Do interoceptive accuracy and interoceptive sensibility predict emotion regulation?

Abstract

Introduction

Interoception refers to awareness, interpretation, and integration of sensations in the body. While interoceptive accuracy has long been regarded as a core component of emotional experience, less is known about the relationship of interoceptive accuracy and related facets of interoception to emotion regulation deficits. This study explores how interoceptive accuracy and interoceptive sensibility relate to emotion regulation in a non-clinical sample.

Methods

Undergraduate participants completed a heartbeat perception task and the Multidimensional Assessment of Interoceptive Awareness (Noticing and Body Listening sub-scales), and rated their confidence in performance on the heartbeat perception task. Participants also completed self-report measures of emotional awareness and regulation (Profile of Emotional Competence, intrapersonal emotion identification and emotion regulation sub-scales), and rated their use of different coping strategies (Brief COPE).

Results

Noticing predicted emotion identification, emotion regulation, and the use of adaptive but not maladaptive coping strategies. Heartbeat perception accuracy did not significantly contribute to the prediction of any outcome variables.

Discussion

Future work is needed to extend these findings to clinical populations. The results from this study support the use of interoceptive training interventions to promote emotional wellbeing.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Aldao, A., Gee, D. G., De Los Reyes, A., & Seager, I. (2016). Emotion regulation as a transdiagnostic factor in the development of internalizing and externalizing psychopathology: current and future directions. Devlopment and Psychopathology,28(4pt1), 927–946. https://doi.org/10.1017/s0954579416000638.

    Article  Google Scholar 

  2. Beck, A. T. (1993). Cognitive therapy: past, present, and future. Journal of Consulting and Clinical Psychology,61(2), 194.

    Article  Google Scholar 

  3. Betka, S., Pfeifer, G., Garfinkel, S., Prins, H., Bond, R., Sequeira, H., et al. (2018). how do self-assessment of alexithymia and sensitivity to bodily sensations relate to alcohol consumption? Alcoholism, Clinical and Experimental Research,42(1), 81–88. https://doi.org/10.1111/acer.13542.

    Article  Google Scholar 

  4. BIOPAC (1997). BIOPAC MP100 psychophysiological data acquisition system: BIOPAC Systems, Inc.

  5. Bornemann, B., Herbert, B. M., Mehling, W. E., & Singer, T. (2014). Differential changes in self-reported aspects of interoceptive awareness through 3 months of contemplative training. Frontiers in Psychology,5, 1504. https://doi.org/10.3389/fpsyg.2014.01504.

    Article  Google Scholar 

  6. Brasseur, S., Grégoire, J., Bourdu, R., & Mikolajczak, M. (2013). The profile of emotional competence (PEC): development and validation of a self-reported measure that fits dimensions of emotional competence theory. PLoS ONE,8(5), e62635. https://doi.org/10.1371/journal.pone.0062635.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cali, G., Ambrosini, E., Picconi, L., Mehling, W. E., & Committeri, G. (2015). Investigating the relationship between interoceptive accuracy, interoceptive awareness, and emotional susceptibility. Frontiers in Psychology,6, 1202. https://doi.org/10.3389/fpsyg.2015.01202.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Carver, C. S. (1997). You want to measure coping but your protocol is too long: consider the brief cope. International Journal of Behavioral Medicine,4(1), 92.

    Article  Google Scholar 

  9. Ceunen, E., Van Diest, I., & Vlaeyen, J. W. (2013). Accuracy and awareness of perception: related, yet distinct (commentary on Herbert et al., 2012). Biological Psychology,92(2), 426–427. https://doi.org/10.1016/j.biopsycho.2012.09.012.

    Article  Google Scholar 

  10. Coffey, E., Berenbaum, H., & Kerns, J. (2003). Brief report. Cognition and Emotion,17(4), 671–679. https://doi.org/10.1080/02699930302304.

    Article  Google Scholar 

  11. Craig, A. (2002). How do you feel? Interoception: the sense of the physiological condition of the body. Nature Reviews Neuroscience,3(8), 655. https://doi.org/10.1038/nrn894.

    Article  Google Scholar 

  12. Craig, A. (2008). Interoception and emotion: a neuroanatomical perspective. Handbook of Emotions,3(602), 272–288.

    Google Scholar 

  13. Craske, M. G., Lang, A. J., Tsao, J. C., Mystkowski, J. L., & Rowe, M. K. (2001). Reactivity to interoceptive cues in nocturnal panic. Journal of Behavior Therapy and Experimental Psychiatry,32(3), 173–190.

    Article  Google Scholar 

  14. Damasio, A. R. (1996). The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical Transactions of the Royal Society of London B Series,351(1346), 1413–1420.

    Article  Google Scholar 

  15. Dunn, B. D., Stefanovitch, I., Evans, D., Oliver, C., Hawkins, A., & Dalgleish, T. (2010). Can you feel the beat? Interoceptive awareness is an interactive function of anxiety- and depression-specific symptom dimensions. Behaviour Research and Therapy,48(11), 1133–1138. https://doi.org/10.1016/j.brat.2010.07.006.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Dworkin, B. R. (2007). Interoception. In J. T. Cacioppo, L. G. Tassinary, & G. G. Berntson (Eds.), Handbook of psychophysiology (pp. 482–506). UK: Cambridge University Press. https://doi.org/10.1017/CBO9780511546396.021.

    Google Scholar 

  17. Ehlers, A. (1998). Why Van der Does, Van Dyck and Spinhoven (1997) did not demonstrate that superior heartbeat perception in panic disorder is partly an artefact. Journal of Affective Disorders,49(3), 241–247.

    Article  Google Scholar 

  18. Ehlers, A., & Breuer, P. (1992). Increased cardiac awareness in panic disorder. Journal of Abnormal Psychology,101(3), 371–382.

    Article  Google Scholar 

  19. Ehlers, A., Breuer, P., Dohn, D., & Fiegenbaum, W. (1995). Heartbeat perception and panic disorder: Possible explanations for discrepant findings. Behaviour Research and Therapy,33(1), 69–76.

    Article  Google Scholar 

  20. Ernst, J., Boker, H., Hattenschwiler, J., Schupbach, D., Northoff, G., Seifritz, E., et al. (2014). The association of interoceptive awareness and alexithymia with neurotransmitter concentrations in insula and anterior cingulate. Social Cognitive and Affective Neuroscience,9(6), 857–863. https://doi.org/10.1093/scan/nst058.

    Article  Google Scholar 

  21. Fairclough, S. H., & Goodwin, L. (2007). The effect of psychological stress and relaxation on interoceptive accuracy: implications for symptom perception. Journal of Psychosomatic Research,62(3), 289–295. https://doi.org/10.1016/j.jpsychores.2006.10.017.

    Article  Google Scholar 

  22. Farb, N., Daubenmier, J., Price, C. J., Gard, T., Kerr, C., Dunn, B. D., et al. (2015). Interoception, contemplative practice, and health. Frontiers in Psychology,6, 763. https://doi.org/10.3389/fpsyg.2015.00763.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods,39(2), 175–191.

    Article  Google Scholar 

  24. Fischer, D., Messner, M., & Pollatos, O. (2017). Improvement of interoceptive processes after an 8-week body scan intervention. Frontiers in Human Neuroscience,11, 452. https://doi.org/10.3389/fnhum.2017.00452.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Fissler, M., Winnebeck, E., Schroeter, T., Gummersbach, M., Huntenburg, J. M., Gaertner, M., et al. (2016). An investigation of the effects of brief mindfulness training on self-reported interoceptive awareness, the ability to decenter, and their role in the reduction of depressive symptoms. Mindfulness,7(5), 1170–1181.

    Article  Google Scholar 

  26. Forkmann, T., Scherer, A., Meessen, J., Michal, M., Schachinger, H., Vogele, C., et al. (2016). Making sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy. International Journal of Psychophysiology,109, 71–80. https://doi.org/10.1016/j.ijpsycho.2016.09.019.

    Article  Google Scholar 

  27. Furman, D. J., Waugh, C. E., Bhattacharjee, K., Thompson, R. J., & Gotlib, I. H. (2013). Interoceptive awareness, positive affect, and decision making in major depressive disorder. Journal of Affective Disorders,151(2), 780–785. https://doi.org/10.1016/j.jad.2013.06.044.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Füstös, J., Gramann, K., Herbert, B. M., & Pollatos, O. (2013). On the embodiment of emotion regulation: interoceptive awareness facilitates reappraisal. Social Cognitive and Affective Neuroscience,8(8), 911–917. https://doi.org/10.1093/scan/nss089.

    Article  Google Scholar 

  29. Garfinkel, S. N., Seth, A. K., Barrett, A. B., Suzuki, K., & Critchley, H. D. (2015). Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology,104, 65–74. https://doi.org/10.1016/j.biopsycho.2014.11.004.

    Article  PubMed  Google Scholar 

  30. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of Personality and Social Psychology,85(2), 348–362.

    Article  Google Scholar 

  31. Gunther, V., Rufer, M., Kersting, A., & Suslow, T. (2016). Predicting symptoms in major depression after inpatient treatment: the role of alexithymia. Nordic Journal of Psychiatry,70(5), 392–398. https://doi.org/10.3109/08039488.2016.1146796.

    Article  Google Scholar 

  32. Herbert, B. M., Herbert, C., & Pollatos, O. (2011). On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness? Journal of Personality,79(5), 1149–1175. https://doi.org/10.1111/j.1467-6494.2011.00717.x.

    Article  Google Scholar 

  33. Herbert, B. M., Muth, E. R., Pollatos, O., & Herbert, C. (2012). Interoception across modalities: on the relationship between cardiac awareness and the sensitivity for gastric functions. PLoS ONE,7(5), e36646. https://doi.org/10.1371/journal.pone.0036646.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Herbert, B. M., & Pollatos, O. (2012). The body in the mind: on the relationship between interoception and embodiment. Topics in Cognitive Science,4(4), 692–704. https://doi.org/10.1111/j.1756-8765.2012.01189.x.

    Article  Google Scholar 

  35. Herbert, B. M., & Pollatos, O. (2014). Attenuated interoceptive sensitivity in overweight and obese individuals. Eating Behaviors,15(3), 445–448. https://doi.org/10.1016/j.eatbeh.2014.06.002.

    Article  PubMed  PubMed Central  Google Scholar 

  36. IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. NY: IBM Corp.

  37. James, W. (1884). What is an emotion? Mind,9(34), 188–205.

    Article  Google Scholar 

  38. Kever, A., Pollatos, O., Vermeulen, N., & Grynberg, D. (2015). Interoceptive sensitivity facilitates both antecedent-and response-focused emotion regulation strategies. Personality and Individual Differences,87, 20–23.

    Article  Google Scholar 

  39. Khalsa, S. S., Adolphs, R., Cameron, O. G., Critchley, H. D., Davenport, P. W., Feinstein, J. S., et al. (2018). Interoception and mental health: a roadmap. Biological Psychiatry Cognitive Neuroscience and Neuroimaging,3(6), 501–513. https://doi.org/10.1016/j.bpsc.2017.12.004.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Knoll, J. F., & Hodapp, V. (1992). A comparison between two methods for assessing heartbeat perception. Psychophysiology,29(2), 218–222.

    Article  Google Scholar 

  41. Lackner, R. J., & Fresco, D. M. (2016). Interaction effect of brooding rumination and interoceptive awareness on depression and anxiety symptoms. Behaviour Research and Therapy,85, 43–52. https://doi.org/10.1016/j.brat.2016.08.007.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. USA: Springer Publishing Company.

    Google Scholar 

  43. Leweke, F., Leichsenring, F., Kruse, J., & Hermes, S. (2012). Is alexithymia associated with specific mental disorders? Psychopathology,45(1), 22–28. https://doi.org/10.1159/000325170.

    Article  Google Scholar 

  44. Limmer, J., Kornhuber, J., & Martin, A. (2015). Panic and comorbid depression and their associations with stress reactivity, interoceptive awareness and interoceptive accuracy of various bioparameters. Journal of Affective Disorders,185, 170–179. https://doi.org/10.1016/j.jad.2015.07.010.

    Article  Google Scholar 

  45. Lumley, M. A., Neely, L. C., & Burger, A. J. (2007). The assessment of alexithymia in medical settings: implications for understanding and treating health problems. Journal of Personality Assessment,89(3), 230–246. https://doi.org/10.1080/00223890701629698.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Mahmoud, J. S., Staten, R., Hall, L. A., & Lennie, T. A. (2012). The relationship among young adult college students’ depression, anxiety, stress, demographics, life satisfaction, and coping styles. Issues in Mental Health Nursing,33(3), 149–156. https://doi.org/10.3109/01612840.2011.632708.

    Article  Google Scholar 

  47. Mallorquí-Bagué, N., Garfinkel, S. N., Engels, M., Eccles, J. A., Pailhez, G., Bulbena, A., et al. (2014). Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility. Frontiers in Psychology,5, 1162. https://doi.org/10.3389/fpsyg.2014.01162.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Mehling, W. (2016). Differentiating attention styles and regulatory aspects of self-reported interoceptive sensibility. Philosophical Transactions of the Royal Society of London Series B Biological Science,371(1708), 20160013. https://doi.org/10.1098/rstb.2016.0013.

    Article  Google Scholar 

  49. Mehling, W. E., Acree, M., Stewart, A., Silas, J., & Jones, A. (2018). The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLoS ONE,13(12), e0208034. https://doi.org/10.1371/journal.pone.0208034.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Mehling, W. E., Price, C., Daubenmier, J. J., Acree, M., Bartmess, E., & Stewart, A. (2012). The multidimensional assessment of interoceptive awareness (MAIA). PLoS ONE,7(11), e48230. https://doi.org/10.1371/journal.pone.0048230.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Murphy, J., Brewer, R., Hobson, H., Catmur, C., & Bird, G. (2018). Is alexithymia characterised by impaired interoception? Further evidence, the importance of control variables, and the problems with the heartbeat counting task. Biological Psychology,136, 189–197. https://doi.org/10.1016/j.biopsycho.2018.05.010.

    Article  Google Scholar 

  52. Murphy, J., Catmur, C., & Bird, G. (2019). Classifying individual differences in interoception: Implications for the measurement of interoceptive awareness. Psychonomic Bulletin and Review,26(5), 1467–1471. https://doi.org/10.3758/s13423-019-01632-7.

    Article  Google Scholar 

  53. Palser, E. R., Fotopoulou, A., Pellicano, E., & Kilner, J. M. (2020). Dissociation in how core autism features relate to interoceptive dimensions: evidence from cardiac awareness in children. Journal of Autism Developmental Disorders,50, 572–582. https://doi.org/10.1007/s10803-019-04279-4.

    Article  Google Scholar 

  54. Palser, E. R., Fotopoulou, A., Pellicano, E., & Kilner, J. M. (2018). The link between interoceptive processing and anxiety in children diagnosed with autism spectrum disorder: extending adult findings into a developmental sample. Biological Psychology,136, 13–21. https://doi.org/10.1016/j.biopsycho.2018.05.003.

    Article  Google Scholar 

  55. Pollatos, O., Kurz, A. L., Albrecht, J., Schreder, T., Kleemann, A. M., Schopf, V., et al. (2008). Reduced perception of bodily signals in anorexia nervosa. Eating Behaviors,9(4), 381–388. https://doi.org/10.1016/j.eatbeh.2008.02.001.

    Article  Google Scholar 

  56. Pollatos, O., Traut-Mattausch, E., & Schandry, R. (2009). Differential effects of anxiety and depression on interoceptive accuracy. Depress Anxiety,26(2), 167–173. https://doi.org/10.1002/da.20504.

    Article  Google Scholar 

  57. Porges, S. (1993). Body perception questionnaire. Laboratory of Developmental Assessment: University of Maryland.

    Google Scholar 

  58. Price, C. J., & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: theory and approach of mindful awareness in body-oriented therapy (MABT). Frontiers Psychology,9, 798. https://doi.org/10.3389/fpsyg.2018.00798.

    Article  Google Scholar 

  59. Price, C. J., & Thompson, E. A. (2007). Measuring dimensions of body connection: body awareness and bodily dissociation. Journal of Alternative and Complementary Medicine,13(9), 945–953. https://doi.org/10.1089/acm.2007.0537.

    Article  Google Scholar 

  60. Quintana, D. S., Guastella, A. J., Outhred, T., Hickie, I. B., & Kemp, A. H. (2012). Heart rate variability is associated with emotion recognition: direct evidence for a relationship between the autonomic nervous system and social cognition. International Journal of Psychophysiology,86(2), 168–172. https://doi.org/10.1016/j.ijpsycho.2012.08.012.

    Article  Google Scholar 

  61. Ring, C., & Brener, J. (1996). Influence of beliefs about heart rate and actual heart rate on heartbeat counting. Psychophysiology,33(5), 541–546.

    Article  Google Scholar 

  62. Schachter, S., & Singer, J. (1962). Cognitive, social, and physiological determinants of emotional state. Psychological Review,69(5), 379.

    Article  Google Scholar 

  63. Schandry, R. (1981). Heart beat perception and emotional experience. Psychophysiology,18(4), 483–488.

    Article  Google Scholar 

  64. Schultchen, D., Zaudig, M., Krauseneck, T., Berberich, G., & Pollatos, O. (2019). Interoceptive deficits in patients with obsessive–compulsive disorder in the time course of cognitive-behavioral therapy. PLoS ONE,14(5), e0217237.

    Article  Google Scholar 

  65. Schwerdtfeger, A. R., Heene, S., & Messner, E. M. (2019). Interoceptive awareness andperceived control moderate the relationship between cognitive reappraisal, self-esteem, and cardiac activity in daily life. International Journal of Psychophysiology,141, 84–92.

    Article  Google Scholar 

  66. Sherrington, C. S. (1909). The integrative action of the nervous system: CUP Archive.

  67. Störmer, S. W., Heiligtag, U., & Knoll, J. F. (1989). Heartbeat detection and knowledge of results: a new method and some theoretical thoughts. Journal of Psychophysiology.,3(4), 409–417.

    Google Scholar 

  68. Van der Does, A. J., Van Dyck, R., & Spinhoven, P. (1997). Accurate heartbeat perception in panic disorder: fact and artefact. Journal of Affective Disorders,43(2), 121–130.

    Article  Google Scholar 

  69. Van Dyck, Z., Vögele, C., Blechert, J., Lutz, A. P., Schulz, A., & Herbert, B. M. (2016). The water load test as a measure of gastric interoception: development of a two-stage protocol and application to a healthy female population. PLoS ONE,11(9), e0163574.

    Article  Google Scholar 

  70. Weiss, S., & Pollatos, O. (2014). Ocd and interoception. European Health Psychologist,16(S), 325.

    Google Scholar 

  71. Wiebking, C., Bauer, A., De Greck, M., Duncan, N. W., Tempelmann, C., & Northoff, G. (2010). Abnormal body perception and neural activity in the insula in depression: an fMRI study of the depressed “material me”. The World Journal of Biological Psychiatry,11(3), 538–549.

    Article  Google Scholar 

  72. Wiens, S. (2005). Interoception in emotional experience. Current Opinion in Neurology,18(4), 442–447.

    Article  Google Scholar 

  73. Williams, D. P., Cash, C., Rankin, C., Bernardi, A., Koenig, J., & Thayer, J. F. (2015). Resting heart rate variability predicts self-reported difficulties in emotion regulation: a focus on different facets of emotion regulation. Frontiers in Psychology,6, 261. https://doi.org/10.3389/fpsyg.2015.00261.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Yoris, A., Esteves, S., Couto, B., Melloni, M., Kichic, R., Cetkovich, M., et al. (2015). The roles of interoceptive sensitivity and metacognitive interoception in panic. Behavioral and Brain Functions,11, 14. https://doi.org/10.1186/s12993-015-0058-8.

    Article  Google Scholar 

  75. Zamariola, G., Frost, N., Van Oost, A., Corneille, O., & Luminet, O. (2019a). Relationship between interoception and emotion regulation: new evidence from mixed methods. Journal of Affective Disorders,246, 480–485. https://doi.org/10.1016/j.jad.2018.12.101.

    Article  Google Scholar 

  76. Zamariola, G., Luminet, O., Mierop, A., & Corneille, O. (2019b). Does it help to feel your body? Evidence is inconclusive that interoceptive accuracy and sensibility help cope with negative experiences. Cognition and Emotion,1, 12. https://doi.org/10.1080/02699931.2019.1591345.

    Article  Google Scholar 

  77. Zucker, N. L., Merwin, R. M., Bulik, C. M., Moskovich, A., Wildes, J. E., & Groh, J. (2013). Subjective experience of sensation in anorexia nervosa. Behaviour Research and Therapy,51(6), 256–265. https://doi.org/10.1016/j.brat.2013.01.010.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Zucker, N., Mauro, C., Craske, M., Wagner, H. R., Datta, N., Hopkins, H., et al. (2017). Acceptance-based interoceptive exposure for young children with functional abdominal pain. Behaviour Research and Therapy,97, 200–212. https://doi.org/10.1016/j.brat.2017.07.009.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to acknowledge the support of the undergraduate research assistants, Sophie Bell and Iris Yang, who helped to collect this data.

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Authors Stephanie Schuette, Nancy Zucker and Moria Smoski declare that they have no conflicts of interest.

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Schuette, S.A., Zucker, N.L. & Smoski, M.J. Do interoceptive accuracy and interoceptive sensibility predict emotion regulation?. Psychological Research (2020). https://doi.org/10.1007/s00426-020-01369-2

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