Measuring dimensions of body connection: body awareness and bodily dissociation

Neurofeedback and meditation technology in outpatient offender treatment: a feasibility and usability pilot study

Introduction

Although Cognitive Behavioral Therapy (CBT) is the most often used intervention in forensic treatment, its effectivity is not consistently supported. Interventions incorporating knowledge from neuroscience could provide for more successful intervention methods.

Methods

The current pilot study set out to assess the feasibility and usability of the study protocol of a 4-week neuromeditation training in adult forensic outpatients with impulse control problems. The neuromeditation training, which prompts awareness and control over brain states of restlessness with EEG neurofeedback, was offered in addition to treatment as usual (predominantly CBT).

Results

Eight patients completed the neuromeditation training under guidance of their therapists. Despite some emerging obstacles, overall, the training was rated sufficiently usable and feasible by patients and their therapists.

Discussion

The provided suggestions for improvement can be used to implement the intervention in treatment and set up future trials to study the effectiveness of neuromeditation in offender treatment.

The effect of anthropometric measurements and muscle endurance of the trunk and lower extremities on anatomic body awareness in healthy individuals with different levels of physical activity

BACKGROUND

The interaction between anthropometric measurements and muscular endurance and how these factors manifest in anatomical body awareness have not yet been fully investigated. It was aimed to examine the relationship between physical activity, body anthropometric measurements and endurance and anatomical body awareness in healthy individuals.

MATERIALS AND METHODS

A total of 217 individuals aged 19-40 participated in the study. Participants were categorized into inactive (n = 65), minimally active (n = 80), and sufficiently active (n = 72) groups based on the international physical activity questionnaire (IPAQ). Anthropometric measurements including shoulder, abdomen, waist, and hip circumferences were taken. Participants' trunk muscle endurance and lower extremity endurance was assessed through various tests. Anatomic body awareness was evaluated using the Body Awareness Questionnaire (BAQ) with established validity.

RESULTS

While no significant difference in shoulder circumference measurements was found between the inactive and minimally active groups (p > 0.05), the sufficiently active group showed significantly higher shoulder circumference measurements compared to the other groups (p < 0.05). Significant differences were observed among all endurance tests between the groups (p < 0.05). Participants' body endurance increased significantly with higher activity levels. Moreover, anatomic body awareness exhibited significant variation among the three groups (p < 0.05), with the sufficiently active group having the highest level of anatomic body awareness. Positive correlations were found between all endurance tests and anatomic body awareness (p < 0.05), as well as a positive correlation between physical activity levels and anatomic body awareness (p < 0.05).

CONCLUSION

It is suggested that physical performance and endurance increase anatomical body awareness when applied with appropriate treatment methods, can be applied for a healthier life and can be an additional application in the clinical environment.

The Neurophysiology of Interoceptive Disruptions in Trauma-Exposed Populations

In the aftermath of psychological trauma, many individuals experience perturbations in interoception, a term that broadly references the ability to accurately detect body signals and integrate these signals with emotional states. These interoceptive disruptions can manifest in different ways, including blunting or amplification of sensitivity to internal physiological signals. In this chapter we review extant neurophysiological research on interoception in trauma-exposed populations, with a particular focus on the effects of chronic interpersonal trauma, such as childhood maltreatment and racial discrimination. We explore research that used different types of interoceptive assays, from self-report measures to electrophysiological and neuroimaging tools to characterize the disruptions in pain perception, interoceptive acuity, and physiological responses that may arise after a traumatic event. Finally, we discuss interventions that are designed to target interoceptive mechanisms, from exposure-based therapies to mindfulness-based practices, as well as future directions in trauma interoception research.

An Overview of the Bodily Awareness Representation and Interoception: Insights and Progress in the Field of Neurorehabilitation Research

In the last two decades, the scientific literature on so-called body representations has been increasing, and the notion of body awareness (BA) is particularly interesting for neurorehabilitation. In this article, we present results derived from recent studies on this representation, considering the different definitions and explicative models proposed as well as the empirical settings used to test it, providing an extensive overview of these issues. This article discusses the challenge of understanding how we integrate the sensory experiences of proprioception (knowing where our body is in space) and interoception (sensing internal bodily sensations, like hunger of thirst) with our perception of self. This is a difficult problem to analyze because our awareness of our body is inherently linked to our perspective, since the body is the means through which we interact with the world. Presenting the different viewpoints offered by recent theories on this concern, we highlighted that the neurorehabilitation and psychiatric settings offer two important fields useful for the study of BA because in them it is possible to analyze bodily representations by inducing/observing a controlled discrepancy between dysfunctional content and sensory inputs.

Long-term effects of combined mindfulness intervention and app intervention compared to single interventions during the COVID-19 pandemic: a randomized controlled trial

Objectives

The study examines the short-, middle-, and long-term effects of a combined intervention (face-to-face mindfulness intervention plus the mindfulness app 7Mind), compared to single interventions (face-to-face mindfulness intervention alone and an intervention via app 7Mind alone). The subgroups were compared with an active control group on mindfulness, mindful characteristics, mental health, emotion regulation, and attentional abilities during the COVID-19 pandemic. Additionally, the study explores whether students' engagement with the app and their formal mindfulness practice at home improves intervention outcomes.

Methods

The study employs a randomized controlled trial approach involving three intervention groups and an active control group, with two follow-ups conducted over 12 months. The study included 177 university students who were randomly assigned to a mindfulness group (n = 42), a mindfulness app group (7Mind app, n = 44), a mindfulness + app group (n = 45), and an active control group (n = 46). The duration of the interventions was 4 weeks. The outcome variables were assessed at pre- and post-intervention, at 4 and 12 months post-intervention.

Results

At post-intervention and during both follow-ups, students in the combined mindfulness intervention did not demonstrate better outcomes compared to students in the single interventions or the active control group across all measures. Additionally, no statistically significant difference was observed between all interventions and the active control groups on any of the measures. However, it is noteworthy that all intervention groups and the active control group exhibited improvement in mindfulness, body awareness, emotion regulation, stress, and attentional abilities over the short, medium, and long term. Moreover, higher app usage in the app groups was significantly associated with increased body awareness. However, greater app use was also correlated with higher stress.

Conclusion

The results suggest that the mindfulness intervention and the mindfulness app were similar to the active control condition (communication training) on the investigated variables in the short, medium, and long term. Furthermore, an increased use of a mindfulness app can negatively affect stress.

The Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2): psychometric properties in a Dutch non-clinical sample

BACKGROUND

Interoceptive awareness is a multidimensional construct that refers to the sensation, interpretation, and integration of signals within the body. There is increasing evidence that problems with interoceptive awareness form an important component of mental health problems. The Multidimensional Assessment of Interoceptive Awareness 2 (MAIA-2) is presently the most used self-report questionnaire to measure interoceptive awareness. The aim of the present study is to psychometrically evaluate the Dutch version of the MAIA-2.

METHOD

The psychometric properties of the MAIA-2-NL were examined in a non-clinical sample of 1054 participants aged between 18 and 83. Internal consistency and test-retest reliability were investigated. Factor structure was examined by exploratory factor analysis (EFA), followed by confirmatory factor analysis (CFA).

RESULTS

Internal consistency was good, with McDonald's omega (ω) ranging from 0.67 to 0.89. Test-retest reliability was moderate to good, with intraclass correlation coefficients (ICC) ranging from 0.67 to 0.79. Factor analyses suggested a six-factor structure, combining the original subscales Noticing with Emotional awareness and Self-regulation with Body listening. However, a CFA based on the original eight factors showed a somewhat better fit than the CFA based on six factors.

CONCLUSION

The MAIA-2-NL is a reliable and valid instrument to measure interoceptive awareness in healthy Dutch adults. We recommend to maintain the original 37 items.

Changes in Interoception in Mind-body Therapies for Chronic Pain: A Systematic Review and Meta-Analysis

BACKGROUND

Emerging literature has demonstrated deficits in interoception (i.e., the perception of physical sensations from inside the body) in individuals with chronic pain conditions. Mind-body therapies (MBTs) are purported to improve chronic pain in part through improving or restoring interoceptive abilities. The present systematic review and meta-analysis aimed to examine changes in interoception in MBTs for chronic pain conditions.

METHODS

A systematic search of PubMed, PsycINFO, Scopus, CINAHL, and ProQuest Dissertation and Theses was conducted from database inception to February 2023. English language intervention studies evaluating the effect of MBTs on interoception in adults with chronic pain conditions were examined. Changes in pain (severity and interference) following treatment were examined as secondary outcomes.

RESULTS

A total of 11 studies (10 unique samples) were identified. Meta-analytic results reveal significant improvements in total interoceptive awareness (Becker's d = 1.168, p < .01) as well as improvements in seven of eight subdomains of interoceptive awareness (ds = 0.28 to 0.81). MBTs were also associated with reductions in both pain intensity (d = -1.46, p = .01) and pain interference (d = -1.07, p < .001).

CONCLUSIONS

Preliminary research suggests that MBTs demonstrate improvements in interoceptive awareness and reduce pain in adults with chronic pain. Literature on changes in other domains of interoception, such as interoceptive accuracy, following MBTs is severely lacking. Although more rigorous studies are needed to corroborate results, the present findings lay an important foundation for future research to examine interoception as a possible underlying mechanism of MBTs to improve pain outcomes.

A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories

Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.

Perception of benefits-barriers of exercise, physical activity level, and body awareness in women with premenstrual syndrome

INTRODUCTION

The study aims to investigate the relationship between premenstrual syndrome (PMS) and physical activity, body awareness, and the benefits/barriers to exercise (a), as well as to compare women with and without PMS in relation to these parameters (b).

MATERIALS AND METHODS

Participants were administered The Premenstrual Syndrome Scale (PMSS), International Physical Activity Questionnaire-Short Form (IPAQ-SF), Body Awareness Questionnaire, and The Exercise Benefits/Barriers Scale.

RESULTS

The age range of the participants included in the study was 19-48, with a mean age of 26.45 ± 7.14. A statistically significant difference was found between the women with and without PMS in terms of PMSS score, exercise benefits subscale score, and exercise barriers subscale score (p < 0.05). The results indicated that there was a significant positive correlation between PMSS score and exercise barriers subscale score (p < 0.05). There was a significant positive correlation between IPAQ score and body awareness questionnaire, exercise benefits subscale score, total score of exercise benefits and barriers of scale (p < 0.05). There was a significant negative correlation between IPAQ score and exercise barriers subscale score (p < 0.05). There was a significant positive correlation between body awareness questionnaire score and exercise benefits subscale score, total score of exercise benefits and barriers of scale (p < 0.05). There was a significant negative correlation between body awareness questionnaire score and exercise barriers subscale score (p < 0.05).

CONCLUSION

This study provide valuable insights into the relationship between PMS, physical activity, body awareness, and exercise benefits/barriers among women. By addressing the barriers and benefits to exercise and enhancing body awareness, healthcare professionals can potentially improve women's with PMS overall well-being and encourage them to adopt and maintain a physically active lifestyle.

Relationship between body awareness level and musculoskeletal pain complaints, physical activity level and emotional status in healthy people

INTRODUCTıON/AIM: Defining the physical, psycho-social effects of body awareness may help to explain the functional effects. It was aimed to examine the relationship between the body awareness level and musculoskeletal pain complaints, physical activity level, and emotional state in healthy people.

MATERIALS AND METHODS

A total of 289 healthy individuals between the ages of 18 and 25 were included in the study. Body awareness level was using Body Awareness Questionnaire (BAQ), musculoskeletal pain complaint using The Nordic Musculoskeletal Questionnaire (NMQ), physical activity levels using International Physical Activity Questionnaire (IPAQ-short form) and emotional status using Beck Depression Inventory (BDI) were assessed.

RESULTS

The mean age of the participants was 19.50 ± 1.55 years. The mean pain intensity was 2.48 ± 1.99. The BAQ score average was 91.87 ± 15.55. Thirty percent of the participants had a mild level and 14.9% had a moderate level of depression risk. While there was a weak positive relationship between the Disease Startup sub-dimension of BAQ and the moderate-level IPAQ score (r = 0.135, p = 0.022). Also there was a weak negative relationship between Disease Startup sub-dimension and the level of depression risk. A weak positive relationship was found between the changes in the body process and attention to subjects sub-dimension and the level of depression risk (r = 0.127, p = 0.030). There was a positive correlation between level of depression risk and pain intensity (r = 0.237, p = 0.000). Body awareness levels of individuals who had back pain in the last 1 month were higher than those who did not experience pain (p = 0.029).

CONCLUSION

The results of the study showed that physical activity positively affected body awareness level. The body awareness level was directly related to the pain associated with the musculoskeletal system and emotional state. There is a need more studies examining the relationship between body awareness and pain, physical activity and emotional status with subdimensions of the BAQ.

Influence of psychological inflexibility and mindfulness on hypersexuality and sexual satisfaction in a Spanish sample

Sexual satisfaction is tremendously relevant to wellbeing and quality of life. Inversely, hypersexuality may increase the risk of psychological distress, unprotected sex, and marital problems. This study attempts to explore the sociodemographic variables related to hypersexuality and the relationship between hypersexuality and sexual dissatisfaction with psychological inflexibility, cognitive fusion, body awareness, bodily dissociation, and mindfulness skills in the Spanish population. The sample was made up of 530 participants between 18 and 67 years of age. In total, 5.5% displayed hypersexuality, more likely in males, lesbians and gay men, singles, and students. An online survey was conducted including standardized questionnaires as follows: AAQ-II, CFQ, SBC, MAAS, NSSS-S, and HBI. Significant moderate positive correlations were found between hypersexuality and psychological inflexibility, cognitive fusion, and bodily dissociation, and an inverse moderate correlation with mindfulness skills. Moderate negative correlations were found between sexual satisfaction and bodily dissociation. Linear regression showed psychological inflexibility was the variable with the most weight on hypersexuality, while bodily dissociation was the variable with the most influence on sexual dissatisfaction. This study suggests lesbians and gay men, males, and singles may show an increased vulnerability toward engaging in hypersexual behavior and provides justification for interventions focused on psychological inflexibility and mindfulness skills to treat hypersexuality and improve sexual satisfaction.

Feel-Own-Move: a psychomotor therapy program for victims of intimate partner violence living in shelter homes. Feasibility and effects on mental health, bodily dissociation, and quality of life

Introduction

Intimate partner violence (IPV) is a worldwide concern, impacting victims' mental health, physical health, and quality of life. High rates of posttraumatic stress disorder (PTSD), depression, anxiety, bodily dissociation, and somatic symptoms have been found in victims of IPV, with an important impact on the chronicity of impairments and on the outcomes of psychological interventions. Therapeutic interventions available in shelter homes for victims are scarce in addressing their body-mind needs therefore asking for better empirical research. Thus, the aim of this study was to evaluate the feasibility and effects of Feel-Own-Move (FOM), an 8-week psychomotor therapy program for victims of IPV, on their mental health, levels of bodily dissociation, and general quality of life.

Methods

A within-subject repeated measures design was used to evaluate the intervention effects, and feasibility results were analyzed.

Results

Seventeen women completed the program (mean age 42.8 years, range 21-64). Results showed a significant decrease in levels of bodily dissociation, with FOM having a large effect size. The intervention also had a large effect size at increasing the environment domain of quality of life, although no statistically significant differences were found. FOM ended with excellent rates of reach, adherence, acceptability, and satisfaction. A positive retention rate was also found.

Discussion

In conclusion, FOM seems to be a feasible psychomotor therapy intervention for female victims of IPV living in shelters. Importantly, this program showed to be effective in reducing bodily dissociation among participants, which is suggested to prospectively contribute to their mental health and quality of life.

The Role of Perfectionistic Self-Presentation and Problematic Instagram Use in the Relationship Between Self-Concept Clarity and Body Disconnection: A Serial Mediation Model

By combining authors who hypothesized that modern technology has greatly increased people's ability and people's possibility to distance themselves from their embodied awareness and those who have shown that communication through social media is more congenial to people with a tendency towards perfectionistic self-presentation (PSP), this study analyses the influence of self-concept clarity (SCC) in bodily dissociation (BD) and hypothesizes that people with a low SCC are more prone to BD and that PSP and problematic Instagram use (PIU) may play a serial mediating role in this relationship. Two hundred and 19 women (M_age = 31.8 ± 11.25) completed an online survey that included the Italian-validated versions of the Perfectionistic Self-Presentation Scale, the Scale of Body Connection and the Bergen Facebook Scale modified for Instagram use. A Serial Mediation Model (Hayes's PROCESS Model 6) shows that both PSP and PIU significantly serially mediate the association between SCC and BD (β = -.025 SE = .011, 95% CI = [-.0498, -.0070]) and that there is a mediating effect of PIU between SCC and BD (β = -.04 SE = .020, 95% CI = [-.0865, -.0098]), but no mediating effect of PSP between SCC and BD was found (β = -.052 SE = .031, 95% CI = [-.1184, +.0039]). A possible explanation is that people with low SCC try to avoid others noticing their imperfections because they fail to integrate it into their self-concept and tend to use Instagram in a problematic way because this tool allows them to largely control the information they share. This use, in turn, alters their state of mind-body connection and this increases the disconnection from one's bodily sensations. The absence of mediation by the PSP between SCC and BD and the presence of PIU mediation between SCC and BD underlines the importance of technology in this relationship. The implications and limitations of this study will be discussed.

Embodying Consciousness through Interoception and a Balanced Time Perspective

This review presents current research and scientific knowledge in body mind sciences through the lens of interoception, as a representative of the body; and time perspective, as the representative of the mind. This intertwining dichotomy has been a subject of discourse in many fields, all having the common denominator of consciousness. Our aim is to expand on the congruities of these seemingly deconstructed worlds-of science and philosophy, of the body and the mind, to show that the place of consciousness lies in the zone between these two. Being aware of the body in the present moment. We introduce interoception and time perspective, focusing on how interoceptive signals are depicted in autonomic nervous system (ANS) regulation, and how this relates to the concept of a balanced time perspective (BTP), a highly adaptive psychological characteristic. Time perspective and interoception are also reviewed in the case of clinical conditions. We assess findings on interoceptive pathways in the body, finding convergence with balanced time perspective through the neuroanatomical lens. We conclude with findings that both dysregulated interoceptive states and a time perspective disbalance are recognized as defining features of mental disorders, proposing prospective practical therapeutic approaches, as well as implications for further research in the field.

The impact of traumatic childhood experiences on interoception: disregarding one's own body

BACKGROUND

Deficient interoception, the processing and perception of internal bodily signals, has been discussed as a mechanism underlying various mental disorders. First results indicate a mediating role of interoception in the interplay of traumatic childhood experiences and adult mental disorders. Traumatic childhood experiences may hinder the adequate processing, integration, and trust in bodily signals that are important in order to understand and regulate own needs and emotions, thereby increasing the vulnerability for mental disorders. However, an overarching study investigating alterations in different interoceptive measures and trauma-related disorders as well as their mediating role between early trauma and emotion dysregulation is still missing.

METHODS

One hundred thirty-six individuals with varying levels of traumatic childhood experiences who either had a current diagnosis of major depression, posttraumatic stress disorder, or somatic symptom disorder, or no mental disorder, took part in a multidimensional assessment of interoceptive processes, including interoceptive accuracy, sensibility, and awareness. Kruskal-Wallis tests were used to compare groups regarding interoceptive processes and associations with traumatic childhood experiences and emotion dysregulation were analyzed with Spearman correlations. Furthermore, mediation analyses were computed to examine and compare interoceptive processes as potential mediators between traumatic childhood experiences and emotion dysregulation.

RESULTS

Only body dissociation, a measure for interoceptive sensibility, was significantly reduced in individuals with a current mental disorder. Body dissociation was also the only interoceptive measure significantly associated with traumatic childhood experiences and emotion dysregulation and the only significant mediator in the relationship between traumatic childhood experiences and emotion dysregulation across groups.

CONCLUSION

Results suggest body dissociation, but not other interoceptive measures, as an important feature linking traumatic childhood experiences to current emotion dysregulation, an important transdiagnostic feature. As body dissociation refers to a habitual non-attendance or disregard of interoceptive signals, integrative therapeutic interventions could help affected individuals to overcome difficulties in emotion perception and regulation.

TRIAL REGISTRATION

The general study design was preregistered; see the German Clinical Trials Register (DRKS-ID: DRKS00015182). This study's analysis plan was not preregistered.

The integration of yoga breathing techniques in cognitive behavioral therapy for post-traumatic stress disorder: A pragmatic randomized controlled trial

Introduction

In trauma-focused Cognitive Behavioral Therapy (TF-CBT), stabilization techniques are used before confrontation ones to increase stress/affect tolerance and thus effectiveness of CBT. This study investigated the effects of pranayama, meditative yoga breathing and breath holding techniques, as a complimentary stabilization technique in patients with post-traumatic stress disorder (PTSD).

Methods

Seventy-four PTSD-patients (84% female, 44.2 ± 13 years) were randomized to receive either pranayama at the beginning of each TF-CBT session or TF-CBT alone. The primary outcome was self-reported PTSD severity after 10 sessions of TF-CBT. Secondary outcomes included quality of life, social participation, anxiety, depression, distress tolerance, emotion regulation, body awareness, breath-holding duration, acute emotional reaction to stress, and adverse events (AEs). Intention-to-treat (ITT) and exploratory per-protocol (PP) analyses of covariance with 95% confidence intervals (CI) were performed.

Results

ITT analyses revealed no significant differences on primary or secondary outcomes, except for breath-holding duration in favor of pranayama-assisted TF-CBT (20.81 s, 95%CI = 13.05|28.60). PP analyses of 31 patients without AEs during pranayama revealed significantly lower PTSD severity (-5.41, 95%CI = -10.17|-0.64) and higher mental quality of life (4.89, 95%CI = 1.38|8.41) than controls. In contrast, patients with AEs during pranayama breath holding reported significantly higher PTSD severity (12.39, 95%CI = 5.08|19.71) than controls. Concurrent somatoform disorders were found to be a significant moderator of change in PTSD severity (p = 0.029).

Conclusion

In PTSD patients without concurrent somatoform disorders, the integration of pranayama into TF-CBT might reduce post-traumatic symptoms and increase mental quality of life more efficiently than TF-CBT alone. The results remain preliminary until they can be replicated by ITT analyses.

Clinical trial registration

ClinicalTrials.gov, identifier NCT03748121.

Why context matters when changing the diet: A narrative review of placebo, nocebo, and psychosocial context effects and implications for outcome research and nutrition counselling

Placebo (PE) and nocebo effects (NE) have been subjects of systematic research in medicine and psychotherapy for many decades to distinguish between the (specific) pharmacological effect of medication and the (unspecific) effect of the context. Despite this significant research, the awareness, operationalisation, and reflection of the multiplicity of PE, NE, and psychosocial context effects (PSCE) is currently limited when researching outcomes of diet changes in studies without randomisation and placebo control. This neglection is critical as it could systematically influence outcomes by moderating and mediating them and thus reducing the validity and evidence base of these studies. Therefore, we performed a (non-systematic) narrative review (NR) on the following objectives: (1) present a concise overview about the relevance of PE, NE, and PSCE in medicine and nutrition research; (2) review the current state of research on reflecting context effects when studying diet changes; (3) provide useful theoretical foundations via consideration and integration of micro- and macro context effects; (4) operationalise as hypotheses the potential PE, NE, and PSCE which are specific for researching diet changes; and (5) derive their impact for future research as well as for nutrition counselling. The electronic search in this NR for objective (2) identified N = 5 publications and for objective (4) we found N = 61 articles retrieved in the first round of search, additional references were identified by a manual and snowball search among the cited references resulting finally in N = 37. This NR offers a synoptical basis to foster awareness and operationalisation of a variety of PE, NE, and PSCE. Interdisciplinary research teams should monitor these factors using, e.g., qualitative, mixed-method studies, process evaluation, item bank approaches, moderator and mediator analysis that might reveal substantially new insights, and outcomes of relevance to science and nutrition counselling. Nevertheless, the present NR has several limitations, especially as it is non-systematic, because it is a very heterogeneous field of research, in which the topic we are investigating is usually regarded as marginal and subordinate. Therefore, future research should conduct systematic reviews and particularly theory-based primary studies (experimental research) on hypotheses of PE, NE, and PSCE in outcome research in diet changes.

Questionnaires of interoception do not assess the same construct

There are a number of questionnaires assessing the self-reported trait-like aspect of interoception, also called interoceptive sensibility (ISb). Based on the varying purposes of their development and characteristics, however, it is not likely that they assess exactly the same construct. In a community sample of 265 adults, we examined this assumption for three commonly used questionnaires of ISb, namely the Body Awareness subscale of the Body Perception Questionnaire (BPQ-BA), the Body Awareness Questionnaire (BAQ), and the eight subscales of Multidimensional Assessment of Interoceptive Awareness (MAIA). We investigated their associations, and their relation to positive and negative affect and somatosensory amplification. According to the results of correlation analysis, BPQ-BA, BAQ and MAIA were partly unrelated to each other, partly showed weak to moderate positive associations. Also, differences with respect to their association with positive and negative affect were found. These findings suggest that the investigated questionnaires cannot be used interchangeably to assess the subjective aspect of interoception, and the term ISb is not appropriately defined.

Modular-based psychotherapy (MoBa) versus cognitive-behavioural therapy (CBT) for patients with depression, comorbidities and a history of childhood maltreatment: study protocol for a randomised controlled feasibility trial

INTRODUCTION

In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as well as underlying transdiagnostic mechanisms and factors like early childhood maltreatment may lead to better outcomes. A modular-based psychotherapy (MoBa) approach provides a treatment model of independent and flexible therapy elements within a systematic treatment algorithm to combine and integrate existing evidence-based approaches. By optimally tailoring module selection and application to the specific needs of each patient, MoBa has great potential to improve the currently unsatisfying results of psychotherapy as a bridge between disorder-specific and personalised approaches.

METHODS AND ANALYSIS

In a randomised controlled feasibility trial, N=70 outpatients with episodic or persistent major depression, comorbidity and childhood maltreatment are treated in 20 individual sessions with MoBa or standard cognitive-behavioural therapy for depression. The three modules of MoBa focus on deficits associated with early childhood maltreatment: the systems of negative valence, social processes and arousal. According to a specific questionnaire-based treatment algorithm, elements from cognitive behavioural analysis system of psychotherapy, mentalisation-based psychotherapy and/or mindfulness-based cognitive therapy are integrated for a personalised modular procedure.As a proof of concept, this trial will provide evidence for the feasibility and efficacy (post-treatment and 6-month follow-up) of a modular add-on approach for patients with depression, comorbidities and a history of childhood maltreatment. Crucial feasibility aspects include targeted psychopathological mechanisms, selection (treatment algorithm), sequence and application of modules, as well as training and supervision of the study therapists.

ETHICS AND DISSEMINATION

This study obtained approval from the independent Ethics Committees of the University of Freiburg and the University of Heidelberg. All findings will be disseminated broadly via peer-reviewed articles in scientific journals and contributions to national and international conferences.

TRIAL REGISTRATION NUMBER

DRKS00022093.

The Scale of Body Connection: A Multisample Study to Examine Sensitivity to Change Among Mind-Body and Bodywork Interventions

Purpose: The purpose of this measurement study was to examine the Scale of Body Connection (SBC) sensitivity to change among mind-body or bodywork interventions and to explore the concurrent validity in relation to emotion dysregulation and mindfulness skills. Methods: This study was based on multiple clinical trials that had used the SBC to evaluate changes in body awareness (BA) and bodily dissociation (BD) in response to a mind-body or bodywork intervention. To test for sensitivity to change, t tests were used to examine change and estimate effect sizes. To explore convergent validity, Pearson's product-moment correlations between the SBC subscales and Five-Facet Mindfulness Questionnaire (FFMQ) and Difficulties in Emotion Regulation Scale (DERS) were calculated among a subset of the studies, which also included these measures. Results: The BA and BD scales consistently detected significant positive responses to a range of intervention types (yoga, mindfulness meditation, BA, multimodal therapy, and bodywork), demonstrating SBC sensitivity to change. With a few exceptions, the effect sizes across studies for BA were above 0.35, indicating near moderate-to-large effect sizes. The effect sizes for BD, as a measure of responsiveness, were much smaller than for BA; however, four of the studies had effect sizes between 0.54 and 0.86. Concurrent validity with the DERS was supported by moderate-to-large correlations, and with the FFMQ, it was significant with the BA scale in one included study. Conclusions: The results of this study further establish SBC validity and sensitivity to change across a range of mind-body therapies and confirm prior findings of moderate-to-strong internal consistency reliability. The findings support the use of this brief scale to assess key dimensions of BA and BD in practice and research.

Complementary and alternative medicine for glycemic control of diabetes mellitus: A systematic review

The use of complementary and alternative medicine (CAM) is increasingly popular for the management of diabetes mellitus (DM). The aim of this study was to conduct systematic review of any types of complementary and alternative medicine for glycemic control of diabetes mellitus. Four databases was used in this study, the CINAHL, PUBMED, SCOPUS, and ProQUEST. The systematic review were reported according to the PRISMA guidelines. The keywords were used according to medical subject headings (MeSH) in this study were diabetes mellitus AND complementary and alternative medicine AND blood glucose levels or blood sugar or blood glucose. Articles were limited to 2015–2021 and only in English language. We obtained 231 articles from these databases: CINAHL six articles, PUBMED 85 articles, SCOPUS 66 articles, PROQUEST 74 articles. Then, the final results recorded 17 articles. The results of a systematic review showed the effectiveness of natural products as CAM for glycemic control of DM, namely Berberis aristata/Silybum marianum, fenugreek seed, bitter melon, cinnamon or whortleberry supplements, a combination of herbal plants (C. spinosa, R. canina, and S. securigera), Nigella sativa, Mulberry juice, chicory, chamomile tea, and bell pepper juice combined with an integrated approach of yoga therapy. Mind body practices such as auditory guided imagery (AGI), qigong and tai chi exercises, and relaxation. Whole system approach, such as acupressure. Health care providers consider CAM for DM management.

Development and Psychometric Evaluation of the Reactions to Somatic Stress Questionnaire (RSSQ)

Abstract. Background: Stress is a ubiquitous phenomenon in modern societies and is often accompanied by somatic sensations and symptoms, such as tension and nausea. Despite the inherent somatic component of stress, research on coping with stress has previously neglected to consider how somatic stress responses (i.e., somatic stress) may affect stress-coping behavior. Aim: To address this gap in the literature, this study introduces the concept of reactions to somatic stress (RSS). It also provides the first psychometric evaluation of the Reactions to Somatic Stress Questionnaire (RSSQ), a novel 16-item questionnaire that assesses hampering and facilitating RSS. Method: The RSSQ and a battery of questionnaires on related constructs were administered via an online survey to N = 265 participants from the general population. Results: Exploratory ( n = 133) and confirmatory ( n = 132) factor analyses yielded two dimensions of the RSSQ: Hampering RSS (RSS-H) and facilitating RSS (RSS-F). Both subscales showed good internal consistency (α = .81–.89). Correlations with body awareness, emotion regulation skills, and beliefs about stress indicated medium to high convergent and discriminant validity. The RSS-H and RSS-F scores significantly predicted maladaptive and adaptive coping behavior, respectively. This association remained stable after controlling for subjective stress and related measures. Limitations: Generalization of the obtained results is limited to healthy individuals. Conclusion: The study supports the theoretical assumptions underlying the RSS concept. The RSSQ suggests a promising way to assess reactions to somatic stress as they relate to coping with stress. The RSSQ could be used for clinical and health psychological testing or interdisciplinary research.

Body awareness mediates the relationship between body mass index and lipid profiles in adolescents

Aim

The purposes of this study were to 1) investigate the relationship between body awareness and anthropometric measurements and lipid profile in adolescents, 2) determine the potential mediating effect of body awareness due to body mass index (BMI) on lipid profiles.

Materials and methods

The study was carried out with 272 volunteer adolescents between the ages of 10-18 who applied to a private nutrition and counseling clinic. Anthropometric measurements of the participants were evaluated including body height body weight, waist and neck, and mid-upper arm circumference. The lipid profile including total cholesterol, high density lipoprotein-cholesterol (HDL-c), low density lipoprotein-cholestero (LDL-c) and triglyceride was analyzed. A body awareness questionnaire (BAQ), a seven-point Likert-type questionnaire consisting of 18 statements, was administered and questionnaire is interpreted on the total score, and the higher score reflects better body sensitivity. Correlation analysis, linear regression analysis, and path analysis were performed.

Results

Body awareness scores were negatively associated with all anthropometric measurements, namely, BMI, body weight and fat percentage waist and neck and mid-upper arm circumference (all p < 0.05). Body awareness was found to have a negative linear regression relationship with lipid profiles except than HDL-c. The results of path analysis showed that the direct effect of lipid profiles in relation to BMI and the indirect effect of BAQ was statistically significant. This result indicates that body awareness partial mediated the relationship between BMI and lipid profiles.

Conclusion

The research results suggested that increased body awareness is associated body awareness with a lower risk and a decreased body awareness is associated with a higher risk of developing obesity and dyslipidemia.

Developing an intense player-avatar relationship and feeling disconnected by the physical body: A pathway towards internet gaming disorder for people reporting empty feelings?

The literature suggests that alexithymia and emptiness could be risk factors for various addictive behaviors. The present study developed and tested a model that proposes a pathway leading from emptiness and difficulties in identifying emotions to Internet Gaming Disorder (IGD) symptoms via an intense gamer-avatar relationship and bodily dissociative experiences. A sample of 285 (64.2% M; mean age = 30.38 ± 7.53) online gamers using avatar-based videogames was recruited from gaming communities, and they were asked to complete a survey that included the Toronto Alexithymia Scale, the Subjective Emptiness scale, the Scale of Body Connection, the Self-Presence Questionnaire, and the Internet Gaming Disorder Scale-Short Form. The structural model evaluated produced a good fit to the data [χ2 = 175.14, df = 55, p < .001; RMSEA = 0.08 (90% C.I. =0.07–0.09), CFI = 0.96, SRMR = 0.08] explaining 28% of the total variance. Alexithymia was indirectly associated with IGD through the serial mediation of the gamer-avatar relationship and body dissociation. Emptiness was associated with IGD symptoms at the bivariate level, but did not predict IGD directly or indirectly. The current study identifies a potential pathway toward IGD by integrating different lines of research, showing the importance of considering aspects such as the difficulty in recognising and expressing one’s emotions, the gamer- avatar relationship, and the mind-body connection in the context of IGD.

Embodiment-related risk factors for Posttraumatic Stress, Anxiety and Depression in female victims of intimate partner violence

A central notion in the field of embodiment is that body sensorimotor processes and body mental representations influence emotion, cognition and behavior. By affecting the body, intimate partner violence (IPV) can leave victims with a fragile self, and significant physical and mental health problems. In this study, we aim to examine embodiment-related variables and mental health of female victims of IPV, as well as the impact of embodiment on mental health. A total of 38 female victims of IPV (mean age 40.3 ± 10.9 years) were recruited from shelters and the community. The study assessed the levels of Posttraumatic Stress Disorder (PTSD), Anxiety and Depression, and abilities of Movement Imagery, Interoceptive Accuracy, Interoceptive Sensibility, Body Ownership and Bodily Dissociation. Univariate, bivariate and binary regression analysis were used. PTSD, Anxiety and Depression were highly prevalent among our sample, alongside with altered values of body ownership and interoception. All three mental health disorders were significantly correlated with interoceptive self-regulation, interoceptive trusting, and bodily dissociation. For this group of women, each unit rise in the bodily dissociation scale increased two and six times the risk for developing Depression and Anxiety, respectively. The embodiment of female victims of IPV is altered, and higher bodily dissociation can be a risk factor for the development of mental health problems. Restoration of embodiment-related functions could be important for the victims to overcome the negative effects of violent relationships.

Investigating how internet gaming disorder and bodily dissociation experiences vary by game genres

This study aims to investigate whether Internet gaming disorder (IGD) and bodily dissociation vary depending on the most frequently used game genre. Seven hundred and fifteen highly engaged online players (71.5% men; mean age 29.75 ± 7.48 years) recruited in player communities completed a survey that assessed game genre, bodily dissociative experiences and IGD. The results showed significantlly higher levels of IGD among multiplayer online battle arenas (MOBA) and massively multiplayer online role-playing games players relative to first-person shooters (FPS) game players, whilst MOBA players report significantly higher bodily dissociative experiences compared to MORPG and FPS. However, we found that differences on body dissociation disappear at high levels of IGD, with problematic players showing high body disconnection, regardless of the type of game most frequently used. This suggests that high engagement in online games has the potential to disconnect a player from his body, regardless of the type of game used.

Dissociative Model in Patients With Resistant Schizophrenia

BACKGROUND

Schizophrenia is a severe mental illness in which, despite the growing number of antipsychotics from 30 to 50% of patients remain resistant to treatment. Many resistance factors have been identified. Dissociation as a clinical phenomenon is associated with a loss of integrity between memories and perceptions of reality. Dissociative symptoms have also been found in patients with schizophrenia of varying severity. The established dispersion of the degree of dissociation in patients with schizophrenia gave us reason to look for the connection between the degree of dissociation and resistance to therapy.

METHODS

The type of study is correlation analysis. 106 patients with schizophrenia were evaluated. Of these, 45 with resistant schizophrenia and 60 with clinical remission. The Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scales were used to assess clinical symptoms. The assessment of dissociative symptoms was made with the scale for dissociative experiences (DES). Statistical methods were used to analyze the differences in results between the two groups of patients.

RESULTS

Patients with resistant schizophrenia have a higher level of dissociation than patients in remission. This difference is significant and demonstrative with more than twice the level of dissociation in patients with resistant schizophrenia.The level of dissociation measured in patients with resistant schizophrenia is as high as the points on the DES in dissociative personality disorder.

CONCLUSION

Patients with resistant schizophrenia have a much higher level of dissociation than patients in clinical remission. The established difference between the two groups support to assume that resistance to the administered antipsychotics is associated with the presence of high dissociation in the group of resistant patients. These results give us explanation to think about therapeutic options outside the field of antipsychotic drugs as well as to consider different strategies earlier in the diagnostic process.

The Empowering Effect of Embodied Awareness Practice on Body Structural Map and Sensorimotor Activity: The Case of Feldenkrais Method

While outcomes of embodied awareness practices in terms of improved posture and flexibility, movement efficiency, and well-being are often reported, systematic investigations of such training effects and of the actual nature, extent, and neurofunctional correlates of learning mechanisms thought to lie at the core of such practices are very limited. The present study focused on the Feldenkrais method (FM), one of the most established embodied awareness practices, and aimed at investigating the neurofunctional outcomes of the somatic learning process at the core of the method by testing the modulations induced by a standardized FM protocol on the complexity of practicers’ body structural map and on the activity of their sensorimotor network during different movement-related tasks (i.e., gestures observation, execution, and imagery). Twenty-five participants were randomly divided into an experimental group—which completed a 28-session FM protocol based on guided group practice—and a control group, and underwent pre-/post-training psychometric and electrophysiological assessment. Data analysis highlighted, at the end of the FM protocol, a significant increase of EEG markers of cortical activation (task-related mu desynchronization) in precentral regions during action observation and in central regions during action execution and imagery. Also, posterior regions of the sensorimotor network showed systematic activation during all the action-related tasks.

Beyond internalizing and externalizing symptoms: The association between body disconnection and the symptoms of Internet gaming disorder

As the vast majority of online videogames imply the immersion into an alternative reality where a virtual body is also involved, the current cross-sectional study aims to investigate the contribution of low body awareness (i.e. low attention to sensory cues indicating bodily state) and body dissociation (i.e. low emotional connection with one's own body) in predicting Internet gaming disorder (IGD) symptoms, after controlling for internalizing (i.e., depression, anxiety, and stress) and externalizing symptoms (i.e., aggression). A total of 370 online-game players (73% men; mean age 29.63 ± 7.64 years) recruited in online player communities took part in the study and were given a survey that included gaming characteristics, the Depression, Anxiety and Stress Scale -21, the Aggression Questionnaire, the Body Disconnection Scale, and the Internet Gaming Disorder Scale- Short Form. A hierarchical regression analysis showed that low body awareness and high body dissociation predicted IGD scores after controlling for all the other factors. Moreover, we found an interaction effect between physical aggression and body dissociation in predicting IGD scores. On the one hand, these results provide support to previous studies that stressed the potential association between dissociative detachment (in terms of bodily disconnections) and problematic videogaming; on the other hand, the current study provides first evidence of the opportunity to focus on the integration of bodily experiences in clinical practice with people suffering from problematic gaming, as this factor might be incisively related to their aggressive and internalizing symptoms.

[Mindfulness in the sexual health and psychological well-being of professionals and caregivers of people at risk of social exclusion]

INTRODUCTION

The objective of the study was to explore the effect of the Mindfulness-based program (MBSR) on the sexual health and psychological well-being of professionals and volunteers of Doctors of the World who care for people at risk of social exclusion.

METHOD

The entire population of a NGO in southern Spain was chosen because it receives a large number of vulnerable people. Quasi-experimental study with pre and post-test measurements. The intervention lasted 8weeks plus an introductory session, with sessions of 2.5h. Seven instruments were applied before and after the intervention: (a) Mindfulness Scale (MAAS); (b) Body Connection Scale; (c) Compassion Questionnaire (SCS); (d) Ryff's psychological well-being scale; (e) Hurlbert's Fantastic Sexuality Index; (f) Wilson's Sexual Fantasy Scale, and (g) Hudson's Sexual Satisfaction Index (ISS).

RESULTS

Most of the post-test scores were better compared to the pre-test. On the MAAS scale, the score was higher in the post-test than in the pretest (Wilcoxon=-2668, P<.05) and, in the ISS, the score was also higher in the post-test than in the pre-test (Wilcoxon=-2.201, P<.05). However, in the Bodily Dissociation subscale, the score was lower (Wilcoxon=-2.670, P<.05). All effect sizes were moderate to high.

CONCLUSIONS

The application of the MBSR protocol can increase the degree of sexual satisfaction, decrease body dissociation, promote mental health and self-compassion in people who treat vulnerable people, which may have an impact on a higher quality of approach to them.

Relationships Between Mindfulness Facets and Mental and Physical Health in Meditating and Nonmeditating University Students

Abstract. Background: Little is known about the relations of the mindfulness facets to mental and physical health among meditators and nonmeditators. Aim: The main purpose of the present study was to investigate the relationship between the mindfulness facets and mental as well as physical health of university students with and without meditation experience using attentional control, body awareness, nonattachment, and emotion regulation as mediators. Method: Data were collected from a sample of 508 university students (meditators: n = 195, nonmeditators n = 313). Path analysis models were used to examine the associations between the mindfulness facets, all candidate mediators and the outcome variables mental and physical health complaints. Additionally, a bootstrapping procedure was used to test the significance of the indirect effects. Results: Results showed that the associations between the mindfulness facets, the proposed mediators, and mental and physical health complaints were similar between students with and without meditation experience. Nonattachment and body awareness were the most important mediators. Limitations: Only self-report questionnaires were used in the study, and the majority of the sample was women and enrolled in health and social science studies. Conclusion: The results indicated that the investigation of mindfulness at the facet level is worthwhile. The study helps to clarify the associations between the mindfulness facets and mental as well as physical health among students with and without meditation experience. Further, mindfulness mediators should be examined in intervention studies.

Characterizing Pain and Generalized Sensory Sensitivity According to Trauma History Among Patients With Knee Osteoarthritis

BACKGROUND

Childhood trauma and adversity have been linked to chronic pain and pain sensitivity, particularly centralized pain. Yet, there remain numerous gaps in our understanding of this link.

PURPOSE

We explored the association between nonviolent and violent childhood trauma and a component of centralized pain (i.e., generalized sensory sensitivity) and pain sensitivity using self-report measures of centralized pain and quantitative sensory testing (QST).

METHODS

Patients scheduled for a total knee arthroplasty (n = 129) completed questionnaires and QST prior to surgery.

RESULTS

We found that self-report measures of centralized pain (i.e., widespread pain, somatic awareness, and sensory sensitivity) displayed a graded relationship across trauma groups, with patients with a history of violent trauma reporting the highest scores. Univariable multinomial logistic regression analyses showed that higher sensory sensitivity was associated with increased risk of being in the nonviolent trauma group compared to the no trauma group. Furthermore, higher widespread pain, higher somatic awareness, and higher sensory sensitivity distinguished the violent trauma group from the no trauma group. In multivariable analyses, sensory sensitivity is uniquely distinguished between the violent trauma group and the no trauma group. QST did not distinguish between groups.

CONCLUSIONS

The findings highlight the need for future research and interventions that reduce sensory sensitivity for chronic pain patients with a history of violent childhood trauma.

Body connection mediates the relationship between traumatic childhood experiences and impaired emotion regulation in borderline personality disorder

BACKGROUND

Previous studies revealed an association between traumatic childhood experiences and emotional dysregulation in patients with borderline personality disorder (BPD). However, possible mediating pathways are still not fully understood. The aim of the present study was to investigate the potential mediating role of body connection, describing the awareness of the relationship of bodily and mental states, for the association between a history of traumatic childhood experiences and BPD core symptomatology.

METHODS

One-hundred-twelve adult female individuals with BPD and 96 healthy female controls (HC) were included. Impaired emotion regulation, traumatic childhood experiences, and BPD symptomatology were assessed with self-report questionnaires. The Scale of Body Connection was used to assess two dimensions of body connection, that is body awareness, describing attendance to bodily information in daily life and noticing bodily responses to emotions and/or environment and body dissociation, describing a sense of separation from one's own body, due to avoidance or emotional disconnection. Mann-Whitney U tests were employed to test for group differences (BPD vs. HC) on the two SBC subscales and associations with clinical symptoms were analyzed with Spearman correlations. We performed mediation analyses in the BPD group to test the assumption that body connection could act as a mediator between a history of traumatic childhood experiences and emotion dysregulation.

RESULTS

Individuals with BPD reported significantly lower levels of body awareness and significantly higher levels of body dissociation compared to HC. Body dissociation, traumatic childhood experiences, and emotion dysregulation were significantly positively associated. Further analyses revealed that body dissociation, but not body awareness, significantly and fully mediated the positive relationship between traumatic childhood experiences and impaired emotion regulation in the BPD sample. This mediation survived when trait dissociation, i.e., general dissociative experiences not necessarily related to the body, was statistically controlled for.

CONCLUSION

Certain dimensions of body connection seem to be disturbed in BPD patients, with body dissociation being an important feature linking a history of traumatic childhood experiences to current deficits in emotion regulation.

Association of work performance and interoceptive awareness of 'body trusting' in an occupational setting: a cross-sectional study

OBJECTIVES

Work performance has been known to be influenced by both psychological stress (mind) and physical conditions (body). The aim of this study was to investigate the association between work performance and 'body trusting', which is a dimension of interoceptive awareness representing mind-body interactions.

METHODS

A cross-sectional study was conducted among a sample of workers in an industrial manufacturing company in Japan. Participants were assessed with a self-reported questionnaire including evaluations of work performance, body trusting, psychological distress, pain persistence, workplace and home stressors, and workaholism. Participants' sociodemographic, health and lifestyle characteristics were collected from their annual health check data. The association between work performance and body trusting was examined using multivariable regression analyses in the overall sample and in a subsample of people with pain.

RESULTS

A total of 349 workers participated in the study. A significant association between work performance and body trusting was observed, with higher body trusting representing higher work performance. The association was significant after controlling for psychological distress, workplace and home stress, workaholism and participants' characteristics (p<0.001). Compared with people without pain (n=126, 36.1%), people with pain (n=223, 63.9%) showed less body trusting, which was associated with decreased work performance after controlling for pain-related variables (p<0.001).

CONCLUSIONS

Workers with higher body trusting showed higher work performance, even after controlling for various influencing factors. Body trusting may be an important target to promote work performance and to prevent loss of performance induced by health problems.

Experiencing one's own body and body image in living kidney donors-A sociological and psychological study

BACKGROUND

The aim of the study was to perform an in-depth exploratory analysis of the experience and image of one's body among living kidney donors.

METHOD

The research was carried out using mixed methodology. The study on experiencing one's own body was carried out using the sociological methodology of the grounded theory (qualitative research). This method was supplemented with psychometric measurement-the Body Esteem Scale (quantitative research). The basic research method was the in-depth interview. Using this method, a group of 25 living kidney donors who had not experienced any serious health or psychological problems after donation was examined. The participants of the study came from three transplant centers in Poland.

RESULTS

The data from the sociological interviews indicate that the donors: 1. do not experience radical changes in the functioning of their body; 2. maintain full control over it and do not feel the absence of a kidney in the body; 3. consciously and reflectively take care of their body after donation. In addition, the sociological research indicates that caring for one's own body also includes the transferred organ. The kidney donors experience a kind of bodily identity extension, including the recipient's body. However, the personal and social identity of the studied kidney donors is not disturbed in any way. The psychometric data correspond to the sociological results and indicate: 1. a lack of extreme emotional assessments about one's body; 2. awareness of one's own body and consistency of its image; 3. reduced emotional assessment of body zones directly related to the surgery; 4. differences in body image between the sexes.

CONCLUSIONS

The research results presented in the text indicate not only the possibility, but also the need for triangulation of research methods in the study of the experience and image of one's own body in living kidney donors. The proposed research approach employing mixed methodology within the fields of sociology and psychology for researching the phenomenon of living kidney donation is not very common.

Haptotherapy for patients with cancer; experience of haptotherapists and reasons for consultation: A survey among haptotherapists

BACKGROUND AND PURPOSE

Haptotherapy is a type of mind-body therapy that makes use of affective touch. This study aims to provide insights in reasons for haptotherapy for patients with cancer, and in experiences of haptotherapists with these patients.

MATERIALS AND METHODS

In a cross-sectional study, a survey was conducted among 536 Dutch haptotherapists. Multiple-choice and open-ended questions were analyzed both quantitatively and qualitatively.

RESULTS

Of 272 (50.7%) responding haptotherapists, 167 (61.5%) had experience with treating people with cancer. Most frequently, combinations of emotional problems and a disturbed body experience were reported as reasons for haptotherapy. Haptotherapists emphasized the need for affective touch to restore patients' body connection.

CONCLUSION

Two-thirds of the respondents treat patients with cancer, addressing the interaction of body and mind. Reasons for consultation cover a wide range of problems in multiple dimensions, in which a disturbed body experience in combination with emotional problems is mentioned most often.

Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample

The goal of this study is to better understand the relation between the practice of Mindfulness and the sexual activity, sexual satisfaction and erotic fantasies of Spanish-speaking participants. This research focuses on the comparison between people who practice Mindfulness versus naïve people, and explores the practice of Mindfulness and its relation with the following variables about sexuality: body awareness and bodily dissociation, personal sexual satisfaction, partner and relationship-related satisfaction, desire, subjective sexual arousal, genital arousal, orgasm, pain, attitudes towards sexual fantasies and types of sexual fantasies. The sample consisted of 106 selected adults, 32 men and 74 women, who completed six measures on an online survey platform: (a) Mindfulness Attention Awareness Scale (MAAS), (b) Scale of Body Connection (SBC), (c) New Sexual Satisfaction Scale (NSSS), (d) Scale of Sexual Activity in Women (SSA-W) and Men (SSA-M), (e) Hurlbert Index of Sexual Fantasy (HISF), (f) Wilson's Sex Fantasy Questionnaire. In the MAAS, Body Awareness subscale (SBC), NSSS, SSA-W and SSA-M, HISF and intimate fantasies subscale (Wilson's questionnaire), people in the Mindfulness condition showed higher scores and these differences were statistically significant. These results may have relevant implications in the sexuality of clinical and non-clinical samples.

Heartbeat evoked potentials in patients with post-traumatic stress disorder: an unaltered neurobiological regulation system?

BACKGROUND

Early life maltreatment is a risk factor for psychiatric disorders, including post-traumatic stress disorder (PTSD). Post-traumatic stress disorder is a severe and heterogeneous disorder with fluctuating states of emotional over- and undermodulation, including hypervigilance, dissociation, and emotion regulation deficits. The perception and regulation of emotions have been linked to interoception, the cortical representation and sensing of inner bodily processes. Although first therapeutic approaches targeting bodily sensations have been found effective in patients with PTSD, and deficits in interoceptive signal representation have been reported in other trauma-related disorders, such as borderline personality disorder (BPD), the role of interoception remains largely unexplored for PTSD.

OBJECTIVE

The objective was to investigate the cortical representation of cardiac interoceptive signals in patients with PTSD and its associations with early life maltreatment, trait dissociation, and emotion dysregulation.

METHODS

Twenty-four medication-free patients with PTSD and 31 healthy controls (HC) completed a 5-min resting electrocardiogram (ECG) with parallel electroencephalogram (EEG). Heartbeat evoked potential (HEP) amplitudes as a measure for cortical representation of cardiac interoceptive signals were compared between groups and correlated with self-report questionnaires.

RESULTS

We did not find significantly different mean HEP amplitudes in patients with PTSD compared to HC, although HEPs of patients with PTSD were descriptively higher. No significant associations between mean HEP amplitudes and early life maltreatment, trait dissociation or emotion dysregulation were obtained within the groups.

CONCLUSION

The current finding does not indicate deficits in interoceptive signal representation at rest in individuals with PTSD. Whether patients with PTSD show altered HEP modulations during emotion regulation tasks and might benefit from therapeutic approaches aiming at changing the perception of bodily signals, needs to be investigated in future studies.

A Pilot RCT of A Body-Oriented Group Therapy For Complex Trauma Survivors: An Adaptation of Sensorimotor Psychotherapy

This study is a pilot randomized controlled trial that examined the efficacy of a body-oriented group therapy designed to address chronic fear states in the body due to complex trauma. The Trauma and the Body Group (TBG) is a 20-session group psychotherapy that draws upon the principles and techniques of sensorimotor psychotherapy. Thirty-two women with a history of childhood trauma were randomized to immediate treatment or a waitlist control condition. Assessments were conducted one month prior to treatment, immediately after treatment, and six months post-treatment. Significant improvements were found in body awareness, anxiety, and soothing receptivity when comparing treatment to no treatment. The TBG appears to be a valuable tool for helping clients acquire mindfulness and self soothing skills that they can use to reduce posttraumatic symptoms. This study provides preliminary evidence that the TBG provides complex trauma survivors an opportunity to challenge their avoidance of two prominent trauma-related triggers - their bodies and interpersonal relationships - and in so doing may help survivors develop greater body awareness, increase their capacity for self and relational soothing, and reduce their anxiety symptoms.

The experience of embodiment scale: Development and psychometric evaluation

The construct of embodiment captures a broad range of experiences of living in the body. The present program of research involved developing and evaluating a fully structured measure of the experience of embodiment construct, the Experience of Embodiment Scale (EES), via four independent samples of women. Study 1 (N = 92) provided initial support for the internal consistency and convergent validity of the EES. Study 2 (N = 412) involved factor analyses of the EES, leading to the emergence of 6 factors, reflecting different aspects of the experience of embodiment. Further, this study supported the internal consistency of the EES and its subscales, as well as its construct and discriminant validity. As expected, the EES correlated with measures of body- and self-esteem, body connection, sexual assertiveness, among other measures, and did not correlate with the Perfectionism Personal Standards Scale. Study 3 (N = 348) confirmed the factor structure of the scale from Study 2. Study 4 (N = 76) demonstrated that EES scores were stable over a 3-week period. The EES can be used by researchers and clinicians interested in capturing individuals' range of experiences of living in their bodies, both positive and negative.

Patient Communication of Chronic Pain in the Complementary and Alternative Medicine Therapeutic Relationship

Background:

Patient descriptions of pain shape the pain experience, yet there is insufficient understanding of how patient communication can help providers lessen pain’s psychological and physical impact.

Objective:

To examine how individuals communicate their pain experience in the complementary and alternative medicine (CAM) provider-patient relationship.

Method:

Qualitative thematic framing examining semistructured interviews of a purposive and snowball sample of CAM patients (N = 13; 850 double-spaced pages) recruited from the mid-Atlantic region of the United States.

Results:

Complementary and alternative medicine patients communicate the pain experience through an awareness of their interdependence with: (a) relational spaces as attention to the self, the healing practices, and the provider; (b) physical spaces as openness to surroundings and the spatiality and temporality of self; and (c) physiological spaces as breathing and neurological and immune system functioning.

Conclusion:

A therapeutic relationship cultivating interdependence through awareness of relational, physical, and physiological spaces supports patients’ ability to open up to, know, and accept their body. The CAM provider’s work connects their practice with patient awareness of control over their environment, relationships, and physiology to redefine their pain experience.

A multi-method assessment of interoception among sexual trauma survivors

It is well established that many female sexual trauma survivors experience dissociation, particularly disconnection from the body, in the aftermath of sexual trauma. This study aims to address the open question of how sexual trauma is associated with awareness of inner body sensations (i.e., interoception). Given the important role that interoception has in emotion regulation, a process with which survivors often struggle, it is important to understand the associations between interoception and PTSD symptoms among survivors. Through multi-methods, we assessed associations between interoception, dissociation, and PTSD symptoms among 200 female sexual trauma survivors. We assessed two components of interoception: interoceptive accuracy (IAc: accurately perceiving internal body sensations; via heartbeat perception task) and interoceptive sensibility (IS: self-report perception of sensitivity to interoceptive sensations). We hypothesized that IAc and IS would be positively correlated with PTSD, with interactions between IAc/dissociation and IS/dissociation qualifying those main effects, weakening them for survivors with higher dissociation. Results showed an opposite pattern than was predicted: although IAc did explain significant PTSD variance, as IAc increased, PTSD decreased. Although IAc did explain significant variance in PTSD symptoms, interestingly, IS did not. Consistent with extant literature, dissociation predicted significant variance in PTSD. These correlational results suggest that the ability to more accurately perceive inner body sensations is related to lower PTSD symptoms. Findings provide a foundation for future research that can assess if interventions (such as yoga or exercise) that target increasing interoceptive accuracy lead to decreases in PTSD symptoms. We discuss further clinical implications, limitations and future directions.

Imagined paralysis alters somatosensory evoked-potentials

Recent studies employing body illusions have shown that multisensory conflict can alter body representations and modulate low-level sensory processing. One defining feature of these body illusions is that they are sensory driven and thus passive on behalf of the participant. Thus, it remained to establish whether explicit alteration of own-body representations modulates low-level sensory processing. We investigated whether tibial nerve somatosensory-evoked potentials were modulated when participants imagined paralysis of their legs and arms. Imagined paralysis of the legs decreased P40 amplitude, but not imagined paralysis of the arms. These results show modulation of early somatosensory processing via explicit, top-down alteration to the internal representation of the body. Interestingly, P40 suppression positively correlated with bodily awareness scores whereas it negatively correlated with body dissociation scores. This suggests that the ability to actively alter own-body representation and its corresponding sensory processing depends upon dispositions to attend to and focus on bodily sensations.

Do interoceptive accuracy and interoceptive sensibility predict emotion regulation?

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.

A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial

OBJECTIVES

Despite the gains made by current first-line interventions for major depressive disorder (MDD), modest rates of treatment response and high relapse indicate the need to augment existing interventions. Following theory and initial research indicating the promise of mindful yoga interventions (MYIs), this study examines mindful yoga as a treatment of MDD.

METHODS/DESIGN

This randomized controlled trial uses a sample of young females (18-34 years) to examine the efficacy and cost-effectiveness of a 9-week manualized MYI added to treatment as usual (TAU) versus TAU alone. Primary outcome measures consist of clinician-administered (Hamilton Depression Rating Scale) and self-report (Depression-Anxiety-Stress Scales) measures of depression. Underlying mechanisms will be examined, including rumination, negative self-evaluation, intolerance of uncertainty, interoceptive awareness, and dispositional mindfulness. Assessments were conducted at preintervention and will be conducted at postintervention, 6-, and 12-month follow up.

RESULTS

The baseline sample consists of 171 females (88 were randomized into the MYI), reporting a baseline Mage = 25.08 years (SDage = 4.64), MHamilton-depression = 18.39 (SDHamilton = 6.00), and a MDASS-depression = 21.02 (SDDASS = 9.36).

CONCLUSION

This trial will provide important information regarding the benefits of adding yoga-based interventions to TAU for young women with MDD and the mechanisms through which such benefits may occur.