Neural Mechanisms of Vibroacoustically Augmented Breath Focused Mindfulness for Dissociative Trauma-exposed People

Abstract
The ability to detect, interpret and integrate body signals with emotion (i.e., interoception) provides a basis for successful emotion regulation. This is difficult for dissociative individuals, who detach from their bodies; engagement in mindfulness interventions (designed to enhance attention to body sensations) is similarly challenging. However, interoceptive awareness can be improved with exteroceptive signaling, which may in turn lead to changes in neural function that subserve emotion regulation. In our ongoing clinical trial (NCT0467064), we are testing the use of a device that provides sternal vibration proportionate to the breath. Our goal is to examine whether exteroceptive augmentation of breath-focused mindfulness (in the form of breath-synced vibration) will yield changes in interoceptive neural networks in a sample of highly dissociative, trauma-exposed adults, and whether these changes associate with different facets of cognitive and emotion regulation. We compare four mindfulness training interventions with a cross-design of interoceptive (breath focus) and exteroceptive (vibration feedback) awareness in trauma-exposed people. Here we examine if these mindfulness trainings change network reactivity to negatively valenced images, and whether these functional changes relate to brain structure. We also examine whether changes in these neural mechanisms relate to clinical outcomes trial completion rate between groups. We will also present qualitative data on participants’ experiences in the trial and treatment implications for implementing mindfulness with dissociative trauma-exposed people.