Examining the link between multisensory and socio-emotional processing in anxiety and post-traumatic stress disorder

有确凿的证据表明，有社会情绪缺陷(如自闭症谱系障碍)的个人的多感觉过程发生了变化，但很少有研究研究创伤后应激障碍(PTSD)患者的类似过程。本项目将填补这一研究空白，并阐明多感官整合在虚拟现实暴露疗法(VRET)中的作用。患有创伤后应激障碍的个体表现出情绪调节和人际关系困难的改变。有人认为，个体有效调节情感状态和与他人互动的能力可能受到其有效处理多感官社会情绪线索的能力的影响。由于创伤后应激障碍以前被归类为焦虑症，并且表现出与焦虑相似的社会情绪缺陷，高特质焦虑可能被用作非临床样本的有用的类比测量，以研究可能与多感觉整合受损相关的跨诊断过程。小泉等人。(2011)对低特质焦虑和高特质焦虑的个体进行了一项研究，他们发现，多感觉整合受到焦虑程度的调节，与低特质焦虑的个体相比，焦虑程度会通过放大负面威胁相关线索的处理来损害情绪识别。以往对情绪识别的研究主要集中在一种感觉通道--情绪面孔(视觉)中对一种刺激的加工。这是尽管VRET在临床人群中使用的多感觉性质，以及以社会情绪缺陷为特征的障碍中多感觉过程中断的证据。我将考察：1)多感觉整合是否受到特质焦虑的调节，以及焦虑对多感觉加工的影响是否由自闭症特质的程度所介导；3)多感觉加工在创伤后应激障碍中是否受到影响；4)使用VR促进适应性多感觉整合具有治疗意义；5)我们可以从所有三项研究中得出并选择数据中的可解释特征，涉及在多感觉整合中观察到的任何差异以及与社会情绪缺陷的任何联系/交互作用，以设计一种分类算法，使我们能够区分创伤后应激障碍患者和与健康人相比具有高水平焦虑的个人。第一项研究将通过测试普通人群中多感觉能力、特质焦虑和自闭症特征程度之间的联系来实现目标1和2。多感官能力将使用多种类型的情绪刺激在社会情感领域进行测量，并与一般的多感觉能力进行比较。第二项研究将寻求在临床人群中建立这一基础，通过使用类似的研究设计比较患有创伤后应激障碍的个体和匹配的对照组。研究3将通过观察在创伤后应激障碍患者和匹配的对照组中使用单峰和双峰VR条件的效果来检验目标4。希望这项研究能够通过控制压力诱导线索的多感觉呈现来优化VRET对创伤后应激障碍的治疗效果。这项研究预计将显示在高度特质焦虑和创伤后应激障碍中整合情绪线索时多感觉过程的特定损害，这可能与特定的跨诊断过程有关，例如移情/视角采取异常，这些过程跨社会情绪缺陷的障碍运行。

There is firm evidence of altered multisensory processes in individuals with socio-emotional deficits (e.g. autism spectrum disorders), but very few studies examining similar processes in individuals with post-traumatic stress disorder (PTSD). This project will address this research-gap and clarify the role of multisensory integration in Virtual Reality Exposure Therapy (VRET).Individuals with PTSD show altered emotion regulation and interpersonal difficulties. It has been suggested that an individual's ability to effectively regulate affective states and interact with others may be influenced by their ability to efficiently process multisensory socio-emotional cues. As PTSD has previously been classified as an anxiety disorder, and exhibits similar socio-emotional deficits as anxiety, high trait anxiety may be used as a useful analogue measure in non-clinical samples to study transdiagnostic processes that could be associated with impaired multisensory integration. Koizumi et al. (2011) carried out a study in individuals with low vs. high trait anxiety where they found that multisensory integration is modulated by the degree of anxiety in a way that impairs emotion recognition, compared to those with low trait anxiety, by amplifying processing of negative threat-related cues. Previous studies investigating emotion recognition have largely focused on processing of just one type of stimulus within one sensory modality- emotional faces (vision). This is despite the multisensory nature of VRET used with clinical populations, and evidence of disrupted multisensory processes in disorders characterised by socio-emotional deficits. I will examine whether: 1) multisensory integration is modulated by trait anxiety, and whether these effects of anxiety on multisensory processes are mediated by the degree of autistic traits; 3) multisensory processing is affected in PTSD; 4) facilitating adaptive multisensory integration using VR has therapeutic implications; 5) we can derive and select interpretable features in the data, relating to any differences observed in multisensory integration and any links/interactions with socio-emotional deficits, from all 3 studies to design a classification algorithm that allows us to discriminate between PTSD patients and individuals with high levels of anxiety compared to healthy individualsThe first study will address aims 1 and 2 by testing the link between multisensory abilities, trait anxiety and degrees of autistic traits in the general population. Multisensory abilities will be measured in the socio-emotional domain using multiple types of emotional stimuli and compared to general multisensory abilities. The second study will seek to build on this in a clinical population by comparing individuals with PTSD and matched controls using a similar study design. Study 3 will examine aim 4 by looking at the effects of using unimodal vs. bimodal VR conditions in people with PTSD and a matched control group. It is hoped that this research can be applied to optimise the therapeutic effects of VRET for PTSD by manipulating the multisensory presentation of stress-inducing cues. The research is expected to show a specific impairment of multisensory processes in the integration of emotional cues in high trait anxiety and PTSD that may be linked to specific transdiagnostic processes, such as abnormalities in empathy/perspective-taking, that operate across disorders with socio-emotional deficits.