Pick Susannah, Rojas-Aguiluz Maya, Butler Morgan, Mulrenan Heather, Nicholson Timothy R, Goldstein Laura H
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
GKT School of Medical Education, King's College London, London, UK.
Cogn Neuropsychiatry. 2020 Jul;25(4):294-311. doi: 10.1080/13546805.2020.1791061. Epub 2020 Jul 8.
We aimed to examine susceptibility to dissociation and the impact of dissociation on interoceptive processing in individuals with functional neurological disorder (FND). We hypothesised that dissociative states would be elevated and interoceptive accuracy and awareness impaired at baseline in people with FND, and that such differences would be exacerbated following acute dissociation. Nineteen adults with FND were compared to 20 healthy controls. A modified heart-beat tracking task measured interoceptive accuracy and awareness (confidence) before and after a validated dissociation induction procedure. An exteroceptive processing control task was included. Mann-Whitney tests and -values (effect size) were computed for between-group comparisons. The FND group displayed elevated dissociation at baseline (= 0.001, 0.528) compared to controls which increased following dissociation-induction ( < 0.001, = 0.663). Interoceptive accuracy did not differ between groups at baseline (= 0.967, = 0.009); however, the FND group had lower accuracy scores post-induction (= 0.021, = 0.379). A negative correlation (trend) between change scores for dissociation and interoceptive accuracy was noted (= -0.411, = 0.057). Confidence ratings on interoceptive and exteroceptive processing tasks were lower in the FND group (-values < 0.05 or <0.01, -values 0.331-0.489). Individuals with FND experienced greater susceptibility to dissociation, metacognitive deficits and impaired interoceptive accuracy than controls after acute dissociation.
我们旨在研究功能性神经障碍（FND）患者的解离易感性以及解离对其本体感受加工的影响。我们假设，FND患者在基线时的解离状态会升高，本体感受准确性和意识会受损，并且在急性解离后这些差异会加剧。将19名患有FND的成年人与20名健康对照者进行比较。在经过验证的解离诱导程序前后，通过一项改良的心跳追踪任务来测量本体感受准确性和意识（信心）。还纳入了一项外感受加工控制任务。计算曼-惠特尼检验和P值（效应量）用于组间比较。与对照组相比，FND组在基线时的解离水平升高（P = 0.001，r = 0.528），在解离诱导后进一步增加（P < 0.001，r = 0.663）。两组在基线时的本体感受准确性没有差异（P = 0.967，r = 0.009）；然而，FND组在诱导后的准确性得分较低（P = 0.021，r = 0.379）。注意到解离变化分数与本体感受准确性之间存在负相关（趋势）（r = -0.411，P = 0.057）。FND组在本体感受和外感受加工任务上的信心评分较低（P值< 0.05或<0.01，r值0.331 - 0.489）。与对照组相比，FND患者在急性解离后表现出更高的解离易感性、元认知缺陷和受损的本体感受准确性。
