Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

Abstract

Perception of internal bodily sensations includes three dissociable processes: interoceptive accuracy, interoceptive sensibility, and interoceptive awareness. Interoceptive abilities play a crucial role in emotion processing and impairments of these processes have been reported in several psychiatric disorders. Studies investigating interoceptive abilities and their role in emotional experience in individuals with somatic disorders such as inflammatory bowel diseases (IBD) are sparse. Recent findings suggested an association between adverse childhood experiences (ACE) and the development of gastrointestinal disorders. The aim of the current study was to investigate the associations between the different dimensions of interoception and emotional processing in IBD while taking ACE into account. We recruited IBD patients in clinical remission (n = 35) and 35 healthy control participants (HC) matched for age, education and IQ. Interoception was measured as a three-dimensional construct. Interoceptive accuracy was assessed with the heartbeat tracking task and interoceptive sensibility with a self-report measure (Multidimensional Assessment of Interoceptive Awareness questionnaire). Emotional processing was measured using an experimental task, where participants were asked to rate the subjectively perceived valence and arousal when presented with positive, neutral and negative visual stimuli. IBD patients significantly differed in two interoceptive sensibility domains, Emotional awareness and Not-distracting. Patients reported greater awareness of the connection between bodily sensations and emotional states, while showing a stronger tendency to use distraction from unpleasant sensations compared with HC. Higher emotional awareness was linked to higher perceived intensity and arousal of negative stimuli. The strength of this relation was dependent on the severity of ACE, with severer traumatization being associated with a stronger association between emotional awareness and perceived valence and arousal. Our findings suggest that it is the subjective component of interoception, especially the one assessing interoceptive abilities within the scope of emotional experience, which affects emotional processing in IBD. This is the first study providing evidence that IBD patients did not differ in their perception of visceral signals per se but only in the subjective ability to attribute certain physical sensations to physiological manifestations of emotions. Our findings support the hypothesis that ACE affect the association between interoception and emotional processing.

The Effect of Empowering Education Combined With Mindfulness Meditation Training on Negative Emotion and Quality of Life in Patients With Inflammatory Bowel Disease

“…IBD patients are more prone to negative emotions such as anxiety and depression, and their quality of life is significantly reduced ( Rogler et al, 2021 ). Long-term negative emotions will not only aggravate the patient’s condition, but also lead to new psychosomatic symptoms, reduce the patient’s quality of life, affect the treatment of inflammatory bowel disease, and increase the risk of relapse ( Atanasova et al, 2021 ). Mindfulness meditation is a form of body and mind based intervention to guide patients to focus their personal attention on the current experience with an open, curious and receptive attitude ( Gok Metin et al, 2019 ).…”

Intra and inter: Alterations in functional brain resting-state networks in patients with functional constipation

“…Several psychiatric disorders, such as eating disorders (Perry et al, 2021) and depression (Eggart et al, 2021;Hielscher and Zopf, 2021), impair these processes. Regarding somatic diseases such as IBD, previous studies have focused on interoceptive abilities and their role in emotional processing (Longarzo et al, 2017;Atanasova et al, 2021). In light of our findings, future research on FCon should focus on interoceptive abilities, emotion processing, and sensorimotor control.…”

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

“…Such error signals might even replace habitual disregard of bodily symptoms by perceptions of physical symptoms in a positive feedback loop [ 85 ], thereby representing interoceptive regulation attempts [ 84 ]. Therefore, alterations in some interoceptive processes might only to be expected during homeostatic perturbations [ 86 ] such as acute stress [ 51 , 52 , 87 ]. Whether further interoceptive processes might emerge as mediators during active emotion regulation demands in individuals with TCEs needs to be investigated in future studies.…”

“…Importantly, the results obtained in the current study were comparable to previous studies. However, future studies should adapt and compare different interoceptive tasks which incorporate different interoceptive organ systems and physical arousal states [ 87 , 110 – 112 ], instead of the original heartbeat counting task.…”