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Chen YL, Huang KJ, Scoglio AAJ, Borgogna NC, Potenza MN, Blycker GR, Kraus SW. A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories. J Trauma Dissociation 2024; 25:62-82. [PMID: 37415426 DOI: 10.1080/15299732.2023.2231915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 05/09/2023] [Indexed: 07/08/2023]
Abstract
Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.
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Affiliation(s)
- Yen-Ling Chen
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| | - Kuan-Ju Huang
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Arielle A J Scoglio
- Epidemiology Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Natural and Applied Sciences, Bentley University, Waltham, Massachusetts, USA
| | - Nicholas C Borgogna
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Connecticut Mental Health Center, New Haven, Connecticut, USA
- Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA
- Department of Neuroscience, Yale University, New Haven, Connecticut, USA
- Wu Tsai Institute, Yale University, New Haven, Connecticut, USA
| | - Gretchen R Blycker
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- College of Nursing, University of Rhode Island, Kingston, Rhode Island, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
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Lee J, Dhauna J, Silvers JA, Houston MH, Barnert ES. Therapeutic Dance for the Healing of Sexual Trauma: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2143-2164. [PMID: 35466836 DOI: 10.1177/15248380221086898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Therapeutic dance has been increasingly used as a treatment modality for sexual trauma, yet its evidence-based efficacy has not yet been catalogued. We therefore conducted a systematic review to summarize the existing evidence for therapeutic dance as an intervention for healing after sexual trauma. We searched 5 major databases to identify intervention studies on the use of therapeutic dance for individuals with histories of sexual trauma. Studies were included based on the following criteria: 1) the study involves individuals who have been exposed to sexual trauma; 2) the study reports on any form of dance as a therapeutic intervention; and 3) the study reports on dance intervention outcomes. A total of 1,686 sources were identified. Of these, 11 articles met eligibility criteria and were assessed. Reported outcomes were extracted and organized into emergent domains. We found that therapeutic dance acts upon three broad domains-affect, self, and interpersonal relationships - and can be delivered in diverse settings. Across the studies, dance showed benefits on outcomes. However, a significant weakness of the current peer-reviewed literature is the lack of robust empirical intervention research on dance therapy. Overall, the emerging literature suggests that therapeutic dance is a potential intervention for those who have experienced sexual trauma. The review findings presented here can be used to inform practitioners and systems of care targeted for those who have been subject to sexual trauma.
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Affiliation(s)
- Joyce Lee
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Janeet Dhauna
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jennifer A Silvers
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Elizabeth S Barnert
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Price CJ, Sevinc G, Farb NAS. Within-Person Modulation of Neural Networks following Interoceptive Awareness Training through Mindful Awareness in Body-Oriented Therapy (MABT): A Pilot Study. Brain Sci 2023; 13:1396. [PMID: 37891765 PMCID: PMC10605589 DOI: 10.3390/brainsci13101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Interoception, the representation of the body's internal state, is increasingly recognized for informing subjective wellbeing and promoting regulatory behavior. However, few empirical reports characterize interoceptive neural networks, and fewer demonstrate changes to these networks in response to an efficacious intervention. Using a two-group randomized controlled trial, this pilot study explored within-participant neural plasticity in interoceptive networks following Mindful Awareness in Body-oriented Therapy (MABT). Participants (N = 22) were assigned to either 8 weeks of MABT or to a no-treatment control and completed baseline and post-intervention assessments that included subjective interoceptive awareness (MAIA) and neuroimaging of an interoceptive awareness task. MABT was uniquely associated with insula deactivation, increased functional connectivity between the dorsal attention network and the somatomotor cortex, and connectivity changes correlated positively with changes in subjective interoception. Within the MABT group, changes in subjective interoception interacted with changes in a predefined anterior cingulate seed region to predict changes in right middle insula activity, a putative primary interoceptive representation region. While the small sample size requires the replication of findings, results suggest that interoceptive training enhances sensory-prefrontal connectivity, and that such changes are commensurate with enhanced interoceptive awareness.
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Affiliation(s)
| | - Gunes Sevinc
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;
- Ardea Outcomes, Halifax, NS, Canada
| | - Norman A. S. Farb
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada;
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Machorrinho J, Marmeleira J, Veiga G, Santos GD. Feel-Own-Move: a psychomotor therapy program for victims of intimate partner violence living in shelter homes. Feasibility and effects on mental health, bodily dissociation, and quality of life. Front Psychol 2023; 14:1154385. [PMID: 37484072 PMCID: PMC10359431 DOI: 10.3389/fpsyg.2023.1154385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Intimate partner violence (IPV) is a worldwide concern, impacting victims' mental health, physical health, and quality of life. High rates of posttraumatic stress disorder (PTSD), depression, anxiety, bodily dissociation, and somatic symptoms have been found in victims of IPV, with an important impact on the chronicity of impairments and on the outcomes of psychological interventions. Therapeutic interventions available in shelter homes for victims are scarce in addressing their body-mind needs therefore asking for better empirical research. Thus, the aim of this study was to evaluate the feasibility and effects of Feel-Own-Move (FOM), an 8-week psychomotor therapy program for victims of IPV, on their mental health, levels of bodily dissociation, and general quality of life. Methods A within-subject repeated measures design was used to evaluate the intervention effects, and feasibility results were analyzed. Results Seventeen women completed the program (mean age 42.8 years, range 21-64). Results showed a significant decrease in levels of bodily dissociation, with FOM having a large effect size. The intervention also had a large effect size at increasing the environment domain of quality of life, although no statistically significant differences were found. FOM ended with excellent rates of reach, adherence, acceptability, and satisfaction. A positive retention rate was also found. Discussion In conclusion, FOM seems to be a feasible psychomotor therapy intervention for female victims of IPV living in shelters. Importantly, this program showed to be effective in reducing bodily dissociation among participants, which is suggested to prospectively contribute to their mental health and quality of life.
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Affiliation(s)
- Joana Machorrinho
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | - José Marmeleira
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | - Guida Veiga
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | - Graça Duarte Santos
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
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Touch: An integrative review of a somatosensory approach to the treatment of adults with symptoms of post-traumatic stress disorder. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Price CJ, Weng HY. Facilitating Adaptive Emotion Processing and Somatic Reappraisal via Sustained Mindful Interoceptive Attention. Front Psychol 2021; 12:578827. [PMID: 34566738 PMCID: PMC8457046 DOI: 10.3389/fpsyg.2021.578827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/26/2021] [Indexed: 12/03/2022] Open
Abstract
Emotions are by nature embodied, as the brain has evolved to quickly assess the emotional significance of stimuli and output signals to the body's viscera and periphery to aid adaptive responses. Emotions involve both implicit bodily and explicit narrative processes, and patients may experience transdiagnostic distress when bodily signals are not attended to and holistically integrated with explicit narratives about experience. Similarly, therapists may be trained in more implicit body-based approaches (i.e., massage/bodywork, physical and occupational therapy, and nursing/medicine) or more explicit narrative-based approaches (i.e., psychotherapy), and may lack training in skills that integrate both levels of emotion processing to aid healing and growth. To address these gaps, we propose a framework where the bridge between implicit bodily sensations and explicit narratives lies in cultivating mindful awareness of bodily sensations associated with emotions. This process brings subjective awareness to notice inner body experience (or interoceptive awareness) that is often outside of conscious awareness, so that it may be understood and re-integrated in more adaptive ways, which we call somatic reappraisal. Using clinical theory and example vignettes, we present mindful interoceptive awareness for adaptive emotion processing as a framework to cultivate and enhance somatic reappraisal. Mindful interoceptive awareness brings more focused and sustained attention to inner body experience; likewise, internal sensations associated with emotions become more granular, vivid, and can shift in ways that facilitate somatic reappraisal. Learning to sustain interoceptive awareness when engaged with mindfulness qualities of nonjudgment and compassion promotes an experience where new associations between emotions, meanings, and memories can be made that generate insights that are holistic and integrative. A clinical vignette is used in this paper to provide examples of this approach in psychotherapy. An example script for use in mindfulness groups is included, and resources are suggested for clinicians to gain more experience. Mindful interoceptive awareness for adaptive emotion processing is a clinical process that can be learned and applied by a range of clinicians to treat mental and physical health conditions that may benefit greater embodied awareness.
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Affiliation(s)
- Cynthia J. Price
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, United States
| | - Helen Y. Weng
- Osher Center for Integrative Medicine, Neuroscape Center, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States
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Kappas Mazzio A, Mendoza N, Lindsay Brown M, Sinha D, Messing J, Wilson S, Walton L. Yoga as a complementary approach to healing for adult victims and survivors of interpersonal violence. Complement Ther Clin Pract 2021; 44:101427. [PMID: 34246128 DOI: 10.1016/j.ctcp.2021.101427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/08/2021] [Accepted: 06/12/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Yoga is increasingly accepted to improve overall health and wellness and is considered a meaningful adjunct treatment for mental and physical health ailments associated with interpersonal violence (IV). This review provides background information about the use of yoga among individuals with IV histories and aims to inform researchers and practitioners about the available evidence on yoga's application and effectiveness. METHODS Using six databases, we systematically reviewed empirical literature examining yoga among IV survivors. Criteria for study inclusion: yoga included a physical component and was the primary intervention; participants had an IV history; peer-reviewed; and participants were 17 years and older. After review, 10 articles reporting findings from seven independent samples were included. FINDINGS Yoga demonstrated preliminary, positive implications as a complementary treatment for individuals with an IV history. Synthesizing across articles four themes emerged: (1) acceptability and feasibility, (2) enhancement of mental and physical health, (3) promotion of personal growth, and (4) facilitators and barriers to practice. CONCLUSIONS The nascent literature indicates potential benefits of integrating yoga into interventions for IV survivors to enhance physical and psychological functioning. The primary barriers to intervention were resources (e.g., access) and incompatibility with spiritual beliefs for select clients. Despite consistent barriers, preliminary findings indicate yoga has many positive implications for individuals with an IV history. Given the small evidence base and insufficient methodology, additional empirical research with diverse samples and sites, and robust designs, could improve the state of knowledge and strengthen the efficacy of this promising practice.
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Schmitz M, Bertsch K, Löffler A, Steinmann S, Herpertz SC, Bekrater-Bodmann R. Body connection mediates the relationship between traumatic childhood experiences and impaired emotion regulation in borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:17. [PMID: 34001243 PMCID: PMC8127297 DOI: 10.1186/s40479-021-00157-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies revealed an association between traumatic childhood experiences and emotional dysregulation in patients with borderline personality disorder (BPD). However, possible mediating pathways are still not fully understood. The aim of the present study was to investigate the potential mediating role of body connection, describing the awareness of the relationship of bodily and mental states, for the association between a history of traumatic childhood experiences and BPD core symptomatology. METHODS One-hundred-twelve adult female individuals with BPD and 96 healthy female controls (HC) were included. Impaired emotion regulation, traumatic childhood experiences, and BPD symptomatology were assessed with self-report questionnaires. The Scale of Body Connection was used to assess two dimensions of body connection, that is body awareness, describing attendance to bodily information in daily life and noticing bodily responses to emotions and/or environment and body dissociation, describing a sense of separation from one's own body, due to avoidance or emotional disconnection. Mann-Whitney U tests were employed to test for group differences (BPD vs. HC) on the two SBC subscales and associations with clinical symptoms were analyzed with Spearman correlations. We performed mediation analyses in the BPD group to test the assumption that body connection could act as a mediator between a history of traumatic childhood experiences and emotion dysregulation. RESULTS Individuals with BPD reported significantly lower levels of body awareness and significantly higher levels of body dissociation compared to HC. Body dissociation, traumatic childhood experiences, and emotion dysregulation were significantly positively associated. Further analyses revealed that body dissociation, but not body awareness, significantly and fully mediated the positive relationship between traumatic childhood experiences and impaired emotion regulation in the BPD sample. This mediation survived when trait dissociation, i.e., general dissociative experiences not necessarily related to the body, was statistically controlled for. CONCLUSION Certain dimensions of body connection seem to be disturbed in BPD patients, with body dissociation being an important feature linking a history of traumatic childhood experiences to current deficits in emotion regulation.
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Affiliation(s)
- Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- Department of Psychology, LMU Munich, Munich, Germany
| | - Annette Löffler
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Steinmann
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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Rosenow M, Munk N. Massage for Combat Injuries in Veteran with Undisclosed PTSD: a Retrospective Case Report. Int J Ther Massage Bodywork 2021; 14:4-11. [PMID: 33654501 PMCID: PMC7892331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Massage has shown promise in reducing symptoms related to dissociation and anxiety that can exacerbate chronic pain and suffering. The combat wounded, veteran population is increasing and requires a multidisciplinary approach for comprehensive treatment. This case study examines massage therapy use to improve veteran combat injury rehabilitation and recovery experience through purposive, retrospective, and comprehensive SOAP note review. METHODS A 31-year-old White male received seven, 60-min, full body massages for combat related shoulder injury complications incurred approximately six years before presentation. The right shoulder sustained a broken humeral head and complete dislocation during a defensive maneuver in a life-threatening attack. This case study utilized data from three different assessments: goniometric measurements for shoulder range of motion, observation and documentation for environmental comfort behaviors, and client self-report for treatment goal attainment. Six weekly, full body, 60-min massages were completed sequentially. A follow-up 60-min treatment was completed at Week 8. Treatment to the injured area included focused trigger point therapy, myofascial release, and proprioceptive neuromuscular facilitation to the neck, shoulder, and chest. RESULTS Total percent change for active flexion, extension, abduction, adduction, internal rotation, and external rotation were 12.5, 150, 40, 167, 14.3, and 0%, respectively. Total percent change for passive flexion, extension, abduction, adduction, internal rotation, and external rotation were 63.6, 350, 66.7, 450, 133, and 77.8%, respectively. Environmental comfort behaviors were reduced. Client treatment goals were attained. CONCLUSIONS Massage therapy provided meaningful benefit to a combat injury for a veteran with PTSD.
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Affiliation(s)
- Mica Rosenow
- Indiana University School of Health & Human Sciences - IUPUI, Indianapolis, IN, USA
| | - Niki Munk
- Indiana University School of Health & Human Sciences - IUPUI, Indianapolis, IN, USA
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia
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Schmitz M, Müller LE, Seitz KI, Schulz A, Steinmann S, Herpertz SC, Bertsch K. Heartbeat evoked potentials in patients with post-traumatic stress disorder: an unaltered neurobiological regulation system? Eur J Psychotraumatol 2021; 12:1987686. [PMID: 34804381 PMCID: PMC8604531 DOI: 10.1080/20008198.2021.1987686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Early life maltreatment is a risk factor for psychiatric disorders, including post-traumatic stress disorder (PTSD). Post-traumatic stress disorder is a severe and heterogeneous disorder with fluctuating states of emotional over- and undermodulation, including hypervigilance, dissociation, and emotion regulation deficits. The perception and regulation of emotions have been linked to interoception, the cortical representation and sensing of inner bodily processes. Although first therapeutic approaches targeting bodily sensations have been found effective in patients with PTSD, and deficits in interoceptive signal representation have been reported in other trauma-related disorders, such as borderline personality disorder (BPD), the role of interoception remains largely unexplored for PTSD. OBJECTIVE The objective was to investigate the cortical representation of cardiac interoceptive signals in patients with PTSD and its associations with early life maltreatment, trait dissociation, and emotion dysregulation. METHODS Twenty-four medication-free patients with PTSD and 31 healthy controls (HC) completed a 5-min resting electrocardiogram (ECG) with parallel electroencephalogram (EEG). Heartbeat evoked potential (HEP) amplitudes as a measure for cortical representation of cardiac interoceptive signals were compared between groups and correlated with self-report questionnaires. RESULTS We did not find significantly different mean HEP amplitudes in patients with PTSD compared to HC, although HEPs of patients with PTSD were descriptively higher. No significant associations between mean HEP amplitudes and early life maltreatment, trait dissociation or emotion dysregulation were obtained within the groups. CONCLUSION The current finding does not indicate deficits in interoceptive signal representation at rest in individuals with PTSD. Whether patients with PTSD show altered HEP modulations during emotion regulation tasks and might benefit from therapeutic approaches aiming at changing the perception of bodily signals, needs to be investigated in future studies.
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Affiliation(s)
- Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Institute of Psychology, University of Heidelberg, Heidelberg, Germany.,Department of Psychology, LMU Munich, Munich, Germany
| | - Laura E Müller
- Clinic for Psychosomatic Medicine and Psychotherapy, Clinic Darmstadt, Darmstadt, Germany
| | - Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - André Schulz
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Sylvia Steinmann
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Department of Psychology, LMU Munich, Munich, Germany
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Slavin MN, Blycker GR, Potenza MN, Bőthe B, Demetrovics Z, Kraus SW. Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality. J Sex Med 2020; 17:2029-2038. [PMID: 32792283 PMCID: PMC7875089 DOI: 10.1016/j.jsxm.2020.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/11/2020] [Accepted: 07/06/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals with histories of sexual abuse may be more likely to experience sexual-related problems including hypersexuality, but gender-related differences remain unclear. AIM This online study examined sexual abuse history and hypersexuality by gender among 16,823 Hungarian adults, adjusting for age, sexual orientation, relationship status, education, employment status, and residence. METHODS An online questionnaire on one of the largest Hungarian news portals advertised this study examining sexual activities in January 2017. 3 categorizations of age-related sexual abuse were examined: child sexual abuse (CSA) occurring at age 13 and earlier (compared to no abuse), adolescent/adult sexual abuse (AASA; compared to no abuse), and CSA and AASA (CSA/AASA; compared to one age-related category of abuse or the other). OUTCOMES The outcome variable, hypersexuality, was examined as a continuous variable due to the low prevalence of clinical hypersexuality in this sample. 3 multivariate linear regression analyses adjusting for covariates aimed to predict hypersexuality from each category of abuse, along with gender and its interaction with each category. RESULTS In all models, younger age, non-heterosexual sexual orientation, male gender, single relationship status, less than full-time work, and living in a capital city were associated with hypersexuality, and education was not a significant predictor. CSA, AASA, and CSA/AASA predicted hypersexuality in both men and women. There was a significant interaction between CSA/AASA and gender, such that the relationship between CSA/AASA and hypersexuality was stronger in men than in women. CLINICAL TRANSLATION Sexual abuse at each developmental time-point may influence hypersexuality among men and women, although the cumulative impact of CSA and AASA on hypersexuality may be particularly relevant among men. STRENGTHS & LIMITATIONS This is one of the largest studies to examine gender-related differences in the relationship between sexual abuse and hypersexuality. Nevertheless, our study is cross-sectional, and longitudinal work is needed to determine how sexual abuse affects children, adolescents, and adults throughout their lives. CONCLUSION Developmental impacts of sexual abuse may be considered in a gender-informed fashion in order to develop and optimize effective prevention and treatment strategies for hypersexuality. Slavin MN, Blycker GR, Potenza MN, et al. Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality. J Sex Med 2020;17:2029-2038.
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Affiliation(s)
| | - Gretchen R Blycker
- College of Nursing, University of Rhode Island, Kingston, RI, USA; HäIsosam Therapy, Jamestown, RI, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Yale University Department of Neuroscience and Child Study Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
| | - Beáta Bőthe
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Département de Psychologie, Université de Montréal, Montréal, Canada
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
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12
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Piran N, Teall TL, Counsell A. The experience of embodiment scale: Development and psychometric evaluation. Body Image 2020; 34:117-134. [PMID: 32554242 DOI: 10.1016/j.bodyim.2020.05.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 01/25/2023]
Abstract
The construct of embodiment captures a broad range of experiences of living in the body. The present program of research involved developing and evaluating a fully structured measure of the experience of embodiment construct, the Experience of Embodiment Scale (EES), via four independent samples of women. Study 1 (N = 92) provided initial support for the internal consistency and convergent validity of the EES. Study 2 (N = 412) involved factor analyses of the EES, leading to the emergence of 6 factors, reflecting different aspects of the experience of embodiment. Further, this study supported the internal consistency of the EES and its subscales, as well as its construct and discriminant validity. As expected, the EES correlated with measures of body- and self-esteem, body connection, sexual assertiveness, among other measures, and did not correlate with the Perfectionism Personal Standards Scale. Study 3 (N = 348) confirmed the factor structure of the scale from Study 2. Study 4 (N = 76) demonstrated that EES scores were stable over a 3-week period. The EES can be used by researchers and clinicians interested in capturing individuals' range of experiences of living in their bodies, both positive and negative.
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Affiliation(s)
- Niva Piran
- Department of Applied Psychology and Human Development, OISE/University of Toronto, 252 Bloor St. West, Toronto, ON, M5S 1V6, Canada.
| | | | - Alyssa Counsell
- Department of Psychology (JOR 926), Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
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Slavin MN, Scoglio AAJ, Blycker GR, Potenza MN, Kraus SW. Child Sexual Abuse and Compulsive Sexual Behavior: A Systematic Literature Review. CURRENT ADDICTION REPORTS 2020; 7:76-88. [PMID: 33425653 PMCID: PMC7787260 DOI: 10.1007/s40429-020-00298-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Information on potential risk factors and clinical correlates of compulsive sexual behavior (CSB) may help inform more effective prevention and treatment measures. Sexual victimization, specifically, child sexual abuse (CSA), has been associated with CSB. RECENT FINDINGS This systematic review describes 21 studies on the relationship between CSA and CSB. Most studies identified a significant association between CSA and CSB. However, variability in measurements, potential differences in links among community versus clinical samples, relevance of research among college samples, lack of support for gender-related differences, and the need for more longitudinal designs were identified. SUMMARY Research would benefit from more formalized assessments of CSB across different populations. Prevention efforts should be aimed toward individuals who experienced CSA and/or other abuse, particularly if they report engaging in risky sexual behavior. Individuals with CSB who have experienced sexual abuse may benefit from trauma-focused treatment.
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Affiliation(s)
| | - Arielle A. J. Scoglio
- Northeastern University, Institute of Health Equity & Social Justice Research, Boston, MA
| | - Gretchen R. Blycker
- College of Nursing, University of Rhode Island, Kingston, RI
- HäIsosam Therapy, Jamestown, RI
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT
| | - Marc N. Potenza
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT
- Yale University Department of Neuroscience and Child Study Center, New Haven, CT
- Connecticut Council on Problem Gambling, New Haven, CT
- Connecticut Mental Health Center, New Haven, CT
| | - Shane W. Kraus
- University of Nevada, Las Vegas, Department of Psychology, Las Vegas, NV
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Solomonova E, Dubé S, Blanchette-Carrière C, Sandra DA, Samson-Richer A, Carr M, Paquette T, Nielsen T. Different Patterns of Sleep-Dependent Procedural Memory Consolidation in Vipassana Meditation Practitioners and Non-meditating Controls. Front Psychol 2020; 10:3014. [PMID: 32038390 PMCID: PMC6989470 DOI: 10.3389/fpsyg.2019.03014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/19/2019] [Indexed: 01/01/2023] Open
Abstract
Aim Rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep, and sleep spindles are all implicated in the consolidation of procedural memories. Relative contributions of sleep stages and sleep spindles were previously shown to depend on individual differences in task processing. However, no studies to our knowledge have focused on individual differences in experience with Vipassana meditation as related to sleep. Vipassana meditation is a form of mental training that enhances proprioceptive and somatic awareness and alters attentional style. The goal of this study was to examine a potential role for Vipassana meditation experience in sleep-dependent procedural memory consolidation. Methods Groups of Vipassana meditation practitioners (N = 22) and matched meditation-naïve controls (N = 20) slept for a daytime nap in the laboratory. Before and after the nap they completed a procedural task on the Wii Fit balance platform. Results Meditators performed slightly better on the task before the nap, but the two groups improved similarly after sleep. The groups showed different patterns of sleep-dependent procedural memory consolidation: in meditators, task learning was positively correlated with density of slow occipital spindles, while in controls task improvement was positively associated with time in REM sleep. Sleep efficiency and sleep architecture did not differ between groups. Meditation practitioners, however, had a lower density of occipital slow sleep spindles than controls. Conclusion Results suggest that neuroplastic changes associated with meditation practice may alter overall sleep microarchitecture and reorganize sleep-dependent patterns of memory consolidation. The lower density of occipital spindles in meditators may mean that meditation practice compensates for some of the memory functions of sleep.
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Affiliation(s)
- Elizaveta Solomonova
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montréal, QC, Canada.,Culture, Mind and Brain Research Group, Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Simon Dubé
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Cloé Blanchette-Carrière
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada
| | - Dasha A Sandra
- Integrated Program in Neuroscience, McGill University, Montréal, QC, Canada
| | - Arnaud Samson-Richer
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada
| | - Michelle Carr
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Sleep Laboratory, Swansea University, Swansea, United Kingdom
| | - Tyna Paquette
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada
| | - Tore Nielsen
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
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Tarsha MS, Park S, Tortora S. Body-Centered Interventions for Psychopathological Conditions: A Review. Front Psychol 2020; 10:2907. [PMID: 32038351 PMCID: PMC6993757 DOI: 10.3389/fpsyg.2019.02907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 12/09/2019] [Indexed: 01/20/2023] Open
Abstract
World-wide, billions of dollars are spent each year on body-centered interventions to alleviate both physical and psychological pathologies. Given the high demand and increasing popularity of body-centered interventions, there is need for a systematic organization of empirical evidence associated with body-centered therapies. This article reviews the psychological effects of body-centered interventions on emotional well-being, including both self and other-administered (receptive) therapies. Theory behind body-centered interventions rely upon the bidirectional communication pathway between the brain and body. We investigated the bidirectional communication pathway between the brain and body by evaluating evidence across multiple body-centered therapies. The research reviewed includes studies that investigate effects of massage therapy, reflexology, acupuncture, functional relaxation, emotional freedom technique, Rolfing, yoga, tai-chi, and dance/movement therapy on psychological conditions across the lifespan. Results demonstrated that overall, massage therapy, tai-chi, dance/movement therapy, functional relaxation, reflexology, acupuncture and emotional freedom technique seem to alleviate stress, depression, anxiety, bipolar disorder and facilitate pain reduction. Of these, the most robust evidence available was for massage therapy, indicating it is an effective intervention for numerous age groups and populations. Rolfing and reflexology had the least amount of support, with few studies available that had small sample sizes. Although these conclusions are limited by scarcity of high-quality empirical data and contradictory findings, available evidence indicates that body-centered interventions can be effective in reducing psychopathology and supports the proposed mechanism of the bidirectional pathway between the brain and body: the body holds the potential to influence the mind. Integrating body-centered therapies in both clinical settings and as self-care could lead to better outcomes. Lastly, we propose the first taxonomy of body-centered interventions and empirical evidence of their effectiveness for clinicians and researchers.
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Affiliation(s)
- Mary S. Tarsha
- Department of Psychology, Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
| | - Suzi Tortora
- Dancing Dialogue: Healing and Expressive Arts, New York, NY, United States
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16
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A pilot feasibility study of mindfulness childbirth education for women with a history of sexual trauma. Complement Ther Clin Pract 2019; 37:102-108. [DOI: 10.1016/j.ctcp.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 11/21/2022]
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17
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Poppa T, Droutman V, Amaro H, Black D, Arnaudova I, Monterosso J. Sexual trauma history is associated with reduced orbitofrontal network strength in substance-dependent women. Neuroimage Clin 2019; 24:101973. [PMID: 31472330 PMCID: PMC6728879 DOI: 10.1016/j.nicl.2019.101973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/29/2019] [Accepted: 08/03/2019] [Indexed: 12/19/2022]
Abstract
AIM Substance use disorders (SUDs) are highly comorbid with post-traumatic stress disorder (PTSD). PTSD-SUD comorbidity is associated with greater functional impairments and relapse risk. Women with SUDs experience markedly higher rates of trauma and PTSD compared to men with SUDs, particularly due to sexual and domestic abuse. Despite the strong association between trauma exposure and SUDs, the neurobiological correlates are understudied, particularly among females with SUDs. However, there is indication of abnormal somatic and interoceptive processing in women with PTSD. The present study examines interoception-linked differences in intrinsic brain networks in a group of women with SUDs and varying histories of trauma exposure, some of whom have a current PTSD diagnosis. METHODS Pre-intervention data were analyzed from a subset (N = 43) of women in SUD residential treatment recruited for a mindfulness-based intervention efficacy clinical trial. Participants diagnosed with PTSD (n = 14) or not (n = 29) performed a task which involved attending to the somatic and visceral sensations of the breathing cycle (interoception) while undergoing a functional MRI (fMRI) scan. FMRI analysis employed independent components analysis and dual regression. First, we assessed differences in functional connectivity of interoception-modulated functional networks among those with and without PTSD. Second, we tested associations between network strength and lifetime sexual violence exposure across all participants on networks that showed significant group differences. RESULTS PTSD diagnosis was associated with reduced functional connectivity of an orbitofrontal network with the precuneus, mid-posterior insula, lateral prefrontal cortex and angular gyrus. OFC network strength was inversely associated with sexual violence exposure over-and-above the contribution of PTSD status alone. CONCLUSIONS Our findings provide a novel network-level account of brain activity associated with PTSD among women with SUDs, which may inform treatment response in this subpopulation.
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Affiliation(s)
- Tasha Poppa
- Department of Psychology, University of Southern California, Los Angeles, United States of America.
| | - Vita Droutman
- Department of Psychology, University of Southern California, Los Angeles, United States of America
| | - Hortensia Amaro
- Herbert Wertheim College of Medicine, Robert Stempel College of Public Health and Social Work, Florida International University, Los Angeles, United States of America
| | - David Black
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, United States of America
| | - Inna Arnaudova
- Department of Psychiatry, University of California, Los Angeles, United States of America
| | - John Monterosso
- Department of Psychology, University of Southern California, Los Angeles, United States of America
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Ginzburg K, Biran I, Aryeh IG, Tsur N, Defrin R. Pain Perception and Body Awareness Among Individuals With Borderline Personality Disorder. J Pers Disord 2018; 32:618-635. [PMID: 28902571 DOI: 10.1521/pedi_2017_31_316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Studies indicate that individuals with borderline personality disorder (BPD) often demonstrate attenuated pain perception, termed hypoalgesia. This study examines the hypothesis that body awareness moderates the association between BPD and pain perception. Participants consisted of 46 women diagnosed with BPD and 47 healthy controls. Sensory testing included the measurement of heat-pain thresholds, ratings of suprathreshold stimuli, measurement of temperature evoking moderate pain, and temporal summation of noxious mechanical stimuli. Body awareness was assessed by a self-report questionnaire. As hypothesized, among subjects with low levels of body awareness, those with BPD demonstrated hypoalgesia as manifested in their lower suprathreshold pain ratings and moderate pain evoked by higher temperature, in comparison with the controls. Among those with high levels of body awareness, BPD subjects demonstrated increased reactivity to pain as manifested in their higher pain ratings and moderate pain evoked by lower temperature, in comparison with the controls.
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Affiliation(s)
- Karni Ginzburg
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Iftah Biran
- Division of Psychiatry, Sheba Medical Center, Ramat Gan, and The Division of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Itay Goor Aryeh
- Pain Management Center, Department of Anesthesiology and Intensive Care, Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noga Tsur
- I-Core Research Center for Mass Trauma, The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Ruth Defrin
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, and Sagol School of Neurosciences, Tel Aviv University, Tel Aviv, Israel
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Finn H, Warner E, Price M, Spinazzola J. The Boy Who Was Hit in the Face: Somatic Regulation and Processing of Preverbal Complex Trauma. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:277-288. [PMID: 32318157 PMCID: PMC7163863 DOI: 10.1007/s40653-017-0165-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Examination of novel treatment for complexly traumatized youth, in particular, those exposed to preverbal trauma, is necessary given challenges associated with effective intervention for this population. Therapies that facilitate somatic regulation have demonstrated benefit for some trauma survivors. The current article briefly reviews the emerging literature on symptoms of and treatments for complex and preverbal child trauma and describes Sensory Motor Arousal Regulation Therapy (SMART), an intervention for child and adolescent trauma with preliminary empirical support. SMART aims to enhance sensory motor engagement and promote affective, behavioral and physiological regulation using somatic regulation and sensory integration techniques. Utilizing case study methodology, the article illustrates application of SMART in treatment of a latency-aged child with history of exposure to complex and preverbal traumatic experiences. Case analysis suggests the potential contribution of enhanced somatic regulation in traumatized children toward increased relational engagement, behavioral and emotional regulation, and trauma processing.
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Affiliation(s)
- Heather Finn
- The Trauma Center at Justice Resource Institute, 1269 Beacon Street, Brookline, MA 02446 USA
| | - Elizabeth Warner
- The Trauma Center at Justice Resource Institute, 1269 Beacon Street, Brookline, MA 02446 USA
| | - Maggi Price
- The Trauma Center at Justice Resource Institute, 1269 Beacon Street, Brookline, MA 02446 USA
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, MA USA
| | - Joseph Spinazzola
- The Trauma Center at Justice Resource Institute, 1269 Beacon Street, Brookline, MA 02446 USA
- Department of Psychology, Suffolk University, Boston, MA USA
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20
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Carvalheira A, Price C, Neves CF. Body Awareness and Bodily Dissociation Among Those With and Without Sexual Difficulties: Differentiation Using the Scale of Body Connection. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:801-810. [PMID: 28368683 DOI: 10.1080/0092623x.2017.1299823] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The goal of this study was to explore potential body awareness and bodily dissociation differences between men and women with and without sexual difficulties, using the Scale of Body Connection in a sample of 909 participants. In women, bodily dissociation scores were significantly higher across all reported sexual difficulties, except in sexual pain. Women with lack of sexual interest and sexual arousal had significantly lower body awareness when compared to women without these difficulties. These findings suggest the importance of targeting body awareness and bodily dissociation in the treatment of women's sexual difficulties.
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Affiliation(s)
- Ana Carvalheira
- a William James Center for Research , ISPA-University Institute , Lisbon , Portugal
| | - Cynthia Price
- b Department of Biobehavioral Nursing and Health Systems , University of Washington , Seattle , Washington , USA
| | - Cide F Neves
- c Research Unit of Psychology & Health , ISPA-University Institute , Lisbon , Portugal
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21
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Price CJ, Thompson EA, Cheng SC. Scale of Body Connection: A multi-sample construct validation study. PLoS One 2017; 12:e0184757. [PMID: 29028803 PMCID: PMC5640211 DOI: 10.1371/journal.pone.0184757] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 08/30/2017] [Indexed: 12/13/2022] Open
Abstract
The Scale of Body Connection (SBC) was created to address the need for a self-report measure to examine body awareness and bodily dissociation in mind-body research. Developed in the U.S.A., it has been translated into many languages and tested for validity of scale translation. The burgeoning of mind-body research and the widespread use of the SBC scale underscored the need for critical assessment of the instrument’s measurement properties. Thus, a broader evaluation of the SBC was designed using large samples from eight international, cross-sectional studies drawn from community (i.e., non-clinical) populations. Specifically, we assessed scale distribution properties and internal consistency reliabity, and using confirmatory factory analysis we evaluated scale contruct validity and compared male/female measurement models. The results indicated acceptable reliability for both the body awareness and bodily dissociation scales, and a good fit between the proposed theoretic model and the data, providing evidence of construct validity across all samples. Mean differences in body awareness were observed for males vs. females in most samples, with females generally showing higher body awareness compared to males. Multi-group structural equation modeling demonstrated a stable latent factor structure and factor loadings, indicating equivalent measurement models for males and females. In summary, this multi-sample study demonstrated SBC construct validity that supports its use in clinical research as a brief, readily translated, easy to administer measure of body awareness and bodily dissociation.
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Affiliation(s)
- Cynthia J. Price
- Department of Biobehavioral and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - Elaine Adams Thompson
- Department of Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, Washington, United States of America
| | - Sunny Chieh Cheng
- Nursing and Healthcare Leadership Program, University of Washington, Tacoma, Washington, United States of America
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22
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Interoceptive Awareness Is Important for Relapse Prevention: Perceptions of Women Who Received Mindful Body Awareness in Substance Use Disorder Treatment. J Addict Nurs 2016; 27:32-8. [PMID: 26950840 DOI: 10.1097/jan.0000000000000109] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND It is postulated that interventions aimed at facilitating interoceptive awareness (i.e., awareness of inner body sensations) may facilitate regulation and improve substance use disorder (SUD) treatment outcomes. OBJECTIVE The aim of the study was to better understand the role of interoceptive training in SUD treatment, an identified gap in the literature. METHODS On the basis of a National Institute on Drug Abuse (NIDA)-funded pilot randomized clinical trial that used a two-group repeated measures design to examine mindful awareness in body-oriented therapy (MABT) for women in SUD treatment, this study examined the experience of a subset of participants that received and completed MABT intervention in the larger original study. In a qualitative study using a single focus group, participants were asked to respond to multiple questions regarding their current use of interoceptive awareness skills, perceived benefit, learning processes, and suggestions for program development. Interpretive analysis was used to describe the themes that emerged from the focus group responses. RESULTS Participants consistently used interoceptive awareness self-care skills learned in MABT. Interoceptive awareness training and daily practice were perceived as critical for emotional awareness, regulation, and relapse prevention. In addition, findings highlight the relevance of MABT educational strategies such as touch and individual delivery to teach interoceptive awareness and self-care skills for women in SUD treatment. CONCLUSION These findings suggest the positive role of interoceptive awareness in promoting relapse prevention among women in SUD treatment, important for guiding future research, and program development for this population that apply across healthcare disciplines.
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Gesink D, Nattel L. A qualitative cancer screening study with childhood sexual abuse survivors: experiences, perspectives and compassionate care. BMJ Open 2015; 5:e007628. [PMID: 26246075 PMCID: PMC4538265 DOI: 10.1136/bmjopen-2015-007628] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The childhood sexual abuse (CSA) survivor population is substantial and survivors have been identified as part of the population who were under-screened or never-screened for breast, cervical and colon cancer. Our objective was to learn CSA survivor perspectives on, and experiences with, breast, cervical and colon cancer screening with the intention of generating recommendations to help healthcare providers improve cancer screening participation. DESIGN A pragmatic constructivist qualitative study involving individual, semistructured, in-depth interviews was conducted in January 2014. Thematic analysis was used to describe CSA survivor perspectives on cancer screening and identify potential facilitators for screening. PARTICIPANTS A diverse purposive sample of adult female CSA survivors was recruited. The inclusion criteria were: being a CSA survivor, being in a stable living situation, where stable meant able to meet one's financial needs independently, able to maintain supportive relationships, having participated in therapy to recover from past abuse, and living in a safe environment. 12 survivors were interviewed whose ages ranged from the early 40s to mid-70s. Descriptive saturation was reached after 10 interviews. SETTING Interviews were conducted over the phone or Internet. CSA survivors were primarily from urban and rural Ontario, but some resided elsewhere in Canada and the USA. RESULTS The core concept that emerged was that compassionate care at every level of the healthcare experience could improve cancer screening participation. Main themes included: desire for holistic care; unique needs of patients with dissociative identity disorder; the patient-healthcare provider relationship; appointment interactions; the cancer screening environment; and provider assumptions about patients. CONCLUSIONS Compassionate care can be delivered by: building a relationship; practising respect; focusing attention on the patient; not rushing the appointment; keeping the environment positive and comfortable; maintaining patient dignity; sharing control whenever possible; explaining procedures; and using laughter to reduce power imbalance through shared humanity.
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Affiliation(s)
- Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Farb N, Daubenmier J, Price CJ, Gard T, Kerr C, Dunn BD, Klein AC, Paulus MP, Mehling WE. Interoception, contemplative practice, and health. Front Psychol 2015; 6:763. [PMID: 26106345 PMCID: PMC4460802 DOI: 10.3389/fpsyg.2015.00763] [Citation(s) in RCA: 258] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 05/22/2015] [Indexed: 12/27/2022] Open
Abstract
Interoception can be broadly defined as the sense of signals originating within the body. As such, interoception is critical for our sense of embodiment, motivation, and well-being. And yet, despite its importance, interoception remains poorly understood within modern science. This paper reviews interdisciplinary perspectives on interoception, with the goal of presenting a unified perspective from diverse fields such as neuroscience, clinical practice, and contemplative studies. It is hoped that this integrative effort will advance our understanding of how interoception determines well-being, and identify the central challenges to such understanding. To this end, we introduce an expanded taxonomy of interoceptive processes, arguing that many of these processes can be understood through an emerging predictive coding model for mind–body integration. The model, which describes the tension between expected and felt body sensation, parallels contemplative theories, and implicates interoception in a variety of affective and psychosomatic disorders. We conclude that maladaptive construal of bodily sensations may lie at the heart of many contemporary maladies, and that contemplative practices may attenuate these interpretative biases, restoring a person’s sense of presence and agency in the world.
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Affiliation(s)
- Norman Farb
- University of Toronto Mississauga, Mississauga, ON Canada
| | | | | | - Tim Gard
- Maastricht University, Maastricht Netherlands
| | | | | | | | | | - Wolf E Mehling
- University of California San Francisco, San Francisco, CA USA
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Price CJ, Herting JR. Changes in post traumatic stress symptoms among women in substance use disorder treatment: the mediating role of bodily dissociation and emotion regulation. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2013; 7:147-53. [PMID: 24092984 PMCID: PMC3782396 DOI: 10.4137/sart.s12426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Individuals in substance use disorder (SUD) treatment have shown high levels of difficulty with emotion regulation, as well as a high prevalence of reported trauma and symptoms of post-traumatic stress (PTS). Dissociation from the body is a common clinical experience among women with a history of sexual trauma. Research has shown promising effects of mind-body approaches in SUD treatment, as well as the importance of emotional regulation in conceptual models of psychopathology. The current study examines the mediating role of bodily dissociation and emotion regulation on PTS symptoms in a sample of women enrolled in substance use disorder treatment. Results indicate that bodily dissociation and emotion regulation had significant direct effects on PTS symptoms from baseline to a 6-month follow-up, and that bodily dissociation also may indirectly operate to reduce PTS symptoms through its effect on emotion regulation difficulties. These results suggest the importance of addressing bodily dissociation and emotion regulation difficulties in women’s substance use disorder treatment.
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Affiliation(s)
- Cynthia J Price
- Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA
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26
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Association of nonsexual and sexual traumatizations with body image and psychosomatic symptoms in psychosomatic outpatients. Gen Hosp Psychiatry 2010; 32:315-20. [PMID: 20430236 DOI: 10.1016/j.genhosppsych.2010.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 12/29/2009] [Accepted: 01/05/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVE A coherent body image is constituted in an interpersonal process during early development. Violations of body self-boundaries (e.g., sexual traumatizations during childhood) could alter the development of a coherent body image and promote symptoms of dissociation and somatization. METHOD A total of 240 psychosomatic outpatients underwent a clinical diagnostic interview and a psychometric evaluation including the Posttraumatic Stress Scale (PDS), the Body Image Questionnaire (FKB-20), an inventory of somatoform symptoms (SOMS-7), the Brief Symptom Questionnaire (BSI) and the Dissociative Experiences Scale (DES). Subjects were assigned to one of the following subgroups according to their self-reported trauma status: "nontraumatized," "nonsexually traumatized" and "sexually traumatized". RESULTS Nonsexual traumatizations were more often reported by men (53.4% vs. 35.9%), whereas women more often reported sexual traumatization (9.6% vs. 33.5%). Women reporting sexual traumatizations showed a significantly higher negative validation of their own body and significantly more psychological symptoms (BSI-GSI), whereas both men and women with sexual traumatizations reported significantly more somatoform complaints and more dissociative symptoms when compared with nonsexual or nontraumatized patients. CONCLUSION Victims of sexual trauma suffer from a more complex symptom pattern including a more negative perception of their own body compared with patients with nonsexual trauma or no trauma.
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27
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Moyer CA, Dryden T, Shipwright S. Directions and dilemmas in massage therapy research: a workshop report from the 2009 north american research conference on complementary and integrative medicine. Int J Ther Massage Bodywork 2009; 2:15-27. [PMID: 21589729 PMCID: PMC3091464 DOI: 10.3822/ijtmb.v2i2.51] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Massage therapy (MT) is widely used and expanding rapidly, but systematic research on its mechanisms and effects has, in contrast with many other therapeutic fields, a short history. PURPOSE To take stock of the current state of MT research and to explore approaches, directions, and strategies with the potential to make the next two decades of MT research optimally productive. SETTING The 2009 North American Research Conference on Complementary and Integrative Medicine held in Minneapolis, Minnesota. METHOD Using a modified Delphi method, the study authors led an interactive workshop that aimed to identify established MT research findings, needed MT research, weaknesses and limitations in currently available MT research, and directions to pursue in the next two decades of MT research. PARTICIPANTS The thirty-seven conference attendees-including MT researchers, educators, and practitioners, and other health care practitioners who already work interprofessionally with MT-actively participated in the workshop and ensured that a diversity of perspectives were represented. RESULTS The MT field has made rapid and laudable progress in its short history, but at the same time this short history is probably the main reason for most of the current shortcomings in MT research. Drawing on a diversity of backgrounds, workshop participants identified many opportunities and strategies for future research. CONCLUSION Though lost time can never be recovered, the field's late start in research should not be allowed to be a demoralizing handicap to progress. Modern scientific methods and technologies, applied to the range of directions and dilemmas highlighted in this report, can lead to impressive progress in the next twenty years of MT research.
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Price CJ, Thompson EA. Measuring dimensions of body connection: body awareness and bodily dissociation. J Altern Complement Med 2008; 13:945-53. [PMID: 18047441 DOI: 10.1089/acm.2007.0537] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to test the preliminary psychometric properties of the Scale of Body Connection (SBC), a 20-item self-report measure, designed to assess body awareness and bodily dissociation in mind-body intervention research. METHODS The SBC items were based on common expressions of awareness in body therapy. Content validity was established by a panel of experts. The validity and reliability of the scale was examined with an undergraduate sample. To assess the scale's discriminant validity, the respondents were asked to indicate exposure to specific traumas. RESULTS Confirmatory factor analysis, used to examine the scale's construct validity, indicated acceptable goodness-of-fit indices, and revealed uncorrelated subscales, reflecting independent dimensions. Cronbach's alpha revealed equal internal consistency reliability for each subscale for both men and women. Body awareness scores did not differ between individuals with and without reported trauma exposure. Bodily dissociation scores differed between individuals with and without past experience with physical trauma, suggesting the applicability of this subscale for use with populations with trauma histories. CONCLUSIONS The results provide preliminary evidence of the construct validity and internal consistency reliability of the SBC.
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Affiliation(s)
- Cynthia J Price
- School of Nursing, University of Washington, Seattle, WA 98195, USA.
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Price CJ, McBride B, Hyerle L, Kivlahan DR. Mindful awareness in body-oriented therapy for female veterans with post-traumatic stress disorder taking prescription analgesics for chronic pain: a feasibility study. Altern Ther Health Med 2007; 13:32-40. [PMID: 17985809 PMCID: PMC3037268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
CONTEXT Preliminary studies of body therapy for women in trauma recovery suggest positive results but are not specific to women with post-traumatic stress disorder (PTSD) and chronic pain. OBJECTIVE AND PARTICIPANTS To examine the feasibility and acceptability of body-oriented therapy for female veterans with PTSD and chronic pain taking prescription analgesics. DESIGN AND SETTING A 2-group, randomized, repeated-measures design was employed. Female veterans (N=14) were recruited from a Veterans Affairs (VA) healthcare system in the Northwest United States (VA Puget Sound Health Care System, Seattle, Washington). Participants were assigned to either treatment as usual (TAU) or treatment as usual and 8 weekly individual body-oriented therapy sessions (mindful awareness in body-oriented therapy group). MEASURES Written questionnaires and interviews were used to assess intervention acceptability; reliable and valid measures were administered at 3 time points to evaluate measurement acceptability and performance; and within-treatment process measures and a participant post-intervention questionnaire assessed treatment fidelity. INTERVENTION A body-oriented therapy protocol, "Mindful Awareness in Body-oriented Therapy" (MABT) was used. This is a mind-body approach that incorporates massage, mindfulness, and the emotional processing of psychotherapy. RESULTS Over 10 weeks of recruitment, 31 women expressed interest in study participation. The primary reason for exclusion was the lack of prescription analgesic use for chronic pain. Study participants adhered to study procedures, and 100% attended at least 7 of 8 sessions; all completed in-person post-treatment assessment. Written questionnaires about intervention experience suggest increased tools for pain relief/relaxation, increased body/mind connection, and increased trust/safety. Ten of 14 responded to mailed 3-month follow-up. The response-to-process measures indicated the feasibility of implementing the manualized protocol and point to the need for longer sessions and a longer intervention period with this population.
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Affiliation(s)
- Cynthia J Price
- Biobehavioral Nursing and Health Systems, University of Washington, Seattle, USA
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