He Who Seeks Finds (Bodily Signals): Differential Effects of Self-Reported Interoceptive Attention and Accuracy on Subclinical Psychopathology in a German-Speaking Sample

Abstract

Alterations in interoception - the perception of internal bodily signals - have been repeatedly linked to psychopathology. Recent findings suggest that both the attention devoted to, and the accuracy of, interoceptive perceptions have opposed effects on subclinical symptomatology such as alexithymia. Thus, providing well-validated tools that tap onto these interoceptive processes is crucial for advancing the understanding of the relation between interoceptive processing and subclinical psychopathology. In the current multicenter study (N = 857), we aimed to (1) validate the German version of the Interoceptive Attention Scale (IATS; Gabriele et al., 2022), and (2) test the differential association of subjective interoceptive attention and accuracy with subclinical psychopathology, including alexithymia, somatic, depressive, and anxious symptomatology. Across three samples we found a one-factor solution to be the best-fitting model for the IATS. The IATS also showed good internal consistency but poor test-retest reliability. In terms of convergent and discriminate validity, the IATS showed positive correlations with other proposed measures of interoceptive attention, but no relationship with measures of interoceptive accuracy. Further, subjective interoceptive attention and accuracy scores were differentially related to subclinical psychopathology: self-reported interoceptive attention was significantly positively related to all measures of psychopathology (except for depressive symptomatology), interoceptive accuracy scores, however, showed significant negative or nonsignificant relations with subclinical measures of psychopathology. Altogether our data suggest that the IATS is a reliable and valid instrument that can be applied to German samples. Moreover, our findings emphasize the need to distinguish between constructs of interoception in relation to subclinical psychopathology.

Bridging the Gap between Interoception and Mental Health: The German Validation of the Interoceptive Accuracy Scale (IAS) and its Relation to Psychopathological Symptom Burden

“…In particular, such interpretation might depend on language and cultural aspects. Whereas in English, awareness might be more strongly associated with attention (Gabriele et al, 2022), in German, the word awareness (Bewusst-Sein) is conceptually closer to the word accuracy and thus more related to subjective interoceptive accuracy than attention (Tünte et al, 2022). Giving support to this notion, it has recently been observed that the relation between the body awareness scale of the BPQ-(V)SF and selfreported interoceptive accuracy and attention is dependent on participants' interpretation.…”

“…Part of the participants recruited in Vienna and Potsdam were used for validation of other interoception-related questionnaires (Tünte, et al, 2022) or to investigate their relation to emotional experience (Ventura-Bort et al, 2021).…”

“…Providing initial support for the 2x2 factorial model, recent studies have shown that subjective interoceptive attention and accuracy are differentially related to external criteria, as is the case with alexithymia, a condition characterized by difficulties identifying and describing one's own emotions (Brewer et al, 2021, p. 470). Whereas subjective interoceptive attention scores have shown none (Campos et al, 2021) or a positive association with alexithymia scores (Gaggero et al, 2021;Tünte et al, 2022), objective and subjective scores on interoceptive accuracy have been negatively associated with alexithymic traits (Brewer, et al, 2016;Campos et al, 2021;Murphy et al, 2020;Murphy et al, 2018).…”

“…Further, this raises the question of whether interoceptive accuracy and attention are related to other clinical symptoms. Bridging these gaps, the present study aimed at adapting the German version of the IAS (for a validation of the IATS see Tünte et al, 2022) and investigating the relationship between subjective interoceptive accuracy and measures of psychopathology, including trait neuroticism and alexithymia as well as, somatoform, anxiety, and depressive symptomatology.…”