What is the role of interoception in the symptom experience of people with a chronic condition? A systematic review

Locatelli, Giulia; Matus, Austin; James, Richard; Salmoirago‐Blotcher, Elena; Ausili, Davide; Vellone, Ercole; Riegel, Bárbara

doi:10.1016/j.neubiorev.2023.105142

Cited by 18 publications

(3 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interoception is also becoming ever more significant in the realm of mental health, as abnormal or reduced interoceptive processing is associated with various neurological and psychological conditions and exacerbations of their symptoms (Bonaz et al, 2021; Brewer et al, 2021; Nord & Garfinkel, 2022), among them depression and anxiety (Paulus & Stein, 2010), eating disorders (Khalsa et al, 2022), Alzheimer’s disease and other neurodegenerative disorders (Dobrushina, Arina, et al, 2020; Sun et al, 2022). Interoceptive abilities have been correlated with altruistic and prosocial tendencies (Contreras-Huerta et al, 2023; Piech et al, 2017), and lower symptom severity in sufferers of chronic conditions (Locatelli et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Training interoceptive awareness with real-time haptic vs. visual heartbeat feedback

Dobrushina,

Tamim,

Wald

et al. 2024

Preprint

View full text Add to dashboard Cite

The perception of signals from within the body, known as interoception, is increasingly recognized as a prerequisite for physical and mental health. The study is dedicated to the development of effective technological approaches for enhancing interoceptive awareness. We provide evidence of the effectiveness and practical feasibility of a novel real-time haptic heartbeat supplementation technology combining principles of biofeedback and sensory enhancement. In a randomized controlled study, we applied the developed naturalistic haptic feedback on a group of 30 adults, while another group of 30 adults received more traditional real-time visual heartbeat feedback. A single session of haptic, but not visual heartbeat feedback resulted in increased interoceptive accuracy and confidence, as measured by the heart rate discrimination task, and in a shift of attention towards the body. Participants rated the developed technology as more helpful and pleasant than the visual feedback, thus indicating high user satisfaction. The study highlights the importance of matching sensory characteristics of the feedback to the natural bodily prototype. Our work suggests that real-time haptic feedback might be a superior approach to strengthen mind-body interaction in interventions for physical and mental health.

show abstract

Section: Introductionmentioning

confidence: 99%

Training interoceptive awareness with real-time haptic vs. visual heartbeat feedback

Dobrushina,

Tamim,

Wald

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Another factor proposed to be implicated in FM is altered interoceptive accuracy (IA) although evidence is mixed so far. IA, defined as the ability to accurately perceive internal bodily signals (Garfinkel and colleagues, 2015;Locatelli et al, 2023), is essential in the ability to track and adjust to internal bodily changes. Diminished as well as heightened IA has been found in FM (Duschek and colleagues, 2016;Todd et al, 2024).…”

Section: Introductionmentioning

confidence: 99%

The relationship between autonomic nervous system function and interoceptive accuracy in persons with fibromyalgia versus healthy controls

Schoofs,

van Wijck,

Schroeter

et al. 2024

Preprint

View full text Add to dashboard Cite

Fibromyalgia (FM) is a common chronic primary pain syndrome in which underlying mechanisms remain largely unknown. The role of the autonomic nervous system (ANS) and interoceptive accuracy (IA), the ability to accurately sense internal body signals, in relation to pain sensitivity was examined in persons with FM which were compared to healthy controls. ANS activity was expected to differ in FM compared to controls, both at rest and while performing mental stressful tasks, and IA was expected to be different too. It was further explored whether IA mediates the relationship between ANS activity and pain. In total 108 participants (n=54 healthy controls and n=54 persons with FM) underwent ANS measures during alternating rest and mental stress conditions. These ANS measures consisted of skin conductance levels (SCL), heart rate (HR) and HR variability (HRV), cardiac output, pre-ejection period and stroke volume (SV). IA was measured using a heartbeat perception task and pain sensitivity was assessed by determining pressure pain thresholds. Several questionnaires were administered which were associated to ANS, IA and pain measures. During mental stress as compared to rest conditions, higher levels were found for SCL (p <.001) and HR (p <.001) in both groups, while SV (p <.004) was higher in rest versus in mental stress. Significant interactions between condition (rest versus mental stress) and groups (FM versus controls) were found for SCL (p =.04) and HR (p =.01), pointing to lower reactivity to stress in FM. Posthoc tests showed no significant group effects for the different conditions (i.e., for the rest or stress conditions). Group main effects were neither found for any of the ANS measures. Lower IA scores were found in FM compared to controls (p =.009). IA did not significantly mediate the relationship between ANS measures and pain thresholds. Since no differences between persons with FM and controls were found for any of the ANS measures, it can be concluded that ANS functions do not seem to be a crucial underlying mechanism in FM, at least in the relatively healthy subgroup included in this study. Importantly however, results showed that IA is diminished in FM. The role of IA in the pathogenesis and treatment of (at least a subgroup of persons with) FM requires further study. Also, studies into interoceptive modalities other than heartbeat perception are needed.

show abstract

“…Body awareness is closely related to and influenced by proprioception, exteroception and interoception ( 8 ), where interoception is shown to play a role in the symptom experience of chronic pain ( 9 ). Interoception involves sensing, interpreting, and regulating internal body signals and encompasses communication between peripheral systems and the central nervous system ( 10 ). In the literature, body awareness is occasionally delineated as interoceptive awareness, wherein it is characterized as either adaptive or maladaptive ( 11 , 12 ).…”

mentioning

confidence: 99%

Body awareness, stress and symptoms in autonomic dysfunction in patients with chronic pain: an explorative study

Varkey,

Gottfridsson,

Grimby-Ekman

et al. 2024

JRM-CC

View full text Add to dashboard Cite

Objective: To assess pain outcomes, stress levels and body awareness among patients with chronic pain and explore potential associations between these variables. Design: An explorative study. Methods: Patients with chronic pain in primary and specialist care were assessed regarding pain intensity using the Numerical Rating Scale (NRS; 0–10 point scale) and stress levels using the Stress and Crisis Inventory (SCI-93; 0–140). To assess body awareness, multidimensional assessment of interoceptive awareness (MAIA; 0–5), a widely used self-report measure of interoceptive bodily awareness was used. Results: Participants (n = 42) reported an average NRS of 4.4, elevated stress levels and low body awareness. Stress levels were moderately correlated with pain intensity (r = 0.53; p < 0.001; 95% confidence interval [CI] 0.25–0.72) and number of pain sites (r = 0.58; p < 0.001; 95% CI 0.32–0.76). The regression analysis showed that pain outcomes predicted stress level scores and explained almost 50% of variance (R2 = 0.47, p < 0.001). Moreover, shorter pain duration predicted a higher body awareness (p = 0.04). Conclusion: In patients with chronic pain, high pain intensity and multiple painful sites seem to be associated with impaired stress regulation. The patients had low body awareness, which was negatively influenced by pain duration.

show abstract

What is the role of interoception in the symptom experience of people with a chronic condition? A systematic review

Cited by 18 publications

References 51 publications

Training interoceptive awareness with real-time haptic vs. visual heartbeat feedback

Training interoceptive awareness with real-time haptic vs. visual heartbeat feedback

The relationship between autonomic nervous system function and interoceptive accuracy in persons with fibromyalgia versus healthy controls

Body awareness, stress and symptoms in autonomic dysfunction in patients with chronic pain: an explorative study

Contact Info

Product

Resources

About