1
|
Sugawara A, Katsunuma R, Terasawa Y, Sekiguchi A. Interoceptive training impacts the neural circuit of the anterior insula cortex. Transl Psychiatry 2024; 14:206. [PMID: 38782961 PMCID: PMC11116496 DOI: 10.1038/s41398-024-02933-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
Interoception is the perception of afferent information that arises from anywhere and everywhere within the body. Recently, interoceptive accuracy could be enhanced by cognitive training. Given that the anterior insula cortex (AIC) is a key node of interoception, we hypothesized that resting functional connectivity (RSFC) from AIC was involved in an effect of interoceptive training. To address this issue, we conducted a longitudinal intervention study using interoceptive training and obtained RSFC using fMRI before and after the intervention. A heartbeat perception task evaluated interoceptive accuracy. Twenty-two healthy volunteers (15 females, age 19.9 ± 2.0 years) participated. After the intervention, interoceptive accuracy was enhanced, and anxiety levels and somatic symptoms were reduced. Also, RSFC from AIC to the dorsolateral prefrontal cortex (DLPFC), superior marginal gyrus (SMG), anterior cingulate cortex (ACC), and brain stem, including nucleus tractus solitarius (NTS) were enhanced, and those from AIC to the visual cortex (VC) were decreased according to enhanced interoceptive accuracy. The neural circuit of AIC, ACC, and NTS is involved in the bottom-up process of interoception. The neural circuit of AIC, DLPFC, and SMG is involved in the top-down process of interoception, which was thought to represent the cognitive control of emotion. The findings provided a better understanding of neural underpinnings of the effect of interoceptive training on somatic symptoms and anxiety levels by enhancing both bottom-up and top-down processes of interoception, which has a potential contribution to the structure of psychotherapies based on the neural mechanism of psychosomatics.
Collapse
Affiliation(s)
- Ayako Sugawara
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ruri Katsunuma
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- School of Psychology, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Yuri Terasawa
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychology, Keio University, Minato-ku, Tokyo, Japan
| | - Atsushi Sekiguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
| |
Collapse
|
2
|
Fernández J, Albayay J, Gálvez-García G, Iborra O, Huertas C, Gómez-Milán E, Caballo VE. Facial infrared thermography as an index of social anxiety. ANXIETY, STRESS, AND COPING 2024; 37:114-126. [PMID: 37029987 DOI: 10.1080/10615806.2023.2199209] [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: 06/20/2022] [Accepted: 03/29/2023] [Indexed: 04/09/2023]
Abstract
Previous research on physiological indices of social anxiety has offered unclear results. In this study, participants with low and high social anxiety performed five social interaction tasks while being recorded with a thermal camera. Each task was associated with a dimension assessed by the Social Anxiety Questionnaire for Adults (1 = Interactions with strangers. 2 = Speaking in public/Talking with people in authority, 3 = Criticism and embarrassment, 4 = Assertive expression of annoyance, disgust or displeasure, 5 = Interactions with the opposite sex). Mixed-effects models revealed that the temperature of the tip of the nose decreased significantly in participants with low (vs. high) social anxiety (p < 0.001), while no significant differences were found in other facial regions of interest: forehead (p = 0.999) and cheeks (p = 0.999). Furthermore, task 1 was the most effective at discriminating between the thermal change of the nose tip and social anxiety, with a trend for a higher nose temperature in participants with high social anxiety and a lower nose temperature for the low social anxiety group. We emphasize the importance of corroborating thermography with specific tasks as an ecological method, and tip of the nose thermal change as a psychophysiological index associated with social anxiety.
Collapse
Affiliation(s)
- Jesús Fernández
- Centro de Investigación Mente, Cerebro y Comportamiento, Universidad de Granada, Granada, Spain
| | - Javier Albayay
- Centro Interdipartimentale Mente/Cervello, Università degli Studi di Trento, Rovereto, Italy
| | - Germán Gálvez-García
- Departamento de Psicología, Universidad de La Frontera, Temuco, Chile
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Salamanca, Salamanca, Spain
| | - Oscar Iborra
- Centro de Investigación Mente, Cerebro y Comportamiento, Universidad de Granada, Granada, Spain
| | - Carmen Huertas
- Centro de Investigación Mente, Cerebro y Comportamiento, Universidad de Granada, Granada, Spain
| | - Emilio Gómez-Milán
- Centro de Investigación Mente, Cerebro y Comportamiento, Universidad de Granada, Granada, Spain
| | - Vicente E Caballo
- Centro de Investigación Mente, Cerebro y Comportamiento, Universidad de Granada, Granada, Spain
| |
Collapse
|
3
|
Rogowska AM, Tataruch R, Klimowska K. Validation of the shortened 24-item multidimensional assessment of interoceptive awareness, version 2 (Brief MAIA-2). Sci Rep 2023; 13:21270. [PMID: 38042880 PMCID: PMC10693589 DOI: 10.1038/s41598-023-48536-0] [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: 09/03/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023] Open
Abstract
The Multidimensional Assessment of Interoceptive Awareness (MAIA) was translated into many languages and frequently used in the last decade to assess self-reported interoceptive awareness. However, many studies demonstrated weaknesses regarding unstable factor structure and poor reliability of some scales. The 24-item Brief MAIA-2 questionnaire was developed, with only three items demonstrating the highest factor loadings in each of the eight scales of the MAIA-2. The cross-sectional online study used the 37-item MAIA-2 questionnaire in a non-clinical sample of 323 people aged between 16 and 75 (M = 26.17, SD = 9.12), including 177 women (54.80%). The sample comprised 156 athletes (48.30%) and 167 non-athletes (51.70%). The Confirmatory Factor Analysis showed adequate fit indices for a multidimensional model of the Brief MAIA-2, with the original eight scales: Noticing (awareness of subtle bodily sensations, such as the heartbeat, digestive sensations, or the breath), Not Distracting (ability to maintain attention to bodily sensations without being easily distracted by external stimuli), Not Worrying (tendency to not be overly concerned or anxious about bodily sensations or changes in the body), Attention Regulation (ability to regulate attention to bodily sensations and to shift attention between internal and external stimuli), Emotional Awareness (awareness and understanding of how emotions are associated with bodily sensations), Self Regulation (ability to regulate emotional responses and manage distress through an awareness of bodily sensations), Body Listening (tendency to listen to the body for insight and understanding), and Trusting (trust in bodily sensations as a source of information about one's feelings and needs). The hierarchical bi-factor (S·I - 1) model showed even better-fit indices. Therefore, the general factor of interoception was considered in further statistical tests. Confirmatory composite analysis showed high reliability and discriminant and convergent validity for most Brief MAIA-2 scales, except Noticing. Measurement invariance was confirmed across genders (Women, Men) and sports participation (Athletes, Non-athletes). However, group differences were also found for mean scores in particular scales of the Brief MAIA-2. Men scored significantly lower than women in Not Distracting but higher in Not Worrying, Attention Regulation, Self Regulation, Trusting, and the total score of interoceptive awareness. Gender discrepancies may be influenced by linguistic socialization, which tends to categorize shifts in internal states as either physiological or emotional. Athletes scored significantly lower than Non-athletes on the Not Distracting scale, but they showed higher scores in Noticing, Attention Regulation, Emotion Awareness, Self-Regulation, Body Listening, Trusting, and the global score, suggesting that physical training can improve most areas of interoception. Therefore, physical exercises and mindfulness training may be recommended to improve interoception, especially in women and people suffering from somatic and mental problems. The Brief MAIA-2 is a reliable and valid tool to measure multidimensional interoceptive sensibility in a non-clinical population. To improve well-being and athletic performance, Brief MAIA-2 can be used to assess the body's current perception of interoception and to detect its weak areas requiring improvement. However, the study has some limitations, such as a cross-sectional online self-report survey in a conventional non-clinical sample from Poland. Future cross-cultural studies should include representative samples for non-clinical and clinical populations from different countries and geographic regions to compare the Brief MAIA-2 with more objective psychophysiological methods of measuring interoception to reduce the limitations of these studies.
Collapse
Affiliation(s)
| | - Rafał Tataruch
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, 758, Opole, Poland
| | | |
Collapse
|
4
|
Faccini J, Joshi V, Del-Monte J. Nightmares, interoceptive sensibility and nociception: An exploratory study in a general population. Sleep Med 2023; 112:209-215. [PMID: 37918138 DOI: 10.1016/j.sleep.2023.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/01/2023] [Accepted: 09/30/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Nightmares are dysphoric dreams present in both clinical and non-clinical populations. Physiological activity underlies their emotional reactivity. Therefore, the objective of this study was to investigate the role of interoceptive processes (interoceptive sensibility and nociception) in nightmares in the general population. METHOD 542 French participants were recruited from the general population to complete an online survey. Interoceptive sensibility, nociception, nightmare frequency and nightmare distress were assessed through online scales and questionnaires. Network analysis, regression and mediation analyses were conducted to assess the relationship between these variables. RESULTS The results showed the existence of associations between certain dimensions of interoceptive sensibility, nociception, nightmare frequency and nightmare distress. The regression analysis highlighted the involvement of interoceptive dimensions in predicting the nightmare distress score. Mediation analysis highlighted that nociception was a mediating variable in the relationship between nightmare frequency and nightmare distress. CONCLUSION This study provides initial evidence in favour of the involvement of interoceptive processes in the understanding of nightmares. These results offer a new window of understanding the etiology of nightmares but also present the interest to target interoceptive processes in the management of nightmares.
Collapse
Affiliation(s)
- Julie Faccini
- University of Nîmes, LPS Laboratory, Aix-Marseille University, France.
| | - Vrutti Joshi
- University of Nîmes, LPS Laboratory, Aix-Marseille University, France
| | | |
Collapse
|
5
|
Sweetnam TJ, Flack M. Ready, set, …and difficultly slowing down: What role does alexithymia, emotional regulation and interoceptive awareness play in exercise dependence? Acta Psychol (Amst) 2023; 237:103958. [PMID: 37311393 DOI: 10.1016/j.actpsy.2023.103958] [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: 02/23/2023] [Revised: 05/23/2023] [Accepted: 06/08/2023] [Indexed: 06/15/2023] Open
Abstract
Alexithymia is associated with a diverse range of addictive behaviours including exercise addiction symptoms. In addition, emerging research indicates that emotional regulation and interoceptive processes may help explain this relationship. Thus, the current study tested the ability of emotion regulation to mediate the relationship between alexithymia and exercise addiction symptoms and whether interoceptive awareness moderates these relationships. A total of 404 physically active adults (86.8 % female) completed measures of alexithymia, exercise dependence symptoms, difficulties with emotion regulation and interoceptive awareness (Mage = 43.72, SD = 14.09). Alexithymia, emotion regulation, interoceptive awareness and exercise dependence symptoms were all significantly correlated. Further analysis revealed that emotional regulation mediated the relationship between alexithymia and exercise dependence, although the mediation model did not vary as a function of interoceptive awareness. These findings underscore the importance of considering emotion-focused processes in treatment planning and other initiatives designed to help individuals who display exercise dependence symptoms.
Collapse
Affiliation(s)
- Taylor J Sweetnam
- Behavioural Addictions, Alcohol, and Drugs (BAAD) Faculty of Health, Charles Darwin University, Darwin, Northern Territory 0909, Australia.
| | - Mal Flack
- Behavioural Addictions, Alcohol, and Drugs (BAAD) Faculty of Health, Charles Darwin University, Darwin, Northern Territory 0909, Australia.
| |
Collapse
|
6
|
Nayok SB, Sreeraj VS, Shivakumar V, Venkatasubramanian G. A Primer on Interoception and its Importance in Psychiatry. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:252-261. [PMID: 37119217 PMCID: PMC10157017 DOI: 10.9758/cpn.2023.21.2.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 05/01/2023]
Abstract
Interoception is the perception of signals from inside the body. It plays a significant role in the nervous, cardiovascular, respiratory, gastrointestinal, genitourinary, and endocrine systems. It is also closely related to the autonomic nervous system and inflammatory pathways and plays a significant role in our optimal functioning. Recently, interoception has gained more attention in neuropsychiatric research. Anatomical and physiological aspects of interoception like relevant brain areas, the role of the vagus nerve, and the autonomic nervous system are gradually being understood. Different facets of interoception like interoceptive attention, detection, magnitude, discrimination, accuracy, awareness, and appraisal have been proposed and their assessments and importance are being evaluated. Further, interoception is often dysregulated or abnormal in psychiatric disorders. It has been implicated in the psychopathology, etiopathogenesis, clinical features and treatment of mood, anxiety, psychotic, personality and addiction-related disorders. This narrative review attempts to provide a nuanced understanding of the pathway(s), components, functions, assessments, and problems of interoception and will help us to detect its disturbances and evaluate its impact on psychiatric disorders, leading to a better perspective and management. This will also advance interoception-related research.
Collapse
Affiliation(s)
- Swarna Buddha Nayok
- Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Vanteemar S. Sreeraj
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Ganesan Venkatasubramanian
- Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| |
Collapse
|
7
|
Ware M, O’Connor P, Bub K, Backus D, McCully K. Investigating Relationships Among Interoceptive Awareness, Emotional Susceptibility, and Fatigue in Persons With Multiple Sclerosis. Int J MS Care 2023; 25:75-81. [PMID: 36923579 PMCID: PMC10010111 DOI: 10.7224/1537-2073.2022-007] [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: 11/18/2022]
Abstract
BACKGROUND Fatigue is a particularly debilitating symptom for people with multiple sclerosis (MS). Although personality traits and MS have been studied, interoception and emotional susceptibility and their links to fatigue have not yet been explored. METHODS Study participants provided demographic information and completed standardized patient-reported outcomes of walking function, physical activity, subjective fatigue, interoceptive awareness, and emotional susceptibility. A subset of participants participated in semistructured interviews discussing fatigue, body sensations, emotions, and their effects on exercise. Quantitative data were analyzed using multiple regression. Qualitative data were analyzed using thematic analysis. RESULTS Mean ± SD Fatigue Severity Scale scores (5.0 ± 1.3) indicated that fatigue was a problematic symptom. Mean ± SD Multidimensional Assessment of Interoceptive Awareness, Version 2 (2.8 ± 0.6) and Emotional Susceptibility Scale (3.0 ± 1.0) scores indicated lower levels of interoceptive awareness and emotional susceptibility. Quantitative data indicated no relationship between fatigue and interoceptive awareness (β = -0.20; P = .88) and emotional susceptibility (β = 0.03; P = .83), and neither were these related to physical activity (β = -0.07; P = .64). Qualitative themes indicated strong fatigue experiences involving the whole body and individual limbs, anger and frustration, and effects on physical activity. CONCLUSIONS Physically active people with MS report strong sensations of fatigue closely linked to frustration and helplessness. There was agreement between qualitative and quantitative assessments of fatigue but dissonance regarding interoceptive awareness and physical activity. The practice of clinicians, particularly those involved with facilitating or planning physical activity for persons with MS, would benefit from these findings about fatigue.
Collapse
Affiliation(s)
- Megan Ware
- From St Jude Children’s Research Hospital, Memphis, TN, USA (MW)
- Department of Kinesiology (MW, POC, KMC), College of Education, University of Georgia, Athens, GA, USA
| | - Patrick O’Connor
- Department of Kinesiology (MW, POC, KMC), College of Education, University of Georgia, Athens, GA, USA
| | - Kristen Bub
- Department of Educational Psychology (KB), College of Education, University of Georgia, Athens, GA, USA
| | | | - Kevin McCully
- Department of Kinesiology (MW, POC, KMC), College of Education, University of Georgia, Athens, GA, USA
| |
Collapse
|
8
|
Vabba A, Porciello G, Monti A, Panasiti MS, Aglioti SM. A longitudinal study of interoception changes in the times of COVID-19: Effects on psychophysiological health and well-being. Heliyon 2023; 9:e14951. [PMID: 37035351 PMCID: PMC10065811 DOI: 10.1016/j.heliyon.2023.e14951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/18/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
Background Interoception - the processing of the internal state of the body - has been consistently tied to well-being and mental health, which in turn have been severely challenged by the COVID-19 pandemic. Moreover, the fact that symptoms of COVID-19 (high temperature, shortness of breath, fatigue, and even gastro-intestinal problems) directly alter interoceptive signals has fueled people's tendency to constantly check their internal bodily state. Objectives In this longitudinal study we tested for changes in interoception and psychophysiological health and well-being during different stages of the pandemic in 2020 and assessed their potential association. To highlight this association, we combined both subjective (i.e., self-reported questionnaires) and objective (i.e., measures of heart rate variability, HRV and of interoceptive accuracy) measures. Methods 245 Italian participants who had completed the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) prior to the onset of the pandemic, repeated the questionnaire during the first national lockdown in Italy, and four months after restrictions. Participants also completed survey measures of depression (PHQ-9), anxiety (STAI), and sleep disturbance (PSQI). A sub-sample of 28 participants, who had completed the heartbeat counting task (HCT) and a measure of heart rate variability (HRV), was tested again remotely, in the same time windows, using phone applications and photoplethysmography. Results While performance in the HCT remained unvaried, MAIA-2 scores consistently increased from before the pandemic to the national lockdown, and remained largely unvaried after four months. The national lockdown was associated with the lowest psychophysiological health and well-being, as evidenced by a decrease in HRV compared to before the pandemic and by higher scores in self-reported depression, anxiety, and sleep disturbance compared to four months after the lockdown. Interestingly, psychophysiological health and well-being were predicted by specific regulatory components of interoception (e.g., the ability to regulate distress by focusing on body sensations and experiencing one's body as safe and trustworthy). Conclusions Our results suggest an increased attention towards visceral signals during the COVID-19 pandemic, and highlight the positive role of specific components of interoception in contributing to well-being, suggesting that novel interventions aimed at increasing interoception may be developed to protect against stressful life events such as COVID-19.
Collapse
Affiliation(s)
- Alisha Vabba
- Sapienza, Università di Roma and CLNS@Sapienza, Istituto Italiano di Tecnologia, Viale Regina Elena 291, 00161, Rome, Italy
- IRCCS, Santa Lucia Foundation, Via Ardeatina 306/354, 00179, Rome, Italy
- Corresponding author. Department of Psychology, Sapienza, Università di Roma, Via dei Marsi 78, 00185, Rome Italy.
| | - Giuseppina Porciello
- IRCCS, Santa Lucia Foundation, Via Ardeatina 306/354, 00179, Rome, Italy
- Department of Psychology, Sapienza, Università di Roma, Via dei Marsi 78, 00185 Rome, Italy
| | - Alessandro Monti
- Department of Psychology, Sapienza, Università di Roma, Via dei Marsi 78, 00185 Rome, Italy
| | - Maria Serena Panasiti
- IRCCS, Santa Lucia Foundation, Via Ardeatina 306/354, 00179, Rome, Italy
- Department of Psychology, Sapienza, Università di Roma, Via dei Marsi 78, 00185 Rome, Italy
| | - Salvatore Maria Aglioti
- Sapienza, Università di Roma and CLNS@Sapienza, Istituto Italiano di Tecnologia, Viale Regina Elena 291, 00161, Rome, Italy
- IRCCS, Santa Lucia Foundation, Via Ardeatina 306/354, 00179, Rome, Italy
| |
Collapse
|
9
|
Are some interoceptive sensibility components more central than others? Using item pool visualisation to understand the psychometric representation of interoception. PLoS One 2022; 17:e0277894. [PMID: 36455037 PMCID: PMC9714805 DOI: 10.1371/journal.pone.0277894] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/06/2022] [Indexed: 12/05/2022] Open
Abstract
Interoception refers to the processing of stimuli originating within the body and is widely considered a multidimensional construct. However, there remains a lack of consensus regarding the definition and measurement of the subjective, self-reported component, referred to here as interoceptive sensibility. As a contribution to knowledge on the topic, we sought to examine the construct commonality and distinguishability of seven self-report measures of interoceptive sensibility using Item Pool Visualisation (IPV), an illustrative method that locates item pools from within the same dataset and illustrates these in the form of nested radar charts. Adults from the United Kingdom (N = 802) completed seven measures of interoceptive sensibility, and the data were subjected to IPV. Results demonstrated that, of the included measures, the Multidimensional Assessment of Interoceptive Awareness-2 provided the closest and most precise measurement of the core interoceptive sensibility construct (i.e., core of the entire investigated item pool). The Body Awareness Questionnaire and the Private Body Consciousness Scale were also centrally located measures, while the Body Perception Questionnaire and the Body Responsiveness Scale appear to tap more distal aspects of the core construct. We discuss implications for interpreting complicated data patterns using measures of interoceptive sensibility and, more generally, for measuring the construct of interoceptive sensibility.
Collapse
|
10
|
Elliott J, Pfeifer G. Relationship between interoceptive sensibility, age, and COVID-19 anxiety during the first national lockdown in the United Kingdom. Aging Ment Health 2022; 26:2112-2119. [PMID: 35045774 DOI: 10.1080/13607863.2022.2026878] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: Interoception refers to the multidimensional representation of the internal states of the body, including sensation, appraisal, integration, and regulation. COVID-19 targets internal respiratory, temperature and gastrointestinal systems, thus posing a threat to humans that causes anxiety. Here, we examined the relationship between interoceptive sensibility and COVID-19 anxiety during the first UK national lockdown, when uncertainties surrounding the virus were at their peak.Methods: Between April and July 2020, N = 232 individuals across four age-categories completed questionnaires measuring interoceptive sensibility (BPQ-SF and MAIA-2), an adapted State-Trait-Anxiety Inventory (STAI) to assess COVID-19 anxiety, and a Perceived Quality of Life (QoL) questionnaire.Results: Higher scores on the BPQ-SF were related to higher levels of COVID-19 anxiety, while the MAIA-2 subscales Not Worrying, Attention Regulation, and Trusting of bodily signals were related to lower levels of COVID-19 anxiety. Age was related to lower levels of COVID-19 anxiety yet showed no significant (Bonferroni-corrected) relationship with interoceptive dimensions. Trait anxiety, Not Worrying, perceived quality of work, and COVID-19-related media consumption emerged as significant predictors of COVID-19 anxiety.Conclusion: Findings suggest that interoceptive dimensions differentially relate to COVID-19 anxiety irrespective of age, with implications for managing health anxiety and adaptive behaviour during a pandemic across the lifespan.
Collapse
Affiliation(s)
- Jennifer Elliott
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - Gaby Pfeifer
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, United Kingdom
| |
Collapse
|
11
|
Gaggero G, Dellantonio S, Pastore L, Sng KHL, Esposito G. Shared and unique interoceptive deficits in high alexithymia and neuroticism. PLoS One 2022; 17:e0273922. [PMID: 36044535 PMCID: PMC9432684 DOI: 10.1371/journal.pone.0273922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022] Open
Abstract
Interoception is the perception of internal bodily signals. It is considered fundamental to developing emotional awareness. For this reason, interoceptive deficits are often associated with alexithymia, a condition characterized by difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and an externally-oriented style of thinking (EOT). Yet, the atypical interoception found in alexithymia might be of a similar type and/or more serious than those found in other partially overlapping constructs that entail emotional difficulties and behavioural patterns associated with specific emotional styles. Our study explores this issue by examining the relationship between the interoceptive deficits associated with alexithymia and the Big Five personality traits. A non-clinical sample (N = 504) completed the Toronto Alexithymia Scale, the Big Five Inventory and the Multidimensional Assessment of Interoceptive Awareness. Data were analysed using a network analytic approach that conceives psychological traits as networks of interacting symptoms. The estimated network highlighted that EOT is the alexithymia component least associated with interoception and most associated with lower Openness to Experience. Conversely, DIF and Neuroticism are, respectively, the dimensions of alexithymia and the Big Five most highly associated with interoception. We also compared interoceptive abilities in the four groups of participants whose scores were a) high for both alexithymia and neuroticism, b) high only for alexithymia c), high only for neuroticism, and d) low for both. High alexithymia was especially associated with the tendency to ignore sensations of pain or discomfort, while neuroticism was more indicative of the tendency to worry about these sensations. These results suggest that while high alexithymia and neuroticism share some interoceptive deficits, others are unique to alexithymia and contribute to overall lower interoceptive ability in this condition. Our findings suggest that interventions to enhance awareness of bodily sensations can be beneficial especially for profiles who present high neuroticism and alexithymia.
Collapse
Affiliation(s)
- Giulia Gaggero
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
- * E-mail:
| | - Sara Dellantonio
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| | - Luigi Pastore
- Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Kelly H. L. Sng
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| |
Collapse
|
12
|
Da Costa Silva L, Belrose C, Trousselard M, Rea B, Seery E, Verdonk C, Duffaud AM, Verdonk C. Self-Reported Body Awareness: Validation of the Postural Awareness Scale and the Multidimensional Assessment of Interoceptive Awareness (Version 2) in a Non-clinical Adult French-Speaking Sample. Front Psychol 2022; 13:946271. [PMID: 35959024 PMCID: PMC9362853 DOI: 10.3389/fpsyg.2022.946271] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Body awareness refers to the individual ability to process signals originating from within the body, which provide a mapping of the body’s internal landscape (interoception) and its relation with space and movement (proprioception). The present study aims to evaluate psychometric properties and validate in French two self-report measures of body awareness: the Postural Awareness Scale (PAS), and the last version of the Multidimensional Assessment of Interoceptive Awareness questionnaire (version 2, MAIA-2). We collected data in a non-clinical, adult sample (N = 308; 61% women, mean age 35 ± 12 years) using online survey, and a subset of the original sample (n = 122; 62% women, mean age 44 ± 11 years) also completed the retest control. Factor analyses and reliability analyses were conducted. Construct validity of the PAS and the MAIA-2 were examined by testing their association with each other, and with self-report measures of personality (Big Five Inventory), alexithymia (Toronto Alexithymia Scale) and dispositional trait mindfulness (Freiburg Mindfulness Inventory). Factor analyses of the PAS supported the same two-factor structure as previously published versions (in other languages). For the MAIA-2, factor analyses suggested that a six-factor structure, excluding Not-Worrying and Not-Distracting factors, could successfully account for a common general factor of self-reported interoception. We found satisfactory internal consistency, construct validity, and reliability over time for both the PAS and the MAIA-2. Altogether, our findings suggest that the French version of the PAS and the MAIA-2 are reliable self-report tools to assess both components of body awareness (proprioception and interoception dimension, respectively).
Collapse
Affiliation(s)
- Lucie Da Costa Silva
- Department of Neurosciences and Cognitive Sciences, Unit of Neurophysiology of Stress, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Célia Belrose
- Department of Neurosciences and Cognitive Sciences, Unit of Neurophysiology of Stress, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Marion Trousselard
- Department of Neurosciences and Cognitive Sciences, Unit of Neurophysiology of Stress, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Blake Rea
- Department of Neurosciences and Cognitive Sciences, Unit of Neurophysiology of Stress, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Elaine Seery
- Traduction Édition Scientifique, Toulouse, France
| | - Constance Verdonk
- Department of Cardiac Surgery and Cardiology, Bichat-Hospital, Paris, France
| | - Anaïs M. Duffaud
- Department of Neurosciences and Cognitive Sciences, Unit of Neurophysiology of Stress, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Charles Verdonk
- Department of Neurosciences and Cognitive Sciences, Unit of Neurophysiology of Stress, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
- *Correspondence: Charles Verdonk,
| |
Collapse
|
13
|
Talks BJ, Campbell C, Larcombe SJ, Marlow L, Finnegan SL, Lewis CT, Lucas SJ, Harrison OK, Pattinson KT. Baseline Psychological Traits Contribute to Lake Louise Acute Mountain Sickness Score at High Altitude. High Alt Med Biol 2022; 23:69-77. [PMID: 35353609 PMCID: PMC8982137 DOI: 10.1089/ham.2021.0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 01/14/2022] [Indexed: 12/29/2022] Open
Abstract
Talks, Benjamin James, Catherine Campbell, Stephanie J. Larcombe, Lucy Marlow, Sarah L. Finnegan, Christopher T. Lewis, Samuel J.E. Lucas, Olivia K. Harrison, and Kyle T.S. Pattinson. Baseline psychological traits contribute to Lake Louise Acute Mountain Sickness score at high altitude. High Alt Med Biol. 23:69-77, 2022. Background: Interoception refers to an individual's ability to sense their internal bodily sensations. Acute mountain sickness (AMS) is a common feature of ascent to high altitude that is only partially explained by measures of peripheral physiology. We hypothesized that interoceptive ability may explain the disconnect between measures of physiology and symptom experience in AMS. Methods: Two groups of 18 participants were recruited to complete a respiratory interoceptive task three times at 2-week intervals. The control group remained in Birmingham (140 m altitude) for all three tests. The altitude group completed test 1 in Birmingham, test 2 the day after arrival at 2,624 m, and test 3 at 2,728 m after an 11-day trek at high altitude (up to 4,800 m). Results: By measuring changes to metacognitive performance, we showed that acute ascent to altitude neither presented an interoceptive challenge, nor acted as interoceptive training. However, AMS symptom burden throughout the trek was found to relate to sea level measures of anxiety, agoraphobia, and neuroticism. Conclusions: This suggests that the Lake Louise AMS score is not solely a reflection of physiological changes on ascent to high altitude, despite often being used as such by researchers and commercial trekking companies alike.
Collapse
Affiliation(s)
- Benjamin James Talks
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
- Birmingham Medical Research Expeditionary Society, Birmingham, United Kingdom
| | - Catherine Campbell
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Stephanie J. Larcombe
- Birmingham Medical Research Expeditionary Society, Birmingham, United Kingdom
- Medical School, University of Birmingham, Birmingham, United Kingdom
| | - Lucy Marlow
- Warwick Medical School, Warwick University, Coventry, United Kingdom
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Sarah L. Finnegan
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Christopher T. Lewis
- Birmingham Medical Research Expeditionary Society, Birmingham, United Kingdom
- Department of Anesthesia, Ysbyty Gwynedd, Bangor, United Kingdom
| | - Samuel J.E. Lucas
- Birmingham Medical Research Expeditionary Society, Birmingham, United Kingdom
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Olivia K. Harrison
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Kyle T.S. Pattinson
- Birmingham Medical Research Expeditionary Society, Birmingham, United Kingdom
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
14
|
Teng B, Wang D, Su C, Zhou H, Wang T, Mehling WE, Hu Y. The multidimensional assessment of interoceptive awareness, version 2: Translation and psychometric properties of the Chinese version. Front Psychiatry 2022; 13:970982. [PMID: 36440402 PMCID: PMC9691670 DOI: 10.3389/fpsyt.2022.970982] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Multidimensional Assessment of Interoceptive Awareness (MAIA) is a self-report questionnaire developed by Dr. Mehling that has been widely used to assess multiple dimensions of interoceptive awareness. To further improve the MAIA, Mehling developed the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). The goal of this study is to systematically translate the MAIA-2 into Chinese and to investigate the psychometric properties of the Chinese version (MAIA-2C). MATERIALS AND METHODS The translation and adaptation of the questionnaire was conducted according to Beaton's method. A total number of 627 participants were enrolled and completed the survey. The entire sample was randomly divided into a training sample (n = 300, 47.8%) and a validation sample (n = 327, 52.2%) for a cross-validation. Exploratory factor analysis (EFA) was used to identify the factor structure of the MAIA-2C in the training sample while confirmatory factor analysis (CFA) was used to test the factor structure obtained by EFA. The reliability of the MAIA-2C was indicated by Cronbach's alpha. The convergent and discriminant validity were assessed by Pearson intercorrelations between the MAIA-2C and the Five-Facet Mindfulness Questionnaire (FFMQ) and State-Trait Anxiety Inventory-Trait anxiety (STAI-T). RESULTS The EFA results showed an initial 10-factor model, but some items (1, 2, 3, 4, 15, and 16) were deleted because they did not yield the original subscale construct, eventually resulting in a 7-factor model. The CFA results represented a good model fit (χ2/df = 2.170, RMSEA = 0.060, SRMR = 0.0810, CFI = 0.890). The Cronbach's alpha was 0.822 for the total scale and ranged from 0.656 to 0.838 for the subscales. The results of convergent and discriminant validity showed that most MAIA-2C subscales were correlated with the average score and subscales of FFMQ (r = -0.342∼0.535, p < 0.05), and all of the subscales of the MAIA-2C showed negative correlations with the STAI-T total score (r = -0.352∼-0.080, p < 0.05). CONCLUSION The MAIA-2C is a valid and reliable instrument for evaluating multiple dimensions of interoceptive awareness in a Chinese population.
Collapse
Affiliation(s)
- Binyu Teng
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Dan Wang
- National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Conghui Su
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Hui Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Tengfei Wang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Wolf E Mehling
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States.,Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Yuzheng Hu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| |
Collapse
|
15
|
Scarpazza C, Zangrossi A, Huang YC, Sartori G, Massaro S. Disentangling interoceptive abilities in alexithymia. PSYCHOLOGICAL RESEARCH 2021; 86:844-857. [PMID: 34097132 PMCID: PMC8182733 DOI: 10.1007/s00426-021-01538-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 05/25/2021] [Indexed: 12/20/2022]
Abstract
In recent years, research on interoceptive abilities (i.e., sensibility, accuracy, and awareness) and their associations with emotional experience has flourished. Yet interoceptive abilities in alexithymia—a personality trait characterized by a difficulty in the cognitive interpretation of emotional arousal, which impacts emotional experience—remain under-investigated, thereby limiting a full understanding of subjective emotional experience processing. Research has proposed two contrasting explanations thus far: in one model, the dimensions of interoceptive sensibility and accuracy in alexithymia would increase; in the other model, they would decrease. Surprisingly, the contribution of interoceptive awareness has been minimally researched. In this study (N = 182), the relationship between participants’ level of alexithymia and the three interoceptive dimensions was tested. Our results show that the higher the level of alexithymia is, the higher interoceptive accuracy and sensibility (R2 = 0.29 and R2 = 0.14); conversely, the higher the level of alexithymia is, the lower interoceptive awareness (R2 = 0.36). Moreover, an ROC analysis reveals that interoceptive awareness is the most accurate predictor of alexithymia, yielding over 92% accuracy. Collectively, these results support a coherent understanding of interoceptive abilities in alexithymia, whereby the dissociation of interoceptive accuracy and awareness may explain the underlying psycho-physiological mechanisms of alexithymia. A possible neurocognitive mechanism is discussed which suggests insurgence of psychosomatic disorders in alexithymia and related psychotherapeutic approaches.
Collapse
Affiliation(s)
- Cristina Scarpazza
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, PD, Italy.
| | - Andrea Zangrossi
- Department of Neuroscience, University of Padua, Via Giustiniani, 5, 35128, Padua, Italy.,Padova Neuroscience Center (PCN), University of Padua, Via Giustiniani, 5, 35128, Padua, Italy
| | - Yu-Chun Huang
- The Organizational Neuroscience Laboratory, 27 Old Gloucester Street, London, WC1N 3AX, UK.,Department of Psychology, University of Warwick, University Road, Coventry, CV4 7AL, UK
| | - Giuseppe Sartori
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, PD, Italy
| | - Sebastiano Massaro
- The Organizational Neuroscience Laboratory, 27 Old Gloucester Street, London, WC1N 3AX, UK.,Surrey Business School, University of Surrey, Guildford, Rik Medlik Building (MS), Guildford, GU2 7XH, UK
| |
Collapse
|
16
|
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
|