You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Objective: A close relationship between subjective experience and neurophysiological mechanisms could provide a new foundation for neurobiological correlates underlying psychodynamic processes in neuropsychiatric diseases. Pursuing a novel methodological approach by combining both techniques we investigated catatonia, a psychomotor syndrome with uncontrollable anxieties and skinesia (i.e., “immobilization by anxieties”) which, psychodynamically, can be characterized as a “sensori-motor regression” reflecting a basic somatic defense mechanism.
However, psychological and physiological mechanisms of generation of such “sensori-motor regression” in catatonia remain unclear. We therefore investigated in a combined study operationalized subjective psychological characteristics using Repertory-Grid Technique as well as prefrontal cortical activation patterns during emotional-motor stimulation using functional magnetic resonance imaging (fMRI).
Method: We Investigated 18 catatonic patients with an underlying affective or schizoaffective psychosis and compared them with age, sex, diagnosis, and medication matched non-catatonic psychiatric controls (n = 69), and healthy controls (n = 32). Subjective operationalized psychological characteristics were investigated using the Repertory Grid Technique (GRID) for personal constructs of the “self” in an acute and a post-acute state. In addition 10 catatonic patients, 10 psychiatric controls and 10 healthy controls underwent emotional stimulation with motor reaction during functional magnetic resonance imaging (fMRI).
Results: Subjective operationalized psychological characteristics of both the acute and post-acute state could be characterized by significant lack of social contact, decreased self-esteem, and reduced emotional arousal compared to non-catatonic psychiatric and healthy controls. fMRI revealed significant dysfunctional activation patterns in orbitofrontal cortex and alterations in medial prefrontal and premotor cortex durin