Illness perceptions in depersonalization disorder: testing an illness attribution model

Depersonalization disorder (DPD) remains poorly understood and controversial in terms of diagnosis and treatment. Little is known about the cognitive representation of this disorder. In this study, 80 participants with DPD were assessed using the Revised Illness Perception Questionnaire to determine the nature of their perceptions, causal attributions and whether these correlate with levels of depersonalization and affect. Illness perceptions were generally negative; the nature of symptoms was described as mainly psychological but causal attributions were equally divided between psychological and physical. Over half of the sample believed that symptoms were due to ‘physical changes in the brain’. A strong illness identity, psychological illness attributions and high levels of depression were associated with greater depersonalization disorder severity. High levels of anxiety were also prevalent but the relationship between anxiety and depersonalization was unclear. The findings offer some support for a cognitive model of understanding depersonalization disorder, namely that attribution processes are linked to perceived symptom severity and a wide range of experiences come to be seen as part of the disorder. Copyright © 2007 John Wiley & Sons, Ltd.