Critchley Hugo D, Eccles Jessica, Garfinkel Sarah N
Department of Psychiatry, Brighton and Sussex Medical School, Brighton, UK; Sackler Centre for Consciousness Science, University of Sussex, UK.
Handb Clin Neurol. 2013;117:59-77. doi: 10.1016/B978-0-444-53491-0.00006-7.
The mind and body are intrinsically and dynamically coupled. Perceptions, thoughts and feelings change, and respond to, the state of the body. This chapter describes the integration of cognitive and affective processes with the autonomic control of bodily arousal, focusing on reciprocal effects of autonomic responses on decision making, error detection, memory and emotions. Neuroimaging techniques are beginning to detail the neuronal substrates mediating these interactions between mental and physiological states, implicating cortical regions (specifically insular and cingulate cortices) alongside subcortical (amygdala) and brainstem (notably dorsal pons) in these mechanisms. The extent to which bodily states influence mental processes is determined in part by "interoceptive sensitivity," an index of individual differences in the ability to detect one's own bodily sensations. Moreover, the misidentification or misattribution of interoceptive responses is implicated in a number of pathologies such as depersonalization, schizophrenia, and anxiety. Increasing knowledge of the mechanisms of body-mind interactions has wide ranging implications, from decision making to empathy, and may serve elucidate potential avenues of intervention for stress-sensitive conditions in which psychological, cognitive, and emotional factors impact on the expression of physical symptoms.
身心在本质上是动态耦合的。感知、思想和情感会随着身体状态的变化而改变并做出反应。本章描述了认知和情感过程与身体唤醒自主控制的整合，重点关注自主反应对决策、错误检测、记忆和情感的相互影响。神经成像技术开始详细揭示介导心理与生理状态之间这些相互作用的神经元基质，表明这些机制涉及皮质区域（特别是脑岛和扣带回皮质）以及皮质下（杏仁核）和脑干（特别是背侧脑桥）区域。身体状态对心理过程的影响程度部分由“内感受敏感性”决定，这是检测自身身体感觉能力个体差异的一个指标。此外，内感受反应的错误识别或错误归因与人格解体、精神分裂症和焦虑等多种病理状况有关。对身心相互作用机制的认识不断增加，其影响广泛，从决策到同理心，并且可能有助于阐明心理、认知和情感因素影响身体症状表达的应激敏感状况的潜在干预途径。
