e98769. DOI:10.1371/journal.pone.0098769 · 3.53 Impact Factor
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ABSTRACT: Abstract Depersonalization experiences have been studied in the United States and Europe, but there is a dearth of investigations with Latino populations. In the current study we examined the psychometric properties of the Spanish version of the Cambridge Depersonalization Scale in 300 adult individuals from the community and compared the results with those reported previously with non-Latino clinical populations. Discrepant findings have been reported with respect to the factor structure of the CDS. We performed exploratory and confirmatory factor analysis on the CDS items and compare our results with published analysis in other populations. Results revealed that the psychometric properties of the CDS, such as reliability, seem adequate, although the factor structure of the CDS seems to be inconsistent across studies. We selected a four-factor solution, which was most parsimonious and best fit our data. Furthermore, we obtained a moderate, statistically significant relationship (r = 0.64, p =.001) between the CDS and the Dissociative Experiences Scale (DES). Our results, utilizing a non-clinical sample of Puerto Rican adults, suggest that depersonalization experiences can be reliably measured in a Latino and Spanish speaking population.Journal of Trauma & Dissociation 11/2013; DOI:10.1080/15299732.2013.856370 · 1.72 Impact Factor
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ABSTRACT: Describing, understanding, and explaining subjective experience in depression is a great challenge for psychopathology. Attempts to uncover neurobiological mechanisms of those experiences are in need of theoretical concepts that are able to bridge phenomenological descriptions and neurocognitive approaches, which allow us to measure indicators of those experiences in quantitative terms. Based on our own on going work with patients who suffer from depersonalization disorder (DPD) and describe their experience as flat and detached from self, body, and world, we introduce the idea of phenomenal depth as such a concept. Phenomenal depth is conceptualized as a dimension inherent to all experiences, describing the relatedness of one's self with one's mental processes, body, and the world. More precisely, it captures the experience of this relatedness and embeddedness of one's experiences, and it is thus a meta- or secondorder experience. The psychopathology of DPD patients can be understood very generally as an instance of reduced phenomenal depth. We will argue that similar experiences in depression can also be understood as a reduction in phenomenal depth. We relate those ideas to neurocognitive studies of perception, emotion regulation, and the idea of predictive coding. Finally, we will speculate about possible neurobiological underpinnings of the dimension of phenomenal depth.Journal of Consciousness Studies 07/2013; 20(7-8):269-291. · 0.77 Impact Factor