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童年创伤经历对内感受的影响:忽视自身身体。

The impact of traumatic childhood experiences on interoception: disregarding one's own body.

作者信息

Schmitz Marius, Back Sarah N, Seitz Katja I, Harbrecht Nele K, Streckert Lena, Schulz André, Herpertz Sabine C, Bertsch Katja

机构信息

Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.

Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany.

出版信息

Borderline Personal Disord Emot Dysregul. 2023 Feb 15;10(1):5. doi: 10.1186/s40479-023-00212-5.

Abstract

BACKGROUND

Deficient interoception, the processing and perception of internal bodily signals, has been discussed as a mechanism underlying various mental disorders. First results indicate a mediating role of interoception in the interplay of traumatic childhood experiences and adult mental disorders. Traumatic childhood experiences may hinder the adequate processing, integration, and trust in bodily signals that are important in order to understand and regulate own needs and emotions, thereby increasing the vulnerability for mental disorders. However, an overarching study investigating alterations in different interoceptive measures and trauma-related disorders as well as their mediating role between early trauma and emotion dysregulation is still missing.

METHODS

One hundred thirty-six individuals with varying levels of traumatic childhood experiences who either had a current diagnosis of major depression, posttraumatic stress disorder, or somatic symptom disorder, or no mental disorder, took part in a multidimensional assessment of interoceptive processes, including interoceptive accuracy, sensibility, and awareness. Kruskal-Wallis tests were used to compare groups regarding interoceptive processes and associations with traumatic childhood experiences and emotion dysregulation were analyzed with Spearman correlations. Furthermore, mediation analyses were computed to examine and compare interoceptive processes as potential mediators between traumatic childhood experiences and emotion dysregulation.

RESULTS

Only body dissociation, a measure for interoceptive sensibility, was significantly reduced in individuals with a current mental disorder. Body dissociation was also the only interoceptive measure significantly associated with traumatic childhood experiences and emotion dysregulation and the only significant mediator in the relationship between traumatic childhood experiences and emotion dysregulation across groups.

CONCLUSION

Results suggest body dissociation, but not other interoceptive measures, as an important feature linking traumatic childhood experiences to current emotion dysregulation, an important transdiagnostic feature. As body dissociation refers to a habitual non-attendance or disregard of interoceptive signals, integrative therapeutic interventions could help affected individuals to overcome difficulties in emotion perception and regulation.

TRIAL REGISTRATION

The general study design was preregistered; see the German Clinical Trials Register (DRKS-ID: DRKS00015182). This study's analysis plan was not preregistered.

摘要

背景

内感受不足,即对身体内部信号的处理和感知,已被视为多种精神障碍的潜在机制。初步结果表明,内感受在童年创伤经历与成人精神障碍的相互作用中起中介作用。童年创伤经历可能会阻碍对身体信号的充分处理、整合及信任,而这些信号对于理解和调节自身需求及情绪至关重要,从而增加患精神障碍的易感性。然而,目前仍缺乏一项全面研究,来探究不同内感受测量指标的变化与创伤相关障碍之间的关系,以及它们在早期创伤与情绪失调之间的中介作用。

方法

136名有不同程度童年创伤经历的个体参与了内感受过程的多维度评估,这些个体要么目前被诊断为重度抑郁症、创伤后应激障碍或躯体症状障碍,要么没有精神障碍。评估包括内感受准确性、敏感性和意识。采用Kruskal-Wallis检验比较各组在内感受过程方面的差异,并通过Spearman相关性分析内感受过程与童年创伤经历及情绪失调之间的关联。此外,进行中介分析以检验和比较内感受过程作为童年创伤经历与情绪失调之间潜在中介的作用。

结果

只有身体解离(一种内感受敏感性的测量指标)在目前患有精神障碍的个体中显著降低。身体解离也是唯一与童年创伤经历及情绪失调显著相关的内感受测量指标,并且是各组中童年创伤经历与情绪失调之间关系的唯一显著中介因素。

结论

结果表明,身体解离而非其他内感受测量指标,是将童年创伤经历与当前情绪失调联系起来的一个重要特征,而情绪失调是一个重要的跨诊断特征。由于身体解离指的是习惯性地不关注或忽视内感受信号,综合治疗干预可能有助于受影响个体克服情绪感知和调节方面的困难。

试验注册

总体研究设计已预先注册;见德国临床试验注册库(DRKS-ID:DRKS00015182)。本研究的分析计划未预先注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adfa/9930318/868fb2f5de39/40479_2023_212_Fig1_HTML.jpg

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