Schäflein Eva, Sattel Heribert C, Pollatos Olga, Sack Martin
Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
Front Psychol. 2018 Jun 27;9:897. doi: 10.3389/fpsyg.2018.00897. eCollection 2018.
Patients suffering from dissociative disorders are characterized by an avoidance of aversive stimuli. This includes the avoidance of emotions and, in particular, bodily perceptions. In the present pilot study, we explored the potential interoceptive accuracy deficit of patients suffering from dissociative disorders in a heartbeat detection task. Moreover, we investigated the impact of facial mirror-confrontation on interoceptive accuracy and the potential association between cardiac vagal tone derived from heart rate variability and interoceptive accuracy. Eighteen patients suffering from dissociative disorders and 18 healthy controls were assessed with the Mental Tracking Paradigm by Schandry for heartbeat detection at baseline and after confrontations exposing them to their own faces in a mirror (2 min each, accompanied by a negative or positive cognition). During the experiment, cardiac vagal tone was assessed. We used Pearson correlations to calculate potential associations between cardiac vagal tone and interoceptive accuracy. Patients performed significantly worse than the healthy controls in the heartbeat detection task at baseline. They displayed no significant increase in interoceptive accuracy following facial mirror-confrontation. In the patient group, higher cardiac vagal tone was associated with a more precise heartbeat detection performance. Dissociative disorder patients showed a considerable deficit in interoceptive accuracy. Our results fit with the assumption that highly dissociative patients tend to tune out the perceiving of bodily signals. To the extent that bodily signal perception may play a causal role in these disorders, therapeutic approaches enhancing interoceptive accuracy and cardiac vagal tone may be considered important and practicable steps to improve the therapy outcome of this patient group.
患有分离性障碍的患者的特点是回避厌恶刺激。这包括回避情绪，尤其是身体感知。在本试点研究中，我们在心跳检测任务中探索了患有分离性障碍的患者潜在的内感受准确性缺陷。此外，我们研究了面部镜面对质对内感受准确性的影响，以及心率变异性衍生的心脏迷走神经张力与内感受准确性之间的潜在关联。通过施安德里的心理追踪范式，对18名患有分离性障碍的患者和18名健康对照者在基线时以及在镜子中面对自己的脸（每次2分钟，伴有消极或积极认知）的对质后进行心跳检测评估。在实验过程中，评估心脏迷走神经张力。我们使用皮尔逊相关性来计算心脏迷走神经张力与内感受准确性之间的潜在关联。在基线时的心跳检测任务中，患者的表现明显比健康对照者差。在面部镜面对质后，他们的内感受准确性没有显著提高。在患者组中，较高的心脏迷走神经张力与更精确的心跳检测表现相关。分离性障碍患者表现出相当大的内感受准确性缺陷。我们的结果符合这样的假设，即高度分离的患者倾向于忽略身体信号的感知。就身体信号感知可能在这些障碍中起因果作用而言，提高内感受准确性和心脏迷走神经张力的治疗方法可能被认为是改善该患者群体治疗效果的重要且可行的步骤。
