Danböck Sarah K, Franke Laila K, Miedl Stephan F, Liedlgruber Michael, Bürkner Paul-Christian, Wilhelm Frank H
Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria.
Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria.
Behav Res Ther. 2023 May;164:104289. doi: 10.1016/j.brat.2023.104289. Epub 2023 Mar 10.
While research has elucidated processes underlying dissociative symptoms in patients with posttraumatic stress disorder, little is known about the circumstances under which trauma-related dissociation initially arises. To experimentally investigate causes and concomitants of peritraumatic dissociation, we subjected sixty-nine healthy women to aversive-audiovisual and painful-electrical stimulation in a 2(aversive/neutral film) x 2(pain/no pain) within-subject design while recording psychophysiological and fMRI-BOLD responses. Afterwards, participants rated negative-affect, pain, and dissociation for each condition. Using Bayesian multilevel regression models, we examined (1) whether aversive-audiovisual and painful-electrical stimulation elicit higher dissociation-levels than control conditions and (2) whether stronger negative-affect and pain responses (operationalized via self-report, psychophysiological, and neural markers) correlate with higher dissociation-levels. Several key findings emerged: Both aversive-audiovisual and painful-electrical stimulation elicited dissociation. Dissociation was linked to higher self-reported negative-affect, but we did not find enough evidence linking it to psychophysiological and neural negative-affect markers. However, dissociation was associated with higher levels of self-reported pain, a skin-conductance-response-based pain marker, and the fMRI-BOLD-based Neurologic-Pain-Signature. Results indicate that both aversive-audiovisual and painful stimuli can independently cause dissociation. Critically, pain responses captured via self-report, psychophysiological, and neural markers were consistently linked to higher dissociation-levels suggesting a specific, evolutionary meaningful, contribution of pain to the rise of dissociation.
虽然研究已经阐明了创伤后应激障碍患者分离症状背后的过程，但对于创伤相关分离最初出现的情况却知之甚少。为了通过实验研究创伤性分离的原因及伴随情况，我们让69名健康女性在2（厌恶/中性影片）×2（疼痛/无疼痛）的被试内设计中接受厌恶视听和疼痛电刺激，同时记录心理生理和功能磁共振成像血氧水平依赖（fMRI-BOLD）反应。之后，参与者对每种情况的负面情绪、疼痛和分离程度进行评分。我们使用贝叶斯多级回归模型，研究了（1）厌恶视听和疼痛电刺激是否比对照条件引发更高的分离水平，以及（2）更强的负面情绪和疼痛反应（通过自我报告、心理生理和神经标记来衡量）是否与更高的分离水平相关。出现了几个关键发现：厌恶视听和疼痛电刺激都引发了分离。分离与更高的自我报告负面情绪有关，但我们没有找到足够的证据将其与心理生理和神经负面情绪标记联系起来。然而，分离与更高水平的自我报告疼痛、基于皮肤电反应的疼痛标记以及基于fMRI-BOLD的神经疼痛特征有关。结果表明，厌恶视听和疼痛刺激都能独立导致分离。至关重要的是，通过自我报告、心理生理和神经标记捕获的疼痛反应始终与更高的分离水平相关，这表明疼痛对分离的产生具有特定的、具有进化意义的作用。
