Body awareness and reactivity dysfunction are characteristic of a range of psychiatric disorders. Although the neural pathways communicating between the body and brain that contribute to these experiences involve the autonomic nervous system, few research tools for studying subjective bodily experiences have been informed by these neural circuits. This paper describes the factor structure, reliability, and convergent validity of the Body Awareness and Autonomic Reactivity subscales of the Body Perception Questionnaire-Short Form (BPQ-SF). Exploratory and confirmatory factor analyses were applied to data from three samples collected via the internet in Spain and the US and a college population in the US (combined n = 1320). Body awareness was described by a single factor. Autonomic reactivity reflected unique factors for organs above and below the diaphragm. Subscales showed strong reliability; converged with validation measures; and differed by age, sex, medication use, and self-reported psychiatric disorder. Post hoc analyses were used to create the 12-item Body Awareness Very Short Form. Results are discussed in relation to the distinct functions of supra- and sub-diaphragmatic autonomic pathways as proposed by the Polyvagal Theory and their potential dysfunction in psychiatric disorders.

There is increasing amount of evidence pointing toward a high prevalence of psychiatric conditions among individuals with hypermobile type of Ehlers-Danlos syndrome (JHS/hEDS). A literature review confirms a strong association between anxiety disorders and JHSh/hEDS, and there is also limited but growing evidence that JHSh/ hEDS is also associated with depression, eating, and neuro-developmental disorders as well as alcohol and tobacco misuse. The underlying mechanisms behind this association include genetic risks, autonomic nervous system dysfunction, increased exteroceptive and interoceptive mechanisms and decreased proprioception. Recent neuroimaging studies have also shown an increase response in emotion processing brain areas which could explain the high affective reactivity seen in JHS/hEDS. Management of these patients should include psychiatric and psychological approaches, not only to relieve the clinical conditions but also to improve abilities to cope through proper drug treatment, psychotherapy, and psychological rehabilitation adequately coupled with modern physiotherapy. A multidimensional approach to this "neuroconnective phenotype" should be implemented to ensure proper assessment and to guide for more specific treatments. Future lines of research should further explore the full dimension of the psychopathology associated with JHS/hEDS to define the nature of the relationship. © 2017 Wiley Periodicals, Inc.KEY WORDS: joint hypermobility; anxiety; psychopathology; neuroconnective phenotype; hypermobile Ehlers-Danlos syndrome Professor Antonio Bulbena, M.D., M.Sc, Ph.D., is the Chair of the Department of Psychiatry at the Autonoma University of Barcelona with clinical, academic, and administrative contributions particularly in the area of psychosomatic medicine and anxiety disorders, dementia, chocolate and carbohydrates, clinical measurement in psychiatry, phobias, seasonality, and biometeorology. Has recently developed the Neuroconnective Phenotype and has published numerous books, book chapters, and scientific articles in peer-reviewed journals.Carolina Baeza-Velasco, Ph.D., is a clinical psychology at the Paris Descartes University, with important contributions in the area of psychological assessment and treatment of patients with comorbid anxiety disorders and joint hypermobility among other conditions. Has published several articles about the psychological factors of EDS and related conditions. Andrea Bulbena-Cabre, M.D., M.Sc., is a Psychiatry Research Fellow at the Icahn School of Medicine at Mount Sinai/J. J. Peters Bronx VA Hospital. She has specialized in psychosomatic medicine and is currently studying the anxiety-joint hypermobility phenomena in bipolar and psychotic spectrum disorders. Other research interests include substance abuse, especially in synthetic cannabis and psychosis.Guillem Pailhez, M.D., Ph.D., is an Assistant Professor at the Department of Psychiatry at the Autonoma University of Barcelona, has devoted his career in the study of the interactions between mind and body ...

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Objective: Anxiety is associated with increased physiological reactivity and also increased “interoceptive” sensitivity to such changes in internal bodily arousal. Joint hypermobility, an expression of a common variation in the connective tissue protein collagen, is increasingly recognized as a risk factor to anxiety and related disorders. This study explored the link between anxiety, interoceptive sensitivity and hypermobility in a sub-clinical population using neuroimaging and psychophysiological evaluation.Methods: Thirty-six healthy volunteers undertook interoceptive sensitivity tests, a clinical examination for hypermobility and completed validated questionnaire measures of state anxiety and body awareness tendency. Nineteen participants also performed an emotional processing paradigm during functional neuroimaging.Results: We confirmed a significant relationship between state anxiety score and joint hypermobility. Interoceptive sensitivity mediated the relationship between state anxiety and hypermobility. Hypermobile, compared to non-hypermobile, participants displayed heightened neural reactivity to sad and angry scenes within brain regions implicated in anxious feeling states, notably insular cortex.Conclusions: Our findings highlight the dependence of anxiety state on bodily context, and increase our understanding of the mechanisms through which vulnerability to anxiety disorders arises in people bearing a common variant of collagen.