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

边缘型人格障碍（BPD）是一种严重的精神障碍。BPD的核心症状之一是情绪失调。根据目前的病因学模型，情绪失调的发展与童年创伤经历密切相关。这种关系可能是由身体信号感知缺陷（内感受）介导的。在BPD患者中，创伤性童年经历与情绪失调之间存在关联，在健康志愿者中，内感受与情绪调节之间存在关联。自己的研究发现BPD患者的内感受敏感性和中枢神经系统对内感受信号的表征存在缺陷，这在童年创伤经历与情绪失调之间的关系中起中介作用。然而，内感受被概念化为至少具有四个维度的多维结构，因此需要在多维和模态测量中进行评估。除了主观的内感受敏感性和意识以及客观的内感受准确性外，这种测量还应包括对传入信号和中枢神经系统对内感受信号的表征的评估。对于心脏和呼吸模式，这可以通过诱发电位来完成。这些电位的来源位于脑岛前部、前扣带皮层背侧和额包膜，这些大脑区域是感知内感受信号的中心。尤其是前脑岛似乎在表征和评估内感受信号和情绪状态的重叠中起着关键作用。然而，到目前为止，还没有一项研究系统地以多维和多模态的方式调查内感受和情绪的时间和空间神经元相关性。因此，本项目的目的是：(1)研究BPD患者在感知和表征身体信号（内感受）方面的缺陷；(2)内感受在童年创伤性经历与情绪失调关系中的中介作用；(3)内感受维度的神经生理学相关性及其与情绪调节脑区重叠的研究。为了实现这一目标，将进行两项研究。研究1包括对N=50名BPD患者和N=50名健康志愿者的内感受、童年创伤经历和情绪调节的多维和模态评估。研究2包括用结构和功能磁共振成像以及脑电和脑磁联合成像评估N=40名健康志愿者中枢神经系统对不同内感受成分的表征。

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.