A Laboratory and Ambulatory Investigation of Trauma-related Dissociation, Interoceptive Accuracy, and Interoceptive Attention - Project Summary/Abstract Trauma-related dissociation is a common yet disabling experience characterized by a sense of detachment from the body during or following a traumatic event. Approximately 4% of community members and 20% of people with post-traumatic stress disorder (PTSD) report dissociation, meaning more than 13 million Americans experience this type of dissociation in their lifetime. Given that dissociation is characterized by detachment from bodily experiences and that many body-oriented symptoms occur alongside it (i.e., somatic symptoms, intentional harm to the body), it is plausible that interoception, the perception of internal bodily states, is regularly disrupted among these individuals. Indeed, recent theoretical models propose that greater trauma-related dissociation may be associated with poorer interoceptive skills. This is important because poor interoceptive skills are associated with negative mental health outcomes, like posttraumatic stress disorder and dissociative disorders. Unfortunately, there are several barriers that have prevented the progression of research on this topic. For example, past work has failed to capture the multifaceted nature of interoception and been methodologically limited (e.g., used only self-reports; not assessed in naturalistic settings). It is important to understand the interplay between trauma-related dissociation and interoception because no evidence-based treatments exist for dissociation, making this study a critical first step in identifying potential treatment targets. The proposed study will overcome previous limitations by combining self-report and physiological assessments both in laboratory and ambulatory settings to explore the ways in which trauma-related dissociation impacts interoceptive accuracy (i.e., ability to precisely and accurately monitor bodily sensations) and interoceptive attention (i.e., attentiveness to bodily sensations). Adult women between the ages of 18 and 59 with a history of childhood sexual trauma (N = 80), the population most likely to develop trauma-related dissociation, will be recruited from the community to explore whether interoceptive accuracy and attention are worsened by momentary trauma-related dissociation (Aim 1; within-person effects) and worse among people with higher trait trauma-related dissociation (Aim 2; between-person effects). In the laboratory session, participants will complete an interoceptive accuracy task (i.e., Heartbeat Counting Task) and interoceptive attention measure (i.e., Interoceptive Attention Scale) before and after dissociation is induced (i.e., Mirror Gazing Task). This laboratory assessment will be followed by a week of ambulatory assessment with passive physiological monitoring to understand how trauma-related dissociation impacts interoceptive accuracy and attention in naturalistic settings. This project is relevant to the mission of NIMH to identify how and when to intervene to reduce the burden of mental illness. The proposed project will facilitate critical training opportunities in interoception, ambulatory assessment, psychophysiological assessment, and multilevel modeling through planned coursework, workshops, experiential learning, and mentorship from a collaborative and multidisciplinary training team.
