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Williams IA, Reuber M, Levita L. Interoception and stress in patients with Functional Neurological Symptom Disorder. Cogn Neuropsychiatry 2021; 26:75-94. [PMID: 33372576 DOI: 10.1080/13546805.2020.1865895] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Research suggests that patients with Functional Neurological Symptom Disorder (pwFND) struggle to identify their own emotions and associated physiological cues (interoceptive sensitivity, IS). However, it is not known how this deficit interacts with stress. This study aimed to assess IS in pwFND at baseline and following stress induction, and relate the findings to self-reported emotion processing difficulties. METHODS Twenty-six pwFND and 27 healthy controls performed the Heart Beat Detection Task pre- and post-stress induction with the Cold Pressor Test. Participants also completed questionnaires assessing anxiety (GAD-7) and depressive symptomology (PHQ-9), as well as emotion processing (EPS-25). RESULTS Patients reported deficits in emotion processing (p < . 001) and had lower IS (p = .032) than healthy controls. IS improved following stress induction across both groups (p = .003) but patients' IS was lower than that of healthy controls' pre-and post-stress induction. Exploratory analyses revealed that patients reporting sensory symptoms had lower IS at baseline than patients who did not. CONCLUSION Our findings suggest that pwFND are relatively impaired in the identification of their emotions at baseline and following stress induction. This may be related to the experience of functional sensory symptoms and has implications for the psychological treatment of emotion dysregulation in this population.
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Affiliation(s)
| | - Markus Reuber
- Academic Neurology, The University of Sheffield, Sheffield, UK
| | - Liat Levita
- Department of Psychology, The University of Sheffield, Sheffield, UK
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52
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Smith KE, Luo S, Mason TB. A systematic review of neural correlates of dysregulated eating associated with obesity risk in youth. Neurosci Biobehav Rev 2021; 124:245-266. [PMID: 33587960 DOI: 10.1016/j.neubiorev.2021.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/01/2021] [Accepted: 02/06/2021] [Indexed: 12/23/2022]
Abstract
Dysregulated eating among children and adolescents is associated with a wide range of negative mental and physical health outcomes, including obesity. However, less is known regarding underlying neural mechanisms underlying such behaviors. Therefore, the present manuscript systematically reviewed neuroimaging research examining dysregulated eating behavior linked to excess weight in children and adolescents. A systematic literature search identified 23 eligible studies, the majority of which were cross-sectional functional magnetic resonance imaging (fMRI) studies and excluded participants with psychiatric disorders. Dysregulated eating was captured by measures of eating styles and eating self-regulation, eating disorder behaviors, food addiction, objective measures of non-homeostatic eating and caloric restriction. While preliminary, findings suggested eating dysregulation was related to aberrant functioning within the frontostriatal and frontoparietal regions involved in self-regulatory processes, as well as regions involved in satiety signaling and interoception. This heterogeneous body of research is continually growing and may have potential to inform future prevention and intervention approaches. Results also identified several important limitations to consider and highlight key areas for future research.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
| | - Shan Luo
- Department of Psychology, University of Southern California, Los Angeles, CA, United States; Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Tyler B Mason
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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53
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Liné C, Lachal J, Andrieu B. Obésité et conscience de soi intéroceptive : étude qualitative préliminaire chez des adolescentes hospitalisées présentant une obésité. EVOLUTION PSYCHIATRIQUE 2021. [DOI: 10.1016/j.evopsy.2020.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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54
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Abdul Basir SM, Abdul Manaf Z, Ahmad M, Abdul Kadir NB, Ismail WNK, Mat Ludin AF, Shahar S. Reliability and Validity of the Malay Mindful Eating Questionnaire (MEQ-M) among Overweight and Obese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031021. [PMID: 33498903 PMCID: PMC7908380 DOI: 10.3390/ijerph18031021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 01/10/2023]
Abstract
The Mindful Eating Questionnaire is a reliable tool for the assessment of mindful eating behavior among the general population. This study aimed to determine the reliability and validity of The Malay Mindful Eating Questionnaire (MEQ-M) in a sample of overweight and obese adults. This is a cross-sectional survey which involved 144 overweight and obese adults in a selected public university. After linguistic validation of the Malay version of the MEQ, exploratory factor analysis (EFA) with varimax rotation was performed on the scale constructs. The psychometric properties of the MEQ were assessed through Cronbach’s alpha and intraclass correlation coefficient (ICC) analysis. The EFA of the MEQ produced a seven-dimensional model (58.8% of overall variances). The concurrent validity analysis between total MEQ scores and total Mindfulness Attention Awareness Scale (MAAS) scores indicated a weak non-significant correlation (p = 0.679). The internal consistency reliability of the MEQ was reasonable (Cronbach’s α = 0.64). The agreement stability of the MEQ over eight weeks was poor (ICC = 0.10). In conclusion, the psychometric properties of the Malay-translated MEQ are acceptable through construct validity and internal consistency reliability tests. This instrument may be used for assessing mindful eating habits in the Malaysian population, especially among overweight and obese adults.
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Affiliation(s)
- Siti Munirah Abdul Basir
- Dietetic Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia; (S.M.A.B.); (S.S.)
| | - Zahara Abdul Manaf
- Dietetic Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia; (S.M.A.B.); (S.S.)
- Correspondence: ; Tel.: +60-392897677
| | - Mahadir Ahmad
- Clinical Psychology & Behavioural Health Program, Center for Community Health Studies (ReACH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Ba’yah Abdul Kadir
- Centre for Research in Psychology and Human Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Selangor, Bangi 43600, Malaysia; (N.B.A.K.); (W.N.K.I.)
| | - Wan Nur Khairunnisa Ismail
- Centre for Research in Psychology and Human Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Selangor, Bangi 43600, Malaysia; (N.B.A.K.); (W.N.K.I.)
| | - Arimi Fitri Mat Ludin
- Biomedical Science Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Dietetic Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Malaysia; (S.M.A.B.); (S.S.)
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55
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Noradrenergic activation induced by yohimbine decreases interoceptive accuracy in healthy individuals with childhood adversity. Dev Psychopathol 2021; 34:1013-1024. [PMID: 33446284 DOI: 10.1017/s0954579420001613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Acute stress affects interoception, but it remains unclear if this is due to activation of the sympatho-adreno-medullary (SAM) or hypothalamic-pituitary-adrenocortical axis. This study aimed to investigate the effect of SAM axis activation on interoceptive accuracy (IAcc). Central alpha2-adrenergic receptors represent a negative feedback mechanism of the SAM axis. Major depressive disorder and adverse childhood experiences (ACE) are associated with alterations in the biological stress systems, including central alpha2-adrenergic receptors. Here, healthy individuals with and without ACE as well as depressive patients with and without ACE (n = 114; all without antidepressant medication) were tested after yohimbine (alpha2-adrenergic antagonist) and placebo. We assessed IAcc and sensibility in a heartbeat counting task. Increases in systolic and diastolic blood pressure after yohimbine confirmed successful SAM axis activation. IAcc decreased after yohimbine only in the healthy group with ACE, but remained unchanged in all other groups (Group × Drug interaction). This effect may be due to selective upregulation of alpha2-adrenergic receptors after childhood trauma, which reduces capacity for attention focus on heartbeats. The sympathetic neural pathway including alpha2-adrenergic circuitries may be essential for mediating interoceptive signal transmission. Suppressed processing of physical sensations in stressful situations may represent an adaptive response in healthy individuals who experienced ACE.
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56
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Van Den Houte M, Vlemincx E, Franssen M, Van Diest I, Van Oudenhove L, Luminet O. The respiratory occlusion discrimination task: A new paradigm to measure respiratory interoceptive accuracy. Psychophysiology 2021; 58:e13760. [PMID: 33438245 DOI: 10.1111/psyp.13760] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/20/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023]
Abstract
Interoception, or the sense of the internal state of the body, is hypothesized to be essential for a wide range of psychobiological processes and the development and perpetuation of several (mental) health problems. However, the study of interoceptive accuracy, the objectively measured capacity to detect or discriminate conscious bodily signals, has been hampered by the use of tasks with questionable construct validity and is often limited to studying interoception solely in the cardiac domain. We developed a novel task to measure interoceptive accuracy in the respiratory domain, the respiratory occlusion discrimination (ROD) task. In this task, interoceptive accuracy is defined as an individual's ability to detect small differences in lengths of short respiratory occlusions, assessed by means of an adaptive staircase procedure. This article describes a validation study (N = 97) aimed at investigating the internal consistency, test-retest reliability, and discriminant validity of the ROD task. The average just noticeable difference of lengths of respiratory occlusion was 74.22 ms, with large inter-individual variability (SD = 37.1 ms). The results of the validation study indicate acceptable internal consistency (Cronbach's alpha = 0.70), 1-week test-retest reliability (r = 0.53), and discriminant validity, as indicated by a lack of correlation between the ROD task and an auditory discrimination task with identical design (r = 0.18), and a weak correlation with breathing behavior (r = -0.27). The ROD task is a promising novel paradigm to study interoceptive accuracy and its role in various psychobiological processes and disorders.
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Affiliation(s)
- Maaike Van Den Houte
- Research group on Health, Emotion, Cognition, and Memory, Research Institute for Psychological Sciences, UCLouvain, Louvain-La-Neuve, Belgium.,Laboratory for Brain-Gut Axis Studies (LaBGAS), KU Leuven, Leuven, Belgium.,Fund for Scientific Research (FRS-FNRS), Belgium
| | - Elke Vlemincx
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Ilse Van Diest
- Health Psychology Research Group, KU Leuven, Leuven, Belgium
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), KU Leuven, Leuven, Belgium.,Cognitive & Affective Neuroscience Lab, Dartmouth College, Hanover, NH, USA
| | - Olivier Luminet
- Research group on Health, Emotion, Cognition, and Memory, Research Institute for Psychological Sciences, UCLouvain, Louvain-La-Neuve, Belgium.,Fund for Scientific Research (FRS-FNRS), Belgium
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57
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Carey M, Crucianelli L, Preston C, Fotopoulou A. The role of affective touch in whole-body embodiment remains equivocal. Conscious Cogn 2021; 87:103059. [PMID: 33296853 PMCID: PMC7116849 DOI: 10.1016/j.concog.2020.103059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022]
Abstract
Previous studies have highlighted that affective touch delivered at slow velocities (1-10 cm/s) enhances body-part embodiment during multisensory illusions, yet its role towards whole-body embodiment is less established. Across two experiments, we investigated the role of affective touch towards subjective embodiment of a whole mannequin body within the full body illusion, amongst healthy females. Participants perceived affective touch to be more pleasant than non-affective touch, but this did not enhance subjective embodiment within the illusion and no interaction between synchrony (Experiment 1), or congruency (Experiment 2), and the velocity of touch was observed. Finally, the perceived pleasantness of touch was not modulated by subthreshold eating disorder psychopathology, as measured by means of a self-report questionnaire. Therefore, the present findings suggest that enhancement of embodiment due to affective touch may be body-part specific, and not generalise to greater ownership towards a whole body.
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Affiliation(s)
- Mark Carey
- Department of Psychology, University of York, York, United Kingdom
| | - Laura Crucianelli
- Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Aikaterini Fotopoulou
- Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
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58
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Bekrater-Bodmann R, Azevedo RT, Ainley V, Tsakiris M. Interoceptive Awareness Is Negatively Related to the Exteroceptive Manipulation of Bodily Self-Location. Front Psychol 2020; 11:562016. [PMID: 33343444 PMCID: PMC7746809 DOI: 10.3389/fpsyg.2020.562016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/06/2020] [Indexed: 12/21/2022] Open
Abstract
The perception of being located within one's body (i.e., bodily self-location) is an essential feature of everyday self-experience. However, by manipulating exteroceptive input, healthy participants can easily be induced to perceive themselves as being spatially dislocated from their physical bodies. It has previously been suggested that interoception, i.e., the processing of inner physiological signals, contributes to the stability of body representations; however, this relationship has not previously been tested for different dimensions of interoception and bodily self-location. In the present study, using an advanced automatized setup, we systematically manipulated participants' perspective of their own body (first- vs third-person perspective) as well as the synchrony of visuotactile stimulation (synchronous vs asynchronous). The malleability of bodily self-location was assessed using a questionnaire targeting in-body and out-of-body experiences. Participants also performed a heartbeat discrimination task to assess their interoceptive accuracy (behavioral performance), interoceptive sensibility (confidence in their interoceptive abilities), and interoceptive awareness (meta-cognitive representation of interoceptive signals). Bodily self-location was significantly influenced by perspective, with third-person perspective being associated with stronger out-of-body experiences compared to first-person perspective. Furthermore, there was a significant perspective × stimulation interaction, with subsequent analyses showing that participants reported out-of-body experiences particularly under third-person perspective combined with synchronous visuotactile stimulation. Correlation and regression analyses revealed that meta-cognitive interoceptive awareness was specifically and negatively related to the exteroceptively mediated malleability of body experiences. These results indicate that the perception of the self being located within one's body relies on the interaction of exteroceptive input and higher-order interoceptive abilities. This has implications for theoretical considerations about the bodily self in health as well as for the understanding of disturbed bodily self-processing in clinical contexts.
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Affiliation(s)
- Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
| | - Ruben T Azevedo
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom.,Department of Psychology, University of Kent, Canterbury, United Kingdom
| | - Vivien Ainley
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
| | - Manos Tsakiris
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom.,Warburg Institute, School of Advanced Study, University of London, Bloomsbury, United Kingdom.,Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Luxembourg
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59
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D'Ardenne K, Savage CR, Small D, Vainik U, Stoeckel LE. Core Neuropsychological Measures for Obesity and Diabetes Trials: Initial Report. Front Psychol 2020; 11:554127. [PMID: 33117225 PMCID: PMC7557362 DOI: 10.3389/fpsyg.2020.554127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/27/2020] [Indexed: 01/15/2023] Open
Abstract
Obesity and diabetes are known to be related to cognitive abilities. The Core Neuropsychological Measures for Obesity and Diabetes Trials Project aimed to identify the key cognitive and perceptual domains in which performance can influence treatment outcomes, including predicting, mediating, and moderating treatment outcome and to generate neuropsychological batteries comprised of well-validated, easy-to-administer tests that best measure these key domains. The ultimate goal is to facilitate inclusion of neuropsychological measures in clinical studies and trials so that we can gather more information on potential mediators of obesity and diabetes treatment outcomes. We will present the rationale for the project and three options for the neuropsychological batteries to satisfy varying time and other administration constraints. Future directions are discussed. Preprint version of the document is available at https://osf.io/preprints/nutrixiv/7jygx/.
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Affiliation(s)
- Kimberlee D'Ardenne
- Department of Psychology, Arizona State University, Tempe, AZ, United States
| | - Cary R Savage
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United States.,Center for Brain, Biology and Behavior, Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Dana Small
- Modern Diet and Physiology Research Center (MDPRC), Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, United States.,Department of Psychology, Yale University, New Haven, CT, United States.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Uku Vainik
- Institute of Psychology, Faculty of Social Sciences, University of Tartu, Tartu, Estonia.,Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Luke E Stoeckel
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
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60
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Herbert BM. Interoception and Its Role for Eating, Obesity, and Eating Disorders. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The importance of the sense of ourselves from within for understanding adaptive behavior and psychopathology has been increasingly recognized during the last decades. Interoception builds the foundation of our embodied self and dysfunctional interoception lies at the core of many psychosomatic disorders. Eating is fundamental for survival with consequences for health and well-being. It is deeply grounded in homoeostatic and allostatic psychophysiological needs and is driven by interoceptive signals of the body. This narrative review summarizes a selection of empirical findings and draws conclusions on the role of interoception in eating behavior, body weight, and eating disorders. Beyond disordered eating behavior, eating disorders are characterized by impairment of the sense of self, with dysfunctional interoception at its core. Predictive coding accounts are addressed to integrate conclusions and to underline the relevance of interventions to modify interoception.
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Affiliation(s)
- Beate M. Herbert
- Clinical Psychology & Psychotherapy, Department of Psychology, Eberhard Karls University of Tübingen, Germany
- Psychology School, University of Applied Sciences Fresenius, Munich, Germany
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61
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Nusser L, Pollatos O, Zimprich D. Age-Related Effects on Interoceptive Accuracy, General Interoceptive Sensibility, and Specific Interoceptive Sensibility. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: The current research into interoception distinguishes between interoceptive accuracy (IAcc), the accurate detection of internal sensations (e.g., heartbeats) as measured by performance on objective IAcc tasks, and interoceptive sensibility (IS), the subjective belief concerning one’s own experience of internal sensations as measured either through self-report questionnaires or through one’s confidence in the accuracy during an IAcc task. Aims: As the two measures of IS, however, are usually uncorrelated and show differential relationships to IAcc, we suggest different types of IS, a general IS and a specific IS. Further, based on a growing body of research linking IAcc and IS to physical and mental diseases, the development of interoception across the adult lifespan is of importance. Methods: Using Structural Equation Modeling the present paper investigates the relationships among IAcc assessed by a heartbeat counting task, and the two proposed dimensions of IS in 138 participants ( Mage = 42.67, SDage = 18.77). Furthermore, we examine age-related differences in IAcc, as well as in general and specific IS. Results: In terms of the relationship between the three dimensions, general and specific IS were weakly correlated and exhibited different relationships to IAcc. Further, we found different age effects on the three interoceptive dimensions. Whereas IAcc decreased with age, specific IS tend to increase with age, and general IS remained unaffected by age. Conclusion: The findings provide further empirical support for a dissociation between general and specific IS and raised important questions concerning the relation between interoceptive accuracy and the emergence of physical diseases in older age.
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Affiliation(s)
- L. Nusser
- Department of Developmental Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - O. Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - D. Zimprich
- Department of Developmental Psychology, Institute of Psychology and Education, Ulm University, Germany
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Abstract
Internally regulated eating style, the eating style that is driven by internal bodily sensations of hunger and satiation, is a concept that has received increasing attention in the literature and health practice over the last decades. The various attempts that have been made so far to conceptualise internally regulated eating have taken place independently of one another, and each sheds light on only parts of the total picture of what defines internally regulated eating. This has resulted in a literature that is rather fragmented. More importantly, it is not yet clear which are the characteristics that comprise this eating style. In this paper, we identify and describe the full spectrum of these characteristics, namely, sensitivity to internal hunger and satiation signals, self-efficacy in using internal hunger and satiation signals, self-trusting attitude for the regulation of eating, relaxed relationship with food and tendency to savour the food while eating. With this research, we introduce a common language to the field and we present a new theoretical framework that does justice not just to the full breadth of characteristics that are necessary for the internally regulated eating style but also to the associations between them and the potential mechanisms by which they contribute to this eating style.
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63
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Bourdier L, Fatseas M, Maria AS, Carre A, Berthoz S. The Psycho-Affective Roots of Obesity: Results from a French Study in the General Population. Nutrients 2020; 12:nu12102962. [PMID: 32998238 PMCID: PMC7650670 DOI: 10.3390/nu12102962] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/20/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of the study was to examine the extent to which obese people differ in their emotionally driven and addictive-like eating behaviors from normal-weight and overweight people. A total of 1142 participants were recruited from a general population, by a web-based cross-sectional survey assessing anxiety/depression (Hospital Anxiety and Depression Scale), emotional eating (Emotional Appetite Questionnaire), food addiction (modified Yale Food Addiction Scale), and intuitive eating (Intuitive Eating Scale-2). The statistical design was based on analyses of (co)variance, correlograms, and mediations. A set of Body Mass Index (BMI) group comparisons showed that obese people reported higher levels of depression and emotional eating and that they experienced more severe and frequent food addiction symptoms than overweight and normal-weight people. Associations between anxiety, depression, food addiction symptoms’ count, and the difficulties to rely on hunger and satiety cues were found across all weight classes, suggesting that addictive-like eating may represent a unique phenotype of problematic eating behavior that is not synonymous with high BMI or obesity. Conversely, the interrelation between anxiety/depression, emotional eating, and the difficulties to rely on hunger and satiety cues was found only among obese participants, and negative emotional eating mediated the association between depression and anxiety and the difficulties to rely on hunger and satiety cues. This study emphasizes the necessity to develop more comprehensive approaches integrating emotional dysregulation and addictive-like eating behaviors to improve weight management and quality of life of obese people.
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Affiliation(s)
- Lena Bourdier
- Addictology Department, University Hospital of Bordeaux, 33000 Bordeaux, France;
- Correspondence:
| | - Melina Fatseas
- Addictology Department, University Hospital of Bordeaux, 33000 Bordeaux, France;
- CNRS, EPHE, INCIA, UMR 5287, Université de Bordeaux, F-33000 Bordeaux, France;
| | - Anne-Solène Maria
- Private Practice, Stimulus Consulting Ltd., Coastal Road, Cascavelle 90203, Mauritius;
- UVSQ, CESP, INSERM, Université Paris-Sud and Université Paris Descartes, 75014 Paris, France
| | - Arnaud Carre
- LIP/PC2S, Grenoble Alpes University and Savoie Mont Blanc University, F-38000 Grenoble, France;
| | - Sylvie Berthoz
- CNRS, EPHE, INCIA, UMR 5287, Université de Bordeaux, F-33000 Bordeaux, France;
- Department of Psychiatry for Adolescents and Young Adults, Institut Mutualiste Montsouris, 75014 Paris, France
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64
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Hickman L, Seyedsalehi A, Cook JL, Bird G, Murphy J. The relationship between heartbeat counting and heartbeat discrimination: A meta-analysis. Biol Psychol 2020; 156:107949. [PMID: 32911018 DOI: 10.1016/j.biopsycho.2020.107949] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
Interoception concerns the perception of the body's internal state. Despite the importance of this ability for health and aspects of higher-order cognition, its measurement remains problematic. Most studies of interoception employ one of two tasks: the heartbeat counting or heartbeat discrimination task. These tasks are thought to index common abilities, an assertion often used to justify the use of a single measure of cardiac interoception. However, mixed findings regarding the relationship between performance on these tasks raises the question of whether they can be used interchangeably to assess interoceptive accuracy, confidence and awareness ('metacognition'). The present study employed a meta-analytical approach to assess the association between these tasks. Pooled findings from 22 studies revealed a small relationship between accuracy scores on the measures. Additional analyses demonstrated a moderate relationship between confidence ratings but no association between measures of interoceptive awareness. These findings question the interchangeable use of the two tasks.
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Affiliation(s)
- Lydia Hickman
- School of Psychology, University of Birmingham, United Kingdom.
| | - Aida Seyedsalehi
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Jennifer L Cook
- School of Psychology, University of Birmingham, United Kingdom
| | - Geoffrey Bird
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom
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Somatic symptoms and binge eating in women's daily lives. J Psychosom Res 2020; 135:110161. [PMID: 32504896 PMCID: PMC7365755 DOI: 10.1016/j.jpsychores.2020.110161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/06/2020] [Accepted: 05/20/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The present study aimed to determine whether the momentary severity of women's somatic symptoms was concurrently and prospectively associated with their engagement in binge eating in naturalistic settings. METHOD Thirty women (Mage = 34.13, SD = 13.92) who had engaged in binge eating at least once over the month prior to study entry completed a 14-day ecological momentary assessment (EMA) protocol. During each of the 14 days, participants received five semi-random surveys via text message that assessed momentary somatic symptom severity (i.e., headaches, stomachaches/pain, chest/heart pain, faintness/dizziness, shortness of breath, fatigue) and disordered eating behaviors. Generalized estimating equations were used to determine whether momentary somatic symptoms were concurrently and prospectively (i.e., by participants' next assessment) associated with the occurrence of binge eating behavior, while controlling for age and body mass index. RESULTS At the within-person level, more severe stomachaches/pain, faintness/dizziness, shortness of breath, and fatigue were concurrently associated with an increased likelihood of engaging in binge eating. Further, at the between-person level, more severe stomachaches/pain, chest/heart pain, shortness of breath, and fatigue in general were associated with binge eating across the EMA protocol. Momentary stomachache/pain severity also prospectively predicted women's engagement in binge eating behavior at the next assessment. CONCLUSIONS The present results provide initial evidence that multiple somatic symptoms may serve as momentary correlates or proximal antecedents of binge eating behavior in women's daily lives. Somatic symptoms may consequently prove useful to target in eating disorder treatments, perhaps via interoceptive exposure interventions.
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66
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Davey S, Bell E, Halberstadt J, Collings S. Where is an emotion? Using targeted visceroception as a method of improving emotion regulation in healthy participants to inform suicide prevention initiatives: a randomised controlled trial. Trials 2020; 21:642. [PMID: 32664997 PMCID: PMC7362633 DOI: 10.1186/s13063-020-04479-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 06/06/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND William James' 1884 paper "What is an emotion?" has generated much recent interest in affective science regarding somatic contributions to emotion. Studies of interoception ("sensing the physiological condition of the body") suggest that sensing specific parts of the body contributes to the production of emotion, namely when sensing the viscera (i.e. "visceroception" of the heart, gut or lungs). Improved visceroception has, for instance, been linked to increased emotional intensity, suggesting a role for interoception in emotion regulation that may pertain specifically to visceral bodily locations. Thus, in addition to asking James' question, "What is an emotion?", we ask, "Where is an emotion?". Further, there is an evidence base pointing to the connections between emotion regulation and suicide, and between interoception and suicide. This is a preliminary trial investigating whether targeted interoception/visceroception improves emotion regulation. Ultimately, the overall project aims to inform suicide prevention efforts. METHODS The trial utilises a pre-test/post-test control group design, with two experimental groups undergoing visceroceptive interventions (focussing on areas pertaining to the gut or heart) and a control group. The interventions will run for 8 weeks. A spatial cueing task will measure reaction times to bodily changes relating to lower abdomen or chest focus. A stop/signal task will measure emotional inhibition, which is hypothesised to obscure awareness of active bodily locations. Visceroceptive ability will be tracked using a heartbeat estimation task, a water load test, and by self-report questionnaire. The sample will consist of healthcare professionals and healthcare students. Despite these being groups that represent a relatively high suicide risk among professional and student groups, all participants will be healthy, given the preliminary nature of this trial. DISCUSSION To our knowledge, this will be the first project to address whether emotional feeling presents as a localised bodily phenomenon and whether trained awareness of emotional localisation can improve emotion regulation. It will also be the first to investigate relationships between interoception and emotional inhibition (i.e. whether a sustained interoceptive practice leads to the disinhibition of bodily emotional sensations, which can positively contribute to emotion regulation). These empirical findings on emotion regulation from a healthy sample will be used to inform a desk-based enquiry into the role of embodied emotion in suicide prevention, which may make a significant contribution to a growing evidence base on interoception and suicide. TRIAL REGISTRATION ACTR N12619000324112 . Registered on 4 March 2019. Universal Trial Number (UTN): U1111-1221-0201.
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Affiliation(s)
- Steven Davey
- Suicide and Mental Health Research Group, University of Otago, Wellington, PO Box 7343, Wellington, Newtown, 6242, New Zealand.
| | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | | | - Sunny Collings
- Suicide and Mental Health Research Group, University of Otago, Wellington, New Zealand
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Walter H, Kausch A, Dorfschmidt L, Waller L, Chinichian N, Veer I, Hilbert K, Lüken U, Paulus MP, Goschke T, Kruschwitz JD. Self-control and interoception: Linking the neural substrates of craving regulation and the prediction of aversive interoceptive states induced by inspiratory breathing restriction. Neuroimage 2020; 215:116841. [DOI: 10.1016/j.neuroimage.2020.116841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 12/28/2022] Open
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Pick S, Rojas-Aguiluz M, Butler M, Mulrenan H, Nicholson TR, Goldstein LH. Dissociation and interoception in functional neurological disorder. Cogn Neuropsychiatry 2020; 25:294-311. [PMID: 32635804 DOI: 10.1080/13546805.2020.1791061] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: We aimed to examine susceptibility to dissociation and the impact of dissociation on interoceptive processing in individuals with functional neurological disorder (FND). We hypothesised that dissociative states would be elevated and interoceptive accuracy and awareness impaired at baseline in people with FND, and that such differences would be exacerbated following acute dissociation. Methods: Nineteen adults with FND were compared to 20 healthy controls. A modified heart-beat tracking task measured interoceptive accuracy and awareness (confidence) before and after a validated dissociation induction procedure. An exteroceptive processing control task was included. Mann-Whitney tests and r-values (effect size) were computed for between-group comparisons. Results: The FND group displayed elevated dissociation at baseline (p = 0.001, r = 0.528) compared to controls which increased following dissociation-induction (p < 0.001, r = 0.663). Interoceptive accuracy did not differ between groups at baseline (p = 0.967, r = 0.009); however, the FND group had lower accuracy scores post-induction (p = 0.021, r = 0.379). A negative correlation (trend) between change scores for dissociation and interoceptive accuracy was noted (rs = -0.411, p = 0.057). Confidence ratings on interoceptive and exteroceptive processing tasks were lower in the FND group (p-values < 0.05 or <0.01, r-values 0.331-0.489). Conclusions: Individuals with FND experienced greater susceptibility to dissociation, metacognitive deficits and impaired interoceptive accuracy than controls after acute dissociation.
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Affiliation(s)
- Susannah Pick
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Maya Rojas-Aguiluz
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Morgan Butler
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Heather Mulrenan
- GKT School of Medical Education, King's College London, London, UK
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Laura H Goldstein
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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High blood pressure responders show largest increase in heartbeat perception accuracy after post-learning stress following a cardiac interoceptive learning task. Biol Psychol 2020; 154:107919. [DOI: 10.1016/j.biopsycho.2020.107919] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 01/08/2023]
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70
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Desmedt O, Corneille O, Luminet O, Murphy J, Bird G, Maurage P. Contribution of Time Estimation and Knowledge to Heartbeat Counting Task Performance under Original and Adapted Instructions. Biol Psychol 2020; 154:107904. [DOI: 10.1016/j.biopsycho.2020.107904] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 05/09/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
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Abstract
Symptom perception is complex and influenced by a number of psychological factors, including interoceptive ability and alexithymia. Some individuals may have difficulty distinguishing between internal signals, such as emotions and physical symptoms, however research in this area is sparse. The current study aimed to explore the incidence and nature of this phenomenon, labelled, 'Interoceptive Crossover'. 239 individuals completed an online survey and rated the perceived similarity between a range of emotions (e.g., Sad, Happy, Afraid and Calm) and physical symptoms (e.g., Stomach Pain, Fatigue/Tiredness, Headache and Abnormal Heartbeat) to assess the incidence and nature of Interoceptive Crossover. Individuals demonstrated crossover between emotions and physical symptoms. Some crossovers were more unsurprising and reported by a greater proportion of the sample, such as Afraid and Abnormal Heartbeat (74.5%); Sad and Fatigue (29.4%) and Afraid and Shortness of Breath (58.5%). Other crossovers were less prevalent in the sample and more unexpected such as Satisfied with Headache (1.2%); Bored with Back Pain (5.95%) and Happy and Back Pain (0.4%). Overall, individuals demonstrate Interoceptive Crossover of emotions and physical symptoms and some crossovers are more prevalent whilst others are rare and unexpected. This phenomenon needs further study with respect to relevant constructs including alexithymia and interoception.
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Affiliation(s)
- Laura Carter
- Department of Psychology, University of Surrey, Guildford, UK
| | - Jane Ogden
- Department of Psychology, University of Surrey, Guildford, UK
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72
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Schuette SA, Zucker NL, Smoski MJ. Do interoceptive accuracy and interoceptive sensibility predict emotion regulation? PSYCHOLOGICAL RESEARCH 2020; 85:1894-1908. [PMID: 32556535 DOI: 10.1007/s00426-020-01369-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 05/28/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Interoception refers to awareness, interpretation, and integration of sensations in the body. While interoceptive accuracy has long been regarded as a core component of emotional experience, less is known about the relationship of interoceptive accuracy and related facets of interoception to emotion regulation deficits. This study explores how interoceptive accuracy and interoceptive sensibility relate to emotion regulation in a non-clinical sample. METHODS Undergraduate participants completed a heartbeat perception task and the Multidimensional Assessment of Interoceptive Awareness (Noticing and Body Listening sub-scales), and rated their confidence in performance on the heartbeat perception task. Participants also completed self-report measures of emotional awareness and regulation (Profile of Emotional Competence, intrapersonal emotion identification and emotion regulation sub-scales), and rated their use of different coping strategies (Brief COPE). RESULTS Noticing predicted emotion identification, emotion regulation, and the use of adaptive but not maladaptive coping strategies. Heartbeat perception accuracy did not significantly contribute to the prediction of any outcome variables. DISCUSSION Future work is needed to extend these findings to clinical populations. The results from this study support the use of interoceptive training interventions to promote emotional wellbeing.
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Affiliation(s)
- Stephanie A Schuette
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA. .,Duke Psychiatry, Civitan Building, DUMC Box 3026, Durham, NC, 27710, USA.
| | - Nancy L Zucker
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Moria J Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Stimulation of the vagus nerve reduces learning in a go/no-go reinforcement learning task. Eur Neuropsychopharmacol 2020; 35:17-29. [PMID: 32404279 DOI: 10.1016/j.euroneuro.2020.03.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 02/06/2020] [Accepted: 03/27/2020] [Indexed: 02/06/2023]
Abstract
When facing decisions to approach rewards or to avoid punishments, we often figuratively go with our gut, and the impact of metabolic states such as hunger on motivation are well documented. However, whether and how vagal feedback signals from the gut influence instrumental actions is unknown. Here, we investigated the effect of non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) vs. sham (randomized cross-over design) on approach and avoidance behavior using an established go/no-go reinforcement learning paradigm in 39 healthy human participants (23 female) after an overnight fast. First, mixed-effects logistic regression analysis of choice accuracy showed that taVNS acutely impaired decision-making, p = .041. Computational reinforcement learning models identified the cause of this as a reduction in the learning rate through taVNS (∆α = -0.092, pboot = .002), particularly after punishment (∆αPun = -0.081, pboot = .012 vs. ∆αRew =-0.031, pboot = .22). However, taVNS had no effect on go biases, Pavlovian response biases or response time. Hence, taVNS appeared to influence learning rather than action execution. These results highlight a novel role of vagal afferent input in modulating reinforcement learning by tuning the learning rate according to homeostatic needs.
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74
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Winkens LHH, Elstgeest LEM, van Strien T, Penninx BWJH, Visser M, Brouwer IA. Does food intake mediate the association between mindful eating and change in depressive symptoms? Public Health Nutr 2020; 23:1532-1542. [PMID: 31957621 PMCID: PMC10200545 DOI: 10.1017/s1368980019003732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 07/30/2019] [Accepted: 08/19/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine mediation by (i) diet quality and (ii) diet quantity in the associations of mindful eating domains with 3-year change in depressive symptoms. DESIGN Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale at baseline and 3-year follow-up. Four mindful eating domains (Focused Eating; Eating in response to Hunger and Satiety Cues; Eating with Awareness; Eating without Distraction) were measured with the Mindful Eating Behavior Scale. Food intake was measured with a 238-item FFQ. Diet quality was defined as the Mediterranean Diet Score (MDS). Diet quantity was defined as total energy intake (kcal/d; 1 kcal = 4·184 kJ). Mediation analyses with percentile-corrected bootstrap confidence intervals were conducted to calculate indirect effects. SETTING Longitudinal Aging Study Amsterdam. PARTICIPANTS Adults aged 55 years or above (n 929). RESULTS Diet quality (MDS) did not mediate associations of any of the four mindful eating domains with change in depressive symptoms. In contrast, total energy intake did mediate the associations with change in depressive symptoms for the mindful eating domains Eating with Awareness (indirect effects fully adjusted models: B = -0·014, 95 % CI -0·037, -0·002) and Eating without Distraction (B = -0·013, 95 % CI -0·033, -0·001), but not for the other two domains. Post hoc multiple mediation analyses showed similar results. CONCLUSIONS Higher scores on two mindful eating domains were associated with a decrease in depressive symptoms through lower total energy intake. Diet quantity, but not diet quality, could be a possible underlying mechanism in the associations between mindful eating and change in depressive symptoms.
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Affiliation(s)
- LHH Winkens
- Consumption and Healthy Lifestyles Chair Group, Wageningen University & Research, Hollandseweg 1, 6706 KN Wageningen, The Netherlands
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - LEM Elstgeest
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T van Strien
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - BWJH Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - IA Brouwer
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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75
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Nandrino JL, Grynberg D, Gandolphe MC, Willem C, Benaisa K, Van de Maele J, Taccoen A, Verkindt H, Pattou F. Decreased emotional eating behavior is associated with greater excess weight loss five years after gastric banding. Appetite 2020; 149:104620. [PMID: 32070712 DOI: 10.1016/j.appet.2020.104620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 01/03/2023]
Abstract
While significant weight loss has been observed in the first two years following adjustable gastric banding (AGB), research on the long-term effectiveness of gastric restriction (e.g., 5 years) both on weight loss and eating behavior changes is scarce. The present study examined obese patients' changes in eating behavior preoperatively and 5 years after AGB and examined their associations with excess weight loss (EWL). Specifically, we focused on the association between the modification of three eating behavior profiles (i.e., restrained eating, emotional eating and external eating) and %EWL at 5 years. Among the 197 participants who underwent AGB, 136 completed the clinical assessments (weight, depression with the BDI, eating behavior with the DEBQ) before surgery, and after 5 years. Resultsshowed that the mean percentage of EWL was 47% after 5 years. Moreover, patients reported lower emotional eating and external eating after 5 years in comparison to the baseline, whereas there were no differences concerning restrained eating. Importantly, patients who presented higher %EWL at 5 years also reported a greater decrease in emotional eating between the two sessions than those with low %EWL. Our study underlines that eating behaviors are major variables involved in weight loss after gastric restriction. Results showed that emotional and external eating decreased significantly at 5 years whereas restrained eating behaviors did not vary between the pre- and postoperative stages. Moreover, the data suggest that a decrease in emotional eating accounts for the extent of EWL.
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Affiliation(s)
- Jean-Louis Nandrino
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France; Fondation Santé des étudiants de France, Clinique des 4 Cantons, Villeneuve d'Ascq, France.
| | - Delphine Grynberg
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France.
| | - Marie-Charlotte Gandolphe
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France.
| | - Clémence Willem
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France.
| | - Karima Benaisa
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - Justine Van de Maele
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - Aurore Taccoen
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - Hélène Verkindt
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - François Pattou
- UMR INSERM 1190, Recherche Translationnelle sur le Diabète, Université de Lille, France; Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
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Schlinkert C, Herbert BM, Baumann N, Koole SL. Preoccupied with the body: mild stress amplifies the relation between rumination and interoception. Cogn Emot 2020; 34:1382-1394. [PMID: 32223508 DOI: 10.1080/02699931.2020.1746242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Classic and modern emotion theories suggest that the perception of bodily sensations, or interoception, is foundational to emotion processing. The present research examined whether interoception is enhanced among people high in ruminative tendencies, especially under stress. To test this notion, the present research examined the effects of a mild stressor on subjective and objective measures of interoception among people varying in ruminative tendencies. Under conditions of mild stress, rumination was positively associated with self-reported private body consciousness -a marker of interoceptive sensibility- in Study 1 (N = 312) and with heartbeat detection accuracy (especially in the presence of auditory interference) in Study 2 (N = 180). In both studies, rumination was not significantly associated with interoceptive sensibility or accuracy in the absence of stress. These findings suggest that stress-induced amplification of bodily sensations may be important in explaining emotional dysregulation among chronic ruminators.
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Affiliation(s)
- Caroline Schlinkert
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, the Netherland
| | - Beate M Herbert
- Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Nicola Baumann
- Differential Psychology, Personality Psychology and Diagnostics, University of Trier, Trier, Germany
| | - Sander L Koole
- Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Comment on “Zamariola et al. (2018), Interoceptive Accuracy Scores are Problematic: Evidence from Simple Bivariate Correlations”—The empirical data base, the conceptual reasoning and the analysis behind this statement are misconceived and do not support the authors’ conclusions. Biol Psychol 2020; 152:107870. [DOI: 10.1016/j.biopsycho.2020.107870] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/10/2020] [Indexed: 01/17/2023]
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78
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Schultchen D, Küchler AM, Schillings C, Weineck F, Karabatsiakis A, Ebert DD, Baumeister H, Pollatos O. Effectiveness of a guided online mindfulness-focused intervention in a student population: Study protocol for a randomised control trial. BMJ Open 2020; 10:e032775. [PMID: 32209621 PMCID: PMC7202707 DOI: 10.1136/bmjopen-2019-032775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies show that university students experience higher psychological stress than the general population, resulting in increased vulnerability for mental disorders for the student population. Online mindfulness interventions will be delivered to students as a potentially promising and more flexible approach compared to face-to-face interventions with the aim of improving their mental health. This study purposes to investigate the effectiveness of a guided online mindfulness-focused intervention for university students by using both self-reported and psychobiological measures. METHODS AND ANALYSES In this multicentre, two-armed randomised controlled trial with a parallel design, a guided version of the online mindfulness-focused intervention 'StudiCare Mindfulness' will be compared with a waitlist control group. In total, 120 participants will be recruited at different universities (of Applied Sciences) in (Neu-) Ulm. Data will be assessed prior to randomisation, after eight weeks (post-intervention) and six months after randomisation (follow-up). The primary outcome measure is mindfulness. The secondary outcome measures include depression, anxiety and stress levels, well-being, interoceptive sensibility, emotion regulation and alexithymia. Psychobiological parameters comprise interoceptive accuracy, hair cortisol and FKBP5 genotype. Sociodemographic variables, treatment expectations, side and adverse side effects, as well as intervention satisfaction and adherence will be assessed. All data analyses will be conducted according to the intention-to-treat principle. ETHICS AND DISSEMINATION All study procedures have been approved by the Ethics Committee of Ulm University (application No. 48/18). The findings will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER DRKS00014701.
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Affiliation(s)
- Dana Schultchen
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Christine Schillings
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Felicitas Weineck
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | | | - David D Ebert
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Olga Pollatos
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
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Hample K, Mahler K, Amspacher A. An Interoception-Based Intervention for Children with Autism Spectrum Disorder: A Pilot Study. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2020. [DOI: 10.1080/19411243.2020.1743221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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80
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Casals-Gutiérrez S, Abbey H. Interoception, mindfulness and touch: A meta-review of functional MRI studies. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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81
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Reduction of auditory input improves performance on the heartbeat tracking task, but does not necessarily enhance interoception. Exp Brain Res 2020; 238:621-629. [PMID: 32016483 DOI: 10.1007/s00221-020-05740-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
Previous research utilising a between-subjects design has indicated that the use of noise-dampening ear protectors might enhance interoceptive accuracy (IAcc). In the present study, we further examined this effect using a repeated-measures, within-participants design, and investigated potential mechanisms that might explain the effect. 50 participants completed the heartbeat tracking task (HTT) with and without the use of industrial ear protectors, in a counter-balanced order. Participants were asked to count the number of heartbeats occurring in five discrete time intervals of 25, 35, 45, 55 and 95 s, without feeling for a manual pulse. HTT scores were significantly higher when ear protectors were worn, and the improvement in performance was greatest for participants with lower baseline IAcc. The ear protectors were associated with significantly increased self-reported heartbeat audibility, task-related confidence and concentration, and decreased levels of distractibility. Heartbeat audibility was also correlated with HTT performance when the ear protectors were worn. Because the use of industrial ear defenders resulted in increased heartbeat audibility, this manipulation should not be used to assess causal hypotheses related to changes in IAcc. However, it may serve as a simple, non-invasive manipulation to assess the effects of 'externalised' interoceptive signals.
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Willem C, Nandrino JL, Doba K, Roussel M, Triquet C, Verkindt H, Pattou F, Gandolphe MC. Interoceptive reliance as a major determinant of emotional eating in adult obesity. J Health Psychol 2020; 26:2118-2130. [DOI: 10.1177/1359105320903093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This study examined the association between emotional eating, emotion dysregulations, and interoceptive sensibility in 116 patients with obesity by distinguishing an “awareness” and a “reliance” component of interoceptive sensibility. Deficits in interoceptive awareness were only associated with more emotional eating in obesity through less interoceptive reliance and more emotion dysregulations. The results suggest that good interoceptive awareness can increase the risk of emotional eating if not supported by good interoceptive reliance. Interoceptive reliance, like the ability to trust, positively consider, and positively use inner sensations, should be a privileged target of psychotherapeutic interventions in obesity.
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Affiliation(s)
- Clémence Willem
- University of Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Jean-Louis Nandrino
- University of Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Karyn Doba
- University of Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Méline Roussel
- CETRADIMN Diabetology Center, Roubaix Hospital, Roubaix, France
| | - Claire Triquet
- Departmental Hospital of Felleries-Liessies, Sorle le chateau, France
| | - Hélène Verkindt
- General and Endocrine Surgery, Faculty of Medicine, University of Lille, CHU Lille, Inserm, Lille, France
| | - François Pattou
- General and Endocrine Surgery, Faculty of Medicine, University of Lille, CHU Lille, Inserm, Lille, France
| | - Marie-Charlotte Gandolphe
- University of Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
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83
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Thomas EA, Mijangos JL, Hansen PA, White S, Walker D, Reimers C, Beck AC, Garland EL. Mindfulness-Oriented Recovery Enhancement Restructures Reward Processing and Promotes Interoceptive Awareness in Overweight Cancer Survivors: Mechanistic Results From a Stage 1 Randomized Controlled Trial. Integr Cancer Ther 2019; 18:1534735419855138. [PMID: 31165653 PMCID: PMC6552347 DOI: 10.1177/1534735419855138] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Introduction: The primary aims of this Stage I pilot randomized controlled trial were to establish the feasibility of integrating exercise and nutrition counseling with Mindfulness-Oriented Recovery Enhancement (MORE), a novel intervention that unites training in mindfulness, reappraisal, and savoring skills to target mechanisms underpinning appetitive dysregulation a pathogenic process that contributes to obesity among cancer survivors; to identify potential therapeutic mechanisms of the MORE intervention; and to obtain effect sizes to power a subsequent Stage II trial. Methods: Female overweight and obese cancer survivors (N = 51; mean age = 57.92 ± 10.04; 88% breast cancer history; 96% white) were randomized to one of two 10-week study treatment conditions: (a) exercise and nutrition counseling or (b) exercise and nutrition counseling plus the MORE intervention. Trial feasibility was assessed via recruitment and retention metrics. Measures of therapeutic mechanisms included self-reported interoceptive awareness, maladaptive eating behaviors, and savoring, as well as natural reward responsiveness and food attentional bias, which were evaluated as psychophysiological mechanisms. Results: Feasibility was demonstrated by 82% of participants who initiated MORE receiving a full dose of the intervention. Linear mixed models revealed that the addition of MORE led to significantly greater increases in indices of interoceptive awareness, savoring, and natural reward responsiveness, and, significantly greater decreases in external eating behaviors and food attentional bias—the latter of which was significantly associated with decreases in waist-to-hip ratio. Path analysis demonstrated that the effect of MORE on reducing food attentional bias was mediated by increased zygomatic electromyographic activation during attention to natural rewards. Conclusions and Implications: MORE may target appetitive dysregulatory mechanisms implicated in obesity by promoting interoceptive awareness and restructuring reward responsiveness.
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Affiliation(s)
| | | | - Pamela A Hansen
- 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Shelley White
- 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Darren Walker
- 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Celestial Reimers
- 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Anna C Beck
- 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Eric L Garland
- 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Kruschwitz JD, Kausch A, Brovkin A, Keshmirian A, Paulus MP, Goschke T, Walter H. Self-control is linked to interoceptive inference: Craving regulation and the prediction of aversive interoceptive states induced with inspiratory breathing load. Cognition 2019; 193:104028. [DOI: 10.1016/j.cognition.2019.104028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
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85
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Todd J, Aspell JE, Barron D, Swami V. An exploration of the associations between facets of interoceptive awareness and body image in adolescents. Body Image 2019; 31:171-180. [PMID: 31654981 DOI: 10.1016/j.bodyim.2019.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/06/2019] [Accepted: 10/06/2019] [Indexed: 11/17/2022]
Abstract
Previous research suggests that lower interoceptive awareness is associated with more negative body image during adolescence. However, studies have not distinguished between adaptive and maladaptive modes of attention toward interoceptive signals, and relationships between interoceptive awareness and positive body image remain unexplored. To address these issues, a sample of 265 British adolescents (140 girls, 125 boys) aged 13-16 years completed measures of interoceptive awareness, body appreciation, functionality appreciation, body pride, body shame, and body surveillance. Correlational analyses broadly indicated that greater interoceptive awareness was significantly associated with more positive body image. Multiple regressions revealed significant predictive relationships between interoceptive awareness and all facets of body image in both girls and boys, except body surveillance, which was not statistically significant for girls. At the univariate level, the interoceptive awareness facets of Attention Regulation, Body Listening, Self-Regulation, and Trusting emerged as significant predictors for at least one facet of positive body image, whilst the Noticing and Emotional Awareness facets did not. These findings broadly align with previous research with adults, which has indicated that the way interoceptive stimuli are appraised and responded to might be more closely associated with facets of body image than the tendency to notice interoceptive stimuli.
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Affiliation(s)
- Jennifer Todd
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK.
| | - Jane E Aspell
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - David Barron
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK; Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
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86
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Williams PA, Schnefke CH, Flax VL, Nyirampeta S, Stobaugh H, Routte J, Musanabaganwa C, Ndayisaba G, Sayinzoga F, Muth MK. Using Trials of Improved Practices to identify practices to address the double burden of malnutrition among Rwandan children. Public Health Nutr 2019; 22:3175-3186. [PMID: 31221234 PMCID: PMC10260626 DOI: 10.1017/s1368980019001551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 03/07/2019] [Accepted: 04/02/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Low- and middle-income countries (LMIC) are increasingly experiencing the double burden of malnutrition. Studies to identify 'double-duty' actions that address both undernutrition and overweight in sub-Saharan Africa are needed. We aimed to identify acceptable behaviours to achieve more optimal feeding and physical activity practices among both under- and overweight children in Rwanda, a sub-Saharan LMIC with one of the largest recent increases in child overweight. DESIGN We used the Trials of Improved Practices (TIPs) method. During three household visits over 1·5 weeks, we used structured interviews and unstructured observations to collect data on infant and young child feeding practices and caregivers' experiences with testing recommended practices. SETTING An urban district and a rural district in Rwanda. PARTICIPANTS Caregivers with an under- or overweight child from 6 to 59 months of age (n 136). RESULTS We identified twenty-five specific recommended practices that caregivers of both under- and overweight children agreed to try. The most frequently recommended practices were related to dietary diversity, food quantity, and hygiene and food handling. The most commonly cited reason for trying a new practice was its benefits to the child's health and growth. Financial constraints and limited food availability were common barriers. Nearly all caregivers said they were willing to continue the practices and recommend them to others. CONCLUSIONS These practices show potential for addressing the double burden as part of a broader intervention. Still, further research is needed to determine whether caregivers can maintain the behaviours and their direct impact on both under- and overweight.
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Affiliation(s)
- Pamela A Williams
- RTI International, Social Policy, Health and Economics Research Unit, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194, USA
| | - Courtney H Schnefke
- RTI International, Social Policy, Health and Economics Research Unit, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194, USA
| | - Valerie L Flax
- RTI International, Social Policy, Health and Economics Research Unit, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194, USA
| | | | - Heather Stobaugh
- RTI International, Social Policy, Health and Economics Research Unit, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194, USA
| | - Jesse Routte
- Three Stones Consulting, Nyarugenge, Kigali, Rwanda
| | | | | | | | - Mary K Muth
- RTI International, Social Policy, Health and Economics Research Unit, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194, USA
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87
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Duerlund M, Andersen BV, Grønbeck MS, Byrne DV. Consumer reflections on post-ingestive sensations. A qualitative approach by means of focus group interviews. Appetite 2019; 142:104350. [DOI: 10.1016/j.appet.2019.104350] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 01/22/2023]
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88
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Steward T, Juaneda-Seguí A, Mestre-Bach G, Martínez-Zalacaín I, Vilarrasa N, Jiménez-Murcia S, Fernández-Formoso JA, Veciana de Las Heras M, Custal N, Virgili N, Lopez-Urdiales R, García-Ruiz-de-Gordejuela A, Menchón JM, Soriano-Mas C, Fernandez-Aranda F. What Difference Does it Make? Risk-Taking Behavior in Obesity after a Loss is Associated with Decreased Ventromedial Prefrontal Cortex Activity. J Clin Med 2019; 8:jcm8101551. [PMID: 31569607 PMCID: PMC6832276 DOI: 10.3390/jcm8101551] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/21/2019] [Accepted: 09/24/2019] [Indexed: 12/11/2022] Open
Abstract
Altered activity in decision-making neural circuitry may underlie the maladaptive food choices found in obesity. Here, we aimed to identify the brain regions purportedly underpinning risk-taking behavior in individuals with obesity. Twenty-three adult women with obesity and twenty-three healthy weight controls completed the Risky Gains Task during functional magnetic resonance imaging (fMRI). This task allows participants to choose between a safe option for a small, guaranteed monetary reward and risky options with larger rewards. fMRI analyses comparing losing trials to winning trials found that participants with obesity presented decreased activity in the left anterior insula in comparison to controls (p < 0.05, AlphaSim corrected). Moreover, left insula activation during losses vs. wins was negatively correlated with UPPS-P questionnaire sensation seeking scores. During safe vs. risky trials following a loss, the control group exhibited increased activation in the ventromedial prefrontal cortex (vmPFC) (p < 0.05, AlphaSim corrected) in comparison to the OB group. Moreover, vmPFC response in the obesity group during post-loss trials was negatively correlated with risky choices on the task overall. As a whole, our findings support that diminished tuning of the insula towards interoceptive signals may lead to a lack of input to the vmPFC when weighing the costs and benefits of risky choices.
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Affiliation(s)
- Trevor Steward
- School of Psychological Sciences, University of Melbourne, Parkville, Victoria 3010, Australia.
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Asier Juaneda-Seguí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Gemma Mestre-Bach
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Nuria Vilarrasa
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Jose A Fernández-Formoso
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
| | | | - Nuria Custal
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Nuria Virgili
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Rafael Lopez-Urdiales
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Amador García-Ruiz-de-Gordejuela
- Bariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - José M Menchón
- School of Psychological Sciences, University of Melbourne, Parkville, Victoria 3010, Australia.
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
- Departament of Psychobiology and Methodology in Health Sciences. Universitat Autònoma de Barcelona, 08193 Barcelona, Spain.
| | - Fernando Fernandez-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Feixa Llarga s/n, 08907 Barcelona, Spain.
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain.
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89
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Transcutaneous vagus nerve stimulation improves interoceptive accuracy. Neuropsychologia 2019; 134:107201. [PMID: 31562863 DOI: 10.1016/j.neuropsychologia.2019.107201] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/31/2019] [Accepted: 09/20/2019] [Indexed: 12/25/2022]
Abstract
How can interoceptive accuracy, i.e. the objective ability to identify interoceptive signals, be improved? In the present study, we investigated whether non-invasive stimulation of the auricular branch of the vagus nerve (taVNS) modulates cardiac interoceptive accuracy, interoceptive sensibility, i.e. confidence in the identification of bodily signals, and interoceptive awareness, i.e. the capacity to evaluate one's ability in the objective task. Using a single-blind within-subjects design we compared participants' performance on the heartbeat counting task and on the heartbeat discrimination task during active and sham taVNS stimulation. Results revealed improved accuracy during active taVNS on the heartbeat discrimination task but not on the heartbeat counting task. Participants were also more confident during active stimulation, but interoceptive awareness was not modulated by taVNS. These findings show that taVNS can modulate interoceptive processing and suggest its potential as a tool to investigate body-brain interactions.
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90
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Duerlund M, Vad Andersen B, Victor Byrne D. Dynamic Changes in Post-Ingestive Sensations after Consumption of a Breakfast Meal High in Protein or Carbohydrate. Foods 2019; 8:E413. [PMID: 31540054 PMCID: PMC6769841 DOI: 10.3390/foods8090413] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/08/2019] [Accepted: 09/09/2019] [Indexed: 01/18/2023] Open
Abstract
The obesity epidemic urges exploration of several parameters that play an important role in our eating behaviours. Post-ingestive sensations can provide a more comprehensive picture of the eating experience than mere satiety measurements. This study aimed to (1) quantify the dynamics of different post-ingestive sensations after food intake and (2) study the effect of protein and carbohydrate on hedonic and post-ingestive responses. Forty-eight participants (mean age 20.4) were served a breakfast meal high in protein (HighPRO) or high in carbohydrate (HighCHO) on two separate days using a randomised controlled crossover design. Post-ingestive sensations were measured every 30 min, for 3 h post intake using visual analogue scale (VAS). Results showed a significant main effect of time for all post-ingestive sensations. HighCHO induced higher hedonic responses compared to HighPRO, as well as higher ratings for post-ingestive sensations such as Satisfaction, Food joy, Overall wellbeing and Fullness. HighPRO, on the other hand, induced higher ratings for Sweet desire post intake. The development of sensations after a meal might be important for consumers' following food choices and for extra calorie intake. More detailed knowledge in this area could elucidate aspects of overeating and obesity.
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Affiliation(s)
- Mette Duerlund
- Department of Food Science, Faculty of Science and Technology, Aarhus University, Kirstinebjergvej 10, DK-5792 Aarslev, Denmark.
| | - Barbara Vad Andersen
- Department of Food Science, Faculty of Science and Technology, Aarhus University, Kirstinebjergvej 10, DK-5792 Aarslev, Denmark.
| | - Derek Victor Byrne
- Department of Food Science, Faculty of Science and Technology, Aarhus University, Kirstinebjergvej 10, DK-5792 Aarslev, Denmark.
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91
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Gibson J. Mindfulness, Interoception, and the Body: A Contemporary Perspective. Front Psychol 2019; 10:2012. [PMID: 31572256 PMCID: PMC6753170 DOI: 10.3389/fpsyg.2019.02012] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/16/2019] [Indexed: 12/18/2022] Open
Abstract
Mindfulness is often used as an umbrella term to characterize a large number of practices, processes, and characteristics. Critics argue that this broad definition has led to misinformation, misunderstanding, and a general lack of methodologically rigorous research. Some of the confusion surrounding mindfulness is also believed to stem from an undifferentiated use of the term mindfulness and meditation. Mindfulness and all other forms of meditation have been shown to modulate the insula, which is the primary hub for interoception. Some have argued that interoception is foundational to mindfulness and may be the primary mechanism by which one benefits from the practice. However, much like the mindfulness literature, interoception remains broadly defined often without precision and with domain-specific meanings and implications. Research demonstrates that the insula and surrounding neural circuits are believed to be responsible for a number of other functions beyond interoception including attention, awareness, and all subjective experiences, much of which has been linked to the mindfulness literature. It has been assumed that mindfulness produces these neuroplasticity and functional effects. There is evidence that mindfulness and some of its benefits may be better described as increased interoception as a result of the neuroplasticity changes in the insula, and the development of the insula and surrounding neural circuits may cultivate dispositional mindfulness. The purposes of this article are to (1) highlight that it may be more accurate to link many of the identified benefits in the mindfulness literature to interoception and its neurological correlates and (2) propose attentional style as a means to clarify some of the confusion surrounding mindfulness, interoception, and meditation. Different meditations require different attentional styles. Attention can be analogous to a focal point with each focal point providing a unique perspective. Given that all meditative techniques modulate the insula, each meditation can provide a unique perspective from which to investigate complex interoceptive signals that may be unavailable from other meditative traditions. It may prove more useful to anchor scientific findings in the concrete body as a means to investigate those rather than a set of abstract, broadly defined meditative techniques.
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Affiliation(s)
- Jonathan Gibson
- Department of Humanities and Social Sciences, South Dakota School of Mines and Technology, Rapid City, SD, United States
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92
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Willem C, Gandolphe MC, Roussel M, Verkindt H, Pattou F, Nandrino JL. Difficulties in emotion regulation and deficits in interoceptive awareness in moderate and severe obesity. Eat Weight Disord 2019; 24:633-644. [PMID: 31243741 DOI: 10.1007/s40519-019-00738-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/15/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Difficulties in emotion regulation and deficits in interoceptive awareness may be responsible for overeating and weight gain in obesity by increasing the risks of problematic eating behaviors. This study aimed to: (1) examine emotion regulation difficulties and interoceptive deficits in obesity; (2) compare the emotion regulation and interoceptive abilities of moderately and severely obese patients. METHODS Participants were recruited through the university, diabetology centers and bariatric surgery departments. A total of 165 participants were categorized in three groups, matched by age and gender, according to their Body Mass Index (BMI). The severely obese (SO), moderately obese (MO) and normal weight (NW) groups were constituted of 55 participants each. Self-report questionnaires were used to assess emotion regulation difficulties (CERQ-DERS) and interoceptive awareness (MAIA-FFMQ). RESULTS Overall, obese participants reported more emotion regulation difficulties and less interoceptive awareness than NW participants did. They also reported a lack of planning strategies and emotional awareness, as well as less ability to observe, notice and trust body sensations. No differences in emotion regulation and interoceptive abilities were found between MO and SO participants. CONCLUSIONS Emotion regulation and interoceptive awareness should be targeted in the psychotherapeutic care of obese people, regardless of their BMI. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Clémence Willem
- SCALab Laboratory, Department of Psychology, UMR 9193, CNRS, University of Lille, Villeneuve d'ascq, France.
| | - Marie-Charlotte Gandolphe
- SCALab Laboratory, Department of Psychology, UMR 9193, CNRS, University of Lille, Villeneuve d'ascq, France
| | - Méline Roussel
- Diabetology Center, CETRADIMN, Hospital of Roubaix, Roubaix, France
| | - Hélène Verkindt
- General and Endocrine Surgery, University Hospital of Lille, INSERM U1190, University of Lille, Lille, France
| | - François Pattou
- General and Endocrine Surgery, University Hospital of Lille, INSERM U1190, University of Lille, Lille, France
| | - Jean-Louis Nandrino
- SCALab Laboratory, Department of Psychology, UMR 9193, CNRS, University of Lille, Villeneuve d'ascq, France
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93
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Todd J, Aspell JE, Barron D, Swami V. Multiple dimensions of interoceptive awareness are associated with facets of body image in British adults. Body Image 2019; 29:6-16. [PMID: 30771695 DOI: 10.1016/j.bodyim.2019.02.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 01/25/2023]
Abstract
Previous research has identified a relationship between interoception and body image, where lower interoceptive awareness (IA) is associated with negative body image. However, relationships between facets of interoception and positive body image remain unexplored, and men and older adults remain underrepresented. To overcome these limitations, we assessed relationships between multiple dimensions of interoceptive awareness (IA) and multiple facets of body image in community adults. An online sample of 646 British adults (447 women) aged 18-76 years completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Body Appreciation Scale-2, the Functionality Appreciation Scale, the Authentic Pride subscale from the Body and Appearance Self-Conscious Emotions Scale, and the Appearance Orientation and Overweight Preoccupation subscales from the Multidimensional Body-Self Relations Questionnaire. Hierarchical regressions revealed significant predictive relationships between IA and all five facets of body image after controlling for sex, body mass index, and age. In the final models, the MAIA subscales emerged as significant predictors for at least one facet of body image, with the exception of the MAIA Body Listening subscale. These findings extend previous work by demonstrating significant relationships between IA and previously unexplored facets of body image, which may hold promise for practitioner-based interventions.
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Affiliation(s)
- Jennifer Todd
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK.
| | - Jane E Aspell
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK
| | - David Barron
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - Viren Swami
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK; Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
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Oldroyd K, Pasupathi M, Wainryb C. Social Antecedents to the Development of Interoception: Attachment Related Processes Are Associated With Interoception. Front Psychol 2019; 10:712. [PMID: 31068846 PMCID: PMC6491743 DOI: 10.3389/fpsyg.2019.00712] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 03/14/2019] [Indexed: 11/24/2022] Open
Abstract
Current empirical work suggests that early social experiences could have a substantial impact on the areas of the brain responsible for representation of the body. In this context, one aspect of functioning that may be particularly susceptible to social experiences is interoception. Interoceptive functioning has been linked to several areas of the brain which show protracted post-natal development, thus leaving a substantial window of opportunity for environmental input to impact the development of the interoceptive network. In this paper we report findings from two existing datasets showing significant relationships between attachment related processes and interoception. In the first study, looking at a sample of healthy young adults (n = 132, 66 males), we assessed self-reported interoceptive awareness as assessed with the Multidimensional Assessment of Interoceptive Awareness (Mehling et al., 2012) and attachment style as assessed with the Experiences in Close Relationships Scale-Short (Wei et al., 2007). We found relationships between aspects of interoception and attachment style such that avoidant individuals reported lower interoceptive functioning across several dimensions [r's(130) = -0.20 to -0.26, p's < 0.05]. More anxious individuals, on the other hand, reported heightened interoceptive across several dimensions [r's(130) = 0.18 to 0.43, p's < 0.05]. In the second study, we examined the congruence between a youth's self-reported negative emotion and a measure of sympathetic nervous system arousal (SCL). The congruence score was positively associated with parental rejection of negative emotion. These results suggest that parenting style, as reported by the mother, are associated with a youth's ability to coordinate their self-reported emotional and physiological responding across a series of independent assessments, r(108) = -0.24, p < 0.05. In other words, the more maternal reported parental rejection of youth negative emotions, the less congruent a youth's self and physiological reports of distress.
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Affiliation(s)
- Kristina Oldroyd
- Social Development Laboratory, Department of Psychology, The University of Utah, Salt Lake City, UT, United States
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95
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Richard A, Meule A, Georgii C, Voderholzer U, Cuntz U, Wilhelm FH, Blechert J. Associations between interoceptive sensitivity, intuitive eating, and body mass index in patients with anorexia nervosa and normal-weight controls. EUROPEAN EATING DISORDERS REVIEW 2019; 27:571-577. [PMID: 30968474 PMCID: PMC6767487 DOI: 10.1002/erv.2676] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 02/03/2019] [Accepted: 03/12/2019] [Indexed: 11/13/2022]
Abstract
Reduced perception of bodily signals and low levels of intuitive eating have been reported in patients with anorexia nervosa (AN) compared with normal‐weight individuals. However, findings have been inconsistent and treatment progress might account for some of these inconsistencies. Thirty‐seven inpatients with AN and 39 normal‐weight controls completed a heartbeat perception task and the Intuitive Eating Scale–2. Patients with AN reported lower intuitive eating than controls, whereas interoceptive sensitivity did not differ between groups. Higher interoceptive sensitivity was related to higher intuitive eating across both groups. In patients with AN, both higher interoceptive sensitivity and intuitive eating correlated with the number of days in the hospital and with higher body mass index (BMI), when controlling for BMI at admission. These relationships suggest that interoceptive sensitivity and intuitive eating improve during treatment. Future research should determine whether these improvements promote weight gain or follow it.
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Affiliation(s)
- Anna Richard
- Department of Psychology, University of Salzburg, Salzburg, Austria.,Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Adrian Meule
- Department of Psychology, University of Salzburg, Salzburg, Austria.,Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Claudio Georgii
- Department of Psychology, University of Salzburg, Salzburg, Austria.,Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Ulrich Cuntz
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Paracelsus Medical University, Salzburg, Austria
| | - Frank H Wilhelm
- Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, University of Salzburg, Salzburg, Austria.,Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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96
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Ruzanska UA, Warschburger P. Intuitive eating mediates the relationship between self-regulation and BMI - Results from a cross-sectional study in a community sample. Eat Behav 2019; 33:23-29. [PMID: 30851691 DOI: 10.1016/j.eatbeh.2019.02.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 12/15/2022]
Abstract
Self-regulation is a dispositional skill of regulating attention and emotion to attain a certain goal. Poor self-regulation is associated with a higher body mass index (BMI) and is a risk factor for the development of obesity. Intuitive eating, an adaptive eating style characterized by eating in response to internal cues of hunger and satiety, is associated with a lower BMI. Using cross-sectional data, this study examined whether intuitive eating mediates the relationship between self-regulation and BMI in a community sample of adults. Participants (N = 530) completed the Self-Regulation Scale, the Intuitive Eating Scale-2 with its facets Unconditional Permission to Eat (UPE), Eating for Physical Rather Than Emotional Reasons (EPR), Reliance on Hunger and Satiety Cues (RHSC) and Body-Food Choice Congruence (B-FCC). They also self-reported their height and weight. Using percentile bootstrap resampling procedures, the simple mediation analysis showed an indirect relationship between self-regulation and BMI through intuitive eating. The multiple mediation analysis revealed that EPR and B-FCC, but not UPE and RHSC, mediated the relationship between self-regulation and BMI. Intuitive eating seems to play an important intermediating role in the relationship between self-regulation and BMI. Regarding weight management interventions, it could be useful to promote intuitive eating, especially for individuals with low self-regulation. Prospective studies are needed to explore the causal and temporal relationships among self-regulation, intuitive eating and BMI.
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Affiliation(s)
- Ulrike Alexandra Ruzanska
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany.
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany.
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97
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Kazén M, Baumann N, Twenhöfel JF, Kuhl J. When do anorexic patients perceive their body as too fat? Aggravating and ameliorating factors. PLoS One 2019; 14:e0212612. [PMID: 30794659 PMCID: PMC6386369 DOI: 10.1371/journal.pone.0212612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 02/06/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Our study investigated body image representations in female patients with anorexia nervosa and healthy controls using a size estimation with pictures of their own body. We also explored a method to reduce body image distortions through right hemispheric activation. METHOD Pictures of participants' own bodies were shown on the left or right visual fields for 130 ms after presentation of neutral, positive, or negative word primes, which could be self-relevant or not, with the task of classifying the picture as "thinner than", "equal to", or "fatter than" one's own body. Subsequently, activation of the left- or right hemispheric through right- or left-hand muscle contractions for 3 min., respectively. Finally, participants completed the size estimation task again. RESULTS The distorted "fatter than" body image was found only in patients and only when a picture of their own body appeared on the right visual field (left hemisphere) and was preceded by negative self-relevant words. This distorted perception of the patients' body image was reduced after left-hand muscle contractions (right hemispheric activation). DISCUSSION To reduce body image distortions it is advisable to find methods that help anorexia nervosa patients to increase their self-esteem. The body image distortions were ameliorated after right hemispheric activation. A related method to prevent distorted body-image representations in these patients may be Eye Movement Desensitization and Reprocessing (EMDR) therapy.
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Affiliation(s)
- Miguel Kazén
- Institute of Psychology, University of Osnabrück, Osnabrück, Germany
- * E-mail:
| | - Nicola Baumann
- Department of Psychology, University of Trier, Trier, Germany
| | | | - Julius Kuhl
- Institute of Psychology, University of Osnabrück, Osnabrück, Germany
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98
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Abstract
Various aspects of physical and mental health have been linked to an individual’s ability to perceive the physical condition of their body (‘interoception’). In addition, numerous studies have demonstrated a role for interoception in higher-order cognitive abilities such as decision-making and emotion processing. The importance of interoception for health and typical cognitive functioning has prompted interest in how interoception varies over the lifespan. However, few studies have investigated interoception into older adulthood, and no studies account for the set of physiological changes that may influence task performance. The present study examined interoception from young to very late adulthood (until 90 years of age) utilising a self-report measure of interoception (Study One) and an objective measure of cardiac interoception (Study Two). Across both studies, interoception decreased with age, and changes in interoceptive accuracy were observed which were not explained by accompanying physiological changes. In addition to a direct effect of age on interoception, an indirect effect of ageing on cardiac interoceptive accuracy mediated by body mass index (BMI) was found, such that ageing was associated with increased BMI which was, in turn, associated with reduced interoceptive accuracy. Such findings support and extend previous research demonstrating interoceptive decline with advancing age, and highlight the importance of assessing whether decreasing interoceptive ability is responsible for some aspects of age-related ill-health and cognitive impairment.
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99
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Kakoschke N, Aarts E, Verdejo-García A. The Cognitive Drivers of Compulsive Eating Behavior. Front Behav Neurosci 2019; 12:338. [PMID: 30705625 PMCID: PMC6344462 DOI: 10.3389/fnbeh.2018.00338] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/31/2018] [Indexed: 12/18/2022] Open
Abstract
Compulsivity is a central feature of obsessive-compulsive and addictive disorders, which share considerable overlap with excessive eating in terms of repetitive behavior despite negative consequences. Excessive eating behavior is characteristic of several eating-related conditions, including eating disorders [bulimia nervosa (BN), binge eating disorder (BED)], obesity, and food addiction (FA). Compulsivity is proposed to be driven by four distinct cognitive components, namely, contingency-related cognitive flexibility, task/attentional set-shifting, attentional bias/disengagement and habit learning. However, it is unclear whether repetitive behavior in eating-related conditions is underpinned by deficits in these cognitive components. The current mini-review synthesizes the available evidence for performance on compulsivity-related cognitive tasks for each cognitive domain among populations with excessive eating behavior. In three of the four cognitive domains, i.e., set-shifting, attentional bias and habit learning, findings were mixed. Evidence more strongly pointed towards impaired contingency-related cognitive flexibility only in obesity and attentional bias/disengagement deficits only in obesity and BED. Overall, the findings of the reviewed studies support the idea that compulsivity-related cognitive deficits are common across a spectrum of eating-related conditions, although evidence was inconsistent or lacking for some disorders. We discuss the theoretical and practical importance of these results, and their implications for our understanding of compulsivity in eating-related conditions.
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Affiliation(s)
- Naomi Kakoschke
- Monash Institute for Cognitive and Clinical Neurosciences (MICCN), School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Esther Aarts
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Antonio Verdejo-García
- Monash Institute for Cognitive and Clinical Neurosciences (MICCN), School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
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100
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Schaan VK, Schulz A, Rubel JA, Bernstein M, Domes G, Schächinger H, Vögele C. Childhood Trauma Affects Stress-Related Interoceptive Accuracy. Front Psychiatry 2019; 10:750. [PMID: 31681049 PMCID: PMC6813623 DOI: 10.3389/fpsyt.2019.00750] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/18/2019] [Indexed: 12/18/2022] Open
Abstract
Early life adversity (ELA) may cause permanent disturbances in brain-body signaling. These disturbances are thought to contribute to physical symptoms and emotional dysregulation in adulthood. The current study investigated the effects of childhood trauma on young adults' interoceptive accuracy as an indicator of brain-body communication that may be dysregulated by ELA. Sixty-six participants completed an online questionnaire followed by a laboratory session including the socially evaluated cold pressor stress test during which ECG, salivary cortisol, and interoceptive accuracy were assessed. Childhood trauma was negatively related to interoceptive accuracy (IAc) after the stressor. This stress effect could not be observed for heart rate and cortisol, which were unrelated to IAc. Participants reporting higher baseline unpleasantness exhibited lower IAc after the stressor, while increases in unpleasantness due to the stressor were associated with higher IAc. Unpleasantness at baseline mediated the effect of childhood trauma on IAc after the stressor.
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Affiliation(s)
- Violetta K Schaan
- Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Luxembourg, Luxembourg
| | - André Schulz
- Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Luxembourg, Luxembourg
| | - Julian A Rubel
- Department of Psychotherapy Research, Justus-Liebig-University Gießen, Giessen, Germany
| | - Michael Bernstein
- Department of Psychology and Social Sciences, Penn State Abington, Abington Township, PA, United States
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Germany
| | - Hartmut Schächinger
- Department of Clinical Psychophysiology, Institute of Psychobiology, University of Trier, Germany
| | - Claus Vögele
- Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Luxembourg, Luxembourg
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