Enhancing motor imagery in the third-person perspective by manipulating sense of body ownership with virtual reality.

Virtual reality (VR)-guided motor imagery (MI) is a widely used approach for motor rehabilitation, especially for patients with severe motor impairments. Most approaches provide visual guidance from the first-person perspective (1PP). MI training with visual guidance from the third-person perspective (3PP) remains largely unexplored. We argue that 3PP MI training has its own advantages and can supplement 1PP MI. For some movements beyond the view of 1PP, such as shoulder shrugging and other axial movements, MI are suitable performed under 3PP. However, the efficiency of existing paradigms for 3PP MI is unsatisfactory. We speculate that the absence of sense of body ownership (SOO) from 3PP could be one possible factor and hypothesize that 3PP MI could be enhanced by eliciting SOO over a 3PP avatar. Based on our hypothesis, a novel paradigm was proposed to enhance 3PP MI by inducing full-body illusion (FBI) from 3PP, which is similar to the so-called out-of-body experience (OBE), using synchronous visuo-tactile stimulus with VR. The event-related Electroencephalograph (EEG) desynchronization (ERD) at motor-related regions from 31 healthy participants were calculated and compared with a control paradigm without "OBE" FBI induction. This study attempts to enhance 3PP MI with FBI induction. It offers an opportunity to perform MI guided by action observation from 3PP with elicited SOO to the observed avatar. We believe that 3PP MI could provide more possibilities for effective rehabilitation training, when SOO could be elicited to a virtual avatar and the present work demonstrates its viability and effectiveness.

Affective Permeability: On Hysteria and Atmospheres.

BACKGROUND: Phenomenological literature has recently given much attention to the concept of atmosphere, which is the pre-individual affective tonality of the intersubjective space. The importance of atmospheres in psychopathology has been described for various disorders, but little is known about the interaction with hysteria. The aim of the present paper was to describe the psychopathology of hysteria from the angle of the phenomenon of atmosphere, focussing on the hysterical person's peculiar "affective permeability". SUMMARY: Hysterical people have difficulty defining themselves autonomously. As compensation, they adopt models transposed from the external environment such as social gender stereotypes or are influenced by the gaze and desire of others. They also possess a special sensitivity in perceiving the affectivity present in a given social situation, by which they are easily impressed and influenced. Their sensibility to environmental affectivity may allow them to take centre stage, assuming the postures and behaviours that others desire and that they sense by "sniffing" the atmosphere in which the encounter is immersed. Thus, a paradox may take place: sensibility is not mere passivity in hysteria but may become a tool for "riding" the emotional atmosphere and manipulating it. KEY MESSAGES: Affective permeability to environmental atmospheres and manipulation of the environment are the two sides of the same coin. This overlap of passive impressionability and active manoeuvring is necessary to be grasped in the clinical encounter with hysterical persons not to be submerged by their theatricality, that is, by the hyper-intensive expressivity of their feelings and behaviours.

Simulating the situated-self drives hippocampo-cortical engagement during inner narration of events.

We often use inner narration when thinking about past and future events. The present paradigm explicitly addresses the influence of the language used in inner narration on the hippocampus-dependent event construction process. We assessed the language context effect during the inner narration of different event types: past, future, daydream, and self-unrelated fictitious events. The language context was assessed via a fluent bilingual population who used inner narration, either in their first language (L1) or second language (L2). Not all inner narration of events elicited hippocampo-cortical activity. In fact, only the angular gyrus and precuneus-retrosplenial cortex were activated by inner narration across all event types. More precisely, only inner narration of events which entailed the simulation of bodily self-location in space (whether or not they were time-marked: past, future, daydream) depended on the hippocampo-cortical system, while inner narration of events that did not entail bodily self-location (self-unrelated fictitious) did not. The language context of the narration influenced the bilinguals' hippocampo-cortical system by enhancing the co-activation of semantic areas with the hippocampus for inner narration of events in the L2. Overall, this study highlights 2 important characteristics of hippocampo-cortical-dependent inner narration of events: The core episodic hippocampal system is activated for inner narration of events simulating self-location in space (regardless of time-marking), and the inner language used for narration (L1 or L2) mediates hippocampal functional connectivity.

LIVE-streaming 3D images: A neuroscience approach to full-body illusions.

Inspired by recent technological advances in the gaming industry, we used capture cards to create and LIVE-stream high quality 3D-images. With this novel technique, we developed a real-life stereoscopic 3D full-body illusion paradigm (3D projection). Unlike previous versions of the full-body illusion that rely upon unwieldy head-mounted displays, this paradigm enables the unobstructed investigation of such illusions with neuroscience methods (e.g., transcranial direct current stimulation, transcranial magnetic stimulation, electroencephalography, and near-infrared spectroscopy) and examination of their neural underpinnings. This paper has three aims: (i) to provide a step-by-step guide on how to implement 3D LIVE-streaming, (ii) to explain how this can be used to create a full-body illusion paradigm; and (iii) to present evidence that documents the effectiveness of our methods (de Boer et al., 2020), including suggestions for potential applications. Particularly significant is the fact that 3D LIVE-streaming is not GPU-intensive and can easily be applied to any device or screen that can display 3D images (e.g., TV, tablet, mobile phone). Therefore, these methods also have potential future clinical and commercial benefits. 3D LIVE-streaming could be used to enhance future clinical observations or educational tools, or potentially guide medical interventions with real-time high-quality 3D images. Alternatively, our methods can be used in future rehabilitation programs to aid recovery from nervous system injury (e.g., spinal cord injury, brain damage, limb loss) or in therapies aimed at alleviating psychosis symptoms. Finally, 3D LIVE-streaming could set a new standard for immersive online gaming as well as augmenting online and mobile experiences (e.g., video chat, social sharing/events).

Bodily Experience in Depression: Using Focusing as a New Interview Technique.

INTRODUCTION: Research on body aspects in depression primarily focuses on somatic complaints, while phenomenologists emphasize the pre-reflective bodily experience of depression as relevant for the psychopathology of it. Despite this increasing acknowledgement of the subjective body's impact on depression, empirically, it remains rarely studied. METHODS: Relying on the psychotherapy method of Focusing (Gendlin, 1982), interviews were developed, which enable participants with depression to get in contact with pre-reflective bodily experiences through turning inward, attentively observing all bodily feelings that arise, and finding symbolizations for these feelings. RESULTS: In 501 codings of the conducted interviews, the theme of passivity emerged on a continuum ranging from inhibition of drive to lack of drive. It can be split into 5 components (heaviness, emptiness, paralysis, blockage, and alienation), which were felt in the head or the whole body. Moreover, participants reported active, pressuring feelings in the chest and stomach areas, which were associated with specific emotions in some participants. DISCUSSION: In conclusion, through focusing, participants were able to take note of their pre-reflective bodily feelings and described feelings of passivity, active, pressuring feelings, and an ambivalence between these two parts. Results support the notion that depression is associated with specific pre-reflective bodily experiences and lay a foundation for future research.

Body experience and the mother-child relationship in pregnancy: a cross-sectional study of pregnant Portuguese women.

Objective: In spite of the huge physical transformations that occur during pregnancy, there is little research on the role of body experience in the establishment of the mother-child relationship in pregnancy. The aim of the present study was to address this gap. Method: A sample of 330 pregnant women completed questionnaires assessing mother-child relationship (the Maternal-Fetal Attachment Scale), body experience, and other demographic and pregnancy variables. Results: Pearson's correlations revealed a number of variables were related to mother-child relationship in pregnancy, and t-tests and ANOVAs showed some between-subjects differences based on demographic variables. After controlling for these variables, regression analyses revealed that body experience was a significant predictor of both subscales of the Maternal-Fetal Attachment Scale: emotional investment in the baby and maternal role-taking. Conclusion: These findings highlight the connection between body experience and the psychological tasks of pregnancy and draw attention to new ways of assessing and improving mother-child relationships as early as in pregnancy. Results are discussed in terms of their clinical implications.

A two-dimensional model of disrupted body integrity: initial evaluation in head and neck cancer.

PURPOSE: This cross-sectional study presents an initial psychometric evaluation of a two-dimensional (perceptual and evaluative) conceptualization and measure of disrupted body integrity (DBI)-illness-related disruption of the sense of the body as an integrated, smoothly functioning whole. METHODS: Male and female head and neck cancer (HNC) outpatients (N = 98) completed a questionnaire package prior to outpatient visits. MAIN OUTCOME MEASURES: The Disrupted Body Integrity Scale (DBIS) was developed to measure the perceptual and evaluative facets of DBI. Self-report measures of disfigurement, stigma, depressive symptoms, and negative affect were also completed. RESULTS: Almost all DBIS subscales demonstrated good internal consistency. Results largely supported the DBIS's construct validity. The majority of subscales correlated within the predicted range of r's = .40-.70. Almost all DBIS constructs were positively linked with either depressive symptoms or disfigurement. None correlated with positive affect, and only two subscales, abnormal sensations (perceptual) and physical vulnerability (evaluative), correlated with negative affect. DBIS constructs showed little relation with stigma, once disfigurement effects were controlled for. CONCLUSIONS: Findings offer preliminary evidence for the DBIS and the relevance of DBI in HNC. Further evaluation of DBI in disease adaptation and the DBIS's factor structure is warranted.

The depersonalized brain: New evidence supporting a distinction between depersonalization and derealization from discrete patterns of autonomic suppression observed in a non-clinical sample.

Depersonalization and Derealization are characterised by feelings of detachment from one's bodily self/surroundings and a general emotional numbness. We explored predisposition to trait-based experiences of depersonalization/derealization-type experiences and autonomic arousal toward simulated body-threats, which were delivered to the participant's own body (i.e. Self) and when observed being delivered to another individual (i.e. Other). Ninety participants took part in an "Implied Body-Threat Illusion" task (Dewe, Watson, & Braithwaite, 2016) and autonomic arousal was recorded via standardised skin conductance responses and finger temperature. Autonomic suppression in response to threats delivered to the Self correlated with increases in trait-based depersonalization-type experiences. In contrast, autonomic suppression for threats delivered to Others correlated with trait-based derealization-like experiences. Body-temperature and anticipatory arousal did not correlate reliably with predisposition to depersonalization- or derealization-type experiences. The theoretical implications of these findings are discussed in terms of a fronto-limbic autonomic suppression mechanism.

Anorexia Nervosa and First-Person Perspective: Altruism, Family System, and Body Experience.

Based on the case study of Jeanne, the objective of this article is to study patterns of specific subjectivity in anorexic subjects. We seek to identify, in a first-person perspective, the core vulnerability features of anorexic existence, beyond the dimension of food alone. The identification of a psychopathological structure results in a better understanding of Jeanne's clinical situation and helps formulate psychotherapeutic and prophylactic recommendations. We suggest that so-called "denial" is a psychological mechanism that should be reconsidered. Denial is not a mechanism pertaining to anorexic subjects alone, but is also a process encountered both in the patient's family and in the therapeutic environment. Anorexic denial is based on anosognosia and the refusal to see one's own thinness, while other people's denial consists in a widespread inability to perceive the altruism and intersubjective problematic on which the existence of an anorexic subject fundamentally depends.

The 'not-so-strange' body in the mirror: A principal components analysis of direct and mirror self-observation.

In this study we adopted a psychometric approach to examine how the body is subjectively experienced in a mirror. One hundred and twenty-four healthy participants viewed their body for five minutes directly or via a mirror, and then completed a 20-item questionnaire designed to capture subjective experiences of the body. PCA revealed a two-component structure for both direct and mirror conditions, comprising body evaluations (and alienation) and unusual feelings and perceptions. The relationship between these components and pre-existing tendencies for appearance anxiety, body dysmorphic-type beliefs, dissociative symptomatology, self-objectification and delusion ideation further supported the similarity between direct and mirror conditions; however, the occurrence of strange experiences like those reported to occur during prolonged face viewing was not confirmed. These results suggest that, despite obvious differences in visual feedback, observing the body via a mirror (as an outside observer) is subjectively equivalent to observing the body directly (from our own viewpoint).

First-time pregnant women's experiences of their body in early pregnancy.

BACKGROUND: The body of first-time pregnant women is affected in many ways, and the women may not know what to expect. Conversations between women and healthcare personnel about women's bodily experience in early pregnancy can contribute to increased body knowledge, which may have a positive impact in later stages of their pregnancy and in relation to delivery. The aim of the study was to describe first-time pregnant women's experiences of their body in early pregnancy (pregnancy weeks 10-14). METHOD: Twelve women were asked to draw pictures and answer questions freely about their experiences of their first pregnant body. Hermeneutical text interpretation was used to obtain an overall view of the experiences. FINDINGS: A main theme emerged: 'the body is connected to the cycle of life'. This theme comprised five subthemes: 'bodily longing and a sense of ambivalence', 'being doubtful', 'welcoming changes in body and mind', 'feeling inner strength and struggle to find strength' and 'accepting a different body and mind'. This main theme and the subthemes were further interpreted and were understood as an experience of 'me and my body'. CONCLUSIONS: The body reminded the women to take care of it and gave rise to positive thoughts. When the body exhibited uncomfortable reactions and sensations, these were taken as evidence of pregnancy, which was also seen positive but it also triggered a sense of dissatisfaction with the body and a feeling of it becoming alien.

The psychological determinants of obesity in children and adolescents.

The aim of this article is to show selected psychological mechanisms involved in the onset and maintenance of obesity in children and youth. This work presents a review of the literature related to the psychological determinants of obesity from different theoretical approaches. The role of the mother-child relationship, as well as the specific characteristics of the relationships within the family, have been emphasized in the onset of the disorder. Another topic discussed were the specifics of the body experience and certain body image distortions that promote the maintenance of the obese state. The control deficit caused by family relationships was also described.

The second me: Seeing the real body during humanoid robot embodiment produces an illusion of bi-location.

Whole-body embodiment studies have shown that synchronized multi-sensory cues can trick a healthy human mind to perceive self-location outside the bodily borders, producing an illusion that resembles an out-of-body experience (OBE). But can a healthy mind also perceive the sense of self in more than one body at the same time? To answer this question, we created a novel artificial reduplication of one's body using a humanoid robot embodiment system. We first enabled individuals to embody the humanoid robot by providing them with audio-visual feedback and control of the robot head movements and walk, and then explored the self-location and self-identification perceived by them when they observed themselves through the embodied robot. Our results reveal that, when individuals are exposed to the humanoid body reduplication, they experience an illusion that strongly resembles heautoscopy, suggesting that a healthy human mind is able to bi-locate in two different bodies simultaneously.

Disentangling neural processes of egocentric and allocentric mental spatial transformations using whole-body photos of self and other.

Mental imagery of one's body moving through space is important for imagining changing visuospatial perspectives, as well as for determining how we might appear to other people. Previous neuroimaging research has implicated the temporoparietal junction (TPJ) in this process. It is unclear, however, how neural activity in the TPJ relates to the rotation perspectives from which mental spatial transformation (MST) of one's own body can take place, i.e. from an egocentric or an allocentric perspective. It is also unclear whether TPJ involvement in MST is self-specific or whether the TPJ may also be involved in MST of other human bodies. The aim of the current study was to disentangle neural processes involved in egocentric versus allocentric MSTs of human bodies representing self and other. We measured functional brain activity of healthy participants while they performed egocentric and allocentric MSTs in relation to whole-body photographs of themselves and a same-sex stranger. Findings indicated higher blood oxygen level-dependent (BOLD) response in bilateral TPJ during egocentric versus allocentric MST. Moreover, BOLD response in the TPJ during egocentric MST correlated positively with self-report scores indicating how awkward participants felt while viewing whole-body photos of themselves. These findings considerably advance our understanding of TPJ involvement in MST and its interplay with self-awareness.

The multisensory mind: a systematic review of multisensory integration processing in Anorexia and Bulimia Nervosa.

Individuals with Anorexia Nervosa and Bulimia Nervosa present alterations in the way they experience their bodies. Body experience results from a multisensory integration process in which information from different sensory domains and spatial reference frames is combined into a coherent percept. Given the critical role of the body in the onset and maintenance of both Anorexia Nervosa and Bulimia Nervosa, we conducted a systematic review to examine multisensory integration abilities of individuals affected by these two conditions and investigate whether they exhibit impairments in crossmodal integration. We searched for studies evaluating crossmodal integration in individuals with a current diagnosis of Anorexia Nervosa and Bulimia Nervosa as compared to healthy individuals from both behavioral and neurobiological perspectives. A search of PubMed, PsycINFO, and Web of Sciences databases was performed to extract relevant articles. Of the 2348 studies retrieved, 911 were unique articles. After the screening, 13 articles were included. Studies revealed multisensory integration abnormalities in patients affected by Anorexia Nervosa; only one included individuals with Bulimia Nervosa and observed less severe impairments compared to healthy controls. Overall, results seemed to support the presence of multisensory deficits in Anorexia Nervosa, especially when integrating interoceptive and exteroceptive information. We proposed the Predictive Coding framework for understanding our findings and suggested future lines of investigation.

Diagnoses of Anorexia Nervosa and Bulimia Nervosa have increased dramatically in recent years, taking on the characteristics of a mental health emergency. More research is therefore needed to better understand these conditions, especially given their complex and multifaceted nature. Patients affected by these conditions report significant alterations in body-self experience. Body experience results from a cross-modal integration process in which information from different sensory modalities and spatial frames is combined. Therefore, we systematically reviewed studies that focused on multisensory integration in patients affected by Anorexia Nervosa and Bulimia Nervosa, as it may play a key role in the onset and maintenance of these pathologies. Studies in this review found multisensory integration difficulties in patients with Anorexia Nervosa, but not enough studies were retrieved to draw conclusions regarding Bulimia Nervosa. We discussed findings trying to link behavioral, neuropsychological, and neuroscientific evidence in light of the predictive coding framework to provide a different perspective on patients' distorted body experiences. This may lead to new insights to refine our understanding of these complex and poorly understood disorders.

Explanation of near-death experiences: a systematic analysis of case reports and qualitative research.

Background and objective: Some individuals report a near-death experience (NDE) after a life-threatening crisis, which refers to a range of subjective experiences related to impending death. This experience is a phenomenon with transcendental elements, which leads to deep permanent changes in both the individual and the social lives of the NDEr's. Therefore, this study aims to review the near-death experiences of individuals with different religious and cultural views. Methodology: This is a systematic analysis study. All the case report, case series and qualitative research studies which presented patients' NDE experiences were included in the study, without language restrictions, and in the period of 1980-2022. The stages of screening, selection, data extraction, and quality assessment have been gone through by two of the researchers. Data analysis and synthesis has been done qualitatively. JBI Critical Appraisal Checklist tool was used to evaluate the quality of the included studies. Findings: After the initial search, 2,407 studies were included, 54 of which underwent final examination. The total number of the NDEr's in the studies was 465 men, women, and children. Among these studies, 27 were case reports, 20 were case series, and 7 were qualitative studies. Near-death experiences have been categorized into 4 main categories and 19 subcategories. The main categories include emotional experiences (2 subcategories), cognitive experiences (4 subcategories), spiritual and religious experiences (4 subcategories), and supernatural experiences [9 subcategories in two categories (out of body experiences, and supernatural and metaphysical perceptions)]. Conclusion: The most frequent near-death experiences were supernatural experiences, especially the experience of leaving the body. The basis and the content of the patterns mentioned by the NDEr's are similar, and the differences are in the explanation and the interpretation of the experience. There is a common core among them such as out-of-body experiences, passing through a tunnel, heightened senses, etc. Therefore, correct knowledge of near-death experiences leads to providing helpful answers to patients.

Precision or narrative medicine? Child neurology needs both!

Precision medicine aims to understand the mechanisms of diseases and to find treatments adapted to each individual or group of patients, on the basis of biological characteristics and environment. It uses new tools based on digital technologies. Narrative medicine was theorized, in the 2000s, as a reaction to the increasing technicality and the notion of a lack of human relations in care: It focuses on recognizing the essential place of the patient's experience of illness and life history in the diagnosis and management of diseases as well as in the training of caregivers. These two opposite currents are rarely considered together. In fact, they have in common the basic principle that each patient is unique, and both are often more closely intertwined than we think, especially in the field of child neurology. Five case histories and discussions presented here aim to demonstrate that combining the precision approach with the narrative approach can improve the diagnosis, treatment, classification, and understanding of neurological conditions, as well as enhance the dialog with families and make teaching more meaningful. Not only rare diseases but common problems, such as paroxysmal events, pain, epilepsy, intellectual disability, and autism spectrum disorder, are addressed from both perspectives.

Targeting Affective Mood Disorders With Ketamine to Prevent Chronic Postsurgical Pain.

The phencyclidine-derivative ketamine [2-(2-chlorophenyl)-2-(methylamino)cyclohexan-1-one] was added to the World Health Organization's Model List of Essential Medicines in 1985 and is also on the Model List of Essential Medicines for Children due to its efficacy and safety as an intravenous anesthetic. In sub-anesthetic doses, ketamine is an effective analgesic for the treatment of acute pain (such as may occur in the perioperative setting). Additionally, ketamine may have efficacy in relieving some forms of chronic pain. In 2019, Janssen Pharmaceuticals received regulatory-approval in both the United States and Europe for use of the S-enantiomer of ketamine in adults living with treatment-resistant major depressive disorder. Pre-existing anxiety/depression and the severity of postoperative pain are risk factors for development of chronic postsurgical pain. An important question is whether short-term administration of ketamine can prevent the conversion of acute postsurgical pain to chronic postsurgical pain. Here, we have reviewed ketamine's effects on the biopsychological processes underlying pain perception and affective mood disorders, focusing on non-NMDA receptor-mediated effects, with an emphasis on results from human trials where available.

Picturing disturbed body experience: A comparison of body drawings in persons with somatoform disorder and a general population sample.

People with somatic symptom disorder or somatoform disorder are considered to have a troubled relationship to their body that is hard to assess with self-report questionnaires alone. To examine the potential value of own-body drawings as an assessment tool, objective features of drawings from 179 patients referred to treatment for somatoform disorder, were compared to those of 173 age-and-sex matched persons from the general population. While two factors had been found in the somatoform disorder sample, in the general population only the factor that reflected 'details' in own-body drawings was replicated. The two samples did not score differently on this factor. The general population sample showed a less strong association between objective body drawings scores on this 'details' factor and self-reported scores of body experience than the somatoform disorder sample. Moreover, the phenomenological contents of the drawings were more oriented towards health or appearance than the mostly mixed or unclear orientation of persons with somatoform disorder. Because the objective scoring of body drawings did not differ between groups while the contents of body drawings appeared to differ, the results suggest that this objective scoring of body drawings is not appropriate to distinguish people with and without somatoform disorder.