专注还是分心：注意身体会让组胺皮试反应更小吗

一个不太舒服的问题

这不是孤立的问题。作者此前写过亲密关系与积极预期如何影响免疫反应，指向同一个想法：大脑不是免疫系统的被动旁观者。内感受——我们如何察觉并理解身体信号——在惊恐、健康焦虑、抑郁和慢性疼痛中都会改变。注意身体既可能放大恐惧和疼痛，也可能有助于减轻它们。所以关键也许不是“要不要听身体”，而是“怎么听”。

实验做了什么

Mizrachi 和同事做了三项预注册的被试内实验，共 57 名健康成人，每人都作为自己的对照，条件顺序做了平衡。主实验的两次会话间隔 3 到 5 天。流程是在前臂做标准的组胺皮肤点刺，类似过敏测试，产生短暂的局部皮肤反应。一名不知道参与者处于哪种条件的评估者在随后 20 分钟内测量六次风团（肿胀）和红晕（发红），同时记录心率、皮肤电导、皮肤温度、心率变异性和状态焦虑。

实验一（37 人）比较把注意力放在测试部位的感觉上，还是看视频分心。实验二（20 名新参与者）让所有人看同样的抽象图形，一组图形提醒他们关注自己的手，另一组则要求判断图形在现实中是否可能存在。实验三（17 名回访参与者）在涂抹利多卡因乳膏、减少皮肤感觉信号之后，再让参与者关注测试部位。

主要结果

实验一中，20 分钟时关注手臂感觉的人风团约小 1.5 毫米（3.5 毫米对分心时的 5.0 毫米），红晕也更小（10.6 毫米对 14.0 毫米）。约 90% 的参与者在分心时风团或红晕更大。差异在约三分钟内出现，并随时间扩大。在一项探索性分析中，关注内部感觉时 89% 的人在 15 到 20 分钟之间风团稳定或下降，分心时这一比例是 46%。

实验二重现了主要发现：内部注意时风团和红晕约小 1.6 倍，90% 的参与者呈现同样模式。值得注意的是，参与者报告关注手时瘙痒和灼烧感更强——身体感觉更明显，但测得的皮肤反应更小。

实验三中，涂利多卡因并关注内部感觉时，20 分钟风团为 4.0 毫米，大于单纯内部注意的 3.1 毫米，但仍小于分心时的 4.9 毫米。作者据此认为，来自皮肤的感觉反馈参与了这一效应，但在反馈被削弱时注意仍然起作用。

生理指标方面，内部注意时心率变异性高于分心时。心率变异性常被用作副交感活动的间接指标，有时与迷走神经调节联系在一起。前两项实验中，皮肤电导、心率、皮肤温度和自报状态焦虑在两种条件间没有显著差异。心率变异性在利多卡因减少感觉输入后仍保持更高。作者认为这与可能的自上而下的自主神经参与一致，但无法确定是迷走活动导致了皮肤反应的变化。

作者如何评价这项研究

评议者认为这是一项严谨的实验室研究：预注册降低了事后编造假设和分析的风险；被试内设计让每个人做自己的对照，减少了基线皮肤反应性、人格、性别等稳定个体差异的影响；实验二让两种条件看同样的图形且任务难度相近，排除了“看视频还是看十字”或任务负荷不同这类解释；评估者盲法也降低了预期影响主要结果的可能。

但限制同样重要。第一，没有中性条件，比如不做任何注意指令的静息，因此无法判断是关注身体降低了皮肤反应、分心提高了它，还是两者都有。第二，测量的是组胺直接暴露后的风团和红晕，这是有意义的生理结果，但不等同于细胞因子、免疫细胞活动或全身炎症；组胺反应包含血管、感觉和神经源性过程，把它说成广泛的“免疫调节”超出了实际测量范围。第三，参与者是健康的年轻成人，且以女性为主，不能假定同样效应会出现在焦虑、抑郁、创伤、慢性疼痛、自身免疫病或急性感染的人身上。第四，参与者无法对自己注意哪里设盲，虽然不知道具体假设，仍有 14% 猜到了研究目的，预期可能影响行为或生理反应；利多卡因条件是回访参与者后来额外完成的一次会话，习惯化或顺序效应难以排除。

对实践意味着什么

评议者强调，这不意味着心理健康实践明天就该改变。分心仍然是减轻疼痛或可怕操作中痛苦的有价值方式；这项研究也不建议人们去监控每一处酸痛或感觉。对惊恐、健康焦虑、创伤后应激、慢性疼痛或强迫性检查的人来说，聚焦身体的注意可能变得恐惧和痛苦。

但这里用的注意不是威胁扫描。参与者只是被要求把注意力带回测试部位的感觉，这更接近某些正念取向鼓励的好奇、接纳、不评判的注意，而不是过度警觉。正念项目对部分压力、焦虑、抑郁和慢性疼痛的人有帮助，但效果因人而异，对炎症的证据仍是初步的。作者写道，怎么注意也许和是否注意同样重要。

后续研究需要加入中性静息条件、直接测量炎症标志物，并检验心率变异性的变化能否解释皮肤反应的结果，还要确认这些效应是否超出短暂的组胺皮肤反应。作者最后说，她不会因此放弃 Netflix、止痛药或生病时把目光移开的安慰，但这项研究让她想：注意也许不只是心里的聚光灯，它可能是大脑与身体持续对话的一部分。

I hate being ill. When I have flu, a stomach ache or one of those vague “something is coming on” feelings, I become remarkably good at looking away. Netflix goes on. I scroll. I take something for the headache. Anything, really, except sitting with the unpleasant sensation itself.

Distraction can be a kindness. Turning attention away from pain or itch often makes it feel less distressing, and distraction is used during medical procedures. But a new study asks a slightly uncomfortable question:

If we turn attention away from the body, could the body respond differently too?

I have previously written about how love and intimacy (Trachtenberg E., 2026; Schneider et al., 2026) and positive expectations (Trachtenberg E., 2026; Lubianiker et al., 2026) shape immune responses. Both pointed to the same idea: the brain is not a passive observer of the immune system. Rather, thoughts, expectations and relationships can influence bodily responses.

This matters for mental health too. Interoception (i.e., how we notice and make sense of bodily signals) is altered in conditions such as panic, health anxiety, depression and chronic pain (Khalsa et al., 2018). Paying attention to the body can both amplify fear/pain, or be helpful in reducing it. Perhaps the key question is not whether we listen to the body, but how.

Mizrachi and colleagues (2026) tested this directly, asking whether focusing on sensations from a histamine skin-prick test, rather than being distracted from them, changed the body’s physiological response.

Methods

Three preregistered, within-participant experiments were conducted with 57 healthy adults who each served as their own control under counterbalanced conditions. Sessions in the main experiment occurred 3 to 5 days apart.

A standard histamine skin-prick test (similar to an allergy test) was performed on the forearm to produce a short-lived local skin reaction. A researcher blind to participant’s experimental condition measured the wheal (i.e., swelling) and flare (i.e., redness) of the skin six times during the following 20 minutes, in addition to heart rate, skin conductance, skin temperature, heart-rate variability and state anxiety.

• Experiment 1 (37 participants): focused on sensations at the test site or watched video clips as a distraction.
• Experiment 2 (20 new participants): viewed abstract shapes that either reminded participants to focus on their hand or asked them to judge whether the shapes could plausibly exist in real life.
• Experiment 3 (17 returning participants): focused on sensations at the test site after applying lidocaine cream, which reduced sensory signals from the skin.

Results

Experiment 1: Internal attention versus distraction

At 20 minutes, the wheal was ~1.5 mm smaller when people attended to the sensations in their arm (3.5 mm compared with 5.0 mm during distraction). The flare was also smaller: 10.6 mm with internal attention and 14.0 mm with distraction.

Around 90% of participants showed a larger wheal or flare when distracted. Differences appeared within approximately three minutes and grew over time. In an exploratory analysis of the later phase of the response, 89% of participants showed a stable or declining wheal between 15 and 20 minutes while attending internally, compared with 46% during distraction.

Experiment 2: Same screen, different focus

The main finding appeared again: wheal and flare responses were ~1.6 times smaller during internal attention, and 90% of participants showed the same overall pattern. Importantly, participants also rated itch and burning as stronger when they attended to their hand. In other words, attending to the body made the sensations feel more noticeable, while being associated with a smaller measured skin reaction.

Experiment 3: The role of sensory signals

Under internal attention with lidocaine, the 20-minute wheal was larger than with internal attention alone: 4.0 mm versus 3.1 mm. However, it was still smaller than under distraction: 4.0 mm versus 4.9 mm. This suggests that sensory feedback from the skin contributes to the effect, but attention still mattered when that feedback was reduced.

Physiological response

Heart-rate variability was higher during internal attention than distraction. Heart-rate variability is often used as an indirect indicator of parasympathetic activity, sometimes linked with vagal regulation. In contrast, across the first two experiments, skin conductance, heart rate, skin temperature and self-reported state anxiety did not differ significantly between internal attention and distraction. Heart-rate variability remained higher when sensory input was reduced by lidocaine. This pattern is consistent with a possible top-down autonomic contribution, but it cannot establish that vagal activity was responsible for the change in the skin response.

Conclusions

Mizrachi and colleagues conclude that voluntary attention can influence a local, acute inflammatory response in humans. Their findings add to growing evidence that the brain and body are in constant conversation, with attention, expectations and autonomic nervous system activity shaping the body’s response.

The authors propose two complementary processes. Sensory feedback from the inflamed skin may help the response settle, while internally directed attention may engage top-down autonomic regulation.

The finding is striking: in healthy adults, deliberately attending to bodily sensations was linked with a smaller histamine-induced skin response than distraction. This offers an early example of measurable effects of voluntary attention.

Strengths and limitations

This is a thoughtful and unusually rigorous laboratory study. The experiments were pre-registered, reducing the risk that the main hypotheses and analyses were invented after the results were known. The within-participant design was another major strength: each person served as their own control, reducing differences caused by baseline skin reactivity, personality, sex or other stable individual characteristics.

The authors also did more than one simple comparison. Experiment 2 was particularly helpful because participants saw the same shapes in both conditions and reported similar task difficulty. This makes it less likely that the result can be explained simply by watching videos rather than a fixation cross, or by one task being more demanding. Using a blinded assessor for wheal and flare measurements also reduced the risk that expectations affected the primary outcomes.

However, there are important limitations. First, there was no neutral condition, such as resting without a specific attention instruction. We therefore cannot tell whether attending to the body reduced the skin reaction, distraction increased it, or both.

Second, the study measured wheal and flare following direct histamine exposure. These are meaningful physiological outcomes, but they are not the same as measuring cytokines, immune-cell activity or systemic inflammation. Histamine reactions include vascular, sensory and neurogenic processes, so claims about broad “immune regulation” go beyond what was directly measured.

Third, participants were healthy, young adults and mostly women. We cannot assume that the same effect would occur in people with anxiety, depression, trauma, chronic pain, autoimmune illness or acute infection.

Fourth, participants could not be blinded to where they were directing their attention. Although they did not know the precise hypothesis, 14% guessed the study aim. Expectations may therefore have influenced behaviour or physiological responses. The lidocaine condition was also completed as an additional later session by returning participants, making habituation or session-order effects difficult to rule out.

Implications for practice

This is an exciting controlled human study showing that a local skin inflammatory response differed depending on whether people directed their attention towards or away from bodily sensations. By comparing the same people under different attention conditions, the study suggests that attention may shape not only what we feel, but also how the body responds.

This does not mean that mental health practice should change tomorrow. Distraction remains a valuable way to reduce distress during painful or frightening procedures. Equally, this study does not suggest that people should monitor every ache or sensation. For people with panic, health anxiety, post-traumatic stress, chronic pain or compulsive checking, body-focused attention can become fearful and distressing.

However, the attention used here was not threat-scanning. Participants were simply asked to return their attention to sensations at the test site. This resembles the curious, accepting and non-judgemental attention encouraged in some mindfulness approaches more than hypervigilance. Mindfulness-based programmes can be helpful for some people with stress, anxiety, depression and chronic pain, although their effects vary between people and the evidence for effects on inflammation remains tentative. How we attend may matter as much as whether we attend.

The study opens useful questions for mental health research:

• Does accepting or compassionate attention have different effects from anxious, catastrophic attention?
• Would the findings look similar in people with panic disorder, chronic pain or functional neurological symptoms?
• Most importantly, could this influence outcomes that matter to people, including distress, pain, fatigue, functioning and quality of life?

Future studies should include a neutral rest condition, measure inflammatory markers directly and test whether changes in heart-rate variability explain the skin-response findings. They also need to establish whether these effects extend beyond a brief histamine skin reaction.

I am not about to give up Netflix, pain relief or the comfort of looking away when I feel unwell. But this paper makes me wonder whether attention is more than a mental spotlight. It may be part of the ongoing conversation between brain and body. The message is not “always listen to your body,” but that how we attend to it may matter.

Statement of interests

Estherina Trachtenberg knows the last author, Liron Rozenkrantz, personally. The study was thoroughly critically appraised despite this personal connection and Estherina has no professional or financial involvement in the research. She used AI-assisted tools, including Perplexity, to support editing and clarity of wording; all decisions about content, interpretation and emphasis are her own.

Editor

Edited by Éimear Foley. Claude assisted with language refinement and formatting during the editorial phase.

Links

Primary paper

Nofar Mizrachi, Menachem Rottem, Liron Rozenkrantz (2026) Voluntary attention regulates acute immune responses in humans. Nature Human Behaviour. Published online 17 August 2026. https://doi.org/10.1038/s41562-026-02541-1

Other references

Black DS, Slavich GM. (2016) Mindfulness meditation and the immune system: a systematic review of randomised controlled trials. Annals of the New York Academy of Sciences, 1373(1), 13-24.

Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, et al. (2018) Interoception and mental health: a roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(6), 501-513.

Lubianiker, N., Koren, T., Djerasi, M. et al. Upregulation of reward mesolimbic activity and immune response to vaccination: a randomized controlled trial. Nat Med 32, 572–581 (2026). https://doi.org/10.1038/s41591-025-04140-5

Schneider E, Hernández C, Brock R, Eckstein M, Bodenmann G, Heinrichs M, Ehlert U, Läuchli S, Ditzen B. Intranasal Oxytocin and Physical Intimacy for Dermatological Wound Healing and Neuroendocrine Stress: A Randomized Clinical Trial. JAMA Psychiatry. 2026 Feb 1;83(2):118-127.

Trachtenberg E. Oxytocin and affection: does intimacy help wounds heal faster? The Mental Elf. 25 Feb 2026.

Trachtenberg E. Can positive expectations tune the immune system? The Mental Elf. 20 Apr 2026.

Photo credits

• Photo by Afif Ramdhasuma on Unsplash
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• Image created with Claude Opus 5.5, Anthropic.
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