Ateş Çöl Işıl, Sönmez Mehmet Bülent, Vardar Mehmet Erdal
Clinic of Psychiatry, İnegöl State Hospital, Bursa, Turkey.
Department of Psychiatry, Trakya University School of Medicine, Edirne, Turkey.
Noro Psikiyatr Ars. 2016 Mar;53(1):17-22. doi: 10.5152/npa.2015.9898. Epub 2016 Mar 1.
Interoceptive awareness (IA) is defined as an ability to accurately perceive interoceptive processes, which comprise receiving, processing, and integrating body-relevant signals together with external stimuli. Interoceptive processes affect the motivated approach or avoidance behavior toward stimuli. Alcohol and other substances have effects on the autonomic system that result in altered interoceptive processes. Individuals who have disturbed IA may be at a higher risk of addiction because they are not able to utilize sufficiently body-relevant signals to guide their decision-making. The hypothesis that IA in alcohol-addicted patients would be affected and that the disturbed IA would be associated with alcohol craving was tested in this study.
The study was conducted with 55 patients diagnosed with alcohol addiction according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and who had been sober for at least two weeks and 52 non-addicted healthy controls. IA measurements were performed using the heartbeat perception performance method, which determines participants' awareness of their own heartbeat by comparing the number of subjectively perceived heartbeats with an objective heart rate measure recorded with ECG during four separate intervals. In addition, the Alcohol Use Disorders Identification Test (AUDIT), Penn Alcohol Craving Scale (PACS), and Obsessive Compulsive Drinking Scale (OCDS) were performed on the alcohol-addicted patient group.
IA scores were significantly lower in the alcohol-addicted patients than the control subjects. IA scores of alcohol-addicted patients were negatively correlated with the levels of alcohol craving sensations according to the PACS results.
Our results corroborate the suggestion that IA in alcohol-addicted patients would be affected and that poor IA would be associated with alcohol craving and could be a maintaining factor for drinking behavior.
内感受性觉知（IA）被定义为一种准确感知内感受性过程的能力，内感受性过程包括接收、处理和整合与身体相关的信号以及外部刺激。内感受性过程会影响对刺激的主动趋近或回避行为。酒精和其他物质会对自主神经系统产生影响，从而导致内感受性过程发生改变。内感受性觉知受到干扰的个体可能成瘾风险更高，因为他们无法充分利用与身体相关的信号来指导决策。本研究对酒精成瘾患者的内感受性觉知会受到影响以及受干扰的内感受性觉知会与酒精渴望相关这一假设进行了检验。
本研究对55名根据《精神障碍诊断与统计手册》第四版修订版（DSM-IV-TR）标准诊断为酒精成瘾且已戒酒至少两周的患者以及52名非成瘾健康对照者进行。使用心跳感知表现法进行内感受性觉知测量，该方法通过在四个不同时间段将主观感知的心跳次数与心电图记录的客观心率测量值进行比较，来确定参与者对自身心跳的觉知。此外，对酒精成瘾患者组进行了酒精使用障碍识别测试（AUDIT）、宾夕法尼亚酒精渴望量表（PACS）和强迫性饮酒量表（OCDS）。
酒精成瘾患者的内感受性觉知得分显著低于对照组。根据PACS结果，酒精成瘾患者的内感受性觉知得分与酒精渴望感觉水平呈负相关。
我们的结果证实了酒精成瘾患者的内感受性觉知会受到影响，且较差的内感受性觉知会与酒精渴望相关，并且可能是饮酒行为的一个维持因素这一观点。
