Racial Discrimination–Related Interoceptive Network Disruptions: A Pathway to Disconnection

BACKGROUND: Racial discrimination (RD) disrupts regulatory systems in minoritized individuals, particularly systems that govern attention, including attention to visceral signals (interoception). RD frequency is linked to physiological shutdown responses, characterized clinically by dissociation. We examined associations between RD frequency and functional connectivity of attention and interoceptive networks in a sample of trauma-exposed Black women, investigating potential links between connectivity and dissociation severity. METHODS: Seventy-two Black women who were recruited as part of two trauma studies underwent magnetic resonance imaging during performance of an affective Stroop (AS) task and completed dissociation and RD measures. Generalized psychophysiological interaction analyses were used to examine seed-to-voxel (seeds: bilateral amygdala and insula) functional connectivity with RD as a regressor; connectivity was examined during presentation of threat-relevant versus neutral AS distractor images. Connectivity values were extracted from significant clusters and examined in association with dissociative symptoms. We also investigated connectivity in association with posttraumatic stress disorder (PTSD) symptoms for comparison analyses. RESULTS: During attention to threat-relevant AS trials, greater RD frequency was associated with less insula connectivity to several medial prefrontal cortex (mPFC) clusters (false discovery rate-corrected ps < .05). Insula-mPFC connectivity was significantly and negatively associated with derealization symptoms (r = -0.31, p = .009), but not PTSD (r = -0.16, p = .182). CONCLUSIONS: RD frequency was linked to reduced functional connectivity between the insula and mPFC, 2 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 shutdown response in Black individuals.