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An empirical framework for interoceptive sensibility as a transdiagnostic feature of autonomic regulation: a potential mediator of trauma-related psychopathology and somatic mindfulness intervention effects (Abstract and Citation only)
Thesis

An empirical framework for interoceptive sensibility as a transdiagnostic feature of autonomic regulation: a potential mediator of trauma-related psychopathology and somatic mindfulness intervention effects (Abstract and Citation only)

Caitlin Anna Laycox
Southern Cross University, Psychology
Doctor of Philosophy (PhD), Southern Cross University
2024
DOI:
https://doi.org/10.25918/thesis.534

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Abstract

Interoceptive sensibility Interoception Emotion regulation Trauma Trauma-informed yoga Postpartum depression Mismatch negativity Heart rate variability
Dysfunction in interoceptive sensibility, the self-reported interpretation of the body’s internal signalling, has been shown to play a pivotal role in a diverse range of psychological disorders, likely due to the observed integral relationship with emotional regulation and self-regulatory behaviour. Interoceptive sensibility is noted as an important transdiagnostic feature of stress and trauma-related psychopathology that underpins somatic-based mindfulness intervention effects. However, research that specifically assesses this construct as a mediator between somatic-based mindfulness interventions and their effects are limited. To address this gap, the present research had three principal aims. Study 1 Background. The first aim was to assess whether interoceptive sensibility mediates the relationship between previous trauma experience and stress-related psychopathology, such as postpartum depression (PPD). Methods. This was assessed using a cross-sectional survey analysis of seventy-five postpartum women to identify which factors were the strongest predictors of PPD symptoms while also considering the potential mediating effect of interoceptive sensibility on salient predictors and subsequent PPD severity. Results. As anticipated, diminished interoceptive sensibility was significantly related to increased PPD symptoms and significantly mediated the pathway between reported previous trauma experience and PPD symptoms. Additionally, two domains of interoceptive sensibility (trusting and not distracting) independently mediated the relationship between antenatal depression and PPD symptoms. Conclusion. Collectively, these results suggests that interoceptive sensibility may be related to PPD severity, and partially explains the pathway by which trauma experience and antenatal depression lead to PPD severity. Study 2 Background. A secondary aim of this research was to assess whether changes in interoceptive sensibility mediate somatic-based mindfulness intervention effects. Methods. This aim was assessed in a pilot trial including 24 participants experiencing mild to severe stress. This trial explored the effectiveness of a trauma-informed yoga (TIY) intervention to reduce stress, improve interoceptive sensibility, and improve emotional regulation compared to a placebo control take-home mindfulness program. Results. Results indicated that there were significant improvements in stress symptoms, emotional regulation and interoceptive sensibility from baseline to post-intervention. These effects, however, were found for both groups. Interoceptive sensibility did not mediate stress changes from baseline to post-intervention, however changes in emotional regulation accounted for almost 70% of unique variance in stress changes across the intervention in the TIY group. Conclusion. Results did not support the role of interoceptive sensibility as a mediator of intervention effects. Emotional dysregulation may have been a more relevant mechanism of action on stress reduction in the TIY intervention. The observed mirrored improvement in primary outcomes in the control group may have been inflated due to a placebo effect. Study 3 Background. The final aim of this research was to assess potential biomarkers of interoceptive sensibility, namely, heart rate variability (HRV) and EEG mismatch negativity (MMN). Methods. This was assessed in the pilot TIY trial, using a correlational analysis of primary and psychophysiological outcomes at baseline for all participants. Results. Correlational results indicated a significant relationship between three HRV metrics and interoceptive sensibility. However, the direction of this relationship was contrary to predictions. A follow-up correlational analysis at post-intervention did not support the same relationships as baseline. Conclusion. Interpretation of the direction of the observed relationships may suggest that interoceptive sensibility was related to sympathetic (stress- related) markers of autonomic regulation rather than adaptive HRV metrics as hypothesised. Further research is needed to follow-up the stability of these psychophysiological markers over time on a larger sample.

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