The Effect of Aviva Exercise Intervention on Pain Level and Body Awareness in Women with Primary Dysmenorrhea

Background and Objective: Primary dysmenorrhea (PD) is one of the most common clinical disorders in women of reproductive age. Our aim was to examine whether a twice-weekly thirty-minute Aviva exercise intervention could result in improvements in pain level and body awareness in patients with PD. Materials and Methods: In our prospective observational trial, the observation period included two consecutive menstrual cycles and the period of the next menstrual bleeding. The first menstrual bleeding period was the first measurement time (T1), the second was the second measurement time (T2), and the third was the third measurement time (T3) in a total of 78 volunteers. The primary endpoint was the change in the level of menstrual pain according to the Numeric Rating Scale (NRS) questionnaire between the intervention group (IG) and the control group (CG) at T1, T2, and T3. In this study, the secondary outcomes were the differences between the IG and CG regarding the different subscales of the Hungarian version of the Body Awareness Questionnaire (BAQ-H) at T1, T2, and T3; the Borg scale results of the IG; and adherence to the intervention. Statistical tests such as independent-sample t-tests, chi-square tests, Pearson's linear correlation coefficient, and repeated-measure ANCOVA were used for the analyses. Results: In total, 78 volunteers were enrolled: 40 persons in the IG and 38 in the CG. There was a significant change in the level of menstruation pain according to the NRS questionnaire between the IG and CG (p < 0.001). There was no significant difference between the IG and CG regarding the different subscales of the BAQ-H. Only in the case of the "Note responses or changes in body process" subscale of the BAQ-H was there a trend-like effect from the Aviva exercises (p = 0.086). Conclusions: The Aviva exercise could contribute to pain relief from PD. Regarding body awareness, no significant difference was found between the two groups. Due to the short detection period and prospective observational design, our results are preliminary and need to be confirmed in larger clinical trials.

Self-reported interoception, worries and protective behaviors during the COVID-19 pandemic: a longitudinal study

BACKGROUND

Protective behaviors were essential for minimizing the spread of the virus during the coronavirus disease 2019 (COVID-19) pandemic. It is often assumed that awareness of bodily sensations (interoception) can improve decision-making and facilitate adaptive behavior.

OBJECTIVE

This paper investigates cross-sectional and longitudinal relationships between different aspects of self-reported interoception, trait anxiety, COVID-related worry, and health protective behaviors.

METHODS

The study was conducted on a community sample of 265 adults. The two data collection phases took place online, before (baseline) and during the second wave of the COVID-19 pandemic in Hungary.

RESULTS

Contrary to our expectations, neither cross-sectional nor longitudinal associations were found between protective behaviors and indicators of self-reported interoception. However, worry at baseline predicted protective behaviors during the second wave, even after controlling for socio-economical characteristics and protective behaviors at baseline.

CONCLUSION

Our results highlight the adaptivity of health-related worry when behavioral steps to avoid threats are known and available. Also, higher level of perceived interoception did not appear to be health protective under these circumstances.

Pain catastrophizing, pain sensitivity and fear of pain are associated with early life environmental unpredictability: a path model approach

BACKGROUND

Socioeconomic disadvantages in the childhood environment might strongly influence beliefs and behavior characterizing the adult years. When children experience unpredictable and adverse situations, they develop an unpredictability schema with the core belief that situations are unpredictable.

METHODS

In two studies, we examined the association of childhood socioeconomic disadvantages with self-reported pain sensitivity, pain catastrophizing, and pain-related fear. Multidimensional survey measures were used to assess environmental conditions experienced in childhood. In addition, participants completed the Pain Catastrophizing Scale, Pain Sensitivity Questionnaire, Body Awareness Questionnaire, Unpredictability Schema Questionnaire, and Fear of Pain Questionnaire. In Study 1 (N = 252), in separate models, we examined pain sensitivity and pain catastrophizing of a community sample of pain-free young individuals in association with their childhood experiences. In Study 2 (N = 293), in a new sample, but with a wider age range, we examined the association of early life socioeconomic disadvantages with pain-related fear. In both studies, the predictions were tested with Structural Equation Modeling. Our models constituted a path from childhood socioeconomic status and household unpredictability to pain variables via the factors of family resources, unpredictability schemas, and body awareness.

RESULTS AND CONCLUSIONS

The findings converged on the conclusion that individuals experiencing disadvantageous early life conditions tended to have an elevated level of pain catastrophizing, higher perceived sensitivity to pain, and higher level of pain-related fear. These associations were mediated by an unpredictability schema and body awareness.

Sustained attention is related to heartbeat counting task performance but not to self-reported aspects of interoception and mindfulness

Although association between sustained attention and various aspects of interoception (i.e. the perception of the body state) seems plausible, research on this subject is scarce. In the present study, 74 undergraduate students (41 females; age: 22.3 ± 4.04 yrs) filled out the Body Awareness Questionnaire, the Mindful Attention Awareness Scale, and the Somatosensory Amplification Scale and completed the Heartbeat Counting Task (HCT), a sensory-perceptual measure of cardiac interoception and the PEBL Continuous Performance Test (CPT) assessing sustained attention. The HCT score showed a weak to moderate negative correlation with the number of commission errors shown in CPT, indicating a lack of response inhibition (frequentist analysis: r_s = -0.313, p = 0.008; Bayesian analysis: τ_b = -0.216, BF₁₀ = 5.865). Questionnaire measures did not show any connection with CPT-performance. These findings suggest that the subjective representation of attentiveness to bodily processes is unrelated to the objectively measured sustained attention. Response inhibition, however, is moderately related to HCT performance.

Cardiac and Proprioceptive Accuracy Are Not Related to Body Awareness, Perceived Body Competence, and Affect

Interoception in the broader sense refers to the perception of internal states, including the perception of the actual state of the internal organs (visceroception) and the motor system (proprioception). Dimensions of interoception include (1) interoceptive accuracy, i.e., the ability to sense internal changes assessed with behavioral tests, (2) confidence rating with respect to perceived performance in an actual behavioral test, and (3) interoceptive sensibility, i.e., the self-reported generalized ability to perceive body changes. The relationship between dimension of cardioceptive and proprioceptive modalities and their association with affect are scarcely studied. In the present study, undergraduate students (N = 105, 53 males, age: 21.0 ± 1.87 years) filled out questionnaires assessing positive and negative affect (Positive and Negative Affect Schedule), interoceptive sensibility (Body Awareness Questionnaire), and body competence (Body Competence Scale of the Body Consciousness Questionnaire). Following this, they completed a behavioral task assessing cardioceptive accuracy (the mental heartbeat tracking task by Schandry) and two tasks assessing proprioceptive accuracy with respect to the tension of arm flexor muscles (weight discrimination task) and the angular position of the elbow joint (joint position reproduction task). Confidence ratings were measured with visual analog scales after the tasks. With the exception of a weak association between cardioceptive accuracy and the respective confidence rating, no associations between and within modalities were found with respect to various dimensions of interoception. Further, the interoceptive dimensions were not associated with state and trait positive and negative affect and perceived body competence. In summary, interoceptive accuracy scores do not substantially contribute to conscious representations of cardioceptive and proprioceptive ability. Within our data, non-pathological affective states (PANAS) are not associated with the major dimensions of interoception for the cardiac and proprioceptive modalities.

Examining the Factor Structure and Validity of the Multidimensional Assessment of Interoceptive Awareness

The goal of this study was to psychometrically evaluate the Multidimensional Assessment of Interoceptive Awareness (MAIA), a popular self-report questionnaire claimed to assess the most important subjective aspects of interoception. We collected data in two samples (N = 644 and N = 1,516) and focused on the factor structure and validity of MAIA, as well as its associations with personality traits. Confirmatory Factor Analysis suggested that six of the eight subscales measure a common general factor of self-reported interoception; two MAIA subscales, Not-Worrying and Not-Distracting were only weakly related to this factor. Whereas the general factor correlated strongly with a measure of perceived attentiveness to normal nonemotive body processes, and moderately with Extraversion, Openness and Conscientiousness, the Not-Worrying factor showed moderate to strong negative correlations with Emotionality, pain catastrophization, and anxiety-related aspects of body focus. Not-Distracting was only weakly associated with the validating scales. Overall, these findings do not support the claimed eight-factor structure of the MAIA but indicate the existence of an overarching general factor. Additionally, this study provides evidence that interoceptive awareness, as measured by the MAIA, is related to, but distinct from personality.

Verbal Cuing Is Not the Path to Enlightenment. Psychological Effects of a 10-Session Hatha Yoga Practice

Verbal instructions provided during yoga classes can differ substantially. Yoga instructors might choose to focus on the physical aspects of yoga (e.g., by emphasizing the characteristics of the poses), or they might take a more spiritual approach (e.g., by mentioning energy flow and chakras). The present study investigated the effects of verbal cues during yoga practice on various psychological measures. Eighty-four female students (22.0 ± 3.80 years) participated in the study. Two groups attended a beginner level hatha yoga course in which physically identical exercise was accompanied by different verbal cues. The so-called "Sport group" (N = 27) received instructions referring primarily to the physical aspects of yoga practice, while the "Spiritual group" (N = 23) was additionally provided with philosophical and spiritual information. A control group (N = 34) did not receive any intervention. Mindfulness, body awareness, spirituality, and affect were assessed 1 week before and after the training. 2 × 3 mixed (time × intervention) ANOVAs did not show an interaction effect for any of the variables. However, when the two yoga groups were merged and compared to the control group, we found that spirituality increased, and negative affect decreased among yoga participants. In conclusion, yoga practice might influence psychological functioning through its physical components, independent of the style of verbal instructions provided.

The association of different interoceptive dimensions with functional gastrointestinal symptoms

The aim of the current cross-sectional studies was to investigate the association of interoceptive dimensions with irritable bowel syndrome-related functional gastrointestinal symptoms using a multimethod approach. Two studies were conducted in Hungarian volunteers. Study 1 involved questionnaires regarding interoceptive sensibility. In Study 2, an experimental task was additionally used for the measurement of interoceptive accuracy. Reporters of high functional gastrointestinal symptoms were characterised by an increased perception of different somatic sensations together with a reduced trust in bodily signals. Our results support the hypothesis that there are interactions between interoceptive dimensions in the production of functional somatic symptoms. A data accessibility statement is included.

Do body-related sensations make feel us better? Subjective well-being is associated only with the subjective aspect of interoception

According to the proposition of several theoretical accounts, the perception of the bodily cues, interoceptive accuracy and interoceptive sensibility, has a significant positive impact on subjective well-being. Others assume a negative association; however, empirical evidence is scarce. In this study, 142 young adults completed questionnaires assessing subjective well-being, interoceptive sensibility, and subjective somatic symptoms and participated in measurements of proprioceptive accuracy (reproduction of the angle of the elbow joint), gastric sensitivity (water load test), and heartbeat tracking ability (Schandry task). Subjective well-being showed weak to medium positive associations with interoceptive sensibility and weak negative associations with symptom reports. No associations with measures of interoceptive accuracy were found. Gastric sensitivity as opposed to heartbeat perception and proprioceptive accuracy moderated the association between interoceptive sensibility and well-being. Thus, subjective well-being is associated only with the self-reported (perceived) aspect of interoception but not related to the sensory measures of interoceptive accuracy.