Interoception, Stress, and Physical Symptoms in Stress-Associated 					Diseases

Schulz, André; Schultchen, Dana; Vögele, Claus

doi:10.1027/2512-8442/a000063

Cited by 20 publications

(9 citation statements)

References 203 publications

(284 reference statements)

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“…These inconsistent findings might result from methodological differences between the studies, such as various instructions. Moreover, associations between interoceptive abilities and stress were found (e.g., Schulz and Vögele, 2015 ; Maeda et al, 2019 ; Schultchen et al, 2019a ; Schulz et al, 2020 ; Opdensteinen et al, 2021 ). Furthermore, decreased interoceptive abilities have been assumed to play a role in the perception of somatic symptoms ( van den Bergh et al, 2017 , 2019 ).…”

Section: Introductionmentioning

confidence: 98%

The Effects of a 3-Week Heartbeat Perception Training on Interoceptive Abilities

et al. 2022

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Recent studies showed promising short-term effects of heartbeat perception training on interoceptive abilities. Research on the effects of heartbeat perception training on interoceptive abilities over time is sparse. Therefore, the aim of this study was to examine the short-term effects and the effects of a 3-week heartbeat perception training over time on interoceptive abilities, namely, cardiac interoceptive accuracy (IAc) and interoceptive sensibility (IS). A total of 40 healthy participants were randomized to the intervention group (n = 20) or the control group (n = 20). The intervention group conducted three cardiac biofeedback sessions (one per week) at the laboratory, whereas the control group watched a documentary instead. Interoceptive abilities were assessed via the heartbeat perception task (IAc) and confidence ratings (IS) at baseline, after each laboratory session, and 1 week after the last session (post-measurement). IAc was significantly increased in the intervention group compared to the control group after the first training session (short-term effect). There were no significant improvements in IS due to the first session, and neither on IAc nor IS over time. Descriptive trends of improved interoceptive abilities over time were found in both groups. Single session of heartbeat perception training seems to be a promising approach to improve IAc. Future research should further investigate the long-term effects of diverse heartbeat perception training varying in frequency and intensity of the training sessions in diverse samples aiming to improve interoceptive abilities.

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Section: Introductionmentioning

confidence: 98%

The Effects of a 3-Week Heartbeat Perception Training on Interoceptive Abilities

et al. 2022

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“…One such mechanism might be stress. Stress responses form a complex neuro-behavioral cascade, which includes physiological changes and corresponding physical symptoms [ 83 ]. While acute stress reflects a response to a potentially harmful stimulus of limited duration, chronic stress can be elicited either by prolonged exposure or perpetuated in the aftermath of severe stressors.…”

Section: Discussionmentioning

confidence: 99%

The impact of traumatic childhood experiences on interoception: disregarding one’s own body

Schmitz

Back

Seitz

et al. 2023

bord personal disord emot dysregul

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Background Deficient interoception, the processing and perception of internal bodily signals, has been discussed as a mechanism underlying various mental disorders. First results indicate a mediating role of interoception in the interplay of traumatic childhood experiences and adult mental disorders. Traumatic childhood experiences may hinder the adequate processing, integration, and trust in bodily signals that are important in order to understand and regulate own needs and emotions, thereby increasing the vulnerability for mental disorders. However, an overarching study investigating alterations in different interoceptive measures and trauma-related disorders as well as their mediating role between early trauma and emotion dysregulation is still missing. Methods One hundred thirty-six individuals with varying levels of traumatic childhood experiences who either had a current diagnosis of major depression, posttraumatic stress disorder, or somatic symptom disorder, or no mental disorder, took part in a multidimensional assessment of interoceptive processes, including interoceptive accuracy, sensibility, and awareness. Kruskal–Wallis tests were used to compare groups regarding interoceptive processes and associations with traumatic childhood experiences and emotion dysregulation were analyzed with Spearman correlations. Furthermore, mediation analyses were computed to examine and compare interoceptive processes as potential mediators between traumatic childhood experiences and emotion dysregulation. Results Only body dissociation, a measure for interoceptive sensibility, was significantly reduced in individuals with a current mental disorder. Body dissociation was also the only interoceptive measure significantly associated with traumatic childhood experiences and emotion dysregulation and the only significant mediator in the relationship between traumatic childhood experiences and emotion dysregulation across groups. Conclusion Results suggest body dissociation, but not other interoceptive measures, as an important feature linking traumatic childhood experiences to current emotion dysregulation, an important transdiagnostic feature. As body dissociation refers to a habitual non-attendance or disregard of interoceptive signals, integrative therapeutic interventions could help affected individuals to overcome difficulties in emotion perception and regulation. Trial registration The general study design was preregistered; see the German Clinical Trials Register (DRKS-ID: DRKS00015182). This study’s analysis plan was not preregistered.

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“…Alterations in interoceptive signaling may be one mechanism by which an increase in PTSD symptoms may have contributed to increased perception of cardiac symptoms. Activation of physiological stress axes in traumatized individuals may lead to inaccurate perception of interoceptive body signals ( 38 ). In PTSD, cardiac interoceptive accuracy, reflecting correspondence between the perceived and the actual heartbeat signal, is reduced ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between Changes in Post-hospital Cardiac Symptoms and Changes in Acute Coronary Syndrome-Induced Symptoms of Post-traumatic Stress

Känel

Meister-Langraf

Zuccarella-Hackl

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAfter acute coronary syndrome (ACS), one in eight patients develops clinically significant symptoms of Post-traumatic stress disorder (PTSD). We hypothesized that changes in cardiac symptoms from 3 to 12 months after ACS are associated with changes in ACS-induced PTSD symptoms.MethodsAt 3 (n = 154) and/or 12 months (n = 106) post-ACS, patients (n = 156, mean age 59 years, 85% men) completed a clinical interview assessing chest tightness/pain (at rest and/or during exertion), heartbeat symptoms (heart palpitations, racing of heart, heart stumbling or skipping a beat) and PTSD symptoms during the prior 4 weeks. Random mixed regression models examined the association between the onset (or remission) from 3 to 12 months in cardiac symptoms with changes in PTSD symptoms, adjusting for a range of potential predictors of ACS-induced PTSD symptoms.ResultsThe onset of chest tightness/pain [estimate = 0.588, 95% confidence interval: 0.275, 0.090; p < 0.001] and of heartbeat symptoms [0.548 (0.165, 0.931); p = 0.005] from 3 to 12 months was independently associated with an increase in total PTSD symptoms. There were also independent associations between the onset of chest tightness/pain and heartbeat symptoms with an increase in PTSD symptom clusters. Specifically, the onset of chest tightness/pain showed associations with an increase in re-experiencing [0.450 (0.167, 0.733); p = 0.027] and avoidance/numbing [0.287 (0.001, 0.574); p = 0.049]. The onset of heartbeat symptoms showed associations with an increase in re-experiencing [0.392 (0.045, 0.739); p = 0.002], avoidance/numbing [0.513 (0.161, 0.864); p = 0.004] and hyperarousal [0.355 (0.051, 0.659); p = 0.022]. An increase in the total number of cardiac symptoms (score range 0–6) was also associated with an increase in total PTSD symptoms [0.343 (0.202, 0.484); p < 0.001]. Psychotherapy in the post-hospital period moderated the association between the change in heartbeat symptoms and the change in total PTSD symptoms [−0.813 (−1.553, −0.074); p = 0.031 for interaction]; the association between the onset of heart beat symptoms and an increase in total PTSD symptoms was weaker in patients who attended psychotherapy [0.437 (−0.178, 1.052); p = 0.16] than in those who did not [0.825 (0.341, 1.309); p < 0.001].ConclusionChanges in cardiac symptoms between 3 and 12 months after hospitalization are associated with changes in ACS-induced PTSD symptoms. ClinicalTrials.gov #NCT01781247.

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Interoception, Stress, and Physical Symptoms in Stress-Associated Diseases

Cited by 20 publications

References 203 publications

The Effects of a 3-Week Heartbeat Perception Training on Interoceptive Abilities

The Effects of a 3-Week Heartbeat Perception Training on Interoceptive Abilities

The impact of traumatic childhood experiences on interoception: disregarding one’s own body

Association Between Changes in Post-hospital Cardiac Symptoms and Changes in Acute Coronary Syndrome-Induced Symptoms of Post-traumatic Stress

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