Advertisement

Journal of Behavioral Medicine

, Volume 37, Issue 3, pp 564–575 | Cite as

Body awareness: differentiating between sensitivity to and monitoring of bodily signals

  • Karni Ginzburg
  • Noga Tsur
  • Ayelet Barak-Nahum
  • Ruth Defrin
Article

Abstract

Sensitivity to bodily signals is the tendency to be aware of bodily states and to identify subtle bodily reactions to internal and environmental conditions. Monitoring these signals is a top-down process, describing individuals’ tendency to actively scan their bodies in order to detect cues for their physical condition. Two studies examined the relations between these constructs and their adaptivity among young adults. In Study 1, 180 young adults completed questionnaires assessing sensitivity, monitoring, and hypochondriac tendency. In Study 2, 205 students reported their levels of sensitivity, monitoring, pain catastrophizing, and trait anxiety. Although monitoring and sensitivity were correlated, when controlling for their shared variance, only monitoring was associated with high hypochondriac tendency and anxiety. In addition, the adaptivity of sensitivity to bodily signals was dependent on both level of monitoring of bodily signals and pain catastrophizing. That is, pain catastrophizing moderated the effect of sensitivity and monitoring on anxiety. These findings suggest that the adaptivity of sensitivity is determined by the mode of attention characterizing the individual engaged in this process.

Keywords

Body awareness Sensitivity Monitoring Pain catastrophizing 

References

  1. Andersen, R. (2006). Body intelligence scale: Defining and measuring the intelligence of the body. The Humanistic Psychologist, 34, 357–367.CrossRefGoogle Scholar
  2. Appenzeller, O., & Oribe, E. (1997). The autonomic nervous system: An introduction to basic and clinical concepts. Amsterdam: Elsevier.Google Scholar
  3. Aronson, K. R., Barrett, L. F., & Quigley, K. S. (2001). Feeling your body or feeling badly: Evidence for the limited validity of the somatosensory amplification scale as an index of somatic sensitivity. Journal of Psychosomatic Research, 51, 387–394.PubMedCrossRefGoogle Scholar
  4. Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.PubMedCrossRefGoogle Scholar
  5. Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15, 329–342.PubMedCrossRefGoogle Scholar
  6. Barnes, L. L. B., Harp, D., & Jung, W. S. (2002). Reliability generalization of scores on the Spielberger state-trait anxiety inventory. Educational and Psychological Measurement, 62, 603–618.CrossRefGoogle Scholar
  7. Barsky, A. J., & Wyshak, G. (1990). Hypochondriasis and somatosensory amplification. British Journal of Psychiatry, 157, 404–409.PubMedCrossRefGoogle Scholar
  8. Bekker, M. H. J., Croon, M. A., van Balkom, E. G., & Vermee, J. B. (2008). Predicting individual differences in autonomy-connectedness: The role of body awareness, alexithymia, and assertiveness. Journal of Clinical Psychology, 64, 747–765.PubMedCrossRefGoogle Scholar
  9. Bekker, M. H. J., Croon, M. A., & Vermaas, S. (2002). Inner body and outward appearance—the relationship between orientation toward outward appearance, body awareness and symptom perception. Personality and Individual Differences, 33, 213–225.CrossRefGoogle Scholar
  10. Bogaerts, K., Millen, A., Li, W., De Peuter, S., Van Diest, I., Fannes, S., et al. (2008). High symptom reporters are less interoceptively accurate in a symptom-related context. Journal of Psychosomatic Research, 65, 417–424.Google Scholar
  11. Brooks, J. C., Nurmikko, T. J., Bimson, W. E., Singh, K. D., & Roberts, N. (2002). fMRI of thermal pain: Effects of stimulus laterality and attention. Neuroimage, 15, 293–301.PubMedCrossRefGoogle Scholar
  12. Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: An integrative conceptual model. Psychological Bulletin, 139, 793–812.CrossRefGoogle Scholar
  13. Cioffi, D. (1991). Beyond attentional strategies: A cognitive perceptual model of somatic interpretation. Psychological Bulletin, 109, 25–41.PubMedCrossRefGoogle Scholar
  14. Coghill, R. C., Sang, C. N., Maisog, J. M., & Iadarola, M. J. (1999). Pain intensity processing within the human brain: A bilateral, distributed mechanism. Journal of Neurophysiology, 82, 1934–1942.PubMedGoogle Scholar
  15. Conradt, M., Cavanagh, M., Franklin, J., & Rief, W. (2006). Dimensionality of the Whiteley Index: Assessment of hypochondriasis in an Australian sample of primary care patients. Journal of Psychosomatic Research, 60, 137–143.PubMedCrossRefGoogle Scholar
  16. Craig, A. D. (2002). How do you feel? Interoception: The sense of the physiological condition of the body. Nature Reviews Neuroscience, 3, 655–666.PubMedGoogle Scholar
  17. Craig, A. D. (2003). Interoception: The sense of the physiological condition of the body. Current Opinions in Neurobiology, 13, 500–505.CrossRefGoogle Scholar
  18. Craig, A. D. (2010). The sentient self. Brain Structure and Function, 214, 563–577.PubMedCrossRefGoogle Scholar
  19. Craig, A. D., Chen, K., Bandy, D., & Reiman, E. M. (2000). Thermosensory activation of insular cortex. Nature Neuroscience, 3, 184–490.PubMedCrossRefGoogle Scholar
  20. Critchley, H. D. (2009). Psychophysiology of neural, cognitive and affective integration: fMRI and autonomic indicants. International Journal of Psychophysiology, 73, 88–94.PubMedCentralPubMedCrossRefGoogle Scholar
  21. Critchley, H. D., Wiens, S., Rotshtein, P., Ohman, A., & Dolan, R. J. (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience, 7, 189–195.PubMedCrossRefGoogle Scholar
  22. Damasio, A. R. (1993). Descartes’ error: Emotion, reason, and the human brain. New York: Putnam.Google Scholar
  23. Damasio, A. R. (1996). The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical Transactions of the Royal Society B Biological Sciences, 351, 1413–1420.CrossRefGoogle Scholar
  24. Damasio, A. R. (2003). Looking for Spinoza: Joy, sorrow, and the feeling brain. Orlando, FL: Harcourt, Inc.Google Scholar
  25. Damasio, A. R., Grabowski, T. J., Bechara, A., Damasio, H., Ponto, L. L., Parvizi, J., et al. (2000). Subcortical and cortical brain activity during the feeling of self-generated emotions. Nature Neuroscience, 3, 1049–1056.PubMedCrossRefGoogle Scholar
  26. Daubenmier, J. J. (2005). The relationship of yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychology of Women Quarterly, 29, 207–219.CrossRefGoogle Scholar
  27. Davis, K. D. (2000). The neural circuitry of pain as explored with functional MRI. Neurological Research, 22, 313–317.PubMedGoogle Scholar
  28. Devoulyte, K., & Sullivan, M. J. (2003). Pain catastrophizing and symptom severity during upper respiratory tract illness. The Clinical Journal of Pain, 19, 125–133.PubMedCrossRefGoogle Scholar
  29. Dittmann, K. A., & Freedman, M. R. (2009). Body awareness, eating attitudes, and spiritual beliefs of women practicing yoga. Eating Disorders, 17, 273–292.PubMedCrossRefGoogle Scholar
  30. Domschke, K., Stevens, S., Pfleiderer, B., & Gerlach, A. L. (2010). Interoceptive sensitivity in anxiety and anxiety disorders: An overview and integration of neurobiological findings. Clinical Psychology Review, 30, 1–11.PubMedCrossRefGoogle Scholar
  31. Fergus, T. A., & Valentiner, D. P. (2010). Disease phobia and disease conviction are separate dimensions underlying hypochondriasis. Journal of Behavior Therapy and Experimental Psychiatry, 41, 438–444.PubMedCrossRefGoogle Scholar
  32. Gardner, D. G., Cummings, L. L., Dunham, R. B., & Pierce, J. L. (1998). Single-item versus multiple-item measurement scales: An empirical comparison. Educational and Psychological Measurement, 58, 898–915.CrossRefGoogle Scholar
  33. Greenspan, J. D., & Winfield, J. A. (1992). Reversible pain and tactile deficits associated with a cerebral tumor compressing the posterior insula and parietal operculum. Pain, 50, 29–39.PubMedCrossRefGoogle Scholar
  34. Gu, X., Liu, X., Van Dam, N. T., Hof, P. R., & Fan, J. (2013). Cognition-emotion integration in the anterior insular cortex. Cerebral Cortex, 23, 20–27.PubMedCentralPubMedCrossRefGoogle Scholar
  35. Gustafsson, S. A., Edlund, B., Kjellin, L., & Norring, C. (2010). Characteristics measured by the Eating Disorder Inventory for children at risk and protective factors for disordered eating in adolescent girls. International Journal of Women’s Health, 2, 375–379.PubMedCentralPubMedCrossRefGoogle Scholar
  36. Haase, L., Cerf-Ducastel, B., & Murphy, C. (2009). Cortical activation in response to pure taste stimuli during the physiological states of hunger and satiety. Neuroimage, 44, 1008–10021.PubMedCentralPubMedCrossRefGoogle Scholar
  37. Hansell, S., Sherman, G., & Mechanic, D. (1991). Body awareness and medical care utilization among older adults in an HMO. Journals of Gerontology, 46, S151–S159.PubMedCrossRefGoogle Scholar
  38. Haugstad, G. K., Haugstad, T. S., Kirste, U. M., Leganger, S., Wojniusz, S., Klemmetsen, I., et al. (2006). Posture, movement patterns, and body awareness in women with chronic pelvic pain. Journal of Psychosomatic Research, 61, 637–644.PubMedCrossRefGoogle Scholar
  39. Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. Retrieved December 26, 2012, from http://www.afhayes.com/public/process2012.pdf
  40. Herbert, B. M., Pollatos, O., & Schandry, R. (2007). Interoceptive sensitivity and emotion processing: An EEG study. International Journal of Psychophysiology, 65, 214–227.PubMedCrossRefGoogle Scholar
  41. Johnston, N. E., Atlas, L. Y., & Wager, T. D. (2012). Opposing effects of expectancy and somatic focus on pain. PLoS ONE, 7, e38854.PubMedCentralPubMedCrossRefGoogle Scholar
  42. Keough, M. E., Timpano, K. R., Zawilinski, L. L., & Schmidt, N. B. (2011). The association between irritable bowel syndrome and the anxiety vulnerability factors: Body vigilance and discomfort intolerance. Journal of Health Psychology, 16, 91–98.PubMedCrossRefGoogle Scholar
  43. Kesler, A., Kliper, E., Goner-Shilo, D., & Benyamini, Y. (2009). Illness perceptions and quality of life among women with pseudo-tumor cerebri. European Journal of Neurology, 16, 931–936.CrossRefGoogle Scholar
  44. Khalsa, S. S., Rudrauf, D., & Tranel, D. (2009). Interoceptive awareness declines with age. Psychophysiology, 46, 1130–1136.PubMedCentralPubMedCrossRefGoogle Scholar
  45. Kinomuraa, S., Kawashima, R., Yamadaa, R., Onoa, S., Itohb, M., Yoshiokaa, S., et al. (1994). Functional anatomy of taste perception in the human brain studied with positron emission tomography. Brain Research, 659, 263–266.CrossRefGoogle Scholar
  46. Klasen, M., Kenworthy, C. A., Mathiak, K. A., Kircher, T. T., & Mathiak, K. (2011). Supramodal representation of emotions. Journal of Neuroscience, 21, 13635–13643.CrossRefGoogle Scholar
  47. Koroboki, E., Zakopoulos, N., Manios, E., Rotas, V., Papadimitriou, G., & Papageorgiou, C. (2010). Interoceptive awareness in essential hypertension. International Journal of Psychophysiology, 78, 158–162.PubMedCrossRefGoogle Scholar
  48. Kraemer, H. C., & Blasey, C. M. (2004). Centering in regression analyses: A strategy to prevent errors in statistical inference. International Journal of Methods in Psychiatric Research, 13, 141–151.PubMedCrossRefGoogle Scholar
  49. Looper, K. J., & Kirmayer, L. J. (2002). Behavioral medicine approaches to somatoform disorders. Journal of Consulting and Clinical Psychology, 70, 810–827.PubMedCrossRefGoogle Scholar
  50. Lyons, A., & Chamberlain, K. (2006). Health psychology a critical introduction. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  51. Mailloux, J., & Brener, J. (2002). Somatosensory amplification and its relationship to heartbeat detection ability. Psychosomatic Medicine, 64, 353–357.PubMedCrossRefGoogle Scholar
  52. Marks, A. D. G., Sobanski, D. J., & Hine, D. W. (2010). Do dispositional rumination and/or mindfulness moderate the relationship between life hassles and psychological dysfunction in adolescents? Australian and New Zealand Journal of Psychiatry, 44, 831–838.PubMedGoogle Scholar
  53. Mehling, W. E., Gopisetty, V., Daubenmier, J., Price, C. J., Hecht, F. M., & Stewart, A. (2009). Body awareness: Construct and self-report measures. PLoS ONE, 4, e5614.PubMedCentralPubMedCrossRefGoogle Scholar
  54. Mehling, W. E., Hamel, K. A., Acree, M., Byl, N., & Hecht, F. M. (2005). Randomized, controlled trial of breath therapy for patients with chronic low-back pain. Alternative Therapies in Health and Medicine, 11, 44–52.PubMedGoogle Scholar
  55. 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, e48230.PubMedCentralPubMedCrossRefGoogle Scholar
  56. Miller, L. C., Murphy, R., & Buss, A. H. (1981). Consciousness of body: Private and public. Journal of Personality and Social Psychology, 41, 397–406.CrossRefGoogle Scholar
  57. Mirams, L., Poliakoff, E., Brown, R. J., & Lloyd, D. M. (2013). Brief body-scan meditation practice improves somatosensory perceptual decision making. Consciousness and Cognition, 22, 348–359.PubMedCrossRefGoogle Scholar
  58. Oh, S. H., Bae, B. G., Park, C. O., Noh, J. Y., Park, I. H., Wu, W. H., et al. (2010). Association of stress with symptoms of atopic dermatitis. Acta Dermato-Venereologica, 90, 582–588.PubMedCrossRefGoogle Scholar
  59. Olatunji, B. O., Deacon, B. J., Abramowitz, J. S., & Valentiner, D. P. (2007). Body vigilance in nonclinical and anxiety disorder samples: Structure, correlates, and prediction of health concerns. Behavior Therapy, 38, 392–401.PubMedCrossRefGoogle Scholar
  60. Ouwens, M. A., van Strien, T., van Leeuwe, J. F., & van der Staak, C. P. (2009). The dual pathway model of overeating. Replication and extension with actual food consumption. Appetite, 52, 234–237.PubMedCrossRefGoogle Scholar
  61. Paulhus, D. L., Robins, R. W., Trzesniewski, K. H., & Tracy, J. L. (2004). Two replicable suppressor situations in personality research. Multivariate Behavioral Research, 39, 303–328.CrossRefGoogle Scholar
  62. Paus, T. (2001). Primate anterior cingulate cortex: Where motor control, drive and cognition interface. Nature Reviews Neuroscience, 2, 417–424.PubMedCrossRefGoogle Scholar
  63. Pennebaker, J. W. (2000). Psychological factors influencing the reporting of physical symptoms. In A. Stone, J. S. Turkkan, C. A. Bachrach, J. B. Jobe, H. S. Kurtzman, & V. S. Cain (Eds.), The science of self-report: Implications for research and practice (pp. 299–315). Mahwah, NJ: Erlbaum.Google Scholar
  64. Pilowsky, I. (1967). Dimensions of hypochondriasis. British Journal of Psychiatry, 113, 89–93.PubMedCrossRefGoogle Scholar
  65. Ploghaus, A., Tracey, I., Gati, J. S., Clare, S., Menon, R. S., Matthews, P. M., et al. (1999). Dissociating pain from its anticipation in the human brain. Science, 284, 1979–1981.PubMedCrossRefGoogle Scholar
  66. Pollatos, O., Herbert, B. M., Kaufmann, C., Auer, D. P., & Schandry, R. (2007a). Interoceptive awareness, anxiety and cardiovascular reactivity to isometric exercise. International Journal of Psychophysiology, 65, 167–173.PubMedCrossRefGoogle Scholar
  67. Pollatos, O., Herbert, B. M., Matthias, E., & Schandry, R. (2007b). Heart rate response after emotional picture presentation is modulated by interoceptive awareness. International Journal of Psychophysiology, 63, 117–124.PubMedCrossRefGoogle Scholar
  68. Pollatos, O., Schandry, R., Auer, D. P., & Kaufmann, C. (2007c). Brain structures mediating cardiovascular arousal and interoceptive awareness. Brain Research, 1141, 178–187.PubMedCrossRefGoogle Scholar
  69. Pollatos, O., Traut-Mattausch, E., & Schandry, R. (2009). Differential effects of anxiety and depression on interoceptive accuracy. Depression and Anxiety, 26, 167–173.PubMedCrossRefGoogle Scholar
  70. Pollatos, O., Traut-Mattausch, E., Schroeder, H., & Schandry, R. (2007d). Interoceptive awareness mediates the relationship between anxiety and the intensity of unpleasant feelings. Journal of Anxiety Disorders, 21, 931–943.PubMedCrossRefGoogle Scholar
  71. Price, C. J., & Thompson, E. A. (2007). Measuring dimensions of body connection: Body awareness and bodily dissociation. Journal of Alternative and Complementary Medicine, 13, 945–953.CrossRefGoogle Scholar
  72. Raes, F., Watkins, E. R., Williams, J. M. G., & Hermans, D. (2008). Non-ruminative processing reduces overgeneral autobiographical memory retrieval in students. Behaviour Research and Therapy, 46, 748–756.PubMedCrossRefGoogle Scholar
  73. Rief, W., & Barsky, A. J. (2005). Psychobiological perspectives on somatoform disorders. Psychoneuroendocrinology, 30, 996–1002.PubMedCrossRefGoogle Scholar
  74. Roelofs, J., Peters, M. L., van der Zijden, M., & Vlaeyen, J. W. S. (2004). Does fear of pain moderate the effects of sensory focusing and distraction on cold pressor pain in pain-free individuals? Journal of Pain, 5, 250–256.PubMedCrossRefGoogle Scholar
  75. Ross, S., Heath, N. L., & Toste, J. R. (2009). Non-suicidal self-injury and eating pathology in high school students. American Journal of Orthopsychiatry, 79, 83–92.PubMedCrossRefGoogle Scholar
  76. Royet, J. P., Zald, D., Versace, R., Costes, N., Lavenne, F., Koenig, O., et al. (2000). Emotional responses to pleasant and unpleasant olfactory, visual, and auditory stimuli: A positron emission tomography study. Journal of Neurophysiology, 20, 7752–7759.Google Scholar
  77. Schmidt, N. B., Lerew, D. R., & Trakowski, J. H. (1997). Body vigilance in panic disorder: Evaluating attention to bodily perturbations. Journal of Consulting and Clinical Psychology, 65, 214–220.PubMedCrossRefGoogle Scholar
  78. Schmidt, N. B., & Trakowski, J. H. (1999). Attentional focus and fearful responding in patients with panic disorder during a 35% CO2 challenge. Behavior Therapy, 30, 623–640.CrossRefGoogle Scholar
  79. Shields, S. A., Mallory, M. E., & Simon, A. (1989). The body awareness questionnaire: Reliability and validity. Journal of Personality Assessment, 53, 802–815.CrossRefGoogle Scholar
  80. Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  81. Spoor, S. T., Bekker, M. H. J., Van Heck, G. L., Croon, M. A., & Van Strien, T. (2005). Inner body and outward appearance: The relationships between appearance orientation, eating disorder symptoms, and internal body awareness. Eating Disorders, 13, 479–490.PubMedCrossRefGoogle Scholar
  82. Stewart, S. H., Buffett-Jerrott, S. E., & Kokaram, R. (2001). Heartbeat awareness and heart rate reactivity in anxiety sensitivity: A further investigation. Journal of Anxiety Disorders, 15, 535–553.PubMedCrossRefGoogle Scholar
  83. Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7, 524–532.CrossRefGoogle Scholar
  84. Sullivan, M. J., Thorn, B., Haythornthwaite, J. A., Keefe, F., Martin, M., Bradley, L. A., et al. (2001). Theoretical perspectives on the relation between catastrophizing and pain. Clinical Journal of Pain, 17, 52–64.PubMedCrossRefGoogle Scholar
  85. Tessari, A., Tsakiris, M., Borghi, A. M., & Serino, A. (2010). The sense of body: A multidisciplinary approach to body representation. Neuropsychologia, 48, 643–644.PubMedCrossRefGoogle Scholar
  86. Tsakiris, M. (2010). My body in the brain: A neurocognitive model of body-ownership. Neuropsychologia, 48, 703–712.PubMedCrossRefGoogle Scholar
  87. Tsakiris, M., Prabhu, G., & Haggard, P. (2006). Having a body versus moving your body: How agency structures body-ownership. Consciousness and Cognition, 15, 423–432.PubMedCrossRefGoogle Scholar
  88. Tzelgov, J., & Henik, A. (1991). Suppression situations in psychological research: Definitions, implications, and applications. Psychological Bulletin, 109, 524–536.CrossRefGoogle Scholar
  89. Vujanovic, A. A., Zvolensky, M. J., Bernstein, A., Feldner, M. T., & McLeish, A. C. (2007). A test of the interactive effects of anxiety sensitivity and mindfulness in the prediction of anxious arousal, agoraphobic cognitions, and body vigilance. Behaviour Research and Therapy, 45, 1393–1400.PubMedCrossRefGoogle Scholar
  90. Yoshino, A., Okamoto, Y., Onoda, K., Yoshimura, S., Kunisato, Y., Demoto, Y., et al. (2010). Sadness enhances the experience of pain via neural activation in the anterior cingulate cortex and amygdala: An fMRI study. Neuroimage, 15, 1194–1201.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Karni Ginzburg
    • 1
  • Noga Tsur
    • 1
  • Ayelet Barak-Nahum
    • 1
  • Ruth Defrin
    • 2
  1. 1.The Bob Shapell School of Social WorkTel Aviv UniversityTel AvivIsrael
  2. 2.Department of Physical Therapy, School of Allied Health Professions, Sackler Faculty of MedicineTel-Aviv UniversityTel AvivIsrael

Personalised recommendations