Woelk Sascha P, Garfinkel Sarah N
Institute of Cognitive Neuroscience, University College London, London, UK.
Curr Top Behav Neurosci. 2024 May 17. doi: 10.1007/7854_2024_480.
Dissociative symptoms and disorders of dissociation are characterised by disturbances in the experience of the self and the surrounding world, manifesting as a breakdown in the normal integration of consciousness, memory, identity, emotion, and perception. This paper aims to provide insights into dissociative symptoms from the perspective of interoception, the sense of the body's internal physiological state, adopting a transdiagnostic framework.Dissociative symptoms are associated with a blunting of autonomic reactivity and a reduction in interoceptive precision. In addition to the central function of interoception in homeostasis, afferent visceral signals and their neural and mental representation have been shown to shape emotional feeling states, support memory encoding, and contribute to self-representation. Changes in interoceptive processing and disrupted integration of interoceptive signals into wider cognition may contribute to detachment from the body and the world, blunted emotional experience, and altered subjective recall, as experienced by individuals who suffer from dissociation.A better understanding of the role of altered interoceptive integration across the symptom areas of dissociation could thus provide insights into the neurophysiological mechanisms underlying dissociative disorders. As new therapeutic approaches targeting interoceptive processing emerge, recognising the significance of interoceptive mechanisms in dissociation holds potential implications for future treatment targets.
分离症状和解离障碍的特征是自我和周围世界体验的紊乱,表现为意识、记忆、身份、情感和感知的正常整合出现崩溃。本文旨在从内感受(即身体内部生理状态的感觉)的角度,采用跨诊断框架,深入探讨分离症状。分离症状与自主反应迟钝和内感受精度降低有关。除了内感受在体内平衡中的核心功能外,传入的内脏信号及其神经和心理表征已被证明可塑造情绪感受状态、支持记忆编码并有助于自我表征。内感受处理的变化以及内感受信号整合到更广泛认知中的中断,可能导致与身体和世界的脱离、情感体验迟钝以及主观回忆改变,这是解离症患者所经历的。因此,更好地理解内感受整合改变在分离症状领域中的作用,可为分离障碍的神经生理机制提供见解。随着针对内感受处理的新治疗方法的出现,认识到内感受机制在解离中的重要性对未来治疗靶点具有潜在意义。