Disentangling the role of interoceptive sensibility in alexithymia, emotion dysregulation, and depression in healthy individuals

Abstract

Interoception, a multifaceted concept defined as the perception of internal bodily signals, is crucially involved in mental health in general and in emotion regulation in particular, being interoceptive sensibility (IS) one of the most studied interoceptive processes. The main objective of this study was to explore the relationships between IS and emotion regulation processes, analyzing the role of the eight IS dimensions assessed by the Multidimensional Assessment of Interoceptive Awareness-2 (MAIA-2) in alexithymia, emotion dysregulation, and depression. Additionally, this study also aimed to validate the MAIA-2 in a Spanish sample. To do so, 391 healthy adults, native Peninsular Spanish speakers (61.0% women, Mage = 29.00, SDage = 11.40), completed the MAIA-2 and other self-reported questionnaires to measure alexithymia, emotion dysregulation, and depressive symptoms. Results showed that lower scores on the IS dimensions that involve an accepting attitude toward the bodily signals (e.g., not-worrying) were related to alexithymia and emotion dysregulation, which, in turn, predicted depression. Moreover, the eight-factor structure of the MAIA-2 was confirmed with acceptable fit indices. This study highlights the multidimensional nature of the IS and the relevance of IS dimensions that involve a positive appraisal of the body in regulating emotions.

Identifying and regulating emotions after acquired brain injury: the role of interoceptive sensibility

“…These associations are consistent with previous studies showing that trusting in bodily sensations is one of the interoceptive sensibility aspects that has been most consistently related to decreased emotional disturbances and greater well-being in different populations (Brown et al, 2017;Zamariola et al, 2018;Schmitz et al, 2021). Moreover, not distracting from and not-worrying about uncomfortable bodily signals was associated with lower emotion dysregulation, which is also congruent with the findings by Desdentado et al (2023). Taken together, these findings are in line with the existing evidence on the positive effects of mindfulness-based approaches on emotional processing (Wu et al, 2019), given that some core components of mindfulness refer to attending to the present experience and bodily states with a non-judgmental attitude even if they are unpleasant (as opposed to experiencing it as something to worry about or be wary of).…”

“…This framework highlights the relevance of interoceptive sensibility dimensions involving a non-judgmental, accepting attitude and appraisal towards bodily sensations over their subjective noticing in purely quantitative terms. Consistent with this theoretical proposal, a recent study conducted on healthy participants showed that MAIA dimensions that emphasize the adaptive appraisal of interoceptive cues play a relevant role in explaining depressive symptomatology through the mediating role of alexithymia and difficulties in emotion regulation ( Desdentado et al, 2023 ). Specifically, it was found that not-distracting from and not-worrying about uncomfortable bodily sensations, as well as trusting one’s bodily cues and being able to voluntarily focus on them ( attention regulation ) were related to lower alexithymia, which in turn led to lower depressive symptomatology.…”

“…In addition, some of its dimensions conceptually overlap alexithymia, such as the lack of emotional awareness and lack of emotional clarity subscales. Therefore, we focused on the lack of emotional control subscale of the DERS as an index of emotion dysregulation in the structural equation model, as in a previous study conducted by Desdentado et al (2023). Desdentado et al 10.3389/fpsyg.2023.1268926 Frontiers in Psychology 07 frontiersin.org symptomatology (HADS).…”

The Relationship Between Interoceptive Awareness, Emotion Regulation and Clinical Symptoms Severity of Depression, Anxiety and Somatization

“…Unlike all other variables that showed a negative association, accept and notice showed a positive association with depression and anxiety, proposing that high levels of accept and notice may be risk factors depending on the pathological context in which each is manifested. Though many studies suggest that there’s a negative association between the accept subscale and depression [ 54 , 55 ], there may be some situations in which accept leads to passivity or inaction. For example, when an individual experiences bodily sensations that are consistently negative and distressing, such as fatigue, yet does not take action to address the underlying causes of this sensation, it could result in negative consequences, including continued emotional distress, decreased motivation to make positive changes, and a sense of helplessness or hopelessness.…”

Brain–heart dynamics during emotional processing under uncertain conditions: An index of depression risk

“…The disturbance of interoception in MDD may result from an inefficient internal model and unreliable prediction errors (19). Using the structural equation model, a study demonstrated that low levels of interoceptive awareness lead to alexithymia and emotional dysregulation, which in turns predict depression risk (20); this study used a self-report questionnaire to assess interoceptive awareness, namely, the Multidimensional Assessment of Interoceptive Awareness-2 (MAIA-2) (21). In contrast to the aforementioned study, which collected subjective questionnaire data using the MAIA-2, we recorded objective neurophysiological data.…”