1
|
Takemura N, Cheung DST, Fong DYT, Hui D, Lee AWM, Lam TC, Ho JCM, Kam TY, Chik JYK, Lin CC. Tai Chi and Aerobic Exercise on Cancer-Related Dyspnea in Advanced Lung Cancer Patients: A Randomized Clinical Trial. J Pain Symptom Manage 2024; 68:171-179. [PMID: 38729532 DOI: 10.1016/j.jpainsymman.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
CONTEXT Dyspnea, a prevalent and debilitating symptom in patients with advanced lung cancer, negatively affects symptom burden and prognosis. Physical activity has emerged as a promising non-pharmacological intervention for managing dyspnea. OBJECTIVES This study compared the effectiveness of two widely-recognized physical activity modalities, namely Tai Chi (TC) and aerobic exercise (AE) for treating dyspnea in patients with advanced lung cancer. METHODS Patients with advanced lung cancer (n=226) were randomized into TC, AE, or control groups. There was no baseline dyspnea requirement for patients. The AE group received two 60-minute supervised sessions and home-based exercises per month, the TC group received 60-minute sessions twice weekly, and the control group received exercise guidelines for 16 weeks. The primary outcome (sleep quality) of the study has been previously reported. In this secondary analysis, we focused on dyspnea outcomes, including overall and lung cancer-specific dyspnea. Assessments were conducted at baseline (T0), 16 weeks (T1), and one year (T2). RESULTS Compared to the control group, TC significantly improved overall dyspnea at T1 (between-group difference, -8.69; P=0.03) and T2 (between-group difference, -11.45; P=0.01), but not AE. Both AE (between-group difference, -11.04; P=0.01) and TC (between-group difference, -14.19; P<0.001) significantly alleviated lung cancer-specific dyspnea at T2 compared with the control group. CONCLUSION Both TC and AE alleviate dyspnea severity in patients with advanced lung cancer, and continuous exercise can yield substantial improvements. Due to its multi-component nature, Tai Chi has a greater effect on dyspnea.
Collapse
Affiliation(s)
- Naomi Takemura
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine (D.H.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne Wing Mui Lee
- Department of Clinical Oncology (W.M.L., T.C.L.), The University of Hong Kong-Shenzhen Hospital, Guangdong, China; Department of Clinical Oncology (W.M.L., T.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology (W.M.L., T.C.L.), The University of Hong Kong-Shenzhen Hospital, Guangdong, China; Department of Clinical Oncology (W.M.L., T.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Chung-Man Ho
- Department of Medicine (J.C.M.H.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yeung Kam
- Department of Clinical Oncology (T.Y.K.), Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Jeannie Yin Kwan Chik
- Department of Clinical Oncology (J.Y.K.C.), Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Chia-Chin Lin
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong; Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing (C.C.L.), Hong Kong.
| |
Collapse
|
2
|
Horsburgh A, Summers SJ, Lewis A, Keegan RJ, Flood A. The Relationship Between Pain and Interoception: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2024; 25:104476. [PMID: 38244898 DOI: 10.1016/j.jpain.2024.01.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
Interoception refers to the ability to sense internal bodily sensations. Research suggests that dysfunctions in interoception may be implicated in the transition to chronic pain, however, little work has examined interoceptive ability in pain states. Therefore, this systematic review aimed to assess whether interoception is altered in individuals experiencing pain. Following a systematic search of 4 electronic databases from inception to February 2023, 28 studies were included. Outcomes of interoceptive accuracy, interoceptive sensibility, and interoceptive awareness were meta-analysed. The risk of bias was assessed, and the certainty of the evidence was evaluated. Meta-analyses indicated that those with chronic pain display reduced interoceptive accuracy and increased interoceptive sensibility. Subgroup analyses indicated that the change in interoceptive sensibility is dependent on the measure used, with those with chronic pain scoring higher on measures focusing on attention to bodily sensations, while also scoring lower on emotional reactivity. No difference in interoceptive awareness was observed between individuals with chronic pain and pain-free controls. Only one study was found that measured interoception in those experiencing acute pain, while another study recruited those experiencing recurrent pain. These findings suggest that while those with chronic pain self-report as more interoceptively aware, they are less accurate at detecting internal bodily signals. Further research investigating domains of interoception in those experiencing acute and recurrent pain is needed. Data should be interpreted with caution as the certainty of evidence was very low for all completed analyses. This review was registered on the PROSPERO International Prospective Register of Systematic Reviews (Registration ID = CRD42022318843). PERSPECTIVE: This review considered the relationship between interoception and pain and found that an individual's ability to accurately sense internal signals is decreased in those with chronic pain, despite them reporting being more aware of internal sensations. However, there remains little research examining interoception in non-chronic pain states.
Collapse
Affiliation(s)
- Annabel Horsburgh
- University of Canberra Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Simon J Summers
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia; Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Aidan Lewis
- University of Canberra Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Richard J Keegan
- University of Canberra Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Andrew Flood
- University of Canberra Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| |
Collapse
|
3
|
Chan PYS, Lee LY, Davenport PW. Neural mechanisms of respiratory interoception. Auton Neurosci 2024; 253:103181. [PMID: 38696917 DOI: 10.1016/j.autneu.2024.103181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/03/2024] [Accepted: 04/22/2024] [Indexed: 05/04/2024]
Abstract
Respiratory interoception is one of the internal bodily systems that is comprised of different types of somatic and visceral sensations elicited by different patterns of afferent input and respiratory motor drive mediating multiple respiratory modalities. Respiratory interoception is a complex system, having multiple afferents grouped into afferent clusters and projecting into both discriminative and affective centers that are directly related to the behavioral assessment of breathing. The multi-afferent system provides a spectrum of input that result in the ability to interpret the different types of respiratory interceptive sensations. This can result in a response, commonly reported as breathlessness or dyspnea. Dyspnea can be differentiated into specific modalities. These respiratory sensory modalities lead to a general sensation of an Urge-to-Breathe, driven by a need to compensate for the modulation of ventilation that has occurred due to factors that have affected breathing. The multiafferent system for respiratory interoception can also lead to interpretation of the sensory signals resulting in respiratory related sensory experiences, including the Urge-to-Cough and Urge-to-Swallow. These behaviors are modalities that can be driven through the differentiation and integration of multiple afferent input into the respiratory neural comparator. Respiratory sensations require neural somatic and visceral interoceptive elements that include gated attention and detection leading to respiratory modality discrimination with subsequent cognitive decision and behavioral compensation. Studies of brain areas mediating cortical and subcortical respiratory sensory pathways are summarized and used to develop a model of an integrated respiratory neural network mediating respiratory interoception.
Collapse
Affiliation(s)
- Pei-Ying Sarah Chan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
| | - Lu-Yuan Lee
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Paul W Davenport
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| |
Collapse
|
4
|
Zaccaro A, della Penna F, Mussini E, Parrotta E, Perrucci MG, Costantini M, Ferri F. Attention to cardiac sensations enhances the heartbeat-evoked potential during exhalation. iScience 2024; 27:109586. [PMID: 38623333 PMCID: PMC11016802 DOI: 10.1016/j.isci.2024.109586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/17/2024] Open
Abstract
Respiration and cardiac activity intricately interact through complex physiological mechanisms. The heartbeat-evoked potential (HEP) is an EEG fluctuation reflecting the cortical processing of cardiac signals. We recently found higher HEP amplitude during exhalation than inhalation during a task involving attention to cardiac sensations. This may have been due to reduced cardiac perception during inhalation and heightened perception during exhalation through attentional mechanisms. To investigate relationships between HEP, attention, and respiration, we introduced an experimental setup that included tasks related to cardiac and respiratory interoceptive and exteroceptive attention. Results revealed HEP amplitude increases during the interoceptive tasks over fronto-central electrodes. When respiratory phases were taken into account, HEP increases were primarily driven by heartbeats recorded during exhalation, specifically during the cardiac interoceptive task, while inhalation had minimal impact. These findings emphasize the role of respiration in cardiac interoceptive attention and could have implications for respiratory interventions to fine-tune cardiac interoception.
Collapse
Affiliation(s)
- Andrea Zaccaro
- Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesca della Penna
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Elena Mussini
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Eleonora Parrotta
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Marcello Costantini
- Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesca Ferri
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| |
Collapse
|
5
|
Drozdovszky O, Petzke T, Köteles F. Sensory and affective aspects of the perception of respiratory resistance. Biol Futur 2024; 75:51-59. [PMID: 37481740 DOI: 10.1007/s42977-023-00173-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
Perception of airway resistance has a sensory and an affective aspect, i.e., perceived resistance and unpleasantness, respectively. The current study aimed to shed more light on the relationship of these aspects, as well as their malleability to trait-like aspects of body awareness. In a laboratory study, 71 young participants completed two respiratory resistive load discrimination tasks relying on sensory and affective evaluation, respectively, and filled out questionnaires assessing somatosensory amplification, anxiety sensitivity, somatic symptoms distress, and breath awareness. Frequentist and Bayesian statistical analysis revealed no differences in discrimination accuracy with respect to the sensory and affective aspect of perceived resistance. Psychological traits were not associated with accuracy scores. In conclusion, affective evaluation of respiratory load is as accurate as sensory evaluation. Neither sensory not affective accuracy is influenced by various aspects of body awareness.
Collapse
Affiliation(s)
- Orsolya Drozdovszky
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- Ádám György Psychophysiology Research Group, Budapest, Hungary
| | - Tara Petzke
- Psychological Institute, Johannes Gutenberg University, Wallstraße 3, 55122, Mainz, Germany.
| | - Ferenc Köteles
- Ádám György Psychophysiology Research Group, Budapest, Hungary
- Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary
| |
Collapse
|
6
|
Torres S, Vieira AI, Vieira FM, Lencastre L, Guerra MP, Miller KM, Barbosa MR. Psychometric analysis of the body responsiveness questionnaire in the Portuguese population. Sci Rep 2023; 13:22997. [PMID: 38151515 PMCID: PMC10752900 DOI: 10.1038/s41598-023-50530-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023] Open
Abstract
Body responsiveness refers to the tendency to be attuned to the body's needs and use interoceptive information to guide behavior. Despite its potential beneficial effect on the development of positive body image, this construct is currently understudied. To boost research in this area, we examined the factor structure, gender invariance, and psychometric properties of a Portuguese translation of the Body Responsiveness Questionnaire (BRQ). A total of 650 men and women (aged 18-80 years) completed the Portuguese BRQ. To assess its convergent validity, participants also completed measures of body appreciation, emotion regulation, depression symptoms, and psychological quality of life. Exploratory factor analysis indicated a two-factor structure of the BRQ, which was upheld using confirmatory factor analysis: "Importance of Interoceptive Awareness" (ω = .85-.87) and "Perceived Connection" between body and mind (ω = .71-.74). BRQ scores had partial scalar invariance across gender, and no significant gender differences. Convergent and known-groups validity was supported. Participants with overweight/obesity (vs. normal weight) and middle-aged adults (vs. young adults) assigned higher importance to body signals to guide behavior. The Portuguese version of the BRQ is a psychometrically sound measure of body responsiveness and it may contribute to a comprehensive assessment of positive body image to guide intervention.
Collapse
Affiliation(s)
- Sandra Torres
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.
| | - Ana Isabel Vieira
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Filipa Mucha Vieira
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Leonor Lencastre
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Marina Prista Guerra
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Kylee M Miller
- Institute on Development & Disability, Child Development and Rehabilitation Center (CDRC), Oregon Health and Science University, 901 E. 18th Ave, Eugene, OR, 97403, USA
| | - Maria Raquel Barbosa
- Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
- Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| |
Collapse
|
7
|
Vabba A, Panasiti MS, Scattolin M, Spitaleri M, Porciello G, Aglioti SM. The thermoception task: a thermal imaging-based procedure for measuring awareness of changes in peripheral body temperature. J Neurophysiol 2023; 130:1053-1064. [PMID: 37529855 PMCID: PMC10635420 DOI: 10.1152/jn.00014.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/03/2023] Open
Abstract
Although thermal body signals provide crucial information about the state of an organism and changes in body temperature may be a sign of affective states (e.g., stress, pain, sexual arousal), research on thermal awareness is limited. Here we developed a task measuring awareness of changes in peripheral body temperature (thermal interoception) and compared it to the classical heartbeat counting task (cardiac interoception). With an infrared light bulb we delivered stimuli of different temperature intensities to the right hand of 31 healthy participants. Thermal interoceptive accuracy, i.e., the difference between participants' real and perceived change in hand temperature, showed good interindividual variability. We found that thermal interoception did not correlate with (and was generally higher than) cardiac interoception, suggesting that different interceptive channels provide separate contributions to awareness of bodily states. Moreover, the results hint at the great salience of thermal signals and the need for thermoregulation in day-to-day life. Finally, thermal interoceptive accuracy was associated with self-reported awareness of body temperature changes and with the ability to regulate distress by focusing on body sensations. Our task has the potential to significantly increase current knowledge about the role of interoception in cognition and behavior, particularly in social and emotional contexts.NEW & NOTEWORTHY We developed a novel task measuring awareness of changes in peripheral body temperature (i.e., thermal interoception). To avoid tactile confounds present in existing thermoceptive tasks, we used an infrared light bulb to deliver stimuli of different temperature intensities to the hand of participants and asked them to judge the perceived change in their hand temperature. Performance in the task showed good interindividual variability, did not correlate with cardiac interoceptive tasks, and was associated with self-reported thermosensitivity.
Collapse
Affiliation(s)
- Alisha Vabba
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
| | - Maria Serena Panasiti
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Marina Scattolin
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Marco Spitaleri
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Giuseppina Porciello
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Salvatore Maria Aglioti
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
| |
Collapse
|
8
|
Rominger C, Schwerdtfeger AR. Dynamic heartbeat tracking beyond the laboratory: Introducing the novel Graz Ambulatory Interoception Task (GRAIT). Int J Psychophysiol 2023; 192:80-90. [PMID: 37574020 DOI: 10.1016/j.ijpsycho.2023.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/15/2023]
Abstract
We present a novel ambulatory method, the Graz Ambulatory Interoception Task (GRAIT), to assess the accuracy of interoceptive beliefs (AccIB). This method captures both between- and within-person variations of AccIB by having participants counting perceived heartbeats in daily life. Reliability analyses showed high between-person (RkR = 0.99) and moderate within-person reliability (RCn = 0.62). Validity was supported by associations with an established laboratory task (r = 0.87). Within-person associations revealed that interoceptive sensibility, heart rate variability, and states of low arousal coupled with positive affect were linked to AccIB. Study 2 replicated these findings and showed a relationship between AccIB and self-control in everyday life, highlighting the importance of cardiac interoception and its relevance for health.
Collapse
|
9
|
Fekih-Romdhane F, Malaeb D, Fawaz M, Chammas N, Soufia M, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the multidimensional assessment of interoceptive awareness (MAIA-2) questionnaire in a non-clinical sample of Arabic-speaking adults. BMC Psychiatry 2023; 23:577. [PMID: 37558996 PMCID: PMC10410825 DOI: 10.1186/s12888-023-05067-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 07/31/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Interoception refers to processes through which the nervous system identifies, analyzes, and integrates the information generated by the physiological state of the body (e.g., from internal organs such as the stomach, heart, or lungs). Despite its potential interest for clinical research and its wide use globally, no Arabic adaptation and validation of the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) questionnaire exists to date. The goal of this study was to examine the psychometric properties of an Arabic translation of the MAIA-2 in a sample of Arabic-speaking community adults from Lebanon. We hypothesized that the Arabic version of the MAIA-2 would yield adequate internal consistency coefficients; the 8-factor structure model would show a good fit to our data, with measurement invariance and good convergent validity. METHOD The Arabic adaptation of the MAIA-2 was developed using the forward-backward translation method. A non-clinical sample of Arabic-speaking adults (n = 359, 59.9% females, mean age = 22.75 years (SD = 7.04)) took part of this validation study. To check if the model was adequate, several fit indices were calculated: the normed model chi-square (χ²/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ 3 for χ²/df, and ≤ 0.08 for RMSEA, and 0.90 for CFI and TLI indicate good fit of the model to the data. RESULTS Confirmatory Factor Analyses corroborated the validity of the original 8-factor structure of the MAIA-2 [χ2/df = 1603.86/601 = 2.67, RMSEA = 0.068 (90% CI 0.064, 0.072), SRMR = 0.058, CFI = 0.903, TLI = 0.892]. Reliability estimates in our sample revealed good internal consistency, with McDonald's ω coefficients for the subscales ranging from 0.86 to 0.93. Our analyses also revealed measurement invariance of the Arabic MAIA-2 for gender. No statistically significant difference between men and women in all dimensions, except for the not worrying and attention regulation subscales where men scored significantly higher than women. Finally, the Arabic MAIA-2 dimensions showed positive correlations with the intuitive eating dimension "Reliance on Hunger and Satiety Cues", thus providing support for convergent validity. CONCLUSION We contribute the literature by providing the first Arabic adaptation and validation of a measure assessing the multidimensional construct of self-reported interoception. The Arabic MAIA-2 demonstrated good psychometric properties. We thus preliminarily recommend its use to measure the interoceptive awareness construct among Arabic-speaking communities worldwide.
Collapse
Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mirna Fawaz
- Faculty of Health Sciences, Beirut Arab University, Tareek Al Jadida, Afeef Al Tiba, 1105, Beirut, Lebanon
| | - Nancy Chammas
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, 21478, Jeddah, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| |
Collapse
|
10
|
Effects of emotional contexts on respiratory attention task performance. Respir Physiol Neurobiol 2023; 308:103984. [PMID: 36368617 DOI: 10.1016/j.resp.2022.103984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022]
Abstract
Negative emotions have been found associated with high prevalence of respiratory disease and increased subjective feelings of dyspnea, while positive emotional stimulus has been suggested to alleviate dyspneic feelings. However, the extent to which different emotional contexts affect individuals' respiratory interoceptive attention was not clear. Therefore, the purpose of this study was to investigate the influences of emotional contexts on respiratory interoceptive accuracy, and the relationships between respiratory interoceptive accuracy and negative emotions as well as respiratory symptoms. Fifty-six healthy participants completed the self-reported questionnaires of depression, anxiety, and respiratory symptoms. During the experiment, the participants were instructed to watch one neutral and one positive affective picture series and mentally count the number of perceived occlusions (reported at the end of the trials). The Wilcoxon Signed-Rank test and Spearman's correlations were used to examine the effect of the emotional pictures and to explore the relationships between the level of emotional status or respiratory symptoms and respiratory interoceptive task performance. The significance level was set at p < 0.05. Our results did not show a significant difference in participants' occlusion counting task performance between the neutral and positive emotional context. However, Spearman's Rho correlation analysis revealed that depression level was negatively correlated with accuracy of the task performance in the neutral emotional context, and this relationship diminished in the positive emotional context. In summary, our study demonstrated that negative emotional status, especially depression, may lead to decreased respiratory interoceptive accuracy. Future studies are recommended to test the effect of positive emotional context on respiratory interoceptive task performance in individuals with clinical depression and anxiety.
Collapse
|
11
|
Merrigan JJ, Quatman-Yates C, Caputo J, Daniel K, Briones N, Sen I, Bretz S, Duchemin AM, Steinberg B, Hagen JA, Klatt M. Assessment of Virtual Mindfulness-Based Training for Health Care Professionals: Improved Self-Reported Respiration Rates, Perceived Stress, and Resilience. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231187636. [PMID: 37434793 PMCID: PMC10331219 DOI: 10.1177/27536130231187636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Background Mindfulness in Motion (MIM) is a workplace resilience-building intervention that has shown reductions in perceived stress and burnout, as well as increased resilience and work engagement in health care workers. Objective To evaluate effects of MIM delivered in a synchronous virtual format on self-reported respiratory rates (RR), as well as perceived stress and resiliency of health care workers. Methods Breath counts were self-reported by 275 participants before and after 8 weekly MIM sessions. MIM was delivered virtually in a group format as a structured, evidence-based workplace intervention including a variety of mindfulness, relaxation, and resilience-building techniques. Participants counted their breaths for 30 seconds, which was then multiplied by 2 to report RR. Additionally, participants completed Perceived Stress Scale and Connor-Davidson Resiliency Scale. Results According to mixed effect analyses there were main effects of MIM Session (P < .001) and Weeks (P < .001), but no Session by Week interaction (P = .489) on RR. On average, RR prior to MIM sessions were reduced from 13.24 bpm (95% CI = 12.94, 13.55 bpm) to 9.69 bpm (95% CI = 9.39, 9.99 bpm). When comparing average Pre-MIM and Post-MIM RR throughout the MIM intervention, Week-2 (mean = 12.34; 95% CI = 11.89, 12.79 bpm) was not significantly different than Week-1 (mean = 12.78; 95% CI = 12.34, 13.23 bpm), but Week-3 through Week-8 demonstrated significantly lower average Pre-MIM and Post-MIM RR compared to Week-1 (average weekly difference range: 1.36 to 2.48 bpm, P < .05). Perceived stress was reduced from Week-1 (17.52 ± 6.25) to after Week-8 (13.52 ± 6.04; P < .001), while perceived resiliency was increased from Week-1 (11.30 ± 5.14) to after Week-8 (19.29 ± 2.58); P < .001). Conclusion Thus far, completion of MIM sessions has shown acute and long-term effects on self-reported RR, but more research is required to determine the extent of improved parasympathetic (relaxed) states. Collectively, this work has shown value for mind-body stress mitigation and resiliency-building in high stress acute health care environments.
Collapse
Affiliation(s)
- Justin J. Merrigan
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
| | - Catherine Quatman-Yates
- School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, OH, USA
| | - Jacqueline Caputo
- School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, OH, USA
| | - Kayla Daniel
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Nadia Briones
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Ilayda Sen
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Slate Bretz
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Anne-Marie Duchemin
- Stress, Trauma and Resilience Program, Department of Psychiatry, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Beth Steinberg
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Gabbe Health and Wellbeing, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Joshua A. Hagen
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, OH, USA
| | - Maryanna Klatt
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Gabbe Health and Wellbeing, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
12
|
Using targeted visceroception to improve interoceptive sensibility and emotion regulation. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2022.100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
13
|
Ekman E, Koenig CJ, Daubenmier J, Dickson KG, Simmons V, Braun A, Goldin P. Transforming adversity into an ally: A qualitative study of “feeding your demons” meditation. Front Psychol 2022. [DOI: 10.3389/fpsyg.2022.806500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Contemplative science has made great strides in the empirical investigation of meditation practices, such as how mindfulness, compassion, and mantra practices impact health and well-being. However, meditation practices from the Vajrayana Buddhist tradition that use mental imagery to transform distressing beliefs and emotions have been little explored. We examined the “Feeding Your Demons” meditation, a secular adaptation of the traditional Tibetan Vajrayana Buddhist meditation practice of Chöd (“Severance”) in a pilot, randomized controlled trial in which 61 community adults from the U.S. with prior meditation experience and moderate levels of depressive and anxiety symptoms (70% female)were randomly assigned to one month (15 meditation sessions) of “Feeding Your Demons” practice or a waitlist control group. Written diary entries were collected immediately after each meditation session. We used an Interpretive Phenomenological Analysis approach to examine qualitative responses to two questions which probed (1) how participants made meaning of each meditation session and (2) how they thought it may impact their future thoughts and intentions for action. Five major themes were identified based on 20 codes developed through an inductive review of written responses across all participants. The themes included an enhanced sense of self-worth and confidence, empathy for the “demon” or rejected parts of oneself, increased self-awareness, an active-oriented “fierce” self-compassion, and an acceptance form of self-compassion. Overall, participants expressed an ability to reframe, or transform, their relationship to distressing thoughts, emotions, and experiences as they gained personal insights, self-compassion, and acceptance through the meditation process which in turn shaped their future intentions for action in the world. This research suggests that a secular form of a Vajrayana Buddhist practice may be beneficial for Western meditation practitioners with no prior training in Vajrayana Buddhism. Future research is warranted to understand its longer-term impacts on health and well-being.
Collapse
|
14
|
Lachaud L, Jacquet B, Baratgin J. Reducing Choice-Blindness? An Experimental Study Comparing Experienced Meditators to Non-Meditators. Eur J Investig Health Psychol Educ 2022; 12:1607-1620. [PMID: 36354592 PMCID: PMC9689841 DOI: 10.3390/ejihpe12110113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 10/20/2023] Open
Abstract
The mindfulness trait is an intrinsic characteristic of one's disposition that facilitates awareness of the present moment. Meditation has proven to enhance situational awareness. In this study, we compared the performance of participants that were split into two groups depending on their experience in mindfulness meditation (a control group naive to mindfulness meditation and a group of experienced mindfulness meditators). Choice-blindness happens when people fail to notice mismatches between their intentions and the consequences of decisions. Our task consisted of decisions where participants chose one preferred female facial image from a pair of images for a total of 15 decisions. By reversing the decisions, unbeknownst to the participants, three discrepancies were introduced in an online experimental design. Our results indicate that the likelihood of detecting one or more manipulations was higher in the mindful group compared to the control group. The higher FMI scores of the mindful group did not contribute to this observation; only the practice of mindfulness meditation itself did. Thus, this could be explained by better introspective access and control of reasoning processes acquired during practice and not by the latent characteristics that are attributed to the mindfulness trait.
Collapse
Affiliation(s)
- Léa Lachaud
- CHArt RNSR 200515259U, Université Paris 8, 93200 Saint-Denis, France
- Lutin Userlab, Université Paris 8, 75930 Paris, France
| | - Baptiste Jacquet
- CHArt RNSR 200515259U, Université Paris 8, 93200 Saint-Denis, France
- P-A-R-I-S Association, 75005 Paris, France
| | - Jean Baratgin
- CHArt RNSR 200515259U, Université Paris 8, 93200 Saint-Denis, France
- P-A-R-I-S Association, 75005 Paris, France
| |
Collapse
|
15
|
Temiz G, Atkinson-Clement C, Lau B, Czernecki V, Bardinet E, Francois C, Worbe Y, Karachi C. Structural hyperconnectivity of the subthalamic area with limbic cortices underpins anxiety and impulsivity in Tourette syndrome. Cereb Cortex 2022; 33:5181-5191. [PMID: 36310093 DOI: 10.1093/cercor/bhac408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics, which is often associated with psychiatric comorbidities. Dysfunction of basal ganglia pathways might account for the wide spectrum of symptoms in TS patients. Although psychiatric symptoms may be related to limbic networks, the specific contribution of different limbic structures remains unclear. We used tractography to investigate cortical connectivity with the striatal area (caudate, putamen, core and shell of the nucleus accumbens), the subthalamic nucleus (STN), and the adjacent medial subthalamic region (MSR) in 58 TS patients and 35 healthy volunteers. 82% of TS patients showed psychiatric comorbidities, with significantly higher levels of anxiety and impulsivity compared to controls. Tractography analysis revealed significantly increased limbic cortical connectivity of the left MSR with the entorhinal (BA34), insular (BA48), and temporal (BA38) cortices in TS patients compared to controls. Furthermore, we found that left insular-STN connectivity was positively correlated with impulsivity scores for all subjects and with anxiety scores for all subjects, particularly for TS. Our study highlights a heterogenous modification of limbic structure connectivity in TS, with specific abnormalities found for the subthalamic area. Abnormal connectivity with the insular cortex might underpin the higher level of impulsivity and anxiety observed in TS.
Collapse
Affiliation(s)
- Gizem Temiz
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
| | - Cyril Atkinson-Clement
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
| | - Brian Lau
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
| | - Virginie Czernecki
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
- Department of Neurology, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris , 75013 Paris, France
| | - Eric Bardinet
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
| | - Chantal Francois
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
| | - Yulia Worbe
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
- Department of Neurophysiology, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris , 75012 Paris, France
| | - Carine Karachi
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute- ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière , 75013 Paris, France
- Department of Neurosurgery, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris , 75013 Paris, France
| |
Collapse
|
16
|
Kang SS, Sponheim SR, Lim KO. Interoception Underlies Therapeutic Effects of Mindfulness Meditation for Posttraumatic Stress Disorder: A Randomized Clinical Trial. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:793-804. [PMID: 34688923 DOI: 10.1016/j.bpsc.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mindfulness-based interventions have proven efficacy in treating posttraumatic stress disorder (PTSD), but the neurobiological mechanism underlying the therapeutic effects is unknown. As mindfulness meditation cultivates attention to the present moment and bodily sensations, neural functions related to interoception (i.e., central processes of bodily signals) might be such a mechanism. METHODS We conducted a clinical trial in which veterans with PTSD were randomly assigned to receive an 8-week mindfulness-based stress reduction (MBSR) intervention (n = 47) or an active control intervention (present-centered group therapy; n = 51). We assessed pre- and postintervention PTSD symptoms and electroencephalography measures of neural outcomes, including spontaneous brain activity, cognitive task-related brain responses, and interoceptive brain responses (heartbeat-evoked brain responses). We conducted statistical causal mediation analyses using treatment type as a predictor, pre- and postintervention measures of symptom severity as treatment response, and the neural outcomes as mediators. RESULTS Compared with the control group, the MBSR group had greater improvements in PTSD symptoms and increases in spontaneous alpha power (8-13 Hz), task-related frontal theta power (4-7 Hz in 140-220 ms after stimulus), and frontal theta heartbeat-evoked brain responses (3-5 Hz and 265-336 ms after R peak). The mediation analysis using latent difference score modeling revealed that only changes in frontal theta heartbeat-evoked brain responses mediated the MBSR treatment effect. CONCLUSIONS Mindfulness meditation improves brain functions of attentional control and resting brain states reflective of internally oriented relaxation. However, interoceptive neural functions enhanced by MBSR seem to be a primary cerebral mechanism that improves symptoms of PTSD.
Collapse
Affiliation(s)
- Seung Suk Kang
- Department of Biomedical Sciences, University of Missouri-Kansas City, Kansas City, Missouri.
| | - Scott R Sponheim
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Health Care System, Minneapolis, Minnesota
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Health Care System, Minneapolis, Minnesota
| |
Collapse
|
17
|
Kluger FE, Oladimeji DM, Tan Y, Brown NR, Caplan JB. Mnemonic scaffolds vary in effectiveness for serial recall. Memory 2022; 30:869-894. [PMID: 35349387 DOI: 10.1080/09658211.2022.2052322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Memory champions remember vast amounts of information in order and at first encounter by associating each study item to an anchor within a scaffold - a pre-learned, structured memory. The scaffold provides direct-access retrieval cues. Dominated by the familiar-route scaffold (Method of Loci), researchers have little insight into what characteristics of scaffolds make them effective, nor whether individual differences might play a role. We compared participant-generated mnemonic scaffolds: (a) familiar routes (Loci), (b) autobiographical stories (Story), (c) parts of the human body (Body), and (d) routine activities (Routine Activity). Loci, Body, and Story Scaffolds benefited serial recall over Control (no scaffold). The Body and Loci Scaffold were equally superior to the other scaffolds. Measures of visual imagery aptitude and vividness and body responsiveness did not predict accuracy. A second experiment tested whether embodiment could be responsible for the high level of effectiveness of the Body Scaffold; this was not supported. In short, mnemonic scaffolds are not equally effective and embodied cognition may not directly contribute to memory success. The Body Scaffold may be a strong alternative to the Method of Loci and may enhance learning for most learners, including those who do not find the Method of Loci useful.
Collapse
Affiliation(s)
- Felicitas E Kluger
- Department of Psychology and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Debby M Oladimeji
- Department of Psychology and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Yuwei Tan
- Department of Psychology and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Norman R Brown
- Department of Psychology and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Jeremy B Caplan
- Department of Psychology and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| |
Collapse
|
18
|
Garfinkel SN, Schulz A, Tsakiris M. Addressing the need for new interoceptive methods. Biol Psychol 2022; 170:108322. [DOI: 10.1016/j.biopsycho.2022.108322] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/25/2022]
|
19
|
Suksasilp C, Garfinkel SN. Towards a comprehensive assessment of interoception in a multi-dimensional framework. Biol Psychol 2022; 168:108262. [DOI: 10.1016/j.biopsycho.2022.108262] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 12/25/2022]
|
20
|
Davey S, Halberstadt J, Bell E. Where is emotional feeling felt in the body? An integrative review. PLoS One 2021; 16:e0261685. [PMID: 34936672 PMCID: PMC8694467 DOI: 10.1371/journal.pone.0261685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
Contemporary research on "embodied emotion" emphasizes the role of the body in emotional feeling. The evidence base on interoception, arguably the most prominent strand of embodied emotion research, places emphasis on the cardiac, respiratory and gastrointestinal systems. In turn, interoception has evidence-based links with improved emotion regulation. Despite the focus on separate bodily systems, it is unclear whether particular interoceptive locations play a greater role in emotional feeling and emotion regulation. Further, according to Gross' "process model", the sooner that regulation of an emotion occurs, the better; hence, it is additionally important to identify the first body areas to activate. These issues are investigated in a two-stage integrative review. The first stage was preliminary, giving an overview of the evidence base to highlight the distribution of measured body areas. This indicated that 86% of publications (n = 88) measured cardiac activity, 26% measured the respiratory system, and six percent the gastrointestinal system. Given the emphasis placed on all three systems in interoception theory and research on emotion, this suggests a dearth of comprehensive findings pertaining to feeling locations. The second stage investigated the core issues of where emotional feelings are felt in the body and time-related implications for regulation. This was based on ten texts, which together suggested that the head, throat and chest are the most consistently detected locations across and within numerous emotional contexts. Caution is required, however, since-among other reasons discussed-measurement was not time-restricted in these latter publications, and direct physiological measurement was found in only a minority of cases.
Collapse
Affiliation(s)
- Steven Davey
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
| | | | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| |
Collapse
|
21
|
Wu Q, Mao X, Luo W, Fan J, Liu X, Wu Y. Enhanced interoceptive attention mediates the relationship between mindfulness training and the reduction of negative mood. Psychophysiology 2021; 59:e13991. [PMID: 34932832 DOI: 10.1111/psyp.13991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022]
Abstract
Although accumulating evidence has revealed the effect of mindfulness training on the reduction of general stress and the improvement of mental well-being, the underlying mechanism remains unclear. In this study, we investigated whether interoceptive attention to respiratory signals plays a role. Healthy adults were randomly assigned to either receive an 8-week mindfulness training (n = 29) or inactive control (n = 28). The pre- and post-training self-reported states of negative mood were assessed together with an objective measure of interoceptive attention to respiration. Compared to the control group, mindfulness training led to a decrease in the level of negative mood and an increase in interoceptive sensitivity. Mediation analysis further showed that the effect of mindfulness training on the reduction of negative mood was fully mediated by increased interoceptive sensitivity. These results suggest that mindfulness training effectively alleviates negative mood by enhancing interoceptive attention to respiratory signals.
Collapse
Affiliation(s)
- Qiong Wu
- Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Xinrui Mao
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Wei Luo
- Chinese Academy of Social Sciences, Beijing, China
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, New York, New York, USA
| | - Xinghua Liu
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China.,Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Yanhong Wu
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China.,Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| |
Collapse
|
22
|
Robinson E, Foote G, Smith J, Higgs S, Jones A. Interoception and obesity: a systematic review and meta-analysis of the relationship between interoception and BMI. Int J Obes (Lond) 2021; 45:2515-2526. [PMID: 34480102 PMCID: PMC8606313 DOI: 10.1038/s41366-021-00950-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/27/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Interoception refers to the processes by which we sense, interpret and integrate signals originating from within the body. Deficits in interoception have been linked to higher BMI and may contribute to weight gain. However, there have been conflicting findings and it is not clear how higher BMI is associated with different facets of interoception, such as interoceptive accuracy (the ability to detect internal signals) and sensibility (the tendency to attend to internal signals). METHODS We conducted a systematic review and meta-analysis of studies that measured interoception and BMI. We examined relationships between interoception and BMI in children and adults separately and as a function of interoceptive facet and measure. In sensitivity analyses, we tested for evidence of publication bias and whether the results were consistent when studies with a high risk of bias were excluded. RESULTS A total of 87 articles were eligible for inclusion. In adults (121 effects, 10,425 participants), there was cross-sectional evidence of higher BMI being associated with overall deficits in interoception (r = -0.054, 95% CI: -0.084 to -0.025) and this was consistent across sensitivity analyses. There was no statistically significant evidence of moderation by interoceptive facet or measure, although there was some variability in effect size estimates based on interoceptive facet and measures. A smaller meta-analysis limited to studies that compared participants with normal weight vs. overweight/obesity indicated poorer interoception in participants with overweight/obesity (SMD = -0.39, 95% CI -0.60 to -0.18). CONCLUSIONS In cross-sectional studies, deficits in interoception are associated with higher BMI. However, it remains unclear whether deficits in interoception contribute to or are a consequence of weight gain and obesity.
Collapse
Affiliation(s)
- Eric Robinson
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
| | - Georgia Foote
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Jemma Smith
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Andrew Jones
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| |
Collapse
|
23
|
Effects of a Single Yoga Session on Cardiac Interoceptive Accuracy and Emotional Experience. Brain Sci 2021; 11:brainsci11121572. [PMID: 34942874 PMCID: PMC8699040 DOI: 10.3390/brainsci11121572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There is an increasing body of research supporting the idea that cardiac interoceptive accuracy (IAc) can be improved by training. Findings concerning the effects of a single yoga session on IAc and the related construct emotional experience are sparse. The aim of this study was to examine if a single yoga session increases IAc and improves emotional experience. METHODS 137 students were randomly assigned to a 20-min yoga session (n = 47), an endurance session (n = 46), or an inactive control condition (n = 44). IAc and emotional experience were assessed before and after the sessions. RESULTS There were no significant changes in IAc, or positive and negative affect. IAc at baseline and the change in positive effect were found as predictors for IAc after the yoga session. CONCLUSION A 20-min yoga session seems to be not applicable to improve IAc and emotional experience. Future studies should investigate long-term interventions and diverse healthy and clinical populations.
Collapse
|
24
|
Prentice F, Murphy J. Sex differences in interoceptive accuracy: A meta-analysis. Neurosci Biobehav Rev 2021; 132:497-518. [PMID: 34838927 DOI: 10.1016/j.neubiorev.2021.11.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/19/2022]
Abstract
Interoceptive accuracy, the ability to correctly perceive internal signals arising from the body, is thought to be disrupted in numerous mental and physical health conditions. Whilst evidence suggests poorer interoceptive accuracy in females compared to males, raising the possibility that interoceptive differences may relate to sex differences in mental and physical health, results concerning sex differences in interoceptive accuracy are mixed. Given such ambiguity, this meta-analysis aimed to establish the presence or absence of sex differences in interoceptive accuracy across cardiac, respiratory, and gastric domains. A review of 7956 abstracts resulted in 93 eligible studies. Results demonstrated superior accuracy in males across cardiac, but not gastric, tasks, while findings on respiratory tasks were mixed. Effect sizes were consistent across cardiac tasks, but instability and/or moderate heterogeneity was observed across other domains, likely due to the small number of eligible studies. Despite such limitations, results indicate the possibility of sex differences across interoception tasks and domains. Methodological limitations concerning the influence of physiological factors, and directions for future research are discussed.
Collapse
Affiliation(s)
- Freya Prentice
- Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, United Kingdom.
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| |
Collapse
|
25
|
Britton WB, Desbordes G, Acabchuk R, Peters S, Lindahl JR, Canby NK, Vago DR, Dumais T, Lipsky J, Kimmel H, Sager L, Rahrig H, Cheaito A, Acero P, Scharf J, Lazar SW, Schuman-Olivier Z, Ferrer R, Moitra E. From Self-Esteem to Selflessness: An Evidence (Gap) Map of Self-Related Processes as Mechanisms of Mindfulness-Based Interventions. Front Psychol 2021; 12:730972. [PMID: 34880805 PMCID: PMC8645694 DOI: 10.3389/fpsyg.2021.730972] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/25/2021] [Indexed: 12/15/2022] Open
Abstract
Self-related processes (SRPs) have been theorized as key mechanisms of mindfulness-based interventions (MBIs), but the evidence supporting these theories is currently unclear. This evidence map introduces a comprehensive framework for different types of SRPs, and how they are theorized to function as mechanisms of MBIs (target identification). The evidence map then assesses SRP target engagement by mindfulness training and the relationship between target engagement and outcomes (target validation). Discussion of the measurement of SRPs is also included. The most common SRPs measured and engaged by standard MBIs represented valenced evaluations of self-concept, including rumination, self-compassion, self-efficacy, and self-esteem. Rumination showed the strongest evidence as a mechanism for depression, with other physical and mental health outcomes also supported. Self-compassion showed consistent target engagement but was inconsistently related to improved outcomes. Decentering and interoception are emerging potential mechanisms, but their construct validity and different subcomponents are still in development. While some embodied self-specifying processes are being measured in cross-sectional and meditation induction studies, very few have been assessed in MBIs. The SRPs with the strongest mechanistic support represent positive and negative evaluations of self-concept. In sum, few SRPs have been measured in MBIs, and additional research using well-validated measures is needed to clarify their role as mechanisms.
Collapse
Affiliation(s)
- Willoughby B. Britton
- School of Public Health, Brown University, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Gaëlle Desbordes
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Rebecca Acabchuk
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States
| | - Sarah Peters
- School of Public Health, Brown University, Providence, RI, United States
| | - Jared R. Lindahl
- Department of Religious Studies and Clinical and Affective Neuroscience Lab, Brown University, Providence, RI, United States
| | - Nicholas K. Canby
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
- Department of Psychology, Clark University, Worcester, MA, United States
| | - David R. Vago
- Osher Center for Integrative Medicine, Vanderbilt University, Nashville, TN, United States
| | - Travis Dumais
- School of Public Health, Brown University, Providence, RI, United States
| | - Jonah Lipsky
- School of Public Health, Brown University, Providence, RI, United States
| | - Hannah Kimmel
- School of Public Health, Brown University, Providence, RI, United States
| | - Lauren Sager
- School of Public Health, Brown University, Providence, RI, United States
| | - Hadley Rahrig
- School of Public Health, Brown University, Providence, RI, United States
| | - Aya Cheaito
- School of Public Health, Brown University, Providence, RI, United States
| | - Pamela Acero
- School of Public Health, Brown University, Providence, RI, United States
| | - Jodi Scharf
- School of Public Health, Brown University, Providence, RI, United States
| | - Sara W. Lazar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Zev Schuman-Olivier
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Rebecca Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, Bethesda, MD, United States
| | - Ethan Moitra
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
| |
Collapse
|
26
|
Roberts RL, Ledermann K, Garland EL. Mindfulness-oriented recovery enhancement improves negative emotion regulation among opioid-treated chronic pain patients by increasing interoceptive awareness. J Psychosom Res 2021; 152:110677. [PMID: 34801814 DOI: 10.1016/j.jpsychores.2021.110677] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Long-term opioid therapy presents health risks for people with chronic pain. Some chronic pain patients escalate their opioid dose to regulate negative emotions. Therefore, emotion regulatory strategies like reappraisal are key treatment targets for this population. Mindfulness has been shown to enhance reappraisal, but the mechanisms of action are unknown. This study was a secondary analysis of data from a randomized, controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE) to test a specific postulate of the Mindfulness-to-Meaning Theory: that mindfulness-based interventions promote reappraisal, via interoceptive self-regulation, as a means of decreasing emotional distress. METHODS Ninety-five patients with opioid-treated chronic pain (age = 56.8 ± 11.7, 66% female) were randomized to 8 weeks of MORE or Support Group (SG) psychotherapy. An interoceptive awareness latent variable was constructed from the Multidimensional Assessment of Interoceptive Awareness (MAIA). Next, interoceptive self-regulation was assessed as a mediator of the effect of MORE on post-treatment reappraisal, and then reappraisal was examined as a mediator of change in distress through 3-month follow-up. RESULTS MORE participants had greater improvements in interoceptive awareness than the SG as measured by the interoceptive awareness latent variable (β = 0.310, p = 0.008) and by the self-regulation MAIA subscale (β = 0.335, p = 0.001). The effect of MORE on treatment-induced increases in reappraisal was mediated by increased interoceptive self-regulation (indirect effect: β = 0.110, p = 0.030). In turn, decreases in distress through 3-month follow-up were mediated by increases in reappraisal (indirect: β = -0.136, p = 0.031). CONCLUSION MORE facilitated reappraisal of distress by enhancing interoceptive self-regulation, supporting a central mechanistic causal pathway specified by the Mindfulness-to-Meaning Theory.
Collapse
Affiliation(s)
- R Lynae Roberts
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, 395 S. 1500 East, Salt Lake City, UT 84108, USA; College of Social Work, University of Utah, Goodwill Humanitarian Building, 395 S.1500 East, Salt Lake City, UT 84108, USA
| | - Katharina Ledermann
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstrasse 8, Zurich 8091, Switzerland; Department of Clinical and Health Psychology, University of Fribourg, Rue P-A Faucigny 2, Fribourg 1700, Switzerland
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, 395 S. 1500 East, Salt Lake City, UT 84108, USA; College of Social Work, University of Utah, Goodwill Humanitarian Building, 395 S.1500 East, Salt Lake City, UT 84108, USA; Veterans Health Care Administration VISN 19 Whole Health Flagship, VA Salt Lake City Health Care System, USA.
| |
Collapse
|
27
|
Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
Collapse
Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| |
Collapse
|
28
|
Harrison OK, Marlow L, Finnegan SL, Ainsworth B, Pattinson KTS. Dissociating breathlessness symptoms from mood in asthma. Biol Psychol 2021; 165:108193. [PMID: 34560173 PMCID: PMC9355895 DOI: 10.1016/j.biopsycho.2021.108193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 12/21/2022]
Abstract
It is poorly understood why asthma symptoms are often discordant with objective medical tests. Differences in interoception (perception of internal bodily processes) may help explain symptom discordance, which may be further influenced by mood and attention. We explored inter-relationships between interoception, mood and attention in 63 individuals with asthma and 30 controls. Questionnaires, a breathing-related interoception task, two attention tasks, and standard clinical assessments were performed. Questionnaires were analysed using exploratory factor analysis, and linear regression examined relationships between measures. K-means clustering also defined asthma subgroups. Two concordant asthma subgroups (symptoms related appropriately to pathophysiology, normal mood) and one discordant subgroup (moderate symptoms, minor pathophysiology, low mood) were found. In all participants, negative mood correlated with decreased interoceptive ability and faster reaction times in an attention task. Our findings suggest that interpreting bodily sensations relates to mood, and this effect may be heightened in subgroups of individuals with asthma.
Collapse
Affiliation(s)
- Olivia K Harrison
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland; Department of Psychology, University of Otago, Dunedin, New Zealand; Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Lucy Marlow
- Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Sarah L Finnegan
- Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Ben Ainsworth
- Department of Psychology, University of Bath, United Kingdom
| | - Kyle T S Pattinson
- Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.
| |
Collapse
|
29
|
Harrison OK, Garfinkel SN, Marlow L, Finnegan SL, Marino S, Köchli L, Allen M, Finnemann J, Keur-Huizinga L, Harrison SJ, Stephan KE, Pattinson KTS, Fleming SM. The Filter Detection Task for measurement of breathing-related interoception and metacognition. Biol Psychol 2021; 165:108185. [PMID: 34487805 DOI: 10.1016/j.biopsycho.2021.108185] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 08/11/2021] [Accepted: 08/31/2021] [Indexed: 01/07/2023]
Abstract
The study of the brain's processing of sensory inputs from within the body ('interoception') has been gaining rapid popularity in neuroscience, where interoceptive disturbances are thought to exist across a wide range of chronic physiological and psychological conditions. Here we present a task and analysis procedure to quantify specific dimensions of breathing-related interoception, including interoceptive sensitivity, decision bias, metacognitive bias, and metacognitive performance. Two major developments address some of the challenges presented by low trial numbers in interoceptive experiments: (i) a novel adaptive algorithm to maintain task performance at 70-75% accuracy; (ii) an extended hierarchical metacognitive model to estimate regression parameters linking metacognitive performance to relevant (e.g. clinical) variables. We demonstrate the utility of the task and analysis developments, using both simulated data and three empirical datasets. This methodology represents an important step towards accurately quantifying interoceptive dimensions from a simple experimental procedure that is compatible with clinical settings.
Collapse
Affiliation(s)
- Olivia K Harrison
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland; Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Department of Psychology, University of Otago, New Zealand.
| | - Sarah N Garfinkel
- Institute of Cognitive Neuroscience, University College London, United Kingdom
| | - Lucy Marlow
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Sarah L Finnegan
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Stephanie Marino
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Laura Köchli
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Micah Allen
- Aarhus Institute of Advanced Studies, Aarhus University, Denmark; Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark; Cambridge Psychiatry, University of Cambridge, United Kingdom
| | | | | | - Samuel J Harrison
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Klaas E Stephan
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Kyle T S Pattinson
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Stephen M Fleming
- Wellcome Centre for Human Neuroimaging, University College London, United Kingdom; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, United Kingdom; Department of Experimental Psychology, University College London, United Kingdom
| |
Collapse
|
30
|
Gilliam EA, Kilgore KL, Liu Y, Bernier L, Criscitiello S, Litrownik D, Wayne PM, Moy ML, Yeh GY. Managing the experience of breathlessness with Tai Chi: A qualitative analysis from a randomized controlled trial in COPD. Respir Med 2021; 184:106463. [PMID: 34023739 PMCID: PMC8210537 DOI: 10.1016/j.rmed.2021.106463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/03/2021] [Accepted: 05/08/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Chronic obstructive pulmonary disease (COPD) is associated with dyspnea, decreased physical activity, and reduced quality-of-life. While pulmonary rehabilitation is helpful, maintenance of physical activity afterwards is problematic. We sought to explore qualitatively the multi-dimensional, biopsychosocial experience of patients with COPD who participated in Tai Chi (TC) vs. group walking to facilitate physical activity after pulmonary rehabilitation). METHODS We analyzed semi-structured qualitative exit interviews (N = 81) from a randomized controlled trial comparing 6-months TC with a time-matched group walking intervention and usual care control (UC). Transcripts were reviewed by at least 2 independent reviewers utilizing a social constructivist framework and theoretical sampling approach. An in-depth analysis of an exemplar subset was performed to thematic saturation and captured emergent themes within and between groups. RESULTS Focused analysis was conducted on 54 transcripts (N = 21 TC, N = 16 Walking, N = 17 UC). Participants were characterized by mean age 68.5 (±8.3) years, GOLD Stage = 3.0 (IQR 2.0-3.0), baseline FEV1 percent predicted 48.8% (±16.4), and 48.2% female. We identified predominant themes of breathlessness, and associated fear and embarrassment that limited physical activity across all groups. In both TC and walking, participants reported improvements in energy and endurance. Those in TC additionally shared improvements in breathing, mobility, and capacity for daily activities facilitated by body and breath awareness, emotional control and regulation of breathing, and an adaptive reframing of breathlessness. CONCLUSION TC promoted physical and mental wellbeing by diminishing fear and embarrassment associated with breathlessness. Results highlight the multimodal characteristics of TC that may facilitate continued physical activity and improvement in quality of life.
Collapse
Affiliation(s)
- Elizabeth A Gilliam
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA.
| | - Karen L Kilgore
- School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, FL, USA
| | - Yuchen Liu
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA
| | - Lauren Bernier
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA
| | - Shana Criscitiello
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA
| | - Daniel Litrownik
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, Department of Medicine, Veterans Administration Boston Healthcare System, Boston, MA, USA and Harvard Medical School, Boston, MA, USA
| | - Gloria Y Yeh
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
31
|
Verdonk C, Trousselard M, Di Bernardi Luft C, Medani T, Billaud JB, Ramdani C, Canini F, Claverie D, Jaumard-Hakoun A, Vialatte F. The heartbeat evoked potential does not support strong interoceptive sensibility in trait mindfulness. Psychophysiology 2021; 58:e13891. [PMID: 34227116 DOI: 10.1111/psyp.13891] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/07/2021] [Accepted: 06/10/2021] [Indexed: 12/27/2022]
Abstract
The enhancement of body awareness is proposed as one of the cognitive mechanisms that characterize mindfulness. To date, this hypothesis is supported by self-report and behavioral measures but still lacks physiological evidence. The current study investigated relation between trait mindfulness (i.e., individual differences in the ability to be mindful in daily life) and body awareness in combining a self-report measure (Multidimensional Assessment of Interoceptive Awareness [MAIA] questionnaire) with analysis of the heartbeat evoked potential (HEP), which is an event-related potential reflecting the cortical processing of the heartbeat. The HEP data were collected from 17 healthy participants under five minutes of resting-state condition. In addition, each participant completed the Freiburg Mindfulness Inventory and the MAIA questionnaire. Taking account of the important variability of HEP effects, analyses were replicated with the same participants three times (in three distinct sessions). First, group-level analyses showed that HEP amplitude and trait mindfulness do not correlate. Secondly, we observed that HEP amplitude could positively correlate with self-reported body awareness; however, this association was unreliable over time. Interestingly, we found that HEP measure shows very poor reliability over time at the individual level, potentially explaining the lack of reliable association between HEP and psychological traits. Lastly, a reliable positive correlation was found between self-reported trait mindfulness and body awareness. Taken together, these findings provide preliminary evidence that the HEP might not support the increased subjective body awareness in trait mindfulness, thus suggesting that perhaps objective and subjective measures of body awareness could be independent.
Collapse
Affiliation(s)
- Charles Verdonk
- Unit of Neurophysiology of Stress, Department of Neurosciences and Cognitive Sciences, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,Brain Plasticity Unit, CNRS, ESPCI Paris, PSL University, Paris, France
| | - Marion Trousselard
- Unit of Neurophysiology of Stress, Department of Neurosciences and Cognitive Sciences, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,French Military Health Service Academy, Paris, France
| | | | - Takfarinas Medani
- Brain Plasticity Unit, CNRS, ESPCI Paris, PSL University, Paris, France
| | - Jean-Baptiste Billaud
- Unit of Neurophysiology of Stress, Department of Neurosciences and Cognitive Sciences, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Céline Ramdani
- Unit of Neurophysiology of Stress, Department of Neurosciences and Cognitive Sciences, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Frédéric Canini
- Unit of Neurophysiology of Stress, Department of Neurosciences and Cognitive Sciences, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,French Military Health Service Academy, Paris, France
| | - Damien Claverie
- Unit of Neurophysiology of Stress, Department of Neurosciences and Cognitive Sciences, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | | | - François Vialatte
- Brain Plasticity Unit, CNRS, ESPCI Paris, PSL University, Paris, France
| |
Collapse
|
32
|
Reuille-Dupont S. Applications of somatic psychology: movement and body experience in the treatment of dissociative disorders. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2021. [DOI: 10.1080/17432979.2020.1844295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
33
|
Carvalho GB, Damasio A. Interoception and the origin of feelings: A new synthesis. Bioessays 2021; 43:e2000261. [PMID: 33763881 DOI: 10.1002/bies.202000261] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023]
Abstract
Feelings are conscious mental events that represent body states as they undergo homeostatic regulation. Feelings depend on the interoceptive nervous system (INS), a collection of peripheral and central pathways, nuclei and cortical regions which continuously sense chemical and anatomical changes in the organism. How such humoral and neural signals come to generate conscious mental states has been a major scientific question. The answer proposed here invokes (1) several distinctive and poorly known physiological features of the INS; and (2) a unique interaction between the body (the 'object' of interoception) and the central nervous system (which generates the 'subject' of interoception). The atypical traits of the INS and the direct interactions between neural and non-neural physiological compartments of the organism, neither of which is present in exteroceptive systems, plausibly explain the qualitative and subjective aspects of feelings, thus accounting for their conscious nature.
Collapse
Affiliation(s)
- Gil B Carvalho
- Brain and Creativity Institute, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, California, USA
| | - Antonio Damasio
- Brain and Creativity Institute, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
34
|
Van Den Houte M, Vlemincx E, Franssen M, Van Diest I, Van Oudenhove L, Luminet O. The respiratory occlusion discrimination task: A new paradigm to measure respiratory interoceptive accuracy. Psychophysiology 2021; 58:e13760. [PMID: 33438245 DOI: 10.1111/psyp.13760] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/20/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023]
Abstract
Interoception, or the sense of the internal state of the body, is hypothesized to be essential for a wide range of psychobiological processes and the development and perpetuation of several (mental) health problems. However, the study of interoceptive accuracy, the objectively measured capacity to detect or discriminate conscious bodily signals, has been hampered by the use of tasks with questionable construct validity and is often limited to studying interoception solely in the cardiac domain. We developed a novel task to measure interoceptive accuracy in the respiratory domain, the respiratory occlusion discrimination (ROD) task. In this task, interoceptive accuracy is defined as an individual's ability to detect small differences in lengths of short respiratory occlusions, assessed by means of an adaptive staircase procedure. This article describes a validation study (N = 97) aimed at investigating the internal consistency, test-retest reliability, and discriminant validity of the ROD task. The average just noticeable difference of lengths of respiratory occlusion was 74.22 ms, with large inter-individual variability (SD = 37.1 ms). The results of the validation study indicate acceptable internal consistency (Cronbach's alpha = 0.70), 1-week test-retest reliability (r = 0.53), and discriminant validity, as indicated by a lack of correlation between the ROD task and an auditory discrimination task with identical design (r = 0.18), and a weak correlation with breathing behavior (r = -0.27). The ROD task is a promising novel paradigm to study interoceptive accuracy and its role in various psychobiological processes and disorders.
Collapse
Affiliation(s)
- Maaike Van Den Houte
- Research group on Health, Emotion, Cognition, and Memory, Research Institute for Psychological Sciences, UCLouvain, Louvain-La-Neuve, Belgium.,Laboratory for Brain-Gut Axis Studies (LaBGAS), KU Leuven, Leuven, Belgium.,Fund for Scientific Research (FRS-FNRS), Belgium
| | - Elke Vlemincx
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Ilse Van Diest
- Health Psychology Research Group, KU Leuven, Leuven, Belgium
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), KU Leuven, Leuven, Belgium.,Cognitive & Affective Neuroscience Lab, Dartmouth College, Hanover, NH, USA
| | - Olivier Luminet
- Research group on Health, Emotion, Cognition, and Memory, Research Institute for Psychological Sciences, UCLouvain, Louvain-La-Neuve, Belgium.,Fund for Scientific Research (FRS-FNRS), Belgium
| |
Collapse
|
35
|
Trevisan DA, Mehling WE, McPartland JC. Adaptive and Maladaptive Bodily Awareness: Distinguishing Interoceptive Sensibility and Interoceptive Attention from Anxiety‐Induced Somatization in Autism and Alexithymia. Autism Res 2020; 14:240-247. [DOI: 10.1002/aur.2458] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022]
Affiliation(s)
| | - Wolf E. Mehling
- Department of Family and Community Medicine University of California San Francisco San Francisco CA USA
- Osher Center for Integrative Medicine University of California San Francisco San Francisco CA USA
| | | |
Collapse
|
36
|
Wells RE, Collier J, Posey G, Morgan F, Auman T, Strittameter B, Magalhaes R, Adler-Neal A, McHaffie JG, Zeidan F. Attention to breath sensations does not engage endogenous opioids to reduce pain. Pain 2020; 161:1884-1893. [PMID: 32701847 PMCID: PMC7483215 DOI: 10.1097/j.pain.0000000000001865] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The endogenous opioidergic system is critically involved in the cognitive modulation of pain. Slow-breathing-based techniques are widely used nonpharmacological approaches to reduce pain. Yet, the active mechanisms of actions supporting these practices are poorly characterized. Growing evidence suggest that mindfulness-meditation, a slow-breathing technique practiced by nonreactively attending to breathing sensations, engages multiple unique neural mechanisms that bypass opioidergically mediated descending pathways to reduce pain. However, it is unknown whether endogenous opioids contribute to pain reductions produced by slow breathing. The present double-blind, placebo-controlled crossover study examined behavioral pain responses during mindfulness-meditation (n = 19), sham-mindfulness meditation (n = 20), and slow-paced breathing (n = 20) in response to noxious heat (49°C) and intravenous administration (0.15 mg/kg bolus + 0.1 mg/kg/hour maintenance infusion) of the opioid antagonist, naloxone, and placebo saline. Mindfulness significantly reduced pain unpleasantness ratings across both infusion sessions when compared to rest, but not pain intensity. Slow-paced breathing significantly reduced pain intensity and unpleasantness ratings during naloxone but not saline infusion. Pain reductions produced by mindfulness-meditation and slow-paced breathing were insensitive to naloxone when compared to saline administration. By contrast, sham-mindfulness meditation produced pain unpleasantness reductions during saline infusion but this effect was reversed by opioidergic antagonism. Sham-mindfulness did not lower pain intensity ratings. Self-reported "focusing on the breath" was identified as the operational feature particularly unique to the mindfulness-meditation and slow paced-breathing, but not sham-mindfulness meditation. Across all individuals, attending to the breath was associated with naloxone insensitive pain-relief. These findings provide evidence that slow breathing combined with attention to breath reduces pain independent of endogenous opioids.
Collapse
Affiliation(s)
| | - Jason Collier
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | - Grace Posey
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | - Fry Morgan
- Department of Psychiatry, Wake Forest School of Medicine
| | - Timothy Auman
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | | | - Rossana Magalhaes
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | | | - John G. McHaffie
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| | - Fadel Zeidan
- Department of Anesthesiology, University of California San Diego
| |
Collapse
|
37
|
Matiz A, Guzzon D, Crescentini C, Paschetto A, Fabbro F. The role of self body brushing vs mindfulness meditation on interoceptive awareness: A non-randomized pilot study on healthy participants with possible implications for body image disturbances. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
38
|
Antonelli M, Cattaruzza S, Strano F. Vittorio Benussi's "Emotional Functional Autonomy": Resumption and Re-Evaluation. Int J Clin Exp Hypn 2020; 68:384-399. [PMID: 32420806 DOI: 10.1080/00207144.2020.1757386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study resumes and reevaluates the research on emotional functional autonomy developed by Vittorio Benussi in the 1920s, using hypnosuggestive methods. Four fundamental human emotions were studied in hypnosis: hope, happiness, despair, and unhappiness. Participants received training aimed at experiencing neutral hypnosis, characterized by the absence of any suggested images or suggested cognition. During the neutral hypnosis, the participants were asked to experience emotions isolated from all cognitive and imaginative experience so as to produce what can be assumed to be physiological responses driven by emotion only. The measured physiological variables were breathing and skin conductance. The study found evidence for a specific respiratory profile for each of the emotions examined.
Collapse
Affiliation(s)
- Mauro Antonelli
- Department of Psychology, University of Milano-Bicocca , Milan, Italy
| | | | | |
Collapse
|
39
|
Solomonova E, Dubé S, Blanchette-Carrière C, Sandra DA, Samson-Richer A, Carr M, Paquette T, Nielsen T. Different Patterns of Sleep-Dependent Procedural Memory Consolidation in Vipassana Meditation Practitioners and Non-meditating Controls. Front Psychol 2020; 10:3014. [PMID: 32038390 PMCID: PMC6989470 DOI: 10.3389/fpsyg.2019.03014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/19/2019] [Indexed: 01/01/2023] Open
Abstract
Aim Rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep, and sleep spindles are all implicated in the consolidation of procedural memories. Relative contributions of sleep stages and sleep spindles were previously shown to depend on individual differences in task processing. However, no studies to our knowledge have focused on individual differences in experience with Vipassana meditation as related to sleep. Vipassana meditation is a form of mental training that enhances proprioceptive and somatic awareness and alters attentional style. The goal of this study was to examine a potential role for Vipassana meditation experience in sleep-dependent procedural memory consolidation. Methods Groups of Vipassana meditation practitioners (N = 22) and matched meditation-naïve controls (N = 20) slept for a daytime nap in the laboratory. Before and after the nap they completed a procedural task on the Wii Fit balance platform. Results Meditators performed slightly better on the task before the nap, but the two groups improved similarly after sleep. The groups showed different patterns of sleep-dependent procedural memory consolidation: in meditators, task learning was positively correlated with density of slow occipital spindles, while in controls task improvement was positively associated with time in REM sleep. Sleep efficiency and sleep architecture did not differ between groups. Meditation practitioners, however, had a lower density of occipital slow sleep spindles than controls. Conclusion Results suggest that neuroplastic changes associated with meditation practice may alter overall sleep microarchitecture and reorganize sleep-dependent patterns of memory consolidation. The lower density of occipital spindles in meditators may mean that meditation practice compensates for some of the memory functions of sleep.
Collapse
Affiliation(s)
- Elizaveta Solomonova
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montréal, QC, Canada.,Culture, Mind and Brain Research Group, Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Simon Dubé
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Cloé Blanchette-Carrière
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada
| | - Dasha A Sandra
- Integrated Program in Neuroscience, McGill University, Montréal, QC, Canada
| | - Arnaud Samson-Richer
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada
| | - Michelle Carr
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Sleep Laboratory, Swansea University, Swansea, United Kingdom
| | - Tyna Paquette
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada
| | - Tore Nielsen
- Dream and Nightmare Laboratory, Centre for Advanced Research in Sleep Medicine, CIUSSS NÎM - HSCM, Montréal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| |
Collapse
|
40
|
Bigliassi M, Galano BM, Lima-Silva AE, Bertuzzi R. Effects of mindfulness on psychological and psychophysiological responses during self-paced walking. Psychophysiology 2020; 57:e13529. [PMID: 31953844 DOI: 10.1111/psyp.13529] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 12/20/2022]
Abstract
The aim of the present study was to investigate the effects of an audio-guided mindfulness (MF) single session on psychological and psychophysiological responses during an outdoor walking task. Twenty-four participants (12 females and 12 males; Mage = 23.6, SD = 3.9 years) were required to walk 200 m at a pace of their choosing. Two experimental conditions (mindfulness meditation and mindlessness [ML] meditation) and a control condition (CO) were administered. Electrical activity in the brain was measured by the use of a portable electroencephalography (EEG) system during walking. Fast Fourier Transform was used to decompose the EEG samples into theta (5-7 Hz), alpha (8-14 Hz), and beta (15-29 Hz) frequencies. Brain connectivity analysis between frontal and temporo-parietal electrode sites was conducted to explore functional interactions through the use of spectral coherence. Affective and perceptual responses were measured by the use of single-item scales and questionnaires. The present findings indicate that MF was sufficiently potent to reallocate attention toward task-related thoughts, downregulate perceived activation, and enhance affective responses to a greater degree than the other two conditions. Conversely, ML was sufficient to increase the use of dissociative thoughts, make participants less aware of their physical sensations and emotions, induce a more negative affective state, and upregulate perceived activation to a greater extent than MF and CO. The brain mechanisms that underlie the effects of MF on exercise appear to be associated with the enhanced inter-hemispheric connectivity of high-frequency waves between right frontal and left temporo-parietal areas of the cortex.
Collapse
Affiliation(s)
- Marcelo Bigliassi
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Bruno M Galano
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Adriano E Lima-Silva
- Department of Physical Education, Federal University of Technology-Paraná, Curitiba, Brazil
| | - Romulo Bertuzzi
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
41
|
Morgan MC, Cardaciotto L, Moon S, Marks D. Validation of the Philadelphia Mindfulness Scale on experienced meditators and nonmeditators. J Clin Psychol 2019; 76:725-748. [PMID: 31825100 DOI: 10.1002/jclp.22907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The Philadelphia Mindfulness Scale's (PHLMS) psychometric properties, theoretical assumptions, convergent validity, and relationships to symptom, happiness and social desirability measures were investigated in novel samples. METHODS Internet-recruited general public samples of experienced meditators (n = 67, 21 male, 46 female, average age 50) and nonmeditators (n = 61, 28 male, 32 female, and 1 transgender; average age 41.9) were used. RESULTS Meditators scored higher than nonmeditators on both PHLMS Acceptance, t(126) = 2.77, p < .01, d = 0.49, and Awareness t(126) = 4.18, p < .01, d = 0.74. Higher PHLMS Acceptance subscale scores were associated with decreased scores on all symptom measures in nonmeditators, but only in select measures among meditators. Generally, PHLMS Awareness subscale scores were not related to symptoms. Awareness interacted with meditator status on outcome measures. CONCLUSIONS PHLMS may be used in the general public and experienced meditator populations. Mindfulness facets become intercorrelated in experienced meditators.
Collapse
Affiliation(s)
- Matthew C Morgan
- Department of Psychology, La Salle University, Boone, North Carolina
| | - LeeAnn Cardaciotto
- Department of Psychology, La Salle University, Philadelphia, Pennsylvania
| | - Simon Moon
- Department of Psychology, La Salle University, Philadelphia, Pennsylvania
| | - Donald Marks
- School of Psychology, Kean University, Union, New Jersey
| |
Collapse
|
42
|
Treves IN, Tello LY, Davidson RJ, Goldberg SB. The relationship between mindfulness and objective measures of body awareness: A meta-analysis. Sci Rep 2019; 9:17386. [PMID: 31758073 PMCID: PMC6874545 DOI: 10.1038/s41598-019-53978-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 10/29/2019] [Indexed: 01/10/2023] Open
Abstract
Although awareness of bodily sensations is a common mindfulness meditation technique, studies assessing the relationship between mindfulness and body awareness have provided mixed results. The current study sought to meta-analytically examine the relationship between mindfulness operationalized as a dispositional trait or a construct trained through short- (i.e., randomized controlled trials [RCTs]) or long-term mindfulness meditation practice with objective measures of body awareness accuracy. PubMed, Web of Science, PsycINFO, and Scopus were searched. Studies were eligible if they reported the association between mindfulness and body awareness, were published in English, and included adults. Across 15 studies (17 independent samples), a small effect was found linking mindfulness with greater body awareness accuracy (g = 0.21 [0.08, 0.34], N = 879). When separated by study design, only RCTs continued to show a significant relationship (g = 0.20, [0.02, 0.38], k = 7, n = 505). Heterogeneity of effects was low (I2 < 25%), although with wide confidence intervals. Effects were not moderated by study quality. Low fail-safe N estimates reduce confidence in the observed effects. Results suggest a small but potentially detectable relationship between mindfulness and body awareness accuracy. Future investigations could examine individual differences in body awareness as a mechanism within mindfulness interventions.
Collapse
Affiliation(s)
- Isaac N Treves
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Lawrence Y Tello
- School of Public Health, University of California - Berkeley, Berkeley, CA, 94720, USA
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin - Madison, Madison, WI, 53703, USA.,Department of Psychology, University of Wisconsin - Madison, Madison, WI, 53706, USA
| | - Simon B Goldberg
- Center for Healthy Minds, University of Wisconsin - Madison, Madison, WI, 53703, USA. .,Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, 53706, USA.
| |
Collapse
|
43
|
Khalsa SS, Rudrauf D, Hassanpour MS, Davidson RJ, Tranel D. The practice of meditation is not associated with improved interoceptive awareness of the heartbeat. Psychophysiology 2019; 57:e13479. [PMID: 31573689 DOI: 10.1111/psyp.13479] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 12/19/2022]
Abstract
Meditation is commonly assumed to be associated with enhanced interoceptive accuracy. We previously found that experienced meditators did not exhibit a greater ability than nonmeditators to detect heartbeat sensations at rest, despite the meditators' reported subjective ratings of higher accuracy and lower difficulty. Here, attempting to overcome previous methodological limitations, we assessed interoceptive awareness of heartbeat and breathing sensations across physiological arousal levels using infusions of isoproterenol, a beta-adrenergic agonist similar to adrenaline. We hypothesized that meditators would display greater interoceptive awareness than nonmeditators, as evidenced by higher interoceptive detection rates, increased interoceptive accuracy, and differences in localization of heartbeat sensations. We studied 15 meditators and 15 nonmeditators, individually matched on age, gender, and body mass index, using randomized, double-blinded, and placebo-controlled bolus infusions of isoproterenol. Participants reported their experience of heartbeat and breathing sensations using a dial during infusions and the location of heartbeat sensations on a two-dimensional manikin afterward. There was no evidence of higher detection rates or increased accuracy across any dose, although meditators showed a tendency to report cardiorespiratory sensation changes sooner at higher doses. Relative to nonmeditators, meditators exhibited prominent geographical differences in heartbeat localization, disproportionally reporting sensations throughout central regions of the chest, abdomen, neck, back, and head. To further assess indications of potential differences in cardiac interoceptive accuracy between meditators and nonmeditators, we conducted a meta-analysis including 724 participants and found little evidence for such differences. We conclude that the practice of meditation is not associated with improved cardiac interoceptive awareness.
Collapse
Affiliation(s)
- Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma.,Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - David Rudrauf
- CISA/CUI/FAPSE/Campus Biotech, University of Geneva, Geneva, Switzerland
| | - Mahlega S Hassanpour
- Laureate Institute for Brain Research, Tulsa, Oklahoma.,Department of Ophthalmology, The University of Utah School of Medicine, Salt Lake City, Utah
| | - Richard J Davidson
- Department of Psychology and Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin.,Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin
| | - Daniel Tranel
- Department of Neurology, University of Iowa, Iowa City, Iowa.,Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa
| |
Collapse
|
44
|
Khoury B, Dionne F, Grégoire S. La pleine conscience incarnée : un concept unificateur entre les traditions orientales et occidentales de la pleine conscience. ANNALES MEDICO-PSYCHOLOGIQUES 2019. [DOI: 10.1016/j.amp.2018.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
45
|
Agostinho M, Canaipa R, Honigman L, Treister R. No Relationships Between the Within-Subjects' Variability of Pain Intensity Reports and Variability of Other Bodily Sensations Reports. Front Neurosci 2019; 13:774. [PMID: 31456655 PMCID: PMC6701284 DOI: 10.3389/fnins.2019.00774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 07/10/2019] [Indexed: 01/17/2023] Open
Abstract
Purpose The subjective nature of pain assessment and its large variance negatively affect patient–health care provider communication and reduce the assay sensitivity of pain clinical trials. Given the lack of an objective gold standard measure, identifying the source (true or error) of the within-subject variability of pain reports is a challenge. By assessing the within-subjects variability of pain and taste reports, alongside with interoceptive measures, the current study is aimed to investigate if the ability to reliably report bodily sensations is a cross-modal characteristic. Patients and Methods This prospective study enrolled healthy volunteers from local universities. After consenting, subjects underwent the Focus Analgesia Selection Task (FAST), to assess within-subjects variability of pain reports in response to experimental noxious stimuli; a taste task, which similarly assesses within-subjects variability of tastes (salty and sweet) intensity reports; and the heartbeat perception task, an interoceptive task aimed to assess how accurate subjects are in monitoring and reporting their own heartbeat. In addition, all subjects completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Perceived Stress Scale (PSS), and Hospital Anxiety and Depression Scale (HADS). Spearman’s correlations were used to assess relations between all measures. Results Sixty healthy volunteers were recruited. Variability of intensity reports of different modalities were independent of each other (P > 0.05 for all correlations). The only correlation found was within modality, between variability of intensity reports of salt and sweet tastes (Spearman’s r = 0.477, P < 0.001). No correlations were found between any of the task results and questionnaire results. Conclusion Within-subjects variability of pain reports do not relate to variability of reports of other modalities or to interoceptive awareness. Further research is ongoing to investigate the clinical relevance of within-subjects’ variability of pain reports.
Collapse
Affiliation(s)
- Mariana Agostinho
- CIIS, Centre for Interdisciplinary Health Research, Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal
| | - Rita Canaipa
- CIIS, Centre for Interdisciplinary Health Research, Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal
| | - Liat Honigman
- The Clinical Pain Innovation Lab, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Roi Treister
- The Clinical Pain Innovation Lab, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
46
|
Meyerholz L, Irzinger J, Witthöft M, Gerlach AL, Pohl A. Contingent biofeedback outperforms other methods to enhance the accuracy of cardiac interoception: A comparison of short interventions. J Behav Ther Exp Psychiatry 2019; 63:12-20. [PMID: 30557753 DOI: 10.1016/j.jbtep.2018.12.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 11/29/2018] [Accepted: 12/03/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Deviations in interoception might contribute to the development and maintenance of mental disorders. The improvement of interoceptive accuracy (IA) is desirable but assessment and training methods remain controversial. For instance, it was assumed that performance increases in heartbeat counting paradigms after cardiac feedback were due to an improvement of knowledge with regard to heart rate rather than due to an actual improvement in IA. METHODS Here, we examined effects of contingent cardiac feedback training, non-contingent cardiac feedback, mindfulness practice, and a waiting period with external attentional focus on IA. 100 healthy participants underwent a mental tracking paradigm before and after 20 min of training or waiting. RESULTS Results revealed a significant increase of IA in the contingent feedback condition (d = 1.21, p ≤ .001) and no significant changes after non-contingent feedback, mindfulness practice or waiting (d ≤ 0.37; p ≥ .06). Furthermore, IA increase was significantly higher after the contingent feedback training compared to all other conditions, including non-contingent feedback. LIMITATIONS Future studies need to replicate these findings in clinical samples and examine time dependent effects. CONCLUSIONS The results provide evidence for the trainability of heartbeat perception. IA improvements may reduce the symptom burden in people suffering from mental disorders and psychophysiological conditions that have been linked to lower interoceptive accuracy such as depression, somatic symptom disorder, chronic pain, and functional somatic syndromes. Consequently, exploration of biofeedback training procedures shall be continued with the aim of identifying relevant mediators of beneficial effects and future implementation in clinical practice.
Collapse
Affiliation(s)
- Luisa Meyerholz
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Julia Irzinger
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, University of Mainz, Germany
| | - Alexander L Gerlach
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Anna Pohl
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany.
| |
Collapse
|
47
|
Wu X, Shi L, Wei D, Qiu J. Brain connection pattern under interoceptive attention state predict interoceptive intensity and subjective anxiety feeling. Hum Brain Mapp 2019; 40:1760-1773. [PMID: 30536788 PMCID: PMC6865411 DOI: 10.1002/hbm.24488] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/13/2018] [Accepted: 10/31/2018] [Indexed: 01/04/2023] Open
Abstract
Interoception involves the processing of a variety of different types of information ascending from the body. Accumulating evidence has indicated that interoception plays a fundamental role in cognitive and emotional processes, such as anxiety, but how different functional connectivity patterns contribute to emotions and visceral feelings during an interoceptive attention state is still unclear. In the present study, an interoceptive attention task was performed during functional magnetic resonance imaging of healthy subjects, and the participants' subjective ratings of the intensity of interoception and feelings of anxiety were recorded. Several network nodes were selected, based on previous studies, to construct task-dependent functional connectivity patterns, which were processed by support vector regression to predict the corresponding feeling scores. The results showed that for interoception, the cingulo-opercular task control network provided the greatest contribution, whereas the most important feature for anxiety was the connections between the sensorimotor area (SSM) and the salience network (SN). There existed four overlapping connections between the two predictions: two negative connections between the default mode network (DMN) and the SSM, one negative connection between the DMN and the SN, and one positive connection between the ventral attention network and the SN; this overlap might suggest common bodily attention processing that is involved in both interoception and anxiety. This study remediates the lack of network-level biomarkers of interoception and provides a reference at the level of the brain for further understanding anxiety from an interoceptive perspective.
Collapse
Affiliation(s)
- Xinran Wu
- Key Laboratory of Cognition and Personality (SWU)Ministry of EducationChongqingChina
- School of PsychologySouthwest University (SWU)ChongqingChina
| | - Liang Shi
- Key Laboratory of Cognition and Personality (SWU)Ministry of EducationChongqingChina
- School of PsychologySouthwest University (SWU)ChongqingChina
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU)Ministry of EducationChongqingChina
- School of PsychologySouthwest University (SWU)ChongqingChina
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU)Ministry of EducationChongqingChina
- School of PsychologySouthwest University (SWU)ChongqingChina
| |
Collapse
|
48
|
Wang X, Wu Q, Egan L, Gu X, Liu P, Gu H, Yang Y, Luo J, Wu Y, Gao Z, Fan J. Anterior insular cortex plays a critical role in interoceptive attention. eLife 2019; 8:e42265. [PMID: 30985277 PMCID: PMC6488299 DOI: 10.7554/elife.42265] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/13/2019] [Indexed: 12/11/2022] Open
Abstract
Accumulating evidence indicates that the anterior insular cortex (AIC) mediates interoceptive attention which refers to attention towards physiological signals arising from the body. However, the necessity of the AIC in this process has not been demonstrated. Using a novel task that directs attention toward breathing rhythm, we assessed the involvement of the AIC in interoceptive attention in healthy participants using functional magnetic resonance imaging and examined the necessity of the AIC in interoceptive attention in patients with AIC lesions. Results showed that interoceptive attention was associated with increased AIC activation, as well as enhanced coupling between the AIC and somatosensory areas along with reduced coupling between the AIC and visual sensory areas. In addition, AIC activation was predictive of individual differences in interoceptive accuracy. Importantly, AIC lesion patients showed disrupted interoceptive discrimination accuracy and sensitivity. These results provide compelling evidence that the AIC plays a critical role in interoceptive attention.
Collapse
Affiliation(s)
- Xingchao Wang
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Qiong Wu
- Beijing Key Lab of Learning and Cognition, School of PsychologyCapital Normal UniversityBeijingChina
- School of Psychological and Cognitive SciencesPeking UniversityBeijingChina
| | - Laura Egan
- Department of Psychology, Queens CollegeThe City University of New YorkNew YorkUnited States
| | - Xiaosi Gu
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUnited States
- Nash Family Department of NeuroscienceIcahn School of Medicine at Mount SinaiNew YorkUnited States
- The Mental Illness Research, Education, and Clinical CenterThe James J. Peter Veterans Affairs Medical CenterNew YorkUnited States
| | - Pinan Liu
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Hong Gu
- Neuroimaging Research Branch, Intramural Research ProgramNational Institute on Drug AbuseBaltimoreUnited States
| | - Yihong Yang
- Neuroimaging Research Branch, Intramural Research ProgramNational Institute on Drug AbuseBaltimoreUnited States
| | - Jing Luo
- Beijing Key Lab of Learning and Cognition, School of PsychologyCapital Normal UniversityBeijingChina
| | - Yanhong Wu
- School of Psychological and Cognitive SciencesPeking UniversityBeijingChina
- Beijing Key Laboratory of Behavior and Mental HealthPeking UniversityBeijingChina
| | - Zhixian Gao
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Jin Fan
- Department of Psychology, Queens CollegeThe City University of New YorkNew YorkUnited States
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUnited States
- Nash Family Department of NeuroscienceIcahn School of Medicine at Mount SinaiNew YorkUnited States
- Friedman Brain InstituteIcahn School of Medicine at Mount SinaiNew YorkUnited States
| |
Collapse
|
49
|
Hadash Y, Bernstein A. Behavioral assessment of mindfulness: defining features, organizing framework, and review of emerging methods. Curr Opin Psychol 2019; 28:229-237. [PMID: 30959378 DOI: 10.1016/j.copsyc.2019.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
The development and implementation of psychometrically sound behavioral measures of mindfulness are important to advancing the science of mindfulness. To help organize, conceptualize, and guide the development of behavioral measures of mindfulness, we propose defining features, and a four-domain framework, of the behavioral assessment of mindfulness. The framework domains include measurement of (I) objects of mindful awareness, (II) time-course of mindful awareness, (III) sensitivity of mindful awareness, and (IV) attitudes toward present moment experience. We describe mindfulness processes in each domain, and review extant behavioral method(s) and specific behavioral measure(s) of mindfulness processes per domain. Four of the 12 reviewed measures demonstrate acceptable reliabilities and preliminary evidence of construct validity as measures of mindfulness processes.
Collapse
Affiliation(s)
- Yuval Hadash
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, 31905, Israel
| | - Amit Bernstein
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, 31905, Israel.
| |
Collapse
|
50
|
Mehling WE, Acree M, Stewart A, Silas J, Jones A. The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLoS One 2018; 13:e0208034. [PMID: 30513087 PMCID: PMC6279042 DOI: 10.1371/journal.pone.0208034] [Citation(s) in RCA: 238] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022] Open
Abstract
Interoception, the process by which the nervous system senses, interprets, and integrates signals originating from within the body, has become major research topic for mental health and in particular for mind-body interventions. Interoceptive awareness here is defined as the conscious level of interoception with its multiple dimensions potentially accessible to self-report. The Multidimensional Assessment of Interoceptive Awareness (MAIA) is an 8-scale state-trait questionnaire with 32 items to measure multiple dimensions of interoception by self-report and was published in November 2012. Its numerous applications in English and other languages revealed low internal consistency reliability for two of its scales. This study's objective was to improve these scales and the psychometrics of the MAIA by adding three new items to each of the two scales and evaluate these in a new sample. Data were collected within a larger project that took place as part of the Live Science residency programme at the Science Museum London, UK, where visitors to the museum (N = 1,090) completed the MAIA and the six additional items. Based on exploratory factor analysis in one-half of the adult participants and Cronbach alphas, we discarded one and included five of the six additional items into a Version 2 of the MAIA and conducted confirmatory factor analysis in the other half of the participants. The 8-factor model of the resulting 37-item MAIA-2 was confirmed with appropriate fit indices (RMSEA = 0.055 [95% CI 0.052-0.058]; SRMR = 0.064) and improved internal consistency reliability. The MAIA-2 is public domain and available (www.osher.ucsf.edu/maia) for interoception research and the evaluation of clinical mind-body interventions.
Collapse
Affiliation(s)
- Wolf E. Mehling
- University of California San Francisco, Department of Family and Community Medicine, San Francisco, CA, United States of America
- University of California San Francisco, Osher Center for Integrative Medicine, San Francisco, CA, United States of America
| | - Michael Acree
- University of California San Francisco, Osher Center for Integrative Medicine, San Francisco, CA, United States of America
| | - Anita Stewart
- University of California San Francisco, Institute for Health and Aging, San Francisco, CA, United States of America
| | - Jonathan Silas
- Middlesex University London, School of Science & Technology, Department of Psychology, London, United Kingdom
| | - Alexander Jones
- Middlesex University London, School of Science & Technology, Department of Psychology, London, United Kingdom
| |
Collapse
|