Laboratory of Experimental Psychology and Neuroscience (LPEN),Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University,Buenos Aires,Argentina.
Anxiety and Trauma Clinic, INECO (Institute of Cognitive Neurology),Buenos Aires,Argentina.
Psychol Med. 2017 Aug;47(11):1957-1970. doi: 10.1017/S0033291717000368. Epub 2017 Apr 4.
Obsessive-compulsive disorder (OCD) patients typically overmonitor their own behavior, as shown by symptoms of excessive doubt and checking. Although this is well established for the patients' relationship with external stimuli in the environment, no study has explored their monitoring of internal body signals, a process known to be affected in anxiety-related syndromes. Here, we explored this issue through a cardiac interoception task that measures sensing of heartbeats. Our aim was to explore key behavioral and electrophysiological aspects of internal-cue monitoring in OCD, while examining their potential distinctiveness in this condition.
We administered a heartbeat detection (HBD) task (with related interoceptive confidence and awareness measures) to three matched groups (OCD patients, panic disorder patients, healthy controls) and recorded ongoing modulations of two task-relevant electrophysiological markers: the heart evoked potential (HEP) and the motor potential (MP).
Behaviorally, OCD patients outperformed controls and panic patients in the HBD task. Moreover, they exhibited greater amplitude modulation of both the HEP and the MP during cardiac interoception. However, they evinced poorer confidence and awareness of their interoceptive skills.
Convergent behavioral and electrophysiological data showed that overactive monitoring in OCD extends to the sensing of internal bodily signals. Moreover, this pattern discriminated OCD from panic patients, suggesting a condition-distinctive alteration. Our results highlight the potential of exploring interoceptive processes in the OCD spectrum to better characterize the population's cognitive profile. Finally, these findings may lay new bridges between somatic theories of emotion and cognitive models of OCD.
强迫症（OCD）患者通常会过度监控自己的行为，这表现为过度怀疑和检查的症状。尽管这在患者与环境中的外部刺激的关系中已经得到很好的证实，但没有研究探讨过他们对内部身体信号的监控，而这个过程在焦虑相关综合征中是受到影响的。在这里，我们通过一项测量心跳感知的心脏内感受任务来探讨这个问题。我们的目的是探索 OCD 患者内部线索监测的关键行为和电生理方面，同时检查这种情况的潜在独特性。
我们向三组匹配的群体（强迫症患者、惊恐障碍患者、健康对照组）进行了心跳检测（HBD）任务（以及相关的内感受信心和意识测量），并记录了两个与任务相关的电生理标记物的持续调制：心脏诱发电位（HEP）和运动电位（MP）。
在 HBD 任务中，强迫症患者的行为表现优于对照组和惊恐障碍患者。此外，他们在心脏内感受期间表现出 HEP 和 MP 的更大幅度调制。然而，他们的内感受技能的信心和意识较差。
行为和电生理数据的一致性表明，OCD 中的过度监控延伸到了对内部身体信号的感知。此外，这种模式将 OCD 与惊恐障碍患者区分开来，表明存在一种特定于疾病的改变。我们的结果强调了探索 OCD 谱系中的内感受过程来更好地描述该人群认知特征的潜力。最后，这些发现可能为情绪的躯体理论和 OCD 的认知模型之间架起新的桥梁。
