Neural Mechanisms of Vibroacoustically Augmented Breath Focused Mindfulness for Dissociative Traumatized People

振动声学增强呼吸聚焦正念对于解离性创伤患者的神经机制

• 批准号: 10600443
• 负责人: NEGAR FANI
• 金额: $ 3.58万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10600443
• 关键词: Address; Anxiety; Attention; Awareness; Brain; Breathing; Cognitive; Cues; Development; Devices; Disease; Dissociation; Feedback; Functional Magnetic Resonance Imaging; Goals; Impairment; Interoception; Intervention; Mechanoreceptors; Meditation; Mental Depression; Neurobiology; Participant; Patients; Persons; Post-Traumatic Stress Disorders; Recovery; Research; Respiration; Rest; Schizophrenia; Signal Transduction; Stimulus; Symptoms; Trauma; Trust; attentional control; barrier to care; base; clinically significant; design; experience; experimental study; mindfulness; mindfulness meditation; neural network; neuromechanism; new technology; post intervention; recruit; response; success; treatment response

Dissociation is a multifaceted, transdiagnostic, and disabling phenomenon that involves detachment from the self or surroundings. It is prevalent in traumatized people with posttraumatic stress disorder (PTSD), occurs in other disorders including depression, anxiety, and schizophrenia, and is a barrier to recovery in first-line treatments. Dissociation is characterized by attentional impairments and disruptions in body awareness, or interoception. Mindfulness-based meditative practices, including breath-focused mindfulness meditation (BFM), are designed to enhance attentional control through focused awareness on interoceptive cues (breath). However, this is a nearly impossible task for dissociative people, who experience disruptions in body agency and are unable to access or trust body signals. Exteroceptive feedback enhances interoceptive awareness and body agency in experimental studies and may similarly enhance attentional control with minimal cognitive effort. As such, the goal of this study is to address deficits in interoception and attentional control in dissociative traumatized patients via BFM augmented with exteroceptive feedback. This is delivered by a unique device that vibrates in concert with respiration, yielding non-ignorable mechanoreceptor reactivity to breathing. Using a stimulus-driven mechanism, our device is expected to enhance body agency and efficiently engage attention and interoception networks. We will recruit 200 traumatized people with clinically significant dissociation symptoms, divided in four equal groups to yield a 2x2 (breath-focused meditation or rest x with or without vibroacoustic stimulation) design. All participants will attend 8 sessions of their assigned intervention. We will administer attentional control and interoception tasks during fMRI pre- and post-intervention to examine: Aim 1) whether BFM with exteroceptive feedback engages attentional control and interoceptive networks to a significantly greater degree than the other treatment conditions from pre- to post- intervention. We will also examine: Aim 2) whether changes in neural network response correspond with changes in dissociation (and secondarily, other trauma-related problems) to a greater degree in BFM with exteroceptive feedback as compared to the other treatment conditions. The immediate impact of this research is to overcome neurobiological barriers to treatment response in dissociation using novel technology. The long-term impact will be to inform the development of publicly-disseminable devices that can augment current interventi ons.

解离是一个多方面的，transdiagnosis和致残现象，涉及 脱离自我或周围环境。它在受创伤的人中很普遍， 创伤后应激障碍（PTSD），发生在包括抑郁，焦虑， 和精神分裂症，并且是一线治疗中恢复的障碍。解离是 以注意力受损和身体意识或内感受中断为特征。 基于正念的冥想练习，包括专注于呼吸的正念冥想 (BFM)，旨在通过专注于内感受器的意识来增强注意力控制 呼吸（breath）然而，这对解离性的人来说几乎是不可能的任务，他们经历了 身体代理中断，无法访问或信任身体信号。外感受 在实验研究中，反馈增强了内感受意识和身体能动性， 以最小认知努力同样增强注意力控制。因此，本研究的目标 目的是解决分离性创伤患者的内感受和注意力控制缺陷 通过增强了外感受性反馈的BFM。这是由一种独特的装置传递的， 与呼吸一起振动，产生不可消除的机械感受器反应， 呼吸了使用刺激驱动机制，我们的设备有望增强身体代理 并有效地吸引注意力和内感受网络。我们将招募200名精神创伤患者 有临床显著分离症状的人，分为四个相等的组， 2x2（专注于呼吸的冥想或休息x有或没有振动声刺激）设计。所有 参与者将参加8次指定的干预会议。我们将管理注意力 干预前后fMRI期间的控制和内感受任务检查：目的1） 具有外感受反馈的BFM是否涉及注意控制和内感受反馈 网络到一个显着更大的程度比其他治疗条件，从前到后， 干预我们还将检查：目标2）神经网络响应是否发生变化 与解离的变化（其次是其他创伤相关的问题）相对应， 与其他治疗相比，具有外感受性反馈的BFM程度更高 条件这项研究的直接影响是克服神经生物学障碍， 治疗反应解离使用新技术。长期影响将是 告知公众可传播设备的发展， 干预。