Inflammation Changes Associated with Interoception Changes following Vibroacoustically Augmented Breath Focused Mindfulness for Dissociation

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。它在创伤暴露人群中普遍存在， 创伤后应激障碍，发生在其它障碍中（例如，抑郁症，焦虑症），是一个 一线治疗的恢复障碍。解离的特征是身体的分裂 一些研究表明，高度分离的个体 也有较高的炎症程度。基于正念的冥想练习，包括呼吸- 专注的正念冥想（BFM），旨在提高内感受意识， 生理信号（呼吸），也显示出减少炎症。然而，在这方面， 正念通常是一个困难的任务，为解离的人，谁的经验，在身体上的中断 代理，无法访问或信任身体信号。外感受性反馈增强 在实验研究中，内感受性意识和身体能动性可能同样有助于 炎症的变化与正念干预相结合。因此，这一目标 补充是检查炎症的潜在变化与内感受的变化， 分离性创伤患者通过BFM增强外感受性反馈。这是 通过一种独特的装置输送，该装置与呼吸同步振动， 机械感受器对呼吸的反应。使用刺激驱动机制，我们的设备是 期望增强身体代理和有效地吸引注意力和内感受网络。 我们将招募45名有明显临床分离症状的创伤暴露者， 分为四个相等的组，以产生2x2（BFM或非判断性意识x有或没有 振动声刺激）设计。所有参与者都参加了他们指定的8节课 干预我们将在干预前后采集血液样本进行炎症检测（2 时间点），以检查内感受的炎症变化，也进行临床测量 如在干预前后的fMRI期间的内感受任务期间。我们将研究：目标1） 炎症标志物，包括c-反应蛋白、白细胞介素-1和-6， 肿瘤坏死因子α，从干预前到干预后都是显著的;目的2） 炎症标志物与内感受的变化相关（临床上和通过 神经网络反应），以及BFM与外感受性反馈是否显著相关 调节这些变化;目的3）炎症的变化是否与 分离，以及是否BFM与外感受性反馈显着缓和这些 变化

Dissociation is a multifaceted, transdiagnostic, and disabling phenomenon that involves detachment from the self or surroundings. It is prevalent in trauma-exposed people with posttraumatic stress disorder, occurs in other disorders (e.g., depression, anxiety), and is a barrier to recovery in first-line treatments. Dissociation is characterized by disruptions in body awareness, or interoception, and some research suggests that highly dissociative individuals also have higher inflammatory tone. Mindfulness-based meditative practices, including breath- focused mindfulness meditation (BFM), are designed to enhance interoceptive awareness to physiological signals (breath) and are also shown to reduce inflammation. However, mindfulness is often a difficult 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 facilitate changes in inflammation in conjunction with mindfulness interventions. As such, the goal of this supplement is to examine potential changes in inflammation with changes in interoception 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 45 trauma-exposed people with clinically significant dissociation symptoms, divided in four equal groups to yield a 2x2 (BFM or non-judgmental awareness x with or without vibroacoustic stimulation) design. All participants attend 8 sessions of their assigned intervention. We will collect blood samples for inflammatory assays pre and post-intervention (2 time points) to examine change in inflammation with interoception, measured clinically as well as during an interoception task during fMRI pre- and post-intervention. We will examine: Aim 1) whether changes in inflammatory markers, including c-reactive protein, interleukin-1 and -6, and tumor necrosis α, are significant from pre- to post intervention; Aim 2) whether changes in inflammatory markers are associated with change in interoception (measured clinically and via neural network response), and whether BFM with exteroceptive feedback significantly moderates these changes; Aim 3) whether change in inflammation is associated with change in dissociation, and whether BFM with exteroceptive feedback significantly moderates these changes.