Racial Discrimination-related Interoceptive Network Disruptions: A Pathway to Disconnection.

Background: Racial discrimination (RD) disrupts regulatory systems in minoritized individuals, particularly those that govern attention, including attention to visceral signals (interoception). RD frequency is linked to physiological "shut down" responses, characterized clinically by dissociation. We examined associations between RD frequency and functional connectivity of attention and interoceptive networks in sample of trauma-exposed Black women, investigating how connectivity alterations associate with dissociation severity.

Methods: Seventy-two Black women completed MRI scanning and dissociation measures as part of two trauma studies. RD was examined in relation to seed-to-voxel (seeds: bilateral amygdala and insula) functional connectivity in attentional control and interoceptive brain networks during performance of an affective Stroop task; we examined connectivity during viewing of threat-relevant vs neutral distractor images. Connectivity values were extracted from significant clusters and examined in association with dissociative symptoms. We also examined connectivity in association with PTSD symptoms for comparison analyses.

Results: During attention to threat-relevant affective Stroop trials, greater RD frequency was associated with lesser insula connectivity to several medial prefrontal cortex (mPFC) clusters (FDR-corrected ps <.05). Insula-mPFC connectivity significantly and negatively associated with derealization symptoms (r = -.31, p = .009), but not PTSD (r = -.16, p = .182).

Discussion: RD frequency linked to lesser functional connectivity between the insula and mPFC, two interoceptive network nodes, during attention to threat, and diminished connectivity was linked to more severe dissociation. RD may interrupt interoceptive network functioning, and these network alterations may, in turn, influence mind-body disconnection, or physiological "shut down" response in Black individuals.