The nested hierarchical model of self and its non-relational vs relational posttraumatic manifestation: an fMRI meta-analysis of emotional processing.

Different kinds of traumatic experiences like natural catastrophes vs. relational traumatic experiences (e.g., sex/physical abuse, interpersonal partner violence) are involved in the development of the self and PTSD psychopathological manifestations. Looking at a neuroscience approach, it has been proposed a nested hierarchical model of self, which identifies three neural-mental networks: (i) interoceptive; (ii) exteroceptive; (iii) mental. However, it is still unclear how the self and its related brain networks might be affected by non-relational vs relational traumatic experiences. Departing from this background, the current study aims at conducting a meta-analytic review of task-dependent fMRI studies (i.e., emotional processing task) among patients with PTSD due to non-relational (PTSD-NR) and relational (PTSD-R) traumatic experiences using two approaches: (i) a Bayesian network meta-analysis for a region-of-interest-based approach; (ii) a coordinated-based meta-analysis. Our findings suggested that the PTSD-NR mainly recruited areas ascribed to the mental self to process emotional stimuli. Whereas, the PTSD-R mainly activated regions associated with the intero-exteroceptive self. Accordingly, the PTSD-R compared to the PTSD-NR might not reach a higher symbolic capacity to process stimuli with an emotional valence. These results are also clinically relevant in support of the development of differential treatment approaches for non-relational vs. relational PTSD.

Electrochemical Performance of Metal-Free Carbon-Based Catalysts from Different Hydrothermal Carbonization Treatments for Oxygen Reduction Reaction.

This research investigates the difference between products obtained through two hydrothermal carbonization treatments. Our aim is to synthesize metal-free, carbon-based catalysts for the oxygen reduction reaction (ORR) to serve as efficient and cost-effective alternatives to platinum-based catalysts. Catalysts synthesized using the traditional hydrothermal approach exhibit a higher electrocatalytic activity for ORR in alkaline media, despite their more energy-intensive production process. The superior performance is attributed to differences in the particle morphology and the chemical composition of the particle surfaces. The presence of functional groups on the surfaces of catalysts obtained via a traditional approach significantly enhances ORR activity by facilitating deprotonation reactions in an alkaline environment. Our research aims to provide a reference for future investigations, shifting the focus to the fine-tuning of surface chemical compositions and morphologies of metal-free catalysts to enhance ORR activity.

The self and our perception of its synchrony - Beyond internal and external cognition.

The self is the core of our mental life which connects one's inner mental life with the external perception. Since synchrony is a key feature of the biological world and its various species, what role does it play for humans? We conducted a large-scale psychological study (n = 1072) combining newly developed visual analogue scales (VAS) for the perception of synchrony and internal and external cognition complemented by several psychological questionnaires. Overall, our findings showed close connection of the perception of synchrony of the self with both internal (i.e., body and cognition) and external (i.e., others, environment/nature) synchrony being associated positively with adaptive and negatively with maladaptive traits of self. Moreover, we have demonstrated how external (i.e., life events like the COVID-19 pandemic) variables modulate the perception of the self's internal-external synchrony. These findings suggest how synchrony with self plays a central role during times of uncertainty.

In Between the Psychological and Physiological Self - The Impact of Covid-19 Pandemic on the Neuro-Socio-Ecological and Inflammatory Mind-Body-Brain System.

The COVID-19 pandemic has had a profound impact on individuals' sense of self perturbating the sense of connectedness with the others, touching upon deep existential fears and deep intersubjective and cultural layers, emphasizing the importance of a neuro-socio-ecological alignment for the sense of security of psychological self. We can still observe after years how social distancing measures, quarantines, and lockdowns have disrupted social connections and routines, leading to feelings of isolation, anxiety and depressive symptomatology. Furthermore, from a physiological perspective, some people continue to experience health problems long after having COVID-19, and these ongoing health problems are sometimes called post-COVID-19 syndrome or post-COVID conditions (PASC). In this complex scenario, through the operationalization of the sense of self and its psychological and physiological baseline, our aim is to try to shed some new light on elements of resilience vs. vulnerability. Here we intend the self and its baseline as the crossroads between psychology and physiology and we show how COVID-19 pandemic, especially in post-COVID-19 syndrome (PACS), left traces in the mind-body-brain system at a neuro-socio-ecological and inflammatory level.

Dissociative Dimensions and Their Implications for Emotional Dysregulation Underlying Borderline Personality Disorder Features.

ABSTRACT: Emotion dysregulation is considered a core feature of borderline personality disorder (BPD). The role of dissociation in BPD has been discussed from different perspectives. Nevertheless, implications of dissociation for BPD features are not clear. The current study estimated mediation effects of dissociative dimensions on the relationships between several emotion regulation strategies (ERSs) and BPD features among 281 adults recruited from the general population. The online survey administered a comprehensive self-report battery for the assessment of maladaptive and adaptive ERSs together with dissociative dimensions. Borderline personality disorder features were also self-report screened. Results showed significant indirect effects of dissociation on the relationships between ERSs and BPD features. Dissociation was a full mediator of the relationship between deficits with problem-solving skills and BPD criteria. The study confirmed that emotion dysregulation is a core feature of BPD and that the dissociative dimensions should be included as relevant maladaptive mechanisms sustaining BPD emotional difficulties.

Neural responses to emotional stimuli across the dissociative spectrum: Common and specific mechanisms.

AIM: Departing from existing neurobiological models of dissociation, the current study aims at conducting a quantitative meta-analytic review of neural responses to emotional stimuli among individuals ascribed to the dissociative spectrum (DS). Accordingly, the study explored common and specific brain mechanisms across borderline personality disorder, conversion/somatoform disorders, posttraumatic stress disorder, posttraumatic stress disorder related to repeated interpersonal traumatic experiences, and dissociative disorders. METHODS: The meta-analysis included studies that administered emotional stimuli during functional magnetic resonance imaging acquisition among individuals included in the DS. There were two conducted meta-analytic procedures: (i) a Bayesian network meta-analysis for a region-of-interest-based approach; and (ii) robust voxel-based approach. RESULTS: Forty-four independent studies were included for a total of 1384 individuals (DS = 741 patients). The network meta-analysis showed specific patterns of neural activity considering an extended brain network involved in emotion regulation for each condition ascribed to the DS. The voxel-based meta-analysis highlighted an increased activity of dorsal anterior cingulate cortex as a common neurological signature of the DS. CONCLUSION: The common neural feature of the DS captures an implicit appraisal of emotion-eliciting stimuli as threatening and/or noxious for mental and physical integrity of the individual together with painful subjective experiences associated with physiological emotional reactions. Specific brain responses across the DS suggested the engagement in different mechanisms to address emotional stimuli, including implicit avoidance reactions and attempts to overcontrol of affective states together with a disruption of integrative processes of emotional mind-body features.

Attachment anxiety, reflective functioning and well-being as predictors of burn-out and psychological distress among psychotherapists: A longitudinal study.

OBJECTIVE: This study aims to longitudinally investigate the effects of individual's factors on subsequent burn-out/psychological distress in a sample of mental health practitioners, testing if higher attachment anxiety and avoidance and lower reflective functioning (i.e., certainty and uncertainty of mental states) and well-being at baseline may lead to a greater psychological distress and burn-out 1 year later. METHODS: The sample consisted of 40 experienced psychotherapists (females: 72.5%; mean age: 47.40 ± 9.48 years) who completed a battery of questionnaires at baseline and 1 year later. Statistical analyses were conducted with Bayesian multiple linear regressions. RESULTS: Greater attachment anxiety and certainty about mental states and lower individual's well-being at baseline predicted greater burn-out 1 year later. Similarly, greater attachment anxiety and lower individual's well-being at baseline predicted psychological distress at 1 year follow-up. Of note, uncertainty of mental states and avoidant attachment were not associated with outcomes. CONCLUSION: These findings suggest that the levels of burn-out and psychological distress among psychotherapists may be alleviated with interventions targeting attachment insecurity, specific aspects of reflective functioning (i.e., certainty about mental states) and well-being.

The nested hierarchy of self and its trauma: In search for a synchronic dynamic and topographical re-organization.

The sense of self has always been a topic of high interest in both psychoanalysis and most recently in neuroscience. Nowadays, there is an agreement in psychoanalysis that the self emerges from the relationship with the other (e.g., the caregiver) in terms of his/her capacity to attune, regulate, and synchronize with the emergent self of the infant. The outcome of this relational/intersubjective synchronization is the development of the sense of self and its regulatory processes both in dynamic psychology and neuroscience. In this work, we propose that synchrony is a fundamental biobehavioral factor in these dialectical processes between self and others which shapes the brain-body-mind system of the individuals, including their sense of self. Recently in neuroscience, it has been proposed by the research group around Northoff that the self is constituted by a brain-based nested hierarchical three-layer structure, including interoceptive, proprio-exteroceptive, and mental layers of self. This may be disrupted, though, when traumatic experiences occur. Following the three levels of trauma theorized by Mucci, we here suggest how different levels of traumatic experiences might have an enduring effect in yielding a trauma-based topographic and dynamic re-organization of the nested model of self featured by dissociation. In conclusion, we propose that different levels and degrees of traumatic experience are related to corresponding disruptions in the topography and dynamic of the brain-based three-layer hierarchical structure of the self.

Intrinsic Shapes of Empathy: Functional Brain Network Topology Encodes Intersubjective Experience and Awareness Traits.

Trait empathy is an essential personality feature in the intricacy of typical social inclinations of individuals. Empathy is likely supported by multilevel neuronal network functioning, whereas local topological properties determine network integrity. In the present functional MRI study (N = 116), we aimed to trace empathic traits to the intrinsic brain network architecture. Empathy was conceived as composed of two dimensions within the concept of pre-reflective, intersubjective understanding. Vicarious experience consists of the tendency to resonate with the feelings of other individuals, whereas intuitive understanding refers to a natural awareness of others' emotional states. Analyses of graph theoretical measures of centrality showed a relationship between the fronto-parietal network and psychometric measures of vicarious experience, whereas intuitive understanding was associated with sensorimotor and subcortical networks. Salience network regions could constitute hubs for information processing underlying both dimensions. The network properties related to empathy dimensions mainly concern inter-network information flow. Moreover, interaction effects implied several sex differences in the relationship between functional network organization and trait empathy. These results reveal that distinct intrinsic topological network features explain individual differences in separate dimensions of intersubjective understanding. The findings could help understand the impact of brain damage or stimulation through alterations of empathy-related network integrity.

The self and its internal thought: In search for a psychological baseline.

Self-consciousness is neuronally associated with the brain's default mode network as its "neuronal baseline" while, psychologically the self is characterized by different thought modes and dynamics. We here raise the question whether they reflect the "psychological baseline" of the self. We investigate the psychological relationship of the self with thought modes (rumination, reflection) and mind-wandering dynamics (spontaneous, deliberate), as well as with depressive symptomatology. Our findings show a relationship between self-consciousness and i) mind-wandering dynamics, and ii) thought functional modes, in their respective forms. At the same time, self-consciousness is more related to spontaneous mind-wandering than deliberate and to rumination than reflection. Furthermore, iii) rumination acts as a mediator between self-consciousness and spontaneous mind-wandering dynamics; and iv) the relationship between high levels of self-consciousness and depressive symptoms is mediated by ruminative modes and spontaneous mind-wandering dynamics. Together, these findings support the view of the self as "psychological baseline".

Dreaming the unrepressed unconscious and beyond: repression vs dissociation in the oneiric functioning of severe patients.

Starting with Freud and Jung, dreams have always been considered a core source of information for psychoanalysis. Nowadays, neuroscientific findings suggest that dreams are related especially to limbic and right emotional brain circuit, and that during REM stages they engage self-related and visual internally generated processing. These neuroscientific findings together with contemporary psychoanalysis suggest that dreams are related to the sense of self and serve the purpose of re-integrating and re-structuring the integrity of the psyche. However, while dreams are still viewed as 'the via regia to the unconscious', it is the unconscious that has been reconsidered. The repressed unconscious seems to be related with left brain activity while the unrepressed unconscious based on dissociation seems to be associated with limbic and cortical areas of the right hemisphere. This notion of the unconscious might be seen as an implicit self-system encoded in the right brain that evolves in the interaction with a primary caregiver developing through preverbal and bodily stages of maturation enhanced by signals of dual communication. What kind of dreams for which unconscious? What are the differences regarding the capacity to dream for neurotic and borderline personality organizations? Our research aims to integrate psychodynamics, infant research, and neuroscientific findings to better understand the role of dreams in the assessment and treatment of, especially, traumatized and borderline patients. The capacity to dream is here proposed as a sort of enacted manifestation of emotional memories for the development of a more cohesive, coherent and symbolic vs fragmented, diffuse and alexithymic sense of self.

Dissociation and emotion regulation strategies: A meta-analytic review.

OBJECTIVE: Clinical and neurobiological models posited that dissociative mechanisms might affect processes involved in emotional generation and regulation. However, there is a lack of a comprehensive theoretical framework that systematically includes dissociation within emotional functioning. METHODS: The current study aims at conducting a meta-analytic review on the relationship between dissociation and emotion regulation in order to empirically estimate to what extent dissociation is related to emotion regulation processes. The meta-analysis was based on r coefficient as effect size measure, using a random-effect approach. RESULTS: The meta-analysis included 57 independent studies for a total of 11596 individuals. Findings showed an overall moderate relationship between dissociation and emotion regulation (rw = .32; p < .05). The association between dissociation and emotion regulation was the same among clinical samples than non-clinical ones. Furthermore, dissociation showed moderate to large relationships with maladaptive domains of emotion regulation, namely disengagement (rw = 0.34; p < .01) (i.e., behavioral avoidance, experiential avoidance, thought and emotional suppression) and aversive cognitive perseveration (rw = 0.38; p < .001) (i.e., rumination, worry and nonacceptance). The analysis did not find significant relationship between dissociation and adaptive domain of emotional regulation (i.e., problem solving, mindfulness). CONCLUSION: Dissociation in the context of emotion regulation might be viewed as a basic neuro-mental mechanism that automatically contribute to the over-modulation of emotional states through avoidance reactions from internal and external reality. Future longitudinal studies are needed to clarify the causal relationships between dissociation and emotion regulation.

Dissociation vs Repression: A New Neuropsychoanalytic Model for Psychopathology.

Recent research on trauma, attachment and neuroscience point at a clear divide in psychopathology between disorders based on repression, (as in Freud's repression model) and psychopathologies structured on dissociative mechanisms, a response to severe interpersonal trauma. Pathologies based on repression are typical of a neurotic structure, (with better developmental outcome), while pathologies based on dissociation are of more severe, often borderline nature, as in Otto Kernberg's borderline organization (1975). Neurobiology of attachment and affect regulation theory (Allan Schore), developmental psychopathology (Giovanni Liotti) and contemporary relational psychoanalysis (Philip Bromberg), all provide clinical evidence that the most severe psychopathology is of dissociative structure. This paper clarifies the after-effects of first level of traumatization of human agency (i.e., lack of attunement) and of the second level as in cases with actual abuse, maltreatment or incest (Mucci, 2013), with the internalization of a dyad victim/persecutor within the self of the survivor, as seen in borderline psychopathology (Mucci, 2018).

Assessing Mental Representation as an Indicator of Self and Interpersonal Functioning in Psychotherapy Patients.

The goal of this study was to test in a clinical sample the interrater reliability and convergent validity of the Differentiation-Relatedness Scale (D-RS), a measure that evaluates mental representations based on open-ended descriptions of self and significant others. The study also investigated the ability of the D-RS to predict personality disorders (PDs) from Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the dysfunctional trait domains presented in the Alternative DSM-5 Model for Personality Disorders Criterion B in Section III of the DSM-5. We also evaluated if the D-RS predicts observed Section II PDs over and above Criterion B of the Alternative DSM-5 Model for Personality Disorders. We found that the interrater reliability of the D-RS was good on the basis of the mean scores of 6 independent raters and that it showed moderate convergent validity. Results of dominance analyses indicated that the D-RS is a significant predictor of Section II borderline PD and of the overall number of DSM-5 PDs. When we considered the Section III Criterion B for PDs, the D-RS was not able to predict any of the Personality Inventory for DSM-5 domains, suggesting that the D-RS may be more related to personality functioning behind mental representations than to maladaptive personality traits. Finally, results of hierarchical regression analyses suggested that the D-RS produced a significant but modest increase in the prediction of borderline PD traits and the overall number of PDs traits even when the effect of the Personality Inventory for DSM-5 domains were controlled for.

All roads lead to the default-mode network-global source of DMN abnormalities in major depressive disorder.

Major depressive disorder (MDD) is a psychiatric disorder characterized by abnormal resting state functional connectivity (rsFC) in various neural networks and especially in default-mode network (DMN). However, inconsistent findings, i.e., increased and decreased DMN rsFC, have been reported, which raise the question for the source of DMN changes in MDD. Testing whether the DMN abnormalities in MDD can be traced to either a local, i.e., intra-network, or a global, i.e., inter-network, source, we conducted a novel sequence of rsFC analyses, i.e., global FC, intra-network FC, and inter-network FC. Moreover, all analyses were conducted without global signal regression (non-GSR) and with GSR in order to identify the impact of specifically the global component of functional connectivity on within-network functional connectivity within specifically the DMN. In MDD our findings demonstrate (i) increased representation of global signal correlation (GSCORR) in DMN regions, as confirmed independently by degree of centrality (DC) and by an independent DMN template, (ii) increased within-network DMN rsFC, (iii) highly increased inter-network rsFC of both lower- and higher order non-DMN networks with DMN, (iv) high accuracy in classifying MDD vs. healthy subjects by using GSCORR as predictor. Further supporting the global, i.e., non-DMN source of within-network rsFC of the DMN, all results were obtained only when including the global signal, i.e., non-GSR, but not when conducting GSR. Together, we show for the first time increased global signal representation within rsFC of DMN as stemming from inter-network sources as distinguished from local sources, i.e., within- or intra-DMN.

Dissociation as a disorder of integration - On the footsteps of Pierre Janet.

At the end of the 19th century Pierre Janet described dissociation as an altered state of consciousness manifested in disrupted integration of psychological functions. Clinically, such disruption comprises compartmentalization symptoms like amnesia, detachment symptoms like depersonalization/derealization, and structural dissociation of personality with changes in the sense of self. The exact neuronal mechanisms leading to these different symptoms remain unclear. We here suggest to put Janet's original account of dissociation as disrupted integration of psychological functions into a novel context, that is, a neuronal context as related to current brain imaging. This requires a combined theoretical and empirical approach on data supporting such neuronal reframing of Janet. For that, we here review (i) past and (ii) recent psychological and neuronal views on dissociation together with neuroscientific theories of integration, which (iii) are supported and complemented by preliminary fMRI data. We propose three neuronal mechanisms of dynamic integration operating at different levels of the brain's spontaneous activity - temporo-spatial binding on the regional level, temporo-spatial synchronization on the network level, and temporo-spatial globalization on the global level. These neuronal mechanisms, in turn, may be related to different symptomatic manifestation of dissociation operating at different levels, e.g., compartmentalization, detachment, and structural, which, as we suggest, can all be traced to disrupted integration of neuronal and psychological functions as originally envisioned by Janet.

The Self and its World: A Neuro-Ecological and Temporo-Spatial Account of Existential Fear.

The current international crisis situation caused by the COVID-19 pandemic is having a strong psychological impact on our subjectivities. We are constantly threatened by the danger of i) being infected, ii) infecting other people, and (iii) by the loss of social relation. Departing from these premises, we here aim to investigate the psychological and neurodynamics of this complex phenomenon. First, we discuss about recent psychological and neuronal findings on fear and its disorders, related to an unbalanced intero-exteroceptive processing and emotional regulation. Secondly we move to the psychological and neuronal dynamics of self and others characterized by a temporo-spatial alignment with the world. Due to the neural overlap of emotion and self and the deep-reaching neuro-ecological layers of self, emotional feelings like fear and anxiety cannot be detached and dissociated from the world; they signify the world-brain relation, and, more specifically, our self-other relation. The deepest neuro-ecological and neuro-social layers of self are threatened by the loss of subjectivity, which is manifest in our loss of body and thus the fear of dying, and the loss of intersubjectivity that surfaces in our fear of infecting others, which reflect the intimate anchorage of the self with the world. In our opinion the pandemic of COVID-19 deeply affect our sense of self and its spatio-temporal neuronal dynamics providing the prerequisites for the manifestation of fear and existential anxiety, thus disrupting the brain-world relation with significant repercussions on our psyche and on our daily lives.

Traumatization Through Human Agency: "Embodied Witnessing" is Essential in the Treatment of Survivors.

The importance of human relations in understanding and treating trauma is evident not only from the severity of traumatization inflicted by human agency and the dissociation that ensues from traumatic interpersonal relations, but also from the analyst's affective participation which is essential to the reparation of the serious psychopathologies that originate in traumatization. Developing Ferenczi's theorizations, on the identification with the aggressor, I propose that after the abuse the traumatized subject identifies partly with the persecutor and partly with the victim, which sometimes is represented by the body itself, becoming the object of the destructiveness. Such unconscious identifications are accompanied by the dynamics of experiencing complex feelings of guilt and shame (the victim side) and the aggressiveness and anger, (the persecutor/persecuting side). It was Ferenczi who first described the potential for a therapist, acting benevolently and supportively as sole witness, to create the preconditions for the patient to re-contact long-dissociated parts, thanks to the implicit non-verbal and corporal exchange, a concept which is here explained as embodied testimony/witnessing and enactment, and unconscious communication of the right hemispheres of therapist and patient.

Spontaneous Brain Activity Predicts Task-Evoked Activity During Animate Versus Inanimate Touch.

The spontaneous activity of the brain is characterized by an elaborate temporal structure with scale-free properties as indexed by the power law exponent (PLE). We test the hypothesis that spontaneous brain activity modulates task-evoked activity during interactions with animate versus inanimate stimuli. For this purpose, we developed a paradigm requiring participants to actively touch either animate (real hand) or inanimate (mannequin hand) stimuli. Behaviorally, participants perceived the animate target as closer in space, temporally more synchronous with their own self, and more personally relevant, compared with the inanimate. Neuronally, we observed a modulation of task-evoked activity by animate versus inanimate interactions in posterior insula, in medial prefrontal cortex, comprising anterior cingulate cortex, and in medial superior frontal gyrus. Among these regions, an increased functional connectivity was shown between posterior insula and perigenual anterior cingulate cortex (PACC) during animate compared with inanimate interactions and during resting state. Importantly, PLE during spontaneous brain activity in PACC correlated positively with PACC task-evoked activity during animate versus inanimate stimuli. In conclusion, we demonstrate that brain spontaneous activity in PACC can be related to the distinction between animate and inanimate stimuli and thus might be specifically tuned to align our brain with its animate environment.