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Solano Durán P, Morales JP, Huepe D. Interoceptive awareness in a clinical setting: the need to bring interoceptive perspectives into clinical evaluation. Front Psychol 2024; 15:1244701. [PMID: 38933585 PMCID: PMC11199726 DOI: 10.3389/fpsyg.2024.1244701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 04/26/2024] [Indexed: 06/28/2024] Open
Abstract
Interoceptive awareness (IA) is crucial to understanding mental health. The Multidimensional Assessment of Interoceptive Awareness (MAIA) scale, available in approximately 30 languages, has gained global recognition for its research applicability. This review highlights the critical importance of integrating IA evaluation in clinical settings, advocating for the MAIA scale's potential as a screening tool. Through an examination of academic databases, including Scopus, PubMed, Google Scholar, and J-STOR, our analysis spans seven mental health domains: eating disorders (ED), depression, stress, anxiety, autism spectrum disorder (ASD), chronic pain, and suicide ideation (SI). Thirty-eight studies showed links between several dimensions of IA with different disorders. That is, ED was related to Body Trust and Self-Regulation; anxiety to Body Listening, Emotional Awareness, and Self-Regulation; depression to Noticing and Emotional Awareness; ASD to Trusting, Emotional Awareness, and Noticing; chronic pain to Not-Worrying and Self-Regulation; and SI with Trusting. These insights hold profound implications for both clinical practice and mental health research. Integrating IA assessments into standard clinical protocols has the potential to improve our understanding of pathology, enrich patient care, and enhance therapeutic strategies.
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Affiliation(s)
- Paola Solano Durán
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile
- Oficina de Equidad de Género, Instituto Tecnológico de Costa Rica, Cartago, Costa Rica
| | - Juan-Pablo Morales
- Facultad de Educación Psicología y Familia, Universidad Finis Terrae, Santiago, Chile
- University of Sydney Business School, Darlington, NSW, Australia
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile
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Montoya-Hurtado OL, Sobral-Monteiro-Junior R, Meneses-Castaño CY, Sancho-Sánchez C, Martínez-Sabater A, Andrés-Olivera P, Sanchez-Conde P, Sánchez-Toledo JP, Criado-Gutiérrez JM, Criado-Pérez L, Sánchez-González JL, Juárez-Vela R. Body Awareness as a Protective Factor against Suicidal Orientations in College Students. Behav Sci (Basel) 2024; 14:358. [PMID: 38785849 PMCID: PMC11118123 DOI: 10.3390/bs14050358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
In this study, binary logistic regression and linear regression analyses were used to examine the relationship between interoceptive body awareness and suicidal orientation among Colombian university students. Additionally, the bootstrap technique was employed to resample and estimate the distribution of the data. The results support the idea that greater interoceptive awareness may protect against suicidal orientation by improving emotional regulation. An inverse relationship was found between interoceptive awareness and suicidal ideation. These findings align with previous literature emphasizing the importance of body awareness for emotional well-being. Further longitudinal research is needed to explore this relationship more deeply.
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Affiliation(s)
- Olga Lucia Montoya-Hurtado
- Doctoral Program in Program in Health, Disability, Dependency, and Well-Being, University of Salamanca, 37007 Salamanca, Spain;
- Research Department, Escuela Colombiana de Rehabilitación, Bogotá 110121, Colombia;
| | | | | | - Consuelo Sancho-Sánchez
- Department of Physiology and Pharmacology, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (C.S.-S.); (J.M.C.-G.)
| | - Antonio Martínez-Sabater
- Nursing Care and Education Research Group (GRIECE), Nursing Department, Universität de Valencia, 46010 Valencia, Spain;
- Grupo Asociado de Investigación en Cuidados (INCLIVA), Hospital Clínico Universitario, 46010 Valencia, Spain
| | - Pilar Andrés-Olivera
- Psychiatry Service, University of Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain;
- Psychiatric Unit, School of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Pilar Sanchez-Conde
- Department of Surgery, School of Medicine, University Health Care Complex of Salamanca, University of Salamanca, 37007 Salamanca, Spain;
| | - Jesús Pérez Sánchez-Toledo
- Institute of Biomedicine of Salamanca (IBSAL), Prevention, and Early Intervention in Mental Health (PRINT), 37007 Salamanca, Spain; (J.P.S.-T.); (R.J.-V.)
| | - José María Criado-Gutiérrez
- Department of Physiology and Pharmacology, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (C.S.-S.); (J.M.C.-G.)
| | - Laura Criado-Pérez
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26004 Logroño, Spain
| | - Juan Luis Sánchez-González
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain;
| | - Raúl Juárez-Vela
- Institute of Biomedicine of Salamanca (IBSAL), Prevention, and Early Intervention in Mental Health (PRINT), 37007 Salamanca, Spain; (J.P.S.-T.); (R.J.-V.)
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26004 Logroño, Spain
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Velkoff EA, Perkins NM, Dodd DR, Brown TA, Kaye WH, Wierenga CE. Elevated interoceptive deficits in individuals with eating disorders and self-injurious thoughts and behaviors: A replication and extension. Suicide Life Threat Behav 2024; 54:129-137. [PMID: 38009622 DOI: 10.1111/sltb.13024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION People with eating disorders (EDs) frequently report self-injurious thoughts and behaviors (SITBs). We aimed to replicate and extend findings demonstrating greater interoceptive deficits according to SITB severity. We predicted that interoceptive deficits would be greater among people with versus without lifetime SITBs and among those with multiple suicide attempts compared with single attempts or nonsuicidal self-injury. We also predicted that interoception would be increasingly impaired with greater current suicidality severity. METHOD Adults (N = 118) seeking ED treatment reported current and lifetime SITBs upon admission to treatment. We used planned contrasts to compare interoceptive deficits (self-reported using the Eating Disorders Inventory) by SITB and current suicidality groups (assessed by self-report and clinical interview). RESULTS Interoceptive deficits were greater among people with any SITB history compared to those without. People with multiple suicide attempts did not differ in interoceptive deficits from those with single attempts or only nonsuicidal self-injury. Interoceptive deficits were elevated among those with any current suicidality compared to those with no suicidal symptoms; interoceptive deficits did not differ according to severity of suicidality. CONCLUSION Among those with EDs, interoceptive deficits are elevated among those with concurrent SITBs. Interventions aimed at improving interoception may reduce the risk for SITBs.
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Affiliation(s)
- Elizabeth A Velkoff
- Drexel University, Philadelphia, Pennsylvania, USA
- University of California, San Diego, La Jolla, California, USA
| | | | - Dorian R Dodd
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | | | - Walter H Kaye
- University of California, San Diego, La Jolla, California, USA
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Smith AR, Witte TK, Troop-Gordon W, Grunewald W, Crosby E, Hill K, Williams T, Kinkel-Ram S, Santivasci C, Chamberlin J, Aguon-Larson C, Harris I, Esche MA, Tubman LCD, Dretsch LM. Reconnecting to Internal Sensations and Experiences (RISE): An online, multi-session intervention improves interoceptive sensibility for military personnel. Suicide Life Threat Behav 2023; 53:940-957. [PMID: 37655866 DOI: 10.1111/sltb.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE This preregistered randomized controlled trial tested the effects of a four-session, online interoceptive awareness intervention relative to an active comparator, matched for time and attention on interoception and suicidal ideation. METHOD Participants (N = 195; 69% male; mean age = 37) were active duty service members (62%) and veterans (38%) who completed measures of interoceptive sensibility, interoceptive accuracy, and suicidal ideation at baseline. They were randomized to either the interoceptive awareness intervention, Reconnecting to Internal Sensations and Experiences (RISE), or the comparator, Healthy Habits. Participants completed the assessment battery again at posttest as well as a 1 and 3-month follow-up. RESULTS RISE was rated as acceptable and demonstrated excellent feasibility per completion rates (85% completed all four modules). RISE improved the majority of interoceptive sensibility domains assessed (noticing body sensations, not worrying about sensations of pain or discomfort, emotional awareness, self-regulation, body listening, and body trust), and most of these gains remained at 1 and 3-month follow-ups. There were no differences between conditions on suicidal ideation, perhaps due to the low levels of ideation reported, or interoceptive accuracy. CONCLUSIONS RISE is a disseminable, cost-effective, and transdiagnostic intervention that improves interoceptive sensibility up to 3 months.
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Affiliation(s)
- April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Tracy K Witte
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Wendy Troop-Gordon
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - William Grunewald
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Eric Crosby
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Kent Hill
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington, USA
| | - Tammy Williams
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington, USA
| | - Shruti Kinkel-Ram
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington, USA
| | | | - Jacob Chamberlin
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Cyrena Aguon-Larson
- Department of Health Sport and Exercise Sciences, University of Kansas, Lawrence, Kansas, USA
| | - Isaac Harris
- Department of Health Sport and Exercise Sciences, University of Kansas, Lawrence, Kansas, USA
| | - Maj Aaron Esche
- Wright-Patterson Medical Center, Wright-Patterson Airforce Base, Ohio, USA
| | | | - Ltc Michael Dretsch
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
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Montoya-Hurtado OL, Gómez-Jaramillo N, Criado-Gutiérrez JM, Pérez J, Sancho-Sánchez C, Sánchez-Barba M, Tejada-Garrido CI, Criado-Pérez L, Sánchez-González JL, Santolalla-Arnedo I, del Pozo-Herce P, Juárez-Vela R. Exploring the Link between Interoceptive Body Awareness and Suicidal Orientation in University Students: A Cross-Sectional Study. Behav Sci (Basel) 2023; 13:945. [PMID: 37998691 PMCID: PMC10669022 DOI: 10.3390/bs13110945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION The transition to college life can impact the mental health of students. There are mental health care strategies that promote connection with the body's internal signals, which can help to improve mental well-being, manage emotions, and reduce the risk of suicide in university students. AIM This study aimed to examine the association between interoceptive body awareness variables and suicidal orientation in a sample of 169 undergraduate students in Colombia. METHODS An observational, cross-sectional study was conducted in 2023 with Colombian students as the participants. RESULTS The findings revealed a significant and moderately negative correlation between the Multidimensional Assessment of Interoceptive Awareness (MAIA) total score and the Inventory of Suicide Orientation (ISO-30) total score (r = -0.54, p < 0.001). Confidence and self-regulation were identified as the most influential factors in the relationship between MAIA and ISO-30. Significant correlations were observed (p < 0.001), indicating moderate correlation values ranging from -0.43 to -0.57. DISCUSSION Our findings support the existence of a negative correlation between interoceptive body awareness and suicidal orientation. Further research is needed to better understand this relationship and to develop specific interventions based on body awareness to prevent suicide orientation. CONCLUSION There are practical implications associated with recognizing the importance of body awareness in relation to decreasing suicidal orientation, and multidisciplinary teams addressing mental health can incorporate this knowledge.
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Affiliation(s)
- Olga Lucia Montoya-Hurtado
- Research Department, Escuela Colombiana de Rehabilitación, Health and Sports Sciences, Bogota 110121, Colombia;
- Doctoral Program in Program in Health, Disability, Dependency, and Well-Being, University of Salamanca, 37007 Salamanca, Spain
| | - Nicolás Gómez-Jaramillo
- Research Department, Universidad de Manizales, Engineering Program, Manizales 170003, Colombia;
| | - José María Criado-Gutiérrez
- Department of Physiology and Pharmacology, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (J.M.C.-G.); (C.S.-S.)
| | - Jesús Pérez
- Department of Medicine, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
- Biomedical Research Institute of Salamanca (IBSAL), Prevention, and Early Intervention in Mental Health (PRINT), 26004 Logroño, Spain;
| | - Consuelo Sancho-Sánchez
- Department of Physiology and Pharmacology, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (J.M.C.-G.); (C.S.-S.)
| | - Mercedes Sánchez-Barba
- Department of Statistic, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - Clara Isabel Tejada-Garrido
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26004 Logroño, Spain;
- Research Group in Care, GRUPAC, University of La Rioja, 26004 Logroño, Spain
| | - Laura Criado-Pérez
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Juan Luis Sánchez-González
- Faculty of Nursing and Physiotherapy, Department of Nursing and Physiotherapy, Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain;
| | - Iván Santolalla-Arnedo
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26004 Logroño, Spain;
- Research Group in Care, GRUPAC, University of La Rioja, 26004 Logroño, Spain
| | - Pablo del Pozo-Herce
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain;
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Raúl Juárez-Vela
- Biomedical Research Institute of Salamanca (IBSAL), Prevention, and Early Intervention in Mental Health (PRINT), 26004 Logroño, Spain;
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26004 Logroño, Spain;
- Research Group in Care, GRUPAC, University of La Rioja, 26004 Logroño, Spain
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Belanger AN, Timpano KR, Eng GK, Bragdon LB, Stern ER. Associations Between Suicidality and Interoception in Obsessive-Compulsive Disorder. J Obsessive Compuls Relat Disord 2023; 39:100844. [PMID: 37901053 PMCID: PMC10610034 DOI: 10.1016/j.jocrd.2023.100844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Background Individuals with obsessive-compulsive disorder (OCD) are at increased risk for suicide. One potential risk factor is interoceptive sensibility (IS), which is one's subjective experience of bodily sensations. The current study examined the relationship between IS and current suicidal ideation and lifetime history of suicide attempt, controlling for relevant covariates. Methods Participants (N = 145) were a clinical sample of individuals with OCD from the New York City area. A clinical rater administered a diagnostic interview and an OCD severity assessment, and participants completed questionnaires about demographics, IS, and suicidality. Results Current suicidal ideation was associated with reduced trusting of the body, and lifetime history of suicide attempt was related to greater general awareness of sensation. These associations remained significant after controlling for covariates. Conclusions These results suggest that specific facets of IS may be associated with specific domains of suicidality. Decreased body trusting may represent a feeling of disconnection from the body that facilitates desire for death. Increased noticing of bodily sensations may lead to greater mental pain, which could interact with deficits in emotion regulation to increase risk for suicide attempt. Further research on the relationships between IS and suicidality in OCD is warranted.
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Affiliation(s)
- Amanda N. Belanger
- University of Miami, Department of Psychology; 5665 Ponce de Leon Boulevard, Coral Gables, FL, USA 33146
| | - Kiara R. Timpano
- University of Miami, Department of Psychology; 5665 Ponce de Leon Boulevard, Coral Gables, FL, USA 33146
| | - Goi Khia Eng
- New York University Grossman School of Medicine, Department of Psychiatry; One Park Avenue, 8th Floor, New York, NY, USA 10016
- Nathan S. Kline Institute for Psychiatric Research; 140 Old Orangeburg Road, Orangeburg, NY, USA 10962
| | - Laura B. Bragdon
- New York University Grossman School of Medicine, Department of Psychiatry; One Park Avenue, 8th Floor, New York, NY, USA 10016
- Nathan S. Kline Institute for Psychiatric Research; 140 Old Orangeburg Road, Orangeburg, NY, USA 10962
| | - Emily R. Stern
- New York University Grossman School of Medicine, Department of Psychiatry; One Park Avenue, 8th Floor, New York, NY, USA 10016
- Nathan S. Kline Institute for Psychiatric Research; 140 Old Orangeburg Road, Orangeburg, NY, USA 10962
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Grunewald W, Gagliano E, Brown TA, Smith AR. Conformity to masculine norms, interoceptive dysfunction, and changes in muscle dysmorphia symptoms. Body Image 2023; 45:343-354. [PMID: 37037062 DOI: 10.1016/j.bodyim.2023.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/15/2023] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
Muscle dysmorphia (MD) is a psychiatric illness characterized by preoccupation and compulsive behaviors to increase muscle size/definition. Despite its severity, few risk factors/mechanisms for MD have been identified. Conformity to masculine norms may be a MD risk factor. Furthermore, interoceptive dysfunction may facilitate MD. symptoms, as well as underlie relationships between conformity to masculine norms and MD symptoms. However, research has yet to test the mediating role of interoceptive dysfunction for said relationships. The current study tested if interoceptive dysfunction underlies relationships between conformity to masculine norms and MD symptoms among 269 US men who completed three surveys separated by one month that contained measures of focal constructs. Our sample was majority White, heterosexual, and non-Hispanic. A three-wave autoregressive mediation model was tested in which conformity to masculine norms predicted interoceptive dysfunction, which then predicted MD symptoms. Results indicated that conformity to specific masculine norms predicted both interoceptive dysfunction and MD symptoms over time. Furthermore, our hypothesized mediation pathways were not discovered. Conformity to masculine norms appears to be a risk factor for MD symptoms and interoceptive dysfunction. If clinicians can reduce rigid adherence to masculine stereotypes, this may increase connection with one's body and reduce subsequent MD symptoms.
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Affiliation(s)
- William Grunewald
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States.
| | - Elena Gagliano
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States
| | - Tiffany A Brown
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States
| | - April R Smith
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States
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Smith AR, Witte TK, Grunewald W, Kinkel-Ram S, Santivasci C, Crosby E, Williams T, Esche A, Tubman D, Dretsch M. Disrupted interoception in Military Service Members and Veterans with a history of suicidality. Suicide Life Threat Behav 2023; 53:289-302. [PMID: 36683352 DOI: 10.1111/sltb.12942] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION This project tested whether Service Members (SM) and Veterans with current suicidal ideation or a history of suicide attempt had greater interoceptive dysfunction than SM and Veterans with past or no suicidal ideation. METHOD Participants (N = 195; 69% male) were SM (62%) and Veterans (38%) who completed measures of suicidal thoughts and behaviors and subjective and objective interoceptive dysfunction. Participants were split into the following suicide groups: no suicidality, lifetime ideation, current ideation, and past attempt. Planned orthogonal contrasts tested for differences. RESULTS The combined suicidality group (lifetime ideation, current ideation, or past attempt) had worse body trust relative to the no suicidality group, and the current ideation group had worse body trust relative to those with lifetime ideation. Those with a history of suicide attempt had worse body appreciation than the combined group of ideators, and those with current ideation had worse body appreciation relative to those with lifetime ideation. The groups did not differ on objective interoception. CONCLUSION Interoception is disrupted among individuals with suicidality histories within a predominantly male-identified military sample. Individuals with current suicidal ideation had both worse body trust and appreciation relative to those with past ideation. Suicide risk assessments may benefit from including questions related to body trust.
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Affiliation(s)
- April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Tracy K Witte
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - William Grunewald
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | | | | | - Eric Crosby
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Tammy Williams
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington, USA
| | - Aaron Esche
- Wright-Patterson Medical Center, Wright-Patterson Airforce Base, Ohio, USA
| | - David Tubman
- Wright-Patterson Medical Center, Wright-Patterson Airforce Base, Ohio, USA
| | - Michael Dretsch
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
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Spears AP, Gratch I, Nam RJ, Goger P, Cha CB. Future Directions in Understanding and Interpreting Discrepant Reports of Suicidal Thoughts and Behaviors Among Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:134-146. [PMID: 36473063 PMCID: PMC9898197 DOI: 10.1080/15374416.2022.2145567] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Both the quality and utility of youth suicide research depend on how we assess our outcomes of interest: suicidal thoughts and behaviors (STBs). We now have access to more STB assessments than ever before, with measures for youth that vary in what exact experiences are asked about, how such measures elicit information, when and how frequently measures are administered, and who the informants are. This growing armamentarium of assessments has the potential to improve the study and treatment of STBs among youth, but it hinges on meaningful interpretation of assessment responses. Interpretation can be especially challenging when different STB assessments yield conflicting information. Determining how to manage discrepant reports of STBs is a pivotal step toward achieving meaningfully comprehensive STB assessment batteries. Here, we outline several discrepant reporting patterns that have been detected, discuss the potential significance of these observed discrepancies, and present initial steps to formally investigate discrepant reports of STBs among youth. Developing coherent, interpretable, and comprehensive batteries assessing STBs among youth would address a fundamental step to uncovering etiology, improving clinical decision-making and case management, informing intervention development, and tracking prognosis.
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Affiliation(s)
- Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Ilana Gratch
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Rachel J Nam
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Pauline Goger
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
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Gioia AN, Forrest LN, Smith AR. Diminished body trust uniquely predicts suicidal ideation and nonsuicidal self-injury among people with recent self-injurious thoughts and behaviors. Suicide Life Threat Behav 2022; 52:1205-1216. [PMID: 36029117 DOI: 10.1111/sltb.12915] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/13/2022] [Accepted: 08/09/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Self-injurious thoughts and behaviors (SITBs) are difficult to predict, and novel risk factors must be identified. While diminished interoception is associated with SITBs cross-sectionally, the current study assesses whether multiple measures of interoception predict future SITBs. METHODS Adults (N = 43) with recent SITBs completed assessments of interoception during a baseline visit. Participants then completed biweekly assessments for 6 months in which they reported the presence and severity/frequency of suicidal ideation and nonsuicidal self-injury (NSSI). RESULTS Multilevel models were performed, where baseline interoceptive measures predicted presence and severity/frequency of suicidal ideation and NSSI at follow-up. The Multidimensional Assessment of Interoceptive Awareness (MAIA) Trusting subscale was the only significant predictor of the presence/severity of suicidal ideation. The MAIA Trusting, Emotional Awareness, and Body Listening subscales significantly predicted the presence of NSSI. The MAIA Emotional Awareness subscale and the Body Perception Questionnaire significantly predicted NSSI frequency. DISCUSSION Diminished body trust predicted both suicidal ideation and NSSI, indicating a potential shared risk pathway. However, two interoception measures (Body Listening subscale and Body Perception Questionnaire) were associated with NSSI only, indicating potentially unique risk pathways. Given the differential associations between interoception measures and SITBs, results highlight the importance of clearly defining how interoception is measured.
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Affiliation(s)
- Ayla N Gioia
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Lauren N Forrest
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
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Todd J, Aspell JE. Mindfulness, Interoception, and the Body. Brain Sci 2022; 12:brainsci12060696. [PMID: 35741582 PMCID: PMC9220884 DOI: 10.3390/brainsci12060696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023] Open
Abstract
In recent years, there has been a surge of interest in the topics of interoception and mindfulness from researchers, clinicians, and the general public alike (e [...]
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Affiliation(s)
- Jennifer Todd
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge CB1 1PT, UK;
- Centre for Psychological Medicine, Perdana University, Kuala Lumpur 50490, Malaysia
- Correspondence:
| | - Jane E. Aspell
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge CB1 1PT, UK;
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A Pilot Feasibility Study of Reconnecting to Internal Sensations and Experiences (RISE), a Mindfulness-Informed Intervention to Reduce Interoceptive Dysfunction and Suicidal Ideation, among University Students in India. Brain Sci 2022; 12:brainsci12020237. [PMID: 35204000 PMCID: PMC8870213 DOI: 10.3390/brainsci12020237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023] Open
Abstract
Although 20% of the world’s suicides occur in India, suicide prevention efforts in India are lagging (Vijayakumar et al., 2021). Identification of risk factors for suicide in India, as well as the development of accessible interventions to treat these risk factors, could help reduce suicide in India. Interoceptive dysfunction—or an inability to recognize internal sensations in the body—has emerged as a robust correlate of suicidality among studies conducted in the United States. Additionally, a mindfulness-informed intervention designed to reduce interoceptive dysfunction, and thereby suicidality, has yielded promising initial effects in pilot testing (Smith et al., 2021). The current studies sought to replicate these findings in an Indian context. Study 1 (n = 276) found that specific aspects of interoceptive dysfunction were related to current, past, and future likelihood of suicidal ideation. Study 2 (n = 40) was a small, uncontrolled pre-post online pilot of the intervention, Reconnecting to Internal Sensations and Experiences (RISE). The intervention was rated as highly acceptable and demonstrated good retention. Additionally, the intervention was associated with improvements in certain aspects of interoceptive dysfunction and reductions in suicidal ideation and eating pathology. These preliminary results suggest further testing of the intervention among Indian samples is warranted.
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Perkins NM, Ortiz SN, Smith AR, Brausch AM. Suicidal Ideation and Eating Disorder Symptoms in Adolescents: The Role of Interoceptive Deficits. Behav Ther 2021; 52:1093-1104. [PMID: 34452664 PMCID: PMC8403232 DOI: 10.1016/j.beth.2021.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/19/2021] [Accepted: 03/07/2021] [Indexed: 01/11/2023]
Abstract
Eating disorder symptoms and suicidal ideation are relatively common, and often begin to emerge in adolescence. Interoceptive deficits, or the inability to perceive and accurately identify the physiological condition of the body, is an established risk factor for both eating disorders and suicidal thoughts and behaviors. Despite this, longitudinal research examining the temporal dynamics between these variables is scarce, especially within adolescent samples. Using a three-wave longitudinal design, the present study tested bidirectional relationships between interoceptive deficits, eating disorder symptoms, and suicidal ideation to examine whether interoceptive deficits predicted eating disorder symptoms and suicidal ideation over the course of a year among a sample of adolescents. Participants were 436 community adolescents recruited from local middle- and high-schools. Data were collected at baseline, 6-month follow-up, and 12-month follow-up. Study measures assessed current suicidal ideation, eating disorder symptom severity, and interoceptive deficits. Autoregressive cross-lagged modeling was conducted in MPlus. We found baseline eating disorder symptoms significantly predicted suicidal ideation at 6-month follow-up when controlling for baseline suicidal ideation. Baseline interoceptive deficits significantly predicted eating disorder symptoms 6-months later, while 6-month follow-up interoceptive deficits significantly predicted 12-month follow-up suicidal ideation. Our findings highlight the need for early and regular assessment of suicidal ideation and eating disorder symptoms in adolescents. Given that interoceptive deficits was a shared risk factor for both conditions within this sample, these results underscore the need for targeted interventions aimed at improving interoception.
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Affiliation(s)
- Natalie M. Perkins
- Department of Psychology, Miami University, 90 N. Patterson Avenue, Oxford, OH, 45056,Correspondence concerning this article should addressed to Natalie M. Perkins,
| | - Shelby N. Ortiz
- Department of Psychology, Miami University, 90 N. Patterson Avenue, Oxford, OH, 45056
| | - April R. Smith
- Department of Psychology, Miami University, 90 N. Patterson Avenue, Oxford, OH, 45056
| | - Amy M. Brausch
- Department of Psychological Science, Western Kentucky University, 1906 College Heights Boulevard, Bowling Green, KY
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Smith AR, Duffy ME, Joiner TE. Introduction to the Special Issue on Interoception and Suicidality. Behav Ther 2021; 52:1031-1034. [PMID: 34452659 DOI: 10.1016/j.beth.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
Empirically informed theories of suicide highlight the importance of identifying factors that lead from suicide ideation to suicidal behavior. Interoceptive dysfunction may be one such differentiating factor. Interoceptive dysfunction refers to a disconnection from the internal sensations of the body, which can cause difficulty in truly understanding and knowing one's own body. Specifically, interoceptive dysfunction may lead to such disconnection from the self that the body comes to be seen as "other" and potentially even "nonhuman." A burgeoning body of research supports these theoretical links and also highlights the need for methodologically rigorous studies that employ careful measurement of these constructs. Thus, this special section is devoted to articles that advance the understanding of the relationship between interoception and suicidality. A more nuanced understanding of the relationship between interoceptive dysfunction and suicidality is critical for improving suicide prevention and treatment efforts.
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