The role of somatosensory stimulation in social phobia—An analysis of hand coordination in patients and therapeutic dyads during psychodynamic psychotherapy

In the psychotherapeutic treatment of social phobia, the hand movement behaviour exhibited during the interaction provides information about the success of the therapy. In particular, the degree of mutual somatosensory stimulation of the hands (hands moving on each other, as a unit, apart) appears to be relevant regarding the patient's mental state. To test this hypothesis, the present study investigates hand coordination in the course of psychotherapy in patients with and without symptom improvement and in the corresponding therapeutic dyads. Forty-two videos of patient–therapist dyads consisting of 21 patients (n = 11 non-improved; n = 10 improved; according to Liebowitz Social Anxiety Scale self-assessment) from the Social Phobia Research Network project were investigated in early psychotherapy sessions and in pre-last sessions. Hand movements of four randomised video sequences per dyad were analysed with NEUROGES^®-ELAN. Patients with non-improved symptoms displayed shorter act apart coordination and more act on each other coordination than patients with improved symptoms. Patients displayed more act apart and act on each other and less act as a unit coordination than therapists. In therapeutic dyads, act on each other coordination in early sessions, as well as short act apart coordination, was significantly related to non-improvement. Patients with non-improved symptoms are characterised by more hand coordination associated with a high degree of somatosensory stimulation serving self-regulation (act on each other), as well as short complex gestural expressions (act apart). Thus, hand coordination constitutes a progression and outcome parameter informing on somatosensory stimulation.     

The spatial distance rule in the moving and classical rubber hand illusions

The rubber hand illusion (RHI) is a perceptual illusion in which participants perceive a model hand as part of their own body. Here, through the use of one questionnaire experiment and two proprioceptive drift experiments, we investigated the effect of distance (12, 27.5, and 43 cm) in the vertical plane on both the moving and classical RHI. In both versions of the illusion, we found an effect of distance on ownership of the rubber hand for both measures tested. Our results further suggested that the moving RHI might follow a narrower spatial rule. Finally, whereas ownership of the moving rubber hand was affected by distance, this was not the case for agency, which was present at all distances tested. In sum, the present results generalize the spatial distance rule in terms of ownership to the vertical plane of space and demonstrate that also the moving RHI obeys this rule.     

The role of agency for perceived ownership in the virtual hand illusion

The rubber hand illusion shows that people can perceive artificial effectors as part of their own body under suitable conditions, and the virtual hand illusion shows the same for virtual effectors. In this study, we compared a virtual version of the rubber-hand setup with a virtual-hand setup, and manipulated the synchrony between stimulation or movement of a virtual “effector” and stimulation or movement of people’s own hand, the similarity between virtual effector and people’s own hand, and the degree of agency (the degree to which the virtual effector could be controlled by people’s own movements). Synchrony-induced ownership illusion was strongly affected by agency but not similarity, which is inconsistent with top-down modulation approaches but consistent with bottom-up approaches to ownership. However, both agency and similarity induce a general bias towards perceiving an object as part of one’s body, suggesting that ownership judgments integrate various sources of information.     

Pain and Bodily Care: Whose Body Matters?

Pain is unpleasant. It is something that one avoids as much as possible. One might then claim that one wants to avoid pain because one cares about one's body. On this view, individuals who do not experience pain as unpleasant and to be avoided, like patients with pain asymbolia, do not care about their body. This conception of pain has been recently defended by Bain [2014 Bain, D. 2014. Pains That Don't Hurt, Australasian Journal of Philosophy 92/2: 305–20.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]] and Klein [forthcoming Klein, C. forthcoming. What Pain Asymbolia Really Shows, Mind. [Google Scholar]]. In their view, one needs to care about one's body for pain to have motivational force. But does one need to care about one's body qua one's own? Or does one merely need to care about the body that happens to be one's own? In this paper, I will consider various interpretations of the notion of bodily care, in light of a series of pathological cases in which patients report pain in a body part that they do not experience as their own. These cases are problematic if one adopts a first-personal interpretation of bodily care, according to which pain requires one to care about what is represented as one's own body. The objection can run as follows. If the patients experience the body part as alien, then they should not care about it. Therefore, they should be similar to patients with pain asymbolia. But they are not. Hence, bodily care is not necessary to pain. To resist this conclusion, one can try to revise the interpretation of the notion of bodily care and to offer alternative interpretations that are not first-personal. However, I will show that that those alternatives also fail to account for these borderline cases of pain.     

Social-cognitive antecedents of hand washing: Action control bridges the planning–behaviour gap

Objectives. To examine motivational and volitional factors for hand washing in young adults, using the Health Action Process Approach (HAPA) as a theoretical framework.

Design. In a longitudinal design with two measurement points, six weeks apart, university students (N = 440) completed paper-based questionnaires.

Main outcome measures. Prior hand washing frequency, self-efficacy, outcome expectancies, intention and action planning were measured at baseline, and coping planning, action control and hand washing frequency were measured at follow-up.

Results. A theory-based structural equation model was specified. In line with the HAPA, the motivational factors of self-efficacy and outcome expectancies predicted intention, whereas the volitional factors of planning and action control mediated between intention and changes in hand washing frequency. Action control was confirmed as the most proximal factor on hand washing behaviour, thus representing a bridge of the planning–behaviour gap.

Conclusions. Both motivational and volitional processes are important to consider in the improvement of hand hygiene practices. Moreover, the statistically significant effects for planning and action control illustrate the importance of these key self-regulatory factors in the prediction of hand hygiene. The current study highlights the importance of adopting models that account for motivational and volitional factors to better understand hand washing behaviour.     

Sense of body ownership in patients affected by functional motor symptoms (conversion disorder)

Background and aimPatients with functional neurological symptoms are commonly seen in neurological practice. Nevertheless their aetiopathology remains unclear. We have recently shown that patients affected by functional motor symptoms (FMS) present lower interoceptive awareness and higher alexithymia levels than healthy controls. Nevertheless sense of body ownership has never been studied in FMS patients.The aim of the present study was to systematically investigate the sense of body ownership, with the rubber hand illusion (RHI) paradigm, in patients with FMS and healthy controls.Materials and methodsWe included in the study 16 patients with FMS and 18 healthy controls (HC). Patients and HC were asked to complete the Toronto Alexithymia Scale (TAS-20) and the self-consciousness scale (self-objectification questionnaire). All participants underwent the RHI paradigm: illusionary experience was measured by self-report and by proprioceptive alteration.ResultsA Mann–Whitney U test performed revealed that FMS (median = 2.11) participants embodied the rubber hand to the same extent than HC participants (median = 2.0, Z = −0.86, p > 0.05, r = −0.15). The same test revealed no significant difference in the Proprioceptive Drift experience between FMS (median = 0.0) and HC participants (median = −0.5, Z = −0.96, p > 0.05, r = −0.16).ConclusionsOur study revealed that sense of body ownership is not impaired in patients affected by FMS. This, together with the results from our previous experiment (studying the interoceptive awareness), supports the hypothesis that interoceptive awareness and sense of body ownership may be dissociated in patients with FMS.     

自我表征的可塑性:基于橡胶手错觉的研究

自我识别是人类自我觉知的行为标记。传统方法认为稳定的自我表征是自我识别的基础。随着对橡胶手错觉及一系列自我表征和自我识别错觉的揭示,这一能让人将外部客体感知为自身一部分的错觉研究使得我们能够以多感官整合的方式来研究自我表征和自我识别。拥有感和自主感被认为是我们进行自我识别的两类基本体验,本文对一系列橡胶手错觉范式研究的系统回顾表明,拥有感和自主感会发生改变,这说明人的自我表征是可变的和可塑的。     

基于直线临摹的ADHD儿童眼手协调能力研究

ADHD儿童在精细动作方面通常伴随眼手协调运动障碍。以往采用的研究方法多为定性研究,且未在ADHD儿童的运动协调性与同龄正常儿童的差异上得出统一结论。本研究针对精细动作中眼手协调能力进行定量分析。实验要求被试在计算机触摸屏上分别临摹水平线、垂直线和斜线,通过记录临摹直线与呈现直线的偏差程度和拐点数,以分析ADHD儿童眼手协调能力与正常儿童之间的差异。结果表明,ADHD儿童在眼手协调和空间知觉能力上与正常儿童存在显著性差异。此外,本研究表明,改进的定量方法具有良好的可行性。     

Spatial limits on the nonvisual self-touch illusion and the visual rubber hand illusion: Subjective experience of the illusion and proprioceptive drift

The nonvisual self-touch rubber hand paradigm elicits the compelling illusion that one is touching one’s own hand even though the two hands are not in contact. In four experiments, we investigated spatial limits of distance (15 cm, 30 cm, 45 cm, 60 cm) and alignment (0°, 90° anti-clockwise) on the nonvisual self-touch illusion and the well-known visual rubber hand illusion. Common procedures (synchronous and asynchronous stimulation administered for 60 s with the prosthetic hand at body midline) and common assessment methods were used. Subjective experience of the illusion was assessed by agreement ratings for statements on a questionnaire and time of illusion onset. The nonvisual self-touch illusion was diminished though never abolished by distance and alignment manipulations, whereas the visual rubber hand illusion was more robust against these manipulations. We assessed proprioceptive drift, and implications of a double dissociation between subjective experience of the illusion and proprioceptive drift are discussed.