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Neurodevelopmental origins of abnormal cortical morphology in dissociative identity disorder

Research output: Contribution to journalArticle

A. A. T. S. Reinders, S. Chalavi, Y. R. Schlumpf, E. M. Vissia, E. R. S. Nijenhuis, L. Jäncke, D. J. Veltman, C. Ecker

Original languageEnglish
Pages (from-to)157-170
JournalActa Psychiatrica Scandinavica
Issue number2
Early online date27 Nov 2017
Publication statusPublished - Feb 2018


  • Neurodevelopmental origins_REINDERS_Accepted9November2017_GREEN AAM

    Neurodevelopmental_origins_REINDERS_Accepted9November2017_GREEN_AAM.pdf, 1 MB, application/pdf


    Accepted author manuscript

    This is the accepted version of the article, which will be published in final form at This article may be used for non-commercial purposes in accordance with the Wiley Self-Archiving Policy (

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Objective: To examine the two constitutes of cortical volume, that is, cortical thickness and surface area, in individuals with dissociative identity disorder (DID) with the view of gaining important novel insights into the underlying neurobiological mechanisms mediating DID.
Methods: The current study included 32 female patients with DID and 43 matched healthy controls. Between-group differences in cortical volume, thickness, and surface area, the degree of spatial overlap between differences in cortical thickness and surface area, and their relative contribution to differences in regional cortical volume were assessed using a novel spatially-unbiased vertex-wise approach. Whole-brain correlation analyses were performed between measures of cortical anatomy and dissociative symptoms and traumatization.
Results: Individuals with DID differed from controls in cortical volume, thickness, and surface area, with significantly decreased cortical thickness in the insula, anterior cingulate and parietal regions and reduced cortical surface area in temporal and orbitofrontal cortices. Abnormalities in cortical thickness and surface area shared only about 3% of all significantly different cerebral surface locations and involved distinct contributions to the abnormality of cortical volume in DID. Significant negative associations between abnormal brain morphology (surface area and cortical volume) and dissociative symptoms and early childhood traumatization (0 and 3 years of age) were found.
Conclusions: In DID, neuroanatomical areas with decreased cortical thickness and surface area are in different locations in the brain. As cortical thickness and surface area have distinct genetic and developmental origins, our findings may indicate that different neurobiological mechanisms and environmental factors impact on cortical morphology in DID, such as early childhood traumatization.

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