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

分离是一种多方面、跨诊断和禁用的现象，涉及 脱离自我或周围环境。它在遭受创伤的人中很普遍， 创伤后应激障碍(PTSD)，发生在其他障碍中，包括抑郁，焦虑， 和精神分裂症，在一线治疗中是康复的障碍。解离是 注意力障碍的以注意力障碍和身体意识或内感觉障碍为特征的 以正念为基础的冥想练习，包括集中呼吸的正念冥想 (BFM)，旨在通过对内感受器的集中意识来增强注意力控制 暗示(呼吸)。然而，对于分离的人来说，这是一项几乎不可能的任务，他们经历了 身体代理中断，无法获取或信任身体信号。外感 反馈增强了实验研究中的内感意识和身体代理，并可能 同样，以最小的认知努力增强注意力控制。因此，这项研究的目标是 是为了解决分离性创伤患者的内感和注意力控制缺陷 通过外感反馈增强的BFM。这是由一种独特的设备提供的， 与呼吸协调振动，产生不可忽视的机械感受器反应性 呼吸。使用刺激驱动的机制，我们的设备有望增强身体的代理能力 并有效地吸引注意力和内感网络。我们将招募200名精神创伤患者 临床上有明显分离症状的人，分成四组，产生一个 2x2(呼吸集中冥想或休息x，带或不带振动声刺激)设计。全 参与者将参加他们指定的干预措施的8次会议。我们会全神贯注地 干预前后功能磁共振检查中的控制和内感任务：目标1) 具有外感反馈的BFM是否涉及注意控制和内感觉 从治疗前到治疗后，网络的影响程度明显大于其他治疗条件 干预。我们还将研究：目标2)神经网络响应的变化 与精神分裂(其次是其他创伤相关问题)的变化相对应 与其他治疗相比，具有外部感觉反馈的BFM程度更大 条件。这项研究的直接影响是克服神经生物学障碍 使用新技术解离时的治疗反应。长期影响将是 通知可公开传播的设备的开发，这些设备可以增强电流 干预赛。

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.