Nonsuicidal Self-Injury Is Associated With Attenuated Interoceptive Responses to Self-Critical Rumination

Examining the relationship between subtypes of rumination and non-suicidal self-injury: A meta-analytic review

INTRODUCTION

Non-suicidal self-injury (NSSI) is a highly prevalent maladaptive behavior, often used to cope with intense negative affect. Rumination is an emotion regulation strategy that leads to fixation on and exacerbation of (typically) negative affective states. However, studies examining the relationship between rumination and NSSI have yielded mixed results, showing high degrees of heterogeneity.

METHODS

The present study conducted meta-analyses (k = 50) of the association between overall rumination and NSSI, and independent meta-analyses for each of four subtypes of rumination (general, depressive, brooding, reflection rumination). Potential moderators that may influence the magnitude of these relationships were also examined.

RESULTS

A small-to-moderate positive association between rumination and NSSI was found independent of rumination subtype. Moderating effects included NSSI outcome measure and study design for overall rumination and general rumination, respectively. Race was found to moderate the relationships between both brooding and depressive rumination and NSSI, though in inverse directions. An analysis of effect heterogeneity across studies suggested that undetected moderators may be present.

CONCLUSION

Results of this study support the relationships between rumination subtypes and NSSI and identify factors that may impact these relationships. Continued research is needed to understand this association, particularly in more varied subtypes of rumination and cognitive-affective moderators.

The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study

Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.

The role of interoception in age-related obesity: A structural equation modelling study

The obesity pandemic and its adverse effect on health and quality of life are well established. In younger populations, interoception and aberrant eating behaviour contribute to overconsumption and being overweight. Although the incidence of obesity is higher in older individuals, they remain under-researched in the obesity literature. Therefore, the present study considered the role of general (interoceptive sensibility) and appetite-specific (hunger drive and satiety responsiveness) interoception and obesogenic eating behaviour (food responsivity, emotional eating, enjoyment of eating) in the association between age and BMI. A total of 1006 female adults (aged 18 to 80) completed the Adult Eating Behaviour Questionnaire and the Interoceptive Attention and Accuracy scales. Structural Equation Modelling (SEM) in AMOS was used to explore the data for multiple serial mediation effects. Despite being more overweight, older adults reported lower interoceptive attention, hunger drive, emotional overeating, food responsivity, and enjoyment of food. In contrast, compared to younger adults, older adults reported a higher interoceptive accuracy, and a similar responsivity to satiety. Importantly, two indirect pathways positively mediated the link between age and BMI: (1) age ➤(-)➤ interoceptive attention ➤(+)➤ satiety responsivity ➤(-)➤ emotional eating ➤(+)➤ BMI and (2) age ➤(-)➤ interoceptive attention ➤(+)➤ satiety responsivity ➤(-)➤ food responsivity ➤(+)➤ BMI. However, a stronger antagonistic indirect pathway was also present: age ➤(-)➤ interoceptive attention ➤(+)➤ hunger drive ➤(+)➤ emotional eating ➤(+)➤ BMI. The present findings suggested that overall reduced interoceptive attention in older adults may protect against weight gain by lowering hunger and the propensity towards obesogenic eating behaviours. These findings have implications for the design of appetite interventions in older populations.

Interoceptive differences in elite sprint and long-distance runners: A multidimensional investigation

Interoception, the process of detecting and interpreting bodily sensations, may facilitate self-regulation and thereby play a crucial role in achieving elite performance in competitive sports. However, there is a lack of research conducted in world-class athletes. In the present research, two studies examined self-reported (interoceptive sensibility) and behavioural (interoceptive accuracy) interoception in elite (top 100 ranking) sprint and long-distance runners, and non-athletes. Study 1 used the Multidimensional Assessment of Interoceptive Awareness Questionnaire. Sprinters reported having better regulation of attention to internal sensations, greater emotional awareness, better self-regulation, and reported a greater propensity to listen to their body for insight, than distance runners. Compared to non-athletes, sprinters and distance runners had more bodily trust, attention regulation, and self-regualtion. Additionally, elite athletes reported lower emotional awareness, self-regulation, and body listening. Study 2 examined cardioception using two tasks: The Heartbeat Counting Task, and The Heartbeat Detection Task. Elite and non-elite runners performed the tasks under two conditions; in silence, and whilst listening to pre-recorded crowd noise that simulated the live sounds of spectators during a sporting event. Sprinters and distance runners were able to maintain heartbeat detection accuracy when distracted, whereas non-athletes could not. Across both tasks, compared to non-athletes, sprinters and distance runners were more confident than non-athletes in their interoceptive percept. Additionally, elite athletes compared to non-elite athletes were less accurate when counting their heartbeat and were characterised by a higher interoceptive prediction error. Athletic populations have altered interoceptive abilities.

Nonsuicidal self-injury and rumination: A meta-analysis

Trait rumination is the tendency to overthink and focus on negative emotions and events and is related to a number of psychological disorders and maladaptive behaviors including nonsuicidal self-injury (NSSI). The purpose of this study was to conduct a meta-analysis of the relationship between trait rumination and NSSI behaviors. Results from 60 samples showed small effect sizes between trait rumination and NSSI engagement, NSSI frequency, and the number of methods used to self-injure in cross-sectional samples. Results from 13 samples showed small effect sizes between trait rumination and NSSI engagement and NSSI frequency in longitudinal samples. Moderator analyses indicated that this relationship is similar whether the type of rumination is depressive or not and is generally consistent across different ages, genders, and ethnicities. These results help clarify the role of trait rumination as a risk factor for NSSI.

The Associations Between Attitudes Toward Interpersonal Affective Touch, Negative Cognitions and Social Anxiety: A Pilot Study

Objective: Affectionate touch promotes psychological well-being likely through inducing cognitive and neurobiological changes, which implies the inverse association of affectionate touch to negative cognitive and psychosocial outcomes. Our aim was to explore relationships between attitudes toward interpersonal touch and social anxiety through fear of negative evaluation and self-critical rumination as mediating variables.Method: Data from 250 participants (69.6% females, n = 174) ranging in age from 18 to 65 years were collected through self-report inventories assessing attitudes toward physical touch from friends and family, nonromantic intimate person and unfamiliar person, fear of negative evaluation, self-critical rumination, and social anxiety. A moderated-mediation analysis was conducted. Results: No direct link was seen between attitudes toward friends and family touch experiences and social anxiety in both genders, but mediation through fear of negative evaluation was significant (p < .05). Attitudes toward nonromantic intimate touch were related to social anxiety only in females and only indirectly through self-critical rumination (p < .05). In both males and females, attitudes toward touch from unfamiliar persons were linked to social anxiety directly (p < .05) but indirect paths through fear of negative evaluation (p < .05) and self-critical rumination were seen only in females (p < .05). Conclusions: Findings indicate that attitudes toward interpersonal affectionate touch may be predictive of social anxiety and the negative cognitions associated with it, extending previous findings on social pain and attesting to the potential clinical utility of touch-based interventions for social anxiety.

Mediterranean Diet, Interoception and Mental Health: Is it time to look beyond the 'Gut-Brain Axis'?

OBJECTIVE

A Mediterranean style diet (i.e., high in fruit, vegetables, fish, pulses, and wholegrains) is said to benefit psychological health. Many low-level interoceptive processes, such as those involved in the 'gut-brain' axis, are suggested to play a mechanistic role in in this relationship. However, interoceptive sensations in other domains, and at higher hierarchical levels of abstraction, have hitherto been overlooked. One domain often studied in relation to psychological health is cardioception. Therefore, we examined whether the Mediterranean diet was associated with first-order perceptual and second-order metacognitive cardioception.

METHODS

Participants completed the Heartbeat Detection Task, the Heartbeat Counting Task, and the EPIC-Norfolk Food Frequency Questionnaire from which diet was quantified.

RESULTS

Adherence to a Mediterranean style diet was associated with higher cardioceptive accuracy (i.e., perceptual performance) across both tasks. In addition, those consuming a Mediterranean diet had a better ability to detect errors in first order perceptual performance, and a lower prediction error (the magnitude of the difference between accuracy and confidence).

DISCUSSION

These findings indicated that deepening our understanding of how interoceptive processes beyond the 'gut-brain' axis are shaped by diet could deepen our understanding of the link between diet and mental health and wellbeing.

An insula-based network mediates the relation between rumination and interoceptive sensibility in the healthy population

BACKGROUND

Individuals sometimes continuously centered their attention on the same thoughts. When such process tends to be negative and self-referential, we delineated this mental state as rumination, which may undermine body's perception of endogenous signal, but little is known about the certainly relationship and the potential neural mechanisms.

METHODS

Rumination and interoceptive sensibility were measured by questionnaires, then insula-related network of rumination dimensions were examined by the whole brain resting-state functional connectivity (FC) in 479 college students, and whether the insula-based network mediate the relationship between rumination and interoceptive sensibility were tested.

RESULTS

Rumination (including brooding reflective pondering) and interoceptive sensibility showed positive correlations. The neural mechanisms of brooding and reflective pondering were all related to the insula-networks, to be specific, brooding was positively correlated with the FC between the left posterior insula (PI) and left parahippocampal gyrus/ hippocampus (PHG), reflective pondering were positively correlated with the FC between the insula subregion and the dorsolateral prefrontal cortex. Moreover, the relationship between brooding and interoceptive sensibility was mediated by the FC between left PI and left PHG.

LIMITATIONS

We just tested the relationship between rumination and interoceptive sensibility at a cross-sectional level, but it is unclear that whether the longitudinal relationship would be predicted by the related network.

CONCLUSIONS

Our findings provided new insights into neural mechanisms of brooding and reflective pondering, also the integration of brooding and interoceptive sensibility. The insula-related networks may contribute crucially to rumination and interoception.

Introduction to the Special Issue on Interoception and Suicidality

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.