Alterations in interoceptive body perception as a mediator between traumatic childhood experiences and emotional dysregulation: Investigation of neurophysiological and psychological mechanisms.

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Borderline Personality Disorder (BPD) is a severe mental disorder. One of the core symptoms of BPD is emotion dysregulation. According to current etiological models, the development of emotion dysregulation is closely related to traumatic childhood experiences. This relation may be mediated by deficits in the perception of bodily signals (interoception). There is empirical proof for the association between traumatic childhood experiences and emotion dysregulation in BPD patients and between interoception and emotion regulation in healthy volunteers. Own studies revealed deficits in the interoceptive sensitivity and the central nervous system representation of interoceptive signals in BPD patients, which mediated the relationship between traumatic childhood experiences and emotion dysregulation. However, interoception is conceptualized as a multidimensional construct with at least four dimensions, and thus needs to be assessed in a multidimensional and -modal measurement. Along with subjective interoceptive sensitivity and awareness as well as objective interoceptive accuracy, such a measurement should comprise the assessment of afferent signals and of the central nervous system representation of interoceptive signals. For the cardiac and respiratory modalities, this can be done by means of evoked potentials. The sources of these potentials have been located in the anterior insula, the dorsal anterior cingulate cortex and the frontal opercula, brain regions that are central for the perception of interoceptive signals. Particularly the anterior insula seems to be crucially involved in the overlap of representation and evaluation of interoceptive signals and emotional states. However, so far a study is missing that systematically investigates the temporal and spatial neuronal correlates of interoception and emotion in a multidimensional and -modal manner. Therefore, the aims of this project are (1) the investigation of deficits in the perception and representation of bodily signals (interoception) in BPD patients; (2) the investigation of interoception as a mediator in the relation between traumatic childhood experiences and emotion dysregulation; and (3) the investigation of neurophysiological correlates of interoceptive dimensions as well as their overlaps with brain regions involved in emotion regulation. To achieve this, two studies will be performed. Study 1 comprises a multidimensional and –modal assessment of interoception, traumatic childhood experiences and emotion regulation in N=50 BPD patients and N=50 healthy volunteers. Study 2 includes the assessment of central nervous system representations of the different interoceptive components in N=40 healthy volunteers with structural and functional magnetic resonance imaging as well as combined electro- and magnetoecencephalography.