Main effects.

<p>Overview of brain areas with statistically significant cerebral blood flow changes when comparing DID patients to high or low DID simulating controls (CH and CL respectively) for the dissociative identity state main effects.</p><p>DID  =  dissociative identity disorder patient group.</p><p>CH  =  high fantasy prone DID simulating control group.</p><p>CL  =  low fantasy prone DID simulating control group.</p>I<p> =  <i>A priori</i> brain areas based on Reinders et al. (2006) <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Reinders2" target="_blank">[40]</a>.</p>II<p> =  Brain areas found only in the DID within group analysis.</p>III<p> =  Brain areas found in the DID within group analysis, in the DID versus CH between group analysis <i>and</i> in the DID versus CL between group analysis.</p>IIIa<p> =  Brain areas found in the DID within group analysis <i>and</i> in the DID versus CH between group analysis.</p>IIIb<p> =  Brain areas found in the DID within group analysis <i>and</i> in the DID versus CL between group analysis.</p>IV<p> =  Brain areas not found in the DID within group analysis <i>but</i> appears in the between group analysis DID versus CH <i>or</i> DID versus CL.</p>1<p> =  first peak voxel in the cluster of the specified size.</p>2<p> =  second peak voxel in the cluster of the specified size.</p>3<p> =  third peak voxel in the cluster of the specified size.</p>**<p> =  whole brain multiple comparison correction (<i>p</i><0.05) using false discovery rate statistics <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Genovese1" target="_blank">[85]</a>.</p>*<p> =  region of interest multiple comparison correction (<i>p</i><0.05) using false discovery rate statistics <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Genovese1" target="_blank">[85]</a>.</p>u<p> =  Callosomarginal sulcus (SCM) ( =  Cingulate sulcus).</p>v<p> =  Supramarginal gyrus (Rostral I. Parietal Lobule).</p><p>(x, y, z)  =  MNI coordinates in mm.</p><p>L/R  =  Left/Right.</p><p>kE  =  clustersize in voxels (one voxel is 2×2×2 mm).</p><p>NIS  =  neutral identity state.</p><p>TIS  =  trauma-related identity state.</p><p>BA  =  Brodmann area.</p><p>I.  =  inferior; M.  =  middle; S.  =  superior.</p

“Glass brain” renderings show differences in the processing of the trauma-related text (indicated with a small ‘t’) between the trauma-related identity state (TIS) and the neutral identity state (NIS).

<p>Differences in regional cerebral bloodflow patterns for the dissociative identity disorder (DID) group (left) and the comparison of this group to the high (middle) and low (right) fantasy prone DID simulating controls (CH and CL respectively) are depicted. See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone-0039279-t004" target="_blank">Table 4</a> for the specific areas.</p

“Glass brain” renderings show differences in the processing of the trauma-related text (indicated with a small ‘t’) and the neutral text (indicated with a small ‘n’) within the trauma-related identity state (TIS).

<p>Differences in regional cerebral blood flow patterns for the dissociative identity disorder (DID) group (left) and the comparison of this group to the high (middle) and low (right) fantasy prone DID simulating controls (CH and CL respectively) are depicted. See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone-0039279-t003" target="_blank">Table 3</a> for the specific areas.</p

Memory script effects between dissociative identity states.

<p>Overview of brain areas with statistically significant cerebral blood flow changes when comparing DID patients to high or low DID simulating controls (CH and CL respectively) for the trauma-related memory script effects between dissociative identity state.</p><p>DID  =  dissociative identity disorder patient group.</p><p>CH  =  high fantasy prone DID simulating control group.</p><p>CL  =  low fantasy prone DID simulating control group.</p>I<p> =  <i>A priori</i> brain areas based on Reinders et al. (2006) <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Reinders2" target="_blank">[40]</a>.</p>II<p> =  Brain areas found only in the DID within group analysis.</p>III<p> =  Brain areas found in the DID within group analysis, in the DID versus CH between group analysis <i>and</i> in the DID versus CL between group analysis.</p>IIIa<p> =  Brain areas found in the DID within group analysis <i>and</i> in the DID versus CH between group analysis.</p>IIIb<p> =  Brain areas found in the DID within group analysis <i>and</i> in the DID versus CL between group analysis.</p>IV<p> =  Brain areas not found in the DID within group analysis <i>but</i> appear in the between group analysis DID versus CH <i>or</i> DID versus CL.</p>1<p> =  first peak voxel in the cluster of the specified size.</p>2<p> =  second peak voxel in the cluster of the specified size.</p>3<p> =  third peak voxel in the cluster of the specified size.</p>**<p> =  whole brain multiple comparison correction (<i>p</i><0.05) using false discovery rate statistics <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Genovese1" target="_blank">[85]</a>.</p>*<p> =  region of interest multiple comparison correction (<i>p</i><0.05) using false discovery rate statistics <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Genovese1" target="_blank">[85]</a>.</p>u<p> =  Callosomarginal sulcus (SCM) ( =  Cingulate sulcus).</p>v<p> =  Supramarginal gyrus (Rostral I. Parietal Lobule).</p><p>(x, y, z)  =  MNI coordinates in mm.</p><p>L/R  =  Left/Right.</p><p>kE  =  clustersize in voxels (one voxel is 2×2×2 mm).</p><p>NISn  =  neutral identity state exposed to the neutral memory script.</p><p>NISt  =  neutral identity state exposed to the trauma-related memory script.</p><p>TISn  =  trauma-related identity state exposed to the neutral memory script.</p><p>TISt  =  trauma-related identity state exposed to the trauma-related memory script.</p><p>BA  =  Brodmann area.</p><p>I.  =  inferior; M.  =  middle; S.  =  superior.</p

Memory script effects within dissociative identity state.

<p>Overview of brain areas with statistically significant cerebral blood flow changes when comparing DID patients to high or low DID simulating controls (CH and CL respectively) for the trauma-related memory script effects within dissociative identity state.</p><p>DID  =  dissociative identity disorder patient group.</p><p>CH  =  high fantasy prone DID simulating control group.</p><p>CL  =  low fantasy prone DID simulating control group.</p>I<p> =  <i>A priori</i> brain areas based on Reinders et al. (2006) <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Reinders2" target="_blank">[40]</a>.</p>II<p> =  Brain areas found only in the DID within group analysis.</p>III<p> =  Brain areas found in the DID within group analysis, in the DID versus CH between group analysis <i>and</i> in the DID versus CL between group analysis.</p>IIIa<p> =  Brain areas found in the DID within group analysis <i>and</i> in the DID versus CH between group analysis.</p>IIIb<p> =  Brain areas found in the DID within group analysis <i>and</i> in the DID versus CL between group analysis.</p>IV<p> =  Brain areas not found in the DID within group analysis <i>but</i> appear in the between group analysis DID versus CH <i>or</i> DID versus CL.</p>1<p> =  first peak voxel in the cluster of the specified size.</p>2<p> =  second peak voxel in the cluster of the specified size.</p>3<p> =  third peak voxel in the cluster of the specified size.</p>**<p> =  whole brain multiple comparison correction (<i>p</i><0.05) using false discovery rate statistics <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Genovese1" target="_blank">[85]</a>.</p>*<p> =  region of interest multiple comparison correction (<i>p</i><0.05) using false discovery rate statistics <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone.0039279-Genovese1" target="_blank">[85]</a>.</p>u<p> =  Callosomarginal sulcus (SCM) ( =  Cingulate sulcus).</p>v<p> =  Supramarginal gyrus (Rostral I. Parietal Lobule).</p><p>(x, y, z)  =  MNI coordinates in mm.</p><p>L/R  =  Left/Right.</p><p>kE  =  clustersize in voxels (one voxel is 2×2×2 mm).</p><p>NISn  =  neutral identity state exposed to the neutral memory script.</p><p>NISt  =  neutral identity state exposed to the trauma-related memory script.</p><p>TISn  =  trauma-related identity state exposed to the neutral memory script.</p><p>TISt  =  trauma-related identity state exposed to the trauma-related memory script.</p><p>BA  =  Brodmann area.</p><p>I.  =  inferior; M.  =  middle; S.  =  superior.</p

The brain areas indicated with the blue cross (i.e. the peak voxel) are (from top left to bottom right):

<p><b>the left amygdala, the left insula, the left precuneus, and the right occipitotemporal sulcus.</b> These areas have the most significant rCBF differences between the dissociative identity disorder patients and high and low fantasy prone DID simulating controls (CH and CL respectively) and is shown both in directionality, i.e. the bar graphs, and location, i.e. shown on a coronal overlay (left in the picture is left in the brain). Results show the differential processing of the trauma-related text versus the neutral text within the TIS, when comparing the DID groups to the high fantasy prone control group (left) and low fantasy prone control group (right).</p

Between group: Subjective and autonomic reactions.

<p>Factorial statistical analyses of the between group (DID versus high or low fantasy prone DID simulating healthy controls, respectively) subjective reactions (emotional and sensori-motor ratings) and autonomic (discrete heart rate, systolic and diastolic blood pressure and heart rate variability) measurements. The statistical analyses consist of the two main effects and the accompanying interaction effect. Statistical values are reported in <i>p</i> values.</p>**<p> =  <i>p</i><0.0083 (i.e., corrected for multiple comparisons).</p>*<p> =  <i>p</i><0.05 (i.e., uncorrected for multiple comparisons).</p><p>DID  =  dissociative identity disorder.</p><p>CH  =  high fantasy prone DID simulating controls.</p><p>CL  =  low fantasy prone DID simulating controls.</p><p>DIS  =  dissociative identity state.</p><p>DIS*Group  =  interaction effect.</p><p>MS  =  memory script.</p><p>MS*Group  =  interaction effect.</p><p>DIS * MS  =  interaction effect.</p><p>DIS*MS*Group  =  interaction effect.</p><p>HRV-AVG  =  average of normal-to-normal time intervals.</p

The brain areas indicated with the blue cross (i.e. the peak voxel) are (from top left to bottom right): the right caudate nucleus (dorsal part) (2x), the left precuneus, and the right occipitotemporal sulcus.

<p>These areas involve the most significant rCBF difference between the dissociative identity disorder patients and high and low fantasy prone DID simulating controls (CH and CL respectively) and is shown in both directionality, i.e. the bar graphs, and location, i.e. shown on a coronal overlay (left in the picture is left in the brain). Results show the differential processing of the trauma-related text between the TIS and the NIS, when comparing the DID groups to the high fantasy prone control group (left) and low fantasy prone control group (right).</p

“Glass brain” renderings showing the dissociative identity state main effects, both for the trauma-related identity state (TIS) and for the neutral identity state (NIS), for the dissociative identity disorder (DID) group (left) and the comparison of this group to the high (middle) and low (right) fantasy prone DID simulating controls (CH and CL respectively).

<p>See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039279#pone-0039279-t002" target="_blank">Table 2</a> for the specific areas.</p

Patient characteristics.

<p>Demographic patient overview; Patient ID, gender and age are indicated. Patient’s rating of ongoing pain prior to Quantitative Sensory Testing (QST) using a Numeric Rating scale (NRS) indicating “0” as “no pain” and “100” as the ‘‘most intense pain imaginable’’. Involved nerve indicates nerves (N.) or innervations area of nerves affected in relation to the cause of pain. Number of QST abnormalities refers to parameter exceeding CI 95% of z-scores (<−1.96 or >1.96) of values obtained from healthy volunteers for the affected (A.) and contralateral (C.) side of patients.</p