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Toward the Clarification of the Construct of Depersonalization and its Association With Affective and Cognitive Dysfunctions John R. Jacobs & Gregory B. Bovasso Published online: 10 Jun 2010.
To cite this article: John R. Jacobs & Gregory B. Bovasso (1992) Toward the Clarification of the Construct of Depersonalization and its Association With Affective and Cognitive Dysfunctions, Journal of Personality Assessment, 59:2, 352-365, DOI: 10.1207/s15327752jpa5902_11 To link to this article: http://dx.doi.org/10.1207/s15327752jpa5902_11
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JOURNAL OF PERSONALITY ASSESSMENT, 1992, 59(2), 352-365 Copyright @ 1992, Lawrence Erlbaum Associates, Inc.
Toward the Clarification of the Construct of Depersonalization and its Association With Affective and Cognitive Dysfunctions John R. Jacobs Downloaded by [University of Victoria] at 21:36 08 April 2015
Connecticut College
Gregory B. Bovasso Baylor University
Little consensus or systematic research exists regarding the symptoms that constitute depersonalization and its association with affective and perceptual dysfunctions. A scale was constructed to measure depersonalization experiences reported in the literature and four items representing psychotic symptoms. Five factors representing different types of depersonalization emerged: Inauthenticity, SelfNegation, Self-objectification, Derealization, and Body Detachment. Based on the factors, scales were constructed; these scales have internal consistency ranging from .78 to .84. Each of these factor scales was factorially distinguishable from psychosis and correlated between .48 and .58 with the Jackson and Messick (1972) Feelings of Unreality Scale, suggesting divergent and convergent validity. Inauthenticity, the most frequent and pervasive form of depersonalization experience, was best predicted by a cognitive style featuring intense, critical examination of self and others. In contrast, Self-Objectificationwas best ~redictedby thought disorganization and perceptual distortion and was experienced somewhat infrequently by relatively few subjects. All forms of depersonalization were associated with depression, except Inauthenticity.
Although the concept of depersonalization has been present in t h e medical literature for over 100 years, controversy and inconsistency surround the specific symptoms and secondary characteristics attributed t o depersonalization memiah, 1976). T h e American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-111-R]; 1987) defines depersonalization as "a loss of familiarity with both environment and self" and
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dere~li~ation as "a feeling of detachment from one's environment" (P. 47). This distinction dividing depersonalization experiences into two groups was made by Mayer-Gross (1935) and is a convenient categorization that is not based on empirical or clinical evidence. Over the past 50 years, researchers have argued that depersonalization consists of a variety of styles and symptoms (Levy & Wachtel, 1978). However, little empirical research has been done to provide guidelines for the symptoms that should or should not be attributed to depersonalization. Furthermore, the lack of reliable measures of depersonalization has resulted in conflicting repoxts of depersonalization's attributes, incidence, re valence, and relationship to other psychopathologies (Bernstein & Putrnan, 1986; Levy & Wachtel, 1978). The only objective scale for assessing depersonalization (Dixon, 1963) has weak validity (Truemam, 1984). In their review of the depersonalization literature, Levy and Wachtel(1978) discussed the diverse types of symptoms attributed to depersonalization. These include loss of a sense of genuineness or authenticity (Eliot, Rosenberg, & Wagner, 1984; Schmiddleberg, 1957);failure to acknowledge one's experience of emotions or witness of an event (Bird, 1957; Myers & Grant, 1972; Talland, 1968); the perceptions of familiar objects or persons as strange (Roberts, 1960); loss of emotions; gross disorientation or the feeling of being dead (Ackner, 1954; Federn, 1953; Munich, 1978; Oberdorf, 1950);and the perception of the body as strange, detached, or not belonging to the owner (Jacobson, 1964). Other symptoms attributed to depersonalization include self-observation (Stewart, 1964), autoscopic experiences (Grotstein, 1983), and changes in the perception of time (Roberts, 1960). The variety of symptoms attributed to depersonalization indicates a lack of consensus among researchers and suggests the possibility that depersonalization is a multidimensional rather than unitary construct. One form of clepersonalization-inauthentin'ty-involves the loss of genuineness or sense of authenticity in experiencing the self and interactions with others (Eliot et al., 1984; Schmiddleberg, 1957). Subjects with a sense of inauthenticity must remind themselves that they are having an experience. A second form of depersonalization-&realization-involves alterations in the perception of people and objects (Nemiah, 1976; Roberts, 1960). Flor example, subjects experiencing derealization may perceive friends to have changed and become unfamiIiar. A third major form of depersonalization-self-otljectification-involves a profound sense of disorientation in which the world is experienced as rapidly changing and basic distinctions between self and objects are blurred (Ackner, 1954; Federn, 1953; Jackson & Messick, 1972; Tucker, Harrow, & Quinlan, 1973). In addition, these individuals experience themselves as dead or numb or as inanimate objects. The fourth form of depersonalization-self-negationinvolves denial that one is performing certain actions or that one is witnessing
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certain events occurring in the environment which Talland (1968) and Myers and Grant (1972) referred to as a loss of recognition of personal identity, or self-negation. A fifth type of depersonalization-body detachment-involves the perception of the body as distorted or detached. The sense of one's body as strange, unfamiliar, or not belonging to the owner has been noted in case studies for 80 years (Bird, 1957; Dugas & Moutier, 1911; Jacobson, 1964; Mayer-Gross, 1935). Grotstein's (1983) work suggests that autoscopic experiences involving leaving the body or perceiving the self from a distance are related to other forms of body detachment. The absence of a reliable and comprehensive measure of depersonalization has resulted in uncertainty regarding the construct of depersonalization, as well as the estimation of its incidence and prevalence. The DSM-111-R states that a single episode of depersonalization may occur in up to 70% of young adults. Using Bernstein and Putnam's (1986) Dissociative Experiences Scale (DES) in a nonclinical Canadian sample, the prevalence of dissociative experiences ranged from 8% to 70% (Ross, Joshi, & Currie, 1990). However, the DES does not differentiate depersonalization from other dissociative disorders which vary in severity (e.g., Posttraumatic stress disorder and multiple personality disorder). The prevalence of depersonalization disorder, in which episodes are recurrent and sufficiently severe to cause distress and/or functional impairment, is unknown. Various types of depersonalization may be associated with different affective and ~ e r c e p a ldysfunctions. Levy and Wachtel (1978) and Taylor (1982) speculated that depersonalization may be related to two polar cognitive styles. One cognitive style involves a lack of vigilance to reality with emotions overriding logic. A second cognitive style involves a hypervigilance to reality and emotional detachment. A cognitive style marked by inattention to details and a breakdown of evidential reasoning has been associated with gross disorientation in the physical world (Ackner, 1954; Munich, 1978; Taylor, 1982; Tucker et al., 1973). In contrast, a cognitive style involving emotional detachment, critical examination of motivations, and orientation to detail has been associated with feelings of unreality involving a sense of inauthenticity (Eliot et al., 1984; Levy & Wachtel, 1978; Taylor, 1982; Torch, 1978). The relationship between depersonalization and depression also has been observed. Tucker et al. (1973), found that underlying depression was common to all patients complaining of depersonalization experiences. Nueller (1982) argued that the most commonly associated feature of depersonalization is depression. Jacobson (1964)proposed that depersonalization is directly related to depression as well as to preoccupation with the body. In the study, we attempts to assess the various types of depersonalization, their incidence and prevalence, and their association with various traits in a nonclinical population of college students. We hypothesized that the five forms
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of depersonalization just introduced will emerge. Inauthenticity will be most strongly associated with a cognitive style that is emotionally detached and detail oriented. Self-objectification will be most strongly associated with disorganizjed thinking, a cognitive style where aversive emotions impair judgments. Depression will be pervasively associated with the various types of depersonalization.
METHOD
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Subjects The subjects were 368 college students attending a large, urban, public university; they were sampled over several consecutive semesters. Approximately 751% of the subjects were women. The median age was 22, with 25% of the subjects 30 years old or above.
Measures A depersonalization scale was constructed which contained 32 items representing all symptoms in the clinical and experimental literature attributed to depersonalization. Included among these 32 items were the 12 items from Dixons' (1963) scale. Despite the problems with the validity of the Dixon scale, the scale's items were included in the current assessment to ensure the comprehensive inclusion of all experiences attributed to depersonalization. In addition, 4 items representing ~ s ~ c h o tsymptoms ic and 1 item representing a lie were included among the 32 items. Each depersonalization item required the subjects to indicate the frequency with which the experience described in the item occurred during the last 12 months. For each item, the subjects used a rating to indicate whether the experience had occurred never (O), yearly, at least once a year (I), monthly, at least once a month (2), weekly, at least once a week (3), or daily, at least once a day (4). If the experience did not occur during the last 12 months it was rated as (0). The Depersonalization scale was group administered during class periods; the researcher read instructions to the subjects and remained in the room to answer any questions about the form. Ten scales from the Differential Personality Inventory (DM; Jackson & Messick, 1972) were used to assess pathological traits associated with depersonalization. The DPI has been shown to be internally consistent and to have convergent and discriminant validity (Jackson & Carlson, 1973). The DPI has been validated against the Brief Psychiatric Rating Scale (Auld & Noel, 1984) and measures the same general domain of psychopathology as the Minnesota Multiphasic Personality Inventory (Jackson & Hoffman, 1987). The
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DPI was used here because its scales specifically measure phenomena most commonly reported to be associated with depersonalization. The 10 selected DPI scales measured Broodiness, Depression, Desocialization, Feelings of Unreality, Mood Fluctuation, Neurotic Disorganization, Thought Disorganization, Perceptual Distortion, Self-Depreciation, and Shallowness of Affect. The DM items were answered on a true-false basis. For each subject, a total score on each DPI scale was calculated. The DPI Infrequency and Defensiveness scales were also used. Defensiveness measures the tendency not to endorse items that are low in social desirability. Infrequency measures random or careless responding. DPI responses were obtained from 261 of the 368 subjects responding to the depersonalization items. The 107 subjects without DPI data were drawn from the same sample as the other subjects and are therefore comparable to the remainder of the subjects. These 107 subjects were not administered the DPI because of time constraints imposed by the class sessions in which testing occurred. Of the 261 subjects, only 15 subjects endorsed one of the five DPI Infrequency scale items, which was common in 50% or fewer of the subjects in the DM'S normative sample. These 15 subjects were therefore retained in the analysis. The only subjects dropped from the analysis were 11 of the total 368 subjects for whom depersonalization data were available who endorsed the depersonalization lie item.
RESULTS A principal components Factor Analysis with varimax rotation of the ratings of the 32 depersonalization items, 4 psychotic items, and the lie item, extracted nine factors with eigenvalues above 1, accounting for 60.5% of the total variance. A scale was computed for each factor by averaging the ratings of the items loading above .30 on each factor. Five of the nine scales represented items that have been attributed to depersonalization and were found to be internally consistent (i.e., having Cronbach alphas ranging from .78 to .84; see Table 1). Items representing psychosis loaded on separate factors independent of items attributed to depersonalization. The remaining factors, consisting of psychotic items, lie items, and single items, were not retained in further analyses. The five factors representing depersonalization were consistent with those hypothesized based on reports in the psychological literature. The first factor Inauthenticity -contains items related to a loss of genuineness and impairment in the ability to experience emotions. The second factor-Self-Negationcontains items representing the loss of recognition of the self as the person experiencing and perceiving. The third factor-Self-Objectification-contains items that reflect a gross disorientation in the physical world and the experience of the self as an inanimate object. The fourth factor-Derealization-contains
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TABLE 1 Items Loading on Depersonalization Factors Constituting Depersonalization Factor Scales Factor Scale 1: Inauthenticitya 1. When I am interacting with a person or doing an activity, I must tell myself that I am interacting with the person or doing the activity in order to experience it. 2. When I do things it takes a while for me to experience the feelings and sensations that usually accompany the action. 3. I feel that the words I utter are not genuine even though I am not deliberately falsifying them. 4. When I am d o q something I must stop and remind myself it is me who is performing the action. 5. I look at ~ e o p l eand I don't feel that they really are people. Factor Scale 2: self-Negationb 1. I have felt that it was not me who was witnessing a situation. 2. I have felt that it was not me who was experiencing a sensation. 3. I have felt that it was not me who was hearing a sound. 4. I have felt that it was not me who was experiencing an emotion. 5. I have felt that a situation in my life was not happening to me. Factor Scale 3: Self-ObjectificationC 1. When I close my eyes I feel that the world will actually look different when I open them. 2. I feel that I cannot distinguish myself from the objects around me. 3. Parts of my body seem like they are dead. 4. I feel that I am the only person ~nthe world. 5. I have felt like I was dead. Factor Scale 4: ~erealization~ 1. Friends and/or acquaintances have seemed changed and unfamiliar. 2. Things that I am usually familiar with have changed and seem strange. 3. I have felt that there was a wall of glass separating me from other people and the world. 4. Things around me have seemed to behave in a strange way. 5. I have felt that familiar things have seemed remote or d~stantor unnatural. Factor Scale 5: Body Detachmente 1. My body has felt as if it was not part of me. 2. I have felt detached from my body as if it was not part of myself. 3. I have felt distanced from myself as the world when I was about to recewe or received some mystical awareness. 4. I have felt like a stranger to myself. 5. I have felt like I left my body and was looking down at myself.
-
"31.2% of total variance, alpha = .79. b4.9% of total variance, alpha = .84. '4.5% of total variance, alpha = .78. d4.1% of total variance, alpha = .79. '3.6% of total variance, alpha = .130.
items regarding the sense that other people and objects are n o longer familiar. T h e fifth factor-Body Detachment-contains items related t o estrangement from one's body. Consistent with the DSM-III-R, these results indicate that depersonalization is relatively more common in young adults. Age was negatively correlated with
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each of the depersonalizationfactor scales. Also, men scored significantly higher than women on the Inauthenticity scale, F(1, 340) = 3.74, p < .05. The responses on the depersonalization factor scales were not biased by subject reactivity, as indicated by their nonsignificant correlations with responses on the DPI Defensiveness scale.
Depersonalization Incidence and Prevalence
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The items forming the five factor scales were used to classify the incidence and prevalence of depersonalization. For each of the five types of depersonalization, each of the subjects were classified into mutually exclusive incidence categories based on the frequency with which they reported depersonalizationexperiences. The subject categorization was performed in the following order:
1. Daily-The subjects reporting two or more daily depersonalization experiences.
2. Weekly-The
remaining subjects reporting two or more weekly depersonalization experiences. Also included as experiencing weekly depersonalization are subjects reporting one weekly and one daily experience. 3. Monthly-The remaining subjects reporting two or more monthly depersonalization experiences. Also included as experiencing yearly depersonalization are subjects reporting one monthly and one weekly experience and/or one monthly and one daily experience. 4. Yearly-The remaining subjects reporting two or more yearly depersonalization experiences. Also included as experiencing monthly depersonalization are subjects reporting one yearly and one monthly experience, one yearly and one weekly experience, and/or one yearly and one daily experience. 5. Never-The remaining subjects reporting less than two depersonalization experiences occurring daily, weekly, monthly, or ~early. For example, a subject classified as experiencing monthly inauthenticity could report on a monthly basis any two or more of the five experiences of inauthenticity measured by the first factor scale. Alternatively, a subject classified as experiencing monthly inauthenticity could report one monthly experience and one weekly experience and/or one monthly and one daily experience. This categorization scheme ensured that each subject was assigned to one discrete incidence category for each factor. The incidence and prevalence of depersonalization varied depending on the type of depersonalization(see Table 2). The DSM-111-R estimate of the incidence and prevalence of depersonalization appeared only accurate for derealization, which was found to be experienced at least twice yearly or more in approxi-
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TABLE 2
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Incidence and Prevalence of Depersonalization Measured by Each of the Factor Scale:; Depersonalization Incidence Factor Scale
Newer
Inauthenticity
158 42.9%
Self-Negation
157
Self-Objectification
249
Yearly
Monthly
Weekly
Daily
42.7% 67.7% Derealiiation
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Body Detachment
96
26.1% 177 48.1%
Note. N = 368.
mately 75% of the current sample. As stated in the DSM-Ill-R, depersonalization occurs at least once a year in approximately 70% of young adults. Over half of the population experiences inauthenticity, self-negation, or body detachment at least twice a year, whereas approximately one third of the population experiences self-objectification at least twice a year. Overall, derealization and to a lesser extent inauthenticity were the most common forms of depersonalization whereas self-objectification was the least common form of depersonalization. Derealization and Inauthenticity were experienced daily to weekly by approximately 14% of the subjects. In contrast, self-objectification was experienced daily to weekly by approximately 7% of th~e subjects. Co-occurrences of any two of the five types of depersonalization on a daily to weekly basis were extremely rare, ranging from 3 to 11 cases. This mutual exclusivity of the five factors was expected given the derivation of the factor scales based on a principal components extraction and orthogonal rotation.
Depersonalization and Pathology Each of the five depersonalization scales significantly and positively correlated with of the DPI scales, except for the Defensiveness, Desocialization, Familial Discord, and Shallow Affect scales (see Table 3). Stepwise multiple regression analyses were performed to identify the particular variables most strongly associated with the each of the different types of depersonalization. The dependent variables were the five depersonalization factor scales. The independent variables were age and each of the dispositions measured by the DPI that were significantly correlated with each of the depersonalization scales. The regression analysis indicated that the Feelings of Unreality scale was the
TABLE 3 Correlation of Depersonalization Factor Scales With DPI Scales
Depe7sunalization Factor Scalesa
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DPI Scale Broodiness Depression Desocialization Thought Disorganization Familial Discord Feelings of Unreality Mood Fluctuation Neurotic Disorganization Perceptual Distortion Self-Deprecation Shallow Affect Defensiveness Age
1
2
3
4
5
.38** .30** .17* .35** .OO .54** .27** .23* .36** .19* - .04 -.I0 - .19**
.31** .34** .06 .40** .07 .48** .25** .19* .29** .26** - .05 .04 - .24**
.37** .43** .17* .51** .07 .53** .35** .32** .39** .37** .O1 - .04 - .20**
.41** .41** .07 .41** .ll .58** .41** .31** .31** .32** - .05 - .06 - .26**
.36** .42** .13* .39** .OO .51** .35** .30** .25** .23** - .03 -.16* - .22**
Note. Two-tailed tests with pairwise deletion of missing cases were used. n = 253. "Factor scale names are as follows: 1-Inauthenticity, 2-Self-Negation, 3-Self-objectification, 4-Derealization, and 5-Body Detachment.
TABLE 4 Stepwise Regression Analysis: Prediction of Depersonalization Factors Predictor Inauthenticitya Feelings of Unreality Broodiness Self-Negationb Feelings of Unreality Depression Self-Objectificationc Feelings of Unreality Thought Disorganization Depression Perceptual Distortion ~erealization~ Feelings of Unreality Depression Mood Fluctuation Body Detachmente Feelings of Unreality Depression Defensiveness
Beta
Partial Correlation
.46 .14
.43 .14
.41 .15
.39 .15
2.7 .18 .18 .14
2.4 .16 .17 .14
.43 .15 .I5
.4 1 .16 .16
.40 .25 -.I4
.40 .36 -.I7
"Multiple adjusted RZ = .30. bMultiple adjusted RZ = 25. 'Multiple adjusted RZ = .36. dMultiple adjusted R2 = .37. eMultiple adjusted R2 = .32.
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primary predictor of each depersonalization factor (see Table 4). Only the Broodiness scale was a secondary predictor of Inauthenticity. Depression was a secondary predictor of each of the four other types of depersonalization. Self-objectification was also predicted by the Thought Disorganization scale and the Perceptual Distortion scale. Derealization was also predicted by the Mood fluctuation scale. Less defensive subjects were more likely to report frequent Body Detachment.
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DISCUSSION Discussion of the results must first be qualified by the fact that a nonclinical sample was used to validate the depersonalization scales. The incidence and prevalence of the five types of depersonalization, as well as the relationship of the five types of depersonalization to various forms of pathology, may substantively differ in clinical populations. The results, such as the high incidence of inauthenticity, may only be applicable to college students and therefore require replication in a clinical sample. However, the high rate of dissociative disorders in the general population (Ross et al., 1990) makes the results of our study important due to their direct applicability to the general population. Overall, the depersonalization factors measured qualitatively different feelings of unreality which varied in their type and degree of associated psychopathology. The 25 items that loaded significantly on the five depersonalization subscales were characterized by a distortion of or an estrangement from reality. Items that involved only a heightened attention to reality (e.g., "I have felt I was observing myself participate in the world") failed to load on the depersonalization factors. On the other end of the continuum, items that represent psychotic symptoms, such as hallucinations or ideas of reference, loaded on a factor independent of the depersonalization factors. Psychotiic experiences have been distinguished from depersonalization since the earliest observations of depersonalization (Nemiah, 1976). The five types of depersonalization experiences measured by the factor scales correlated between .48 and .58 with Jackson and Messick's (1972) Feelings of Unreality scale. Correlations of approximately .5 were expected, because this scale represents not only depersonalization but more severe dissociative phenomena. Nine of 12 items from Dixon's (1963) depersonalization scale loaded only on the depersonalization factors of Derealization and Body Detachment. Dixon's items seem to represent only these two forms of depersonalization that account for the least amount of the variance in depersonalization. This finding suggests that Dixon's scale represents only a limited range of depersonalization experiences. As expected, five types of depersonalization emerged and were strongly associated with various perceptual and affective dysfunctions. Inauthenticity
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was strongly associated with broodiness, which supports speculation by Eliot et al. (1984), Levy and Wachtel(1978), and Taylor (1982). Broodiness involves an intense critical examination of the motivations of others. In addition, broody individuals tend to be distrustful and cautious about making personal disclosures. They are searching for information that confirms their suspicions and are detail oriented in at least this sphere of their mental life. Broody individuals may find it difficult to suspend their suspicions of others and allow themselves to be spontaneous in their emotional life. This dynamic might account for the impaired ability to experience emotions or sensations characteristic of Inauthenticity. Also, their distrust of others and usual reluctance to make self-disclosures might impair their ability to communicate intimate information. Because revealing personal information is less commonly engaged in by these individuals than by most others, the process of disclosure may be experienced as not quite authentic for broody individuals. Also, these individuals intensely and critically examine the motivations of others and might be more likely to doubt the genuineness of others' statements. In contrast to Inauthenticity, Self-objectification is predicted neither by scrutinization of reality nor by emotional detachment. Self-objectification is predicted by disorganized thinking and perceptual distortion. Thus, SelfObjectification may be associated with a cognitive style in which emotions are strong enough to interfere with the perception of and attention to details. These two traits reflect deficits in the ability to process information, resulting in cognitive and emotional confusion (Jackson & Messick, 1972). The individual with Self-Objectification reports becoming grossly disoriented in the external world and experiences himself or herself as being dead or as an inanimate object. Bird (1957) and Munich (1978) argued that failure to make basic distinctions among sensory input creates a gross disorientation that allows the individual to doubt reality and in turn defend against consequent aversive feelings. The experience of numbness or being dead may be the result of an implosion of intensely painful pmotions created by a situation prior to the depersonalization.Munich (1978)argued that self-objectificationcauses a breakdown in evidential reasoning that consequently intensifies depersonalization. However, depersonalization and disorganized thinking might also interact in facilitating and intensifying each other. Future research could be directed at specifying their association. Self-Objectificationmay be the most pathological form of depersonalization because the items involve the greatest distortion of reality. Studies (Ackner, 1954; Federn, 1953; Munich, 1978; Tucker et al., 1973) have found that clinical symptoms associated with self-objectification were characteristic of individuals diagnosed wirh severe character disorders. Depression predicted all forms of depersonalization, except Inauthenticity, suggesting that a lower level of emotional involvement with people and objects
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may be associated with a sense of unreality of self and others. Depression predicted depersonalization involving SelfcNegation, the denial of the self as the agent of its actions, and Body Detachment, the sense of the body as strangc: or detached. Derealization was ~redictedby both Depression and Mood Fluctuation. When the amount of affect usually associated with certain people and objects fluctuates (e.g., diminishes, intensifies), the reality of these people and objects may also change as they lose familiarity. The association between Body Detachment and depression lends supporlt to Jacobson's (1964) clinical speculation that depersonalization experiences involving the body are caused primarily by depression. Jacobson argued that when depression stems from unacceptable sexual and aggressive fantasies, depersonalization allows the individual to become detached from the source of aversive feelings whether by estrangement from or mystification of the body. Body detachment might also involve violations of self-expectation regardling the body and its performance of various activities. Dissatisfaction with the body image, whether involving weight or other elements of attractiveness, changes due to maturation, disease, accident, or other sources, might facilitate depression and, in turn, body detachment. The development of a scale for various subtyptes of depersonalization allows for a reasonable determination of its incidence and prevalence. In this nonclinical population, experiences of Inauthenticity, Self-Negation, Body Detachment, and Derealization appear to be relatively common. On a monthly basis or more, nearly one half of the subjects experienced Derealization, whereas Inauthenticity, Self-Negation, and Body Detachment were experienced on a monthly basis or more by 32.6%, 25.3%, and 28.0% of the subjects, respectively. Self-Objectification was the least common form of depersonalization, with only 15% of the subjects having experiences involving Self-objectification on a monthly basis or more. Although the five types of depersonalization appear to be discrete, their relationship with different forms of pathology suggests a continuum of pathological severity. Self-Objectification, the rarest type of depersonalization, appears to be the most severe form of depersonalization because of its relationship to Thought Disorganization, Depression, and Perceptual Distortion. Derealization, Self-Negation, and Body Detachment, which are all related to Depression, appear to be of comparatively moderate severity. Inauthenticity appears to be the least severe form of depersonalization. Future research employing both clinical and nonclinical populations rnay explore the specific types of depersonalization that are commonly associated with different types of psychopathology. In addition, an objective scale for the measurement of depersonalization and its subtypes permits further research to establish the number and severity of depersonalization episodes that rnay warrant the diagnosis of depersonalization disorder.
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REFERENCES Ackner, B. (1954). Depersonalization. Joumal of Mental Science, 31, 838-872. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author. Auld, F., & Noel, M. C. (1984). Further evidence of the validity of the Differential Personality Inventory. Academic Psychology Bulletm, 6, 11-19. Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Diseases, 174, 727-735. Bird, B. (1957). Feelings of unreality. International Journal of Psycho-Analysis, 38, 256-265. Dixon, J. (1963).Depersonalization in a non-clinical sample. British Jarma1of Psychiatry, 78,235-242. Dugas, L., & Moutier, F. (1911). La depersonnalisation [Depersonalization]. Paris: Felix Alcan. Eliot, G., Rosenberg, M., & Wagner, M. (1984). Transient depersonalization in youth. Social Psychology Quarterly, 74, 115-129. Fedem, P. (1953). Ego psychology and psychoses. London: Imago. Grotstein, J. S. (1983). Autoscopy: The experience of oneself as a double. Hillstde Journal of Clinzcal Psychiatry, 5, 259-304. Jackson, D. N., & Carlson, D. (1973). Convergent and discriminant validation of the Differential Personality Inventory. Journal of Chnical Psychology, 29, 214-219. Jackson, D. N., & Hoffman, H. (1987). Common dimensions of psychopathology from the MMPI and the Basic Personality Inventory. Journal of Clinical Psychology, 43(6), 661-669. Jackson, D. N., & Messick, S. (1972). Differential Personality Inventmy. Cleveland: Ohio Psychological Corporation. Jacobson, E. (1964). The self and object world. New York: International University Press. Levy, J., & Wachtel, P. (1978). Depersonalization: An effort at clarification. American Journal of Psychoanalysis, 38, 291-300. Mayer-Gross, W. (1935). O n depersonalization. British Journal of Meciical Psychology, 15, 103-135. Munich, R. (1978). Depersonalization in a female adolescent. lnternational Journal of Psychoanalytic Psychotherapy, 6, 187-199. Myers, C., &Grant, C. (1972). A study of depersonalizationin students. British Journal of Psychiatry, 121, 59-65. Nemiah, J. C. (1976). Depersonalization neurosis. In H. I. Kaplan & B. Sadoch (Eds.), The comprehensive textbook of pochtatry (pp. 1268-1273). New York: Basic Books. Nueller, Y. L. (1982). Depersonalization: Symptoms, meanings, therapy. ACTA Psychiatrica Scandinavica, 66, 451-458. Oberdorf, C. P. (1950). The role of anxiety in depersonalization. International Journal of PsychoAnalysis, 31, 1-5. Roberts, W. (1960). Normal and abnormal depersonalization. Journal of Mental Science, 101, 478-493. Ross, C. A., Joshi, S., & Currie, R. (1990). Dissociative experiences in the general population. American Journal of Psychiatry, 147, 1547-1552. Schmiddleberg, M. (1957). Hypocracy, detachment, and adaptation. Psychoanalytic Revtew, 44, 401-409. Stewart, W. A. (1964). A panel discussion on depersonalization. Journal of the Amerzcan Psychoanalytic Associatton, 12, 171-186. Talland, G. (1968). Disorders of memory and learning. Harmondsworth, England: Penguin. Taylor, K. (1982). Depersonalization m the light of Brentano's phenomenology. Bntlsh Journal of Medical Psychology, 55, 297-306. Torch, E. M. (1978). Review of the relationshlp between obsession and depersonalization. ACTA Psychiatr~caScandinavia, 58, 191-198.
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Tucker, G. J., Harrow, M., & Quinlan, D. (1973). Depersonalization, dysphoria, and thought disturbance. American Journal of Psychiatry, 130, 702-706. Truemen, D. (1984). Depersonalization in a college sample. Journal of General Psychology, j!4, 980-989.
Gregory Bovasso 1320 Hidden Ridge Apartment 3 116 Irving, TX 75038
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Received October 23, 1.991 Revised December 23, 1991
Journal of Personality Assessment Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hjpa20
Toward the Clarification of the Construct of Depersonalization and its Association With Affective and Cognitive Dysfunctions John R. Jacobs & Gregory B. Bovasso Published online: 10 Jun 2010.
To cite this article: John R. Jacobs & Gregory B. Bovasso (1992) Toward the Clarification of the Construct of Depersonalization and its Association With Affective and Cognitive Dysfunctions, Journal of Personality Assessment, 59:2, 352-365, DOI: 10.1207/s15327752jpa5902_11 To link to this article: http://dx.doi.org/10.1207/s15327752jpa5902_11
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JOURNAL OF PERSONALITY ASSESSMENT, 1992, 59(2), 352-365 Copyright @ 1992, Lawrence Erlbaum Associates, Inc.
Toward the Clarification of the Construct of Depersonalization and its Association With Affective and Cognitive Dysfunctions John R. Jacobs Downloaded by [University of Victoria] at 21:36 08 April 2015
Connecticut College
Gregory B. Bovasso Baylor University
Little consensus or systematic research exists regarding the symptoms that constitute depersonalization and its association with affective and perceptual dysfunctions. A scale was constructed to measure depersonalization experiences reported in the literature and four items representing psychotic symptoms. Five factors representing different types of depersonalization emerged: Inauthenticity, SelfNegation, Self-objectification, Derealization, and Body Detachment. Based on the factors, scales were constructed; these scales have internal consistency ranging from .78 to .84. Each of these factor scales was factorially distinguishable from psychosis and correlated between .48 and .58 with the Jackson and Messick (1972) Feelings of Unreality Scale, suggesting divergent and convergent validity. Inauthenticity, the most frequent and pervasive form of depersonalization experience, was best predicted by a cognitive style featuring intense, critical examination of self and others. In contrast, Self-Objectificationwas best ~redictedby thought disorganization and perceptual distortion and was experienced somewhat infrequently by relatively few subjects. All forms of depersonalization were associated with depression, except Inauthenticity.
Although the concept of depersonalization has been present in t h e medical literature for over 100 years, controversy and inconsistency surround the specific symptoms and secondary characteristics attributed t o depersonalization memiah, 1976). T h e American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-111-R]; 1987) defines depersonalization as "a loss of familiarity with both environment and self" and
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dere~li~ation as "a feeling of detachment from one's environment" (P. 47). This distinction dividing depersonalization experiences into two groups was made by Mayer-Gross (1935) and is a convenient categorization that is not based on empirical or clinical evidence. Over the past 50 years, researchers have argued that depersonalization consists of a variety of styles and symptoms (Levy & Wachtel, 1978). However, little empirical research has been done to provide guidelines for the symptoms that should or should not be attributed to depersonalization. Furthermore, the lack of reliable measures of depersonalization has resulted in conflicting repoxts of depersonalization's attributes, incidence, re valence, and relationship to other psychopathologies (Bernstein & Putrnan, 1986; Levy & Wachtel, 1978). The only objective scale for assessing depersonalization (Dixon, 1963) has weak validity (Truemam, 1984). In their review of the depersonalization literature, Levy and Wachtel(1978) discussed the diverse types of symptoms attributed to depersonalization. These include loss of a sense of genuineness or authenticity (Eliot, Rosenberg, & Wagner, 1984; Schmiddleberg, 1957);failure to acknowledge one's experience of emotions or witness of an event (Bird, 1957; Myers & Grant, 1972; Talland, 1968); the perceptions of familiar objects or persons as strange (Roberts, 1960); loss of emotions; gross disorientation or the feeling of being dead (Ackner, 1954; Federn, 1953; Munich, 1978; Oberdorf, 1950);and the perception of the body as strange, detached, or not belonging to the owner (Jacobson, 1964). Other symptoms attributed to depersonalization include self-observation (Stewart, 1964), autoscopic experiences (Grotstein, 1983), and changes in the perception of time (Roberts, 1960). The variety of symptoms attributed to depersonalization indicates a lack of consensus among researchers and suggests the possibility that depersonalization is a multidimensional rather than unitary construct. One form of clepersonalization-inauthentin'ty-involves the loss of genuineness or sense of authenticity in experiencing the self and interactions with others (Eliot et al., 1984; Schmiddleberg, 1957). Subjects with a sense of inauthenticity must remind themselves that they are having an experience. A second form of depersonalization-&realization-involves alterations in the perception of people and objects (Nemiah, 1976; Roberts, 1960). Flor example, subjects experiencing derealization may perceive friends to have changed and become unfamiIiar. A third major form of depersonalization-self-otljectification-involves a profound sense of disorientation in which the world is experienced as rapidly changing and basic distinctions between self and objects are blurred (Ackner, 1954; Federn, 1953; Jackson & Messick, 1972; Tucker, Harrow, & Quinlan, 1973). In addition, these individuals experience themselves as dead or numb or as inanimate objects. The fourth form of depersonalization-self-negationinvolves denial that one is performing certain actions or that one is witnessing
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certain events occurring in the environment which Talland (1968) and Myers and Grant (1972) referred to as a loss of recognition of personal identity, or self-negation. A fifth type of depersonalization-body detachment-involves the perception of the body as distorted or detached. The sense of one's body as strange, unfamiliar, or not belonging to the owner has been noted in case studies for 80 years (Bird, 1957; Dugas & Moutier, 1911; Jacobson, 1964; Mayer-Gross, 1935). Grotstein's (1983) work suggests that autoscopic experiences involving leaving the body or perceiving the self from a distance are related to other forms of body detachment. The absence of a reliable and comprehensive measure of depersonalization has resulted in uncertainty regarding the construct of depersonalization, as well as the estimation of its incidence and prevalence. The DSM-111-R states that a single episode of depersonalization may occur in up to 70% of young adults. Using Bernstein and Putnam's (1986) Dissociative Experiences Scale (DES) in a nonclinical Canadian sample, the prevalence of dissociative experiences ranged from 8% to 70% (Ross, Joshi, & Currie, 1990). However, the DES does not differentiate depersonalization from other dissociative disorders which vary in severity (e.g., Posttraumatic stress disorder and multiple personality disorder). The prevalence of depersonalization disorder, in which episodes are recurrent and sufficiently severe to cause distress and/or functional impairment, is unknown. Various types of depersonalization may be associated with different affective and ~ e r c e p a ldysfunctions. Levy and Wachtel (1978) and Taylor (1982) speculated that depersonalization may be related to two polar cognitive styles. One cognitive style involves a lack of vigilance to reality with emotions overriding logic. A second cognitive style involves a hypervigilance to reality and emotional detachment. A cognitive style marked by inattention to details and a breakdown of evidential reasoning has been associated with gross disorientation in the physical world (Ackner, 1954; Munich, 1978; Taylor, 1982; Tucker et al., 1973). In contrast, a cognitive style involving emotional detachment, critical examination of motivations, and orientation to detail has been associated with feelings of unreality involving a sense of inauthenticity (Eliot et al., 1984; Levy & Wachtel, 1978; Taylor, 1982; Torch, 1978). The relationship between depersonalization and depression also has been observed. Tucker et al. (1973), found that underlying depression was common to all patients complaining of depersonalization experiences. Nueller (1982) argued that the most commonly associated feature of depersonalization is depression. Jacobson (1964)proposed that depersonalization is directly related to depression as well as to preoccupation with the body. In the study, we attempts to assess the various types of depersonalization, their incidence and prevalence, and their association with various traits in a nonclinical population of college students. We hypothesized that the five forms
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of depersonalization just introduced will emerge. Inauthenticity will be most strongly associated with a cognitive style that is emotionally detached and detail oriented. Self-objectification will be most strongly associated with disorganizjed thinking, a cognitive style where aversive emotions impair judgments. Depression will be pervasively associated with the various types of depersonalization.
METHOD
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Subjects The subjects were 368 college students attending a large, urban, public university; they were sampled over several consecutive semesters. Approximately 751% of the subjects were women. The median age was 22, with 25% of the subjects 30 years old or above.
Measures A depersonalization scale was constructed which contained 32 items representing all symptoms in the clinical and experimental literature attributed to depersonalization. Included among these 32 items were the 12 items from Dixons' (1963) scale. Despite the problems with the validity of the Dixon scale, the scale's items were included in the current assessment to ensure the comprehensive inclusion of all experiences attributed to depersonalization. In addition, 4 items representing ~ s ~ c h o tsymptoms ic and 1 item representing a lie were included among the 32 items. Each depersonalization item required the subjects to indicate the frequency with which the experience described in the item occurred during the last 12 months. For each item, the subjects used a rating to indicate whether the experience had occurred never (O), yearly, at least once a year (I), monthly, at least once a month (2), weekly, at least once a week (3), or daily, at least once a day (4). If the experience did not occur during the last 12 months it was rated as (0). The Depersonalization scale was group administered during class periods; the researcher read instructions to the subjects and remained in the room to answer any questions about the form. Ten scales from the Differential Personality Inventory (DM; Jackson & Messick, 1972) were used to assess pathological traits associated with depersonalization. The DPI has been shown to be internally consistent and to have convergent and discriminant validity (Jackson & Carlson, 1973). The DPI has been validated against the Brief Psychiatric Rating Scale (Auld & Noel, 1984) and measures the same general domain of psychopathology as the Minnesota Multiphasic Personality Inventory (Jackson & Hoffman, 1987). The
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DPI was used here because its scales specifically measure phenomena most commonly reported to be associated with depersonalization. The 10 selected DPI scales measured Broodiness, Depression, Desocialization, Feelings of Unreality, Mood Fluctuation, Neurotic Disorganization, Thought Disorganization, Perceptual Distortion, Self-Depreciation, and Shallowness of Affect. The DM items were answered on a true-false basis. For each subject, a total score on each DPI scale was calculated. The DPI Infrequency and Defensiveness scales were also used. Defensiveness measures the tendency not to endorse items that are low in social desirability. Infrequency measures random or careless responding. DPI responses were obtained from 261 of the 368 subjects responding to the depersonalization items. The 107 subjects without DPI data were drawn from the same sample as the other subjects and are therefore comparable to the remainder of the subjects. These 107 subjects were not administered the DPI because of time constraints imposed by the class sessions in which testing occurred. Of the 261 subjects, only 15 subjects endorsed one of the five DPI Infrequency scale items, which was common in 50% or fewer of the subjects in the DM'S normative sample. These 15 subjects were therefore retained in the analysis. The only subjects dropped from the analysis were 11 of the total 368 subjects for whom depersonalization data were available who endorsed the depersonalization lie item.
RESULTS A principal components Factor Analysis with varimax rotation of the ratings of the 32 depersonalization items, 4 psychotic items, and the lie item, extracted nine factors with eigenvalues above 1, accounting for 60.5% of the total variance. A scale was computed for each factor by averaging the ratings of the items loading above .30 on each factor. Five of the nine scales represented items that have been attributed to depersonalization and were found to be internally consistent (i.e., having Cronbach alphas ranging from .78 to .84; see Table 1). Items representing psychosis loaded on separate factors independent of items attributed to depersonalization. The remaining factors, consisting of psychotic items, lie items, and single items, were not retained in further analyses. The five factors representing depersonalization were consistent with those hypothesized based on reports in the psychological literature. The first factor Inauthenticity -contains items related to a loss of genuineness and impairment in the ability to experience emotions. The second factor-Self-Negationcontains items representing the loss of recognition of the self as the person experiencing and perceiving. The third factor-Self-Objectification-contains items that reflect a gross disorientation in the physical world and the experience of the self as an inanimate object. The fourth factor-Derealization-contains
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TABLE 1 Items Loading on Depersonalization Factors Constituting Depersonalization Factor Scales Factor Scale 1: Inauthenticitya 1. When I am interacting with a person or doing an activity, I must tell myself that I am interacting with the person or doing the activity in order to experience it. 2. When I do things it takes a while for me to experience the feelings and sensations that usually accompany the action. 3. I feel that the words I utter are not genuine even though I am not deliberately falsifying them. 4. When I am d o q something I must stop and remind myself it is me who is performing the action. 5. I look at ~ e o p l eand I don't feel that they really are people. Factor Scale 2: self-Negationb 1. I have felt that it was not me who was witnessing a situation. 2. I have felt that it was not me who was experiencing a sensation. 3. I have felt that it was not me who was hearing a sound. 4. I have felt that it was not me who was experiencing an emotion. 5. I have felt that a situation in my life was not happening to me. Factor Scale 3: Self-ObjectificationC 1. When I close my eyes I feel that the world will actually look different when I open them. 2. I feel that I cannot distinguish myself from the objects around me. 3. Parts of my body seem like they are dead. 4. I feel that I am the only person ~nthe world. 5. I have felt like I was dead. Factor Scale 4: ~erealization~ 1. Friends and/or acquaintances have seemed changed and unfamiliar. 2. Things that I am usually familiar with have changed and seem strange. 3. I have felt that there was a wall of glass separating me from other people and the world. 4. Things around me have seemed to behave in a strange way. 5. I have felt that familiar things have seemed remote or d~stantor unnatural. Factor Scale 5: Body Detachmente 1. My body has felt as if it was not part of me. 2. I have felt detached from my body as if it was not part of myself. 3. I have felt distanced from myself as the world when I was about to recewe or received some mystical awareness. 4. I have felt like a stranger to myself. 5. I have felt like I left my body and was looking down at myself.
-
"31.2% of total variance, alpha = .79. b4.9% of total variance, alpha = .84. '4.5% of total variance, alpha = .78. d4.1% of total variance, alpha = .79. '3.6% of total variance, alpha = .130.
items regarding the sense that other people and objects are n o longer familiar. T h e fifth factor-Body Detachment-contains items related t o estrangement from one's body. Consistent with the DSM-III-R, these results indicate that depersonalization is relatively more common in young adults. Age was negatively correlated with
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each of the depersonalizationfactor scales. Also, men scored significantly higher than women on the Inauthenticity scale, F(1, 340) = 3.74, p < .05. The responses on the depersonalization factor scales were not biased by subject reactivity, as indicated by their nonsignificant correlations with responses on the DPI Defensiveness scale.
Depersonalization Incidence and Prevalence
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The items forming the five factor scales were used to classify the incidence and prevalence of depersonalization. For each of the five types of depersonalization, each of the subjects were classified into mutually exclusive incidence categories based on the frequency with which they reported depersonalizationexperiences. The subject categorization was performed in the following order:
1. Daily-The subjects reporting two or more daily depersonalization experiences.
2. Weekly-The
remaining subjects reporting two or more weekly depersonalization experiences. Also included as experiencing weekly depersonalization are subjects reporting one weekly and one daily experience. 3. Monthly-The remaining subjects reporting two or more monthly depersonalization experiences. Also included as experiencing yearly depersonalization are subjects reporting one monthly and one weekly experience and/or one monthly and one daily experience. 4. Yearly-The remaining subjects reporting two or more yearly depersonalization experiences. Also included as experiencing monthly depersonalization are subjects reporting one yearly and one monthly experience, one yearly and one weekly experience, and/or one yearly and one daily experience. 5. Never-The remaining subjects reporting less than two depersonalization experiences occurring daily, weekly, monthly, or ~early. For example, a subject classified as experiencing monthly inauthenticity could report on a monthly basis any two or more of the five experiences of inauthenticity measured by the first factor scale. Alternatively, a subject classified as experiencing monthly inauthenticity could report one monthly experience and one weekly experience and/or one monthly and one daily experience. This categorization scheme ensured that each subject was assigned to one discrete incidence category for each factor. The incidence and prevalence of depersonalization varied depending on the type of depersonalization(see Table 2). The DSM-111-R estimate of the incidence and prevalence of depersonalization appeared only accurate for derealization, which was found to be experienced at least twice yearly or more in approxi-
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TABLE 2
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Incidence and Prevalence of Depersonalization Measured by Each of the Factor Scale:; Depersonalization Incidence Factor Scale
Newer
Inauthenticity
158 42.9%
Self-Negation
157
Self-Objectification
249
Yearly
Monthly
Weekly
Daily
42.7% 67.7% Derealiiation
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Body Detachment
96
26.1% 177 48.1%
Note. N = 368.
mately 75% of the current sample. As stated in the DSM-Ill-R, depersonalization occurs at least once a year in approximately 70% of young adults. Over half of the population experiences inauthenticity, self-negation, or body detachment at least twice a year, whereas approximately one third of the population experiences self-objectification at least twice a year. Overall, derealization and to a lesser extent inauthenticity were the most common forms of depersonalization whereas self-objectification was the least common form of depersonalization. Derealization and Inauthenticity were experienced daily to weekly by approximately 14% of the subjects. In contrast, self-objectification was experienced daily to weekly by approximately 7% of th~e subjects. Co-occurrences of any two of the five types of depersonalization on a daily to weekly basis were extremely rare, ranging from 3 to 11 cases. This mutual exclusivity of the five factors was expected given the derivation of the factor scales based on a principal components extraction and orthogonal rotation.
Depersonalization and Pathology Each of the five depersonalization scales significantly and positively correlated with of the DPI scales, except for the Defensiveness, Desocialization, Familial Discord, and Shallow Affect scales (see Table 3). Stepwise multiple regression analyses were performed to identify the particular variables most strongly associated with the each of the different types of depersonalization. The dependent variables were the five depersonalization factor scales. The independent variables were age and each of the dispositions measured by the DPI that were significantly correlated with each of the depersonalization scales. The regression analysis indicated that the Feelings of Unreality scale was the
TABLE 3 Correlation of Depersonalization Factor Scales With DPI Scales
Depe7sunalization Factor Scalesa
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DPI Scale Broodiness Depression Desocialization Thought Disorganization Familial Discord Feelings of Unreality Mood Fluctuation Neurotic Disorganization Perceptual Distortion Self-Deprecation Shallow Affect Defensiveness Age
1
2
3
4
5
.38** .30** .17* .35** .OO .54** .27** .23* .36** .19* - .04 -.I0 - .19**
.31** .34** .06 .40** .07 .48** .25** .19* .29** .26** - .05 .04 - .24**
.37** .43** .17* .51** .07 .53** .35** .32** .39** .37** .O1 - .04 - .20**
.41** .41** .07 .41** .ll .58** .41** .31** .31** .32** - .05 - .06 - .26**
.36** .42** .13* .39** .OO .51** .35** .30** .25** .23** - .03 -.16* - .22**
Note. Two-tailed tests with pairwise deletion of missing cases were used. n = 253. "Factor scale names are as follows: 1-Inauthenticity, 2-Self-Negation, 3-Self-objectification, 4-Derealization, and 5-Body Detachment.
TABLE 4 Stepwise Regression Analysis: Prediction of Depersonalization Factors Predictor Inauthenticitya Feelings of Unreality Broodiness Self-Negationb Feelings of Unreality Depression Self-Objectificationc Feelings of Unreality Thought Disorganization Depression Perceptual Distortion ~erealization~ Feelings of Unreality Depression Mood Fluctuation Body Detachmente Feelings of Unreality Depression Defensiveness
Beta
Partial Correlation
.46 .14
.43 .14
.41 .15
.39 .15
2.7 .18 .18 .14
2.4 .16 .17 .14
.43 .15 .I5
.4 1 .16 .16
.40 .25 -.I4
.40 .36 -.I7
"Multiple adjusted RZ = .30. bMultiple adjusted RZ = 25. 'Multiple adjusted RZ = .36. dMultiple adjusted R2 = .37. eMultiple adjusted R2 = .32.
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primary predictor of each depersonalization factor (see Table 4). Only the Broodiness scale was a secondary predictor of Inauthenticity. Depression was a secondary predictor of each of the four other types of depersonalization. Self-objectification was also predicted by the Thought Disorganization scale and the Perceptual Distortion scale. Derealization was also predicted by the Mood fluctuation scale. Less defensive subjects were more likely to report frequent Body Detachment.
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DISCUSSION Discussion of the results must first be qualified by the fact that a nonclinical sample was used to validate the depersonalization scales. The incidence and prevalence of the five types of depersonalization, as well as the relationship of the five types of depersonalization to various forms of pathology, may substantively differ in clinical populations. The results, such as the high incidence of inauthenticity, may only be applicable to college students and therefore require replication in a clinical sample. However, the high rate of dissociative disorders in the general population (Ross et al., 1990) makes the results of our study important due to their direct applicability to the general population. Overall, the depersonalization factors measured qualitatively different feelings of unreality which varied in their type and degree of associated psychopathology. The 25 items that loaded significantly on the five depersonalization subscales were characterized by a distortion of or an estrangement from reality. Items that involved only a heightened attention to reality (e.g., "I have felt I was observing myself participate in the world") failed to load on the depersonalization factors. On the other end of the continuum, items that represent psychotic symptoms, such as hallucinations or ideas of reference, loaded on a factor independent of the depersonalization factors. Psychotiic experiences have been distinguished from depersonalization since the earliest observations of depersonalization (Nemiah, 1976). The five types of depersonalization experiences measured by the factor scales correlated between .48 and .58 with Jackson and Messick's (1972) Feelings of Unreality scale. Correlations of approximately .5 were expected, because this scale represents not only depersonalization but more severe dissociative phenomena. Nine of 12 items from Dixon's (1963) depersonalization scale loaded only on the depersonalization factors of Derealization and Body Detachment. Dixon's items seem to represent only these two forms of depersonalization that account for the least amount of the variance in depersonalization. This finding suggests that Dixon's scale represents only a limited range of depersonalization experiences. As expected, five types of depersonalization emerged and were strongly associated with various perceptual and affective dysfunctions. Inauthenticity
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was strongly associated with broodiness, which supports speculation by Eliot et al. (1984), Levy and Wachtel(1978), and Taylor (1982). Broodiness involves an intense critical examination of the motivations of others. In addition, broody individuals tend to be distrustful and cautious about making personal disclosures. They are searching for information that confirms their suspicions and are detail oriented in at least this sphere of their mental life. Broody individuals may find it difficult to suspend their suspicions of others and allow themselves to be spontaneous in their emotional life. This dynamic might account for the impaired ability to experience emotions or sensations characteristic of Inauthenticity. Also, their distrust of others and usual reluctance to make self-disclosures might impair their ability to communicate intimate information. Because revealing personal information is less commonly engaged in by these individuals than by most others, the process of disclosure may be experienced as not quite authentic for broody individuals. Also, these individuals intensely and critically examine the motivations of others and might be more likely to doubt the genuineness of others' statements. In contrast to Inauthenticity, Self-objectification is predicted neither by scrutinization of reality nor by emotional detachment. Self-objectification is predicted by disorganized thinking and perceptual distortion. Thus, SelfObjectification may be associated with a cognitive style in which emotions are strong enough to interfere with the perception of and attention to details. These two traits reflect deficits in the ability to process information, resulting in cognitive and emotional confusion (Jackson & Messick, 1972). The individual with Self-Objectification reports becoming grossly disoriented in the external world and experiences himself or herself as being dead or as an inanimate object. Bird (1957) and Munich (1978) argued that failure to make basic distinctions among sensory input creates a gross disorientation that allows the individual to doubt reality and in turn defend against consequent aversive feelings. The experience of numbness or being dead may be the result of an implosion of intensely painful pmotions created by a situation prior to the depersonalization.Munich (1978)argued that self-objectificationcauses a breakdown in evidential reasoning that consequently intensifies depersonalization. However, depersonalization and disorganized thinking might also interact in facilitating and intensifying each other. Future research could be directed at specifying their association. Self-Objectificationmay be the most pathological form of depersonalization because the items involve the greatest distortion of reality. Studies (Ackner, 1954; Federn, 1953; Munich, 1978; Tucker et al., 1973) have found that clinical symptoms associated with self-objectification were characteristic of individuals diagnosed wirh severe character disorders. Depression predicted all forms of depersonalization, except Inauthenticity, suggesting that a lower level of emotional involvement with people and objects
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may be associated with a sense of unreality of self and others. Depression predicted depersonalization involving SelfcNegation, the denial of the self as the agent of its actions, and Body Detachment, the sense of the body as strangc: or detached. Derealization was ~redictedby both Depression and Mood Fluctuation. When the amount of affect usually associated with certain people and objects fluctuates (e.g., diminishes, intensifies), the reality of these people and objects may also change as they lose familiarity. The association between Body Detachment and depression lends supporlt to Jacobson's (1964) clinical speculation that depersonalization experiences involving the body are caused primarily by depression. Jacobson argued that when depression stems from unacceptable sexual and aggressive fantasies, depersonalization allows the individual to become detached from the source of aversive feelings whether by estrangement from or mystification of the body. Body detachment might also involve violations of self-expectation regardling the body and its performance of various activities. Dissatisfaction with the body image, whether involving weight or other elements of attractiveness, changes due to maturation, disease, accident, or other sources, might facilitate depression and, in turn, body detachment. The development of a scale for various subtyptes of depersonalization allows for a reasonable determination of its incidence and prevalence. In this nonclinical population, experiences of Inauthenticity, Self-Negation, Body Detachment, and Derealization appear to be relatively common. On a monthly basis or more, nearly one half of the subjects experienced Derealization, whereas Inauthenticity, Self-Negation, and Body Detachment were experienced on a monthly basis or more by 32.6%, 25.3%, and 28.0% of the subjects, respectively. Self-Objectification was the least common form of depersonalization, with only 15% of the subjects having experiences involving Self-objectification on a monthly basis or more. Although the five types of depersonalization appear to be discrete, their relationship with different forms of pathology suggests a continuum of pathological severity. Self-Objectification, the rarest type of depersonalization, appears to be the most severe form of depersonalization because of its relationship to Thought Disorganization, Depression, and Perceptual Distortion. Derealization, Self-Negation, and Body Detachment, which are all related to Depression, appear to be of comparatively moderate severity. Inauthenticity appears to be the least severe form of depersonalization. Future research employing both clinical and nonclinical populations rnay explore the specific types of depersonalization that are commonly associated with different types of psychopathology. In addition, an objective scale for the measurement of depersonalization and its subtypes permits further research to establish the number and severity of depersonalization episodes that rnay warrant the diagnosis of depersonalization disorder.
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Tucker, G. J., Harrow, M., & Quinlan, D. (1973). Depersonalization, dysphoria, and thought disturbance. American Journal of Psychiatry, 130, 702-706. Truemen, D. (1984). Depersonalization in a college sample. Journal of General Psychology, j!4, 980-989.
Gregory Bovasso 1320 Hidden Ridge Apartment 3 116 Irving, TX 75038
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Received October 23, 1.991 Revised December 23, 1991
