Depersonalization disorder as a systematic downregulation of interoceptive signals

Fedal Saini*, Sonia Ponzo, Francesco Silvestrin, Aikaterini Fotopoulou, Anthony David

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Depersonalisation disorder (DPD) is a psychopathological condition characterised by a feeling of detachment from one’s own body and surrounding, and it is understood as emerging from the downregulation of interoceptive afferents. However, the precise mechanisms that drive this ‘interoceptive silencing’ are yet to be clarified. Here we present a computational and neurobiologically plausible model of DPD within the active inference framework. Specifically, we describe DPD as arising from disrupted interoceptive processing at higher levels of the cortical hierarchy where the interoceptive and exteroceptive streams are integrated. We simulated the behaviour of an agent subjected to a situation of high interoceptive activation despite the absence of a perceivable threat in
the external environment. The simulation showed how a similar condition, if perceived as inescapable, would result in a downregulation of interoceptive signals, whilst leaving the exteroceptive ones unaffected. Such interoceptive silencing would force the agent to over-rely on exteroceptive information and would ultimately lead to the DPD phenomenology. Finally, our simulation shows
that repeated exposure to similar situations over time will lead the agent to increasingly disengage from bodily responses even in the face of a less triggering situation, explaining how a single episode of depersonalization can lead to chronic DPD.
Original languageEnglish
Article number22123 (2022)
Number of pages14
JournalNature Scientific Reports
Publication statusPublished - 21 Dec 2022


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