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An Investigation of the Effects of Brief Mindfulness Training on Self-Reported Interoceptive Awareness, the Ability to Decenter, and Their Role in the Reduction of Depressive Symptoms

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Abstract

Mindfulness-based interventions for the prevention and treatment of depression are predicated on the idea that interoceptive awareness represents a crucial foundation for the cultivation of adaptive ways of responding to negative thoughts and mood states such as the ability to decenter. The current study used a multi-dimensional self-report assessment of interoceptive awareness, including regulatory and belief-related aspects of the construct, in order to characterize deficits in interoceptive awareness in depression, investigate whether brief mindfulness training could reduce these deficits, and to test whether the training unfolds its beneficial effects through the above-described pathway. Currently depressed patients (n = 67) were compared to healthy controls (n = 25) and then randomly allocated to receive either a brief training in mindfulness (per-protocol sample of n = 32) or an active control training (per-protocol sample of n = 28). Patients showed significant deficits across a range of regulatory and belief-related aspects of interoceptive awareness, mindfulness training significantly increased regulatory and belief-related aspects of interoceptive awareness, and reductions in depressive symptoms were mediated through a serial pathway in which training-related increases in aspects of interoceptive awareness were positively associated with the ability to decenter, which in turn was associated with reduced symptoms of depression. These results support the role of interoceptive awareness in facilitating adaptive responses to negative mood.

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  • 13 February 2019

    Maria Fissler and Emilia Winnebeck also are affiliated with the Department of Psychiatry and Psychotherapy, Charit??Universit?tsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany

  • 13 February 2019

    Maria Fissler and Emilia Winnebeck also are affiliated with the Department of Psychiatry and Psychotherapy, Charit�����Universit��tsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany

References

  • Avery, J. A., Drevets, W. C., Moseman, S. E., Bodurka, J., Barcalow, J. C., & Simmons, W. K. (2014). Major depressive disorder is associated with abnormal interoceptive activity and functional connectivity in the insula. Biological Psychiatry, 76(3), 258–266. doi:10.1016/j.biopsych.2013.11.027.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio: Psychological Corporation.

    Google Scholar 

  • Bieling, P. J., Hawley, L. L., Bloch, R. T., Corcoran, K. M., Levitan, R. D., Young, L. T., … Segal, Z. V. (2012). Treatment-specific changes in decentering following mindfulness-based cognitive therapy versus antidepressant medication or placebo for prevention of depressive relapse, Journal of Consulting and Clinical Psychology, 80(3), 365–372. doi:10.1037/a0027483

  • Bornemann, B., Herbert, B. M., Mehling, W. E., & Singer, T. (2015). Differential changes in self-reported aspects of interoceptive awareness through 3 months of contemplative training. Frontiers in Psychology, 6, 504.

    Google Scholar 

  • Craig, A. D. (2002). How do you feel? Interoception: the sense of the physiological condition of the body. Nature Reviews Neuroscience, 3(8), 655–666.

    Article  PubMed  Google Scholar 

  • Critchley, H. D., Wiens, S., Rotshtein, P., Ohman, A., & Dolan, R. J. (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience, 7(2), 189–195. doi:10.1038/nn1176.

    Article  Google Scholar 

  • Delgado-Pastor, L. C., Ciria, L. F., Blanca, B., Mata, J. L., Vera, M. N., & Vila, J. (2015). Dissociation between the cognitive and interoceptive components of mindfulness in the treatment of chronic worry. Journal of Behavior Therapy and Experimental Psychiatry, 48, 192–199. doi:10.1016/j.jbtep.2015.04.001.

    Article  PubMed  Google Scholar 

  • Dunn, B. D., Dalgleish, T., Ogilvie, A. D., & Lawrence, A. D. (2007). Heartbeat perception in depression. Behaviour Research and Therapy, 45(8), 1921–1930. doi:10.1016/j.brat.2006.09.008.

    Article  Google Scholar 

  • Dunn, B. D., Galton, H. C., Morgan, R., Evans, D., Oliver, C., Meyer, M., … Dalgleish, T. (2010a). Listening to your heart. How interoception shapes emotion experience and intuitive decision making, Psychological Science, 21(12), 1835–44. doi:10.1177/0956797610389191

  • Dunn, B. D., Stefanovitch, I., Evans, D., Oliver, C., Hawkins, A., & Dalgleish, T. (2010b). Can you feel the beat? Interoceptive awareness is an interactive function of anxiety- and depression-specific symptom dimensions. Behaviour Research and Therapy, 48(11), 1133–1138. doi:10.1016/j.brat.2010.07.006.

    Article  PubMed  PubMed Central  Google Scholar 

  • First, M. D., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2002). Structured Clinical Interview for DSM-IV TR Axis I disorders, research version. New York: Biometrics Research, New York State Biometric Institute.

    Google Scholar 

  • Fresco, D. M., Moore, M. T., van Dulmen, M. H. M., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behavior Therapy, 38(3), 234–246. doi:10.1016/j.beth.2006.08.003.

    Article  PubMed  Google Scholar 

  • Füstös, J., Gramann, K., Herbert, B. M., & Pollatos, O. (2013). On the embodiment of emotion regulation: interoceptive awareness facilitates reappraisal. Social Cognitive and Affective Neuroscience, 8(8), 911–917. doi:10.1093/scan/nss089.

    Article  PubMed  Google Scholar 

  • Garfinkel, S. N., & Critchley, H. D. (2013). Interoception, emotion and brain: new insights link internal physiology to social behaviour. Commentary on: "Anterior insular cortex mediates bodily sensibility and social anxiety" by Terasawa et al. (2012). Social Cognitive and Affective Neuroscience, 8(3), 231–234.

    Article  PubMed  PubMed Central  Google Scholar 

  • Garfinkel, S. N., Seth, A. K., Barrett, A. B., Suzuki, K., & Critchley, H. D. (2015). Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology, 104, 65–74.

    Article  PubMed  Google Scholar 

  • Gecht, J., Kessel, R., Mainz, V., Gauggel, S., Drueke, B., Scherer, A., & Forkmann, T. (2014). Measuring decentering in self-reports: psychometric properties of the experiences questionnaire in a German sample. Psychotherapy Research : Journal of the Society for Psychotherapy Research, 24(1), 67–79. doi:10.1080/10503307.2013.821635.

    Article  Google Scholar 

  • Hart, W. (1987). The art of living: Vipassana meditation as taught. (S. N. Goenka, Ed.). New York, NY: Harper Collins.

  • Hautzinger, M., Keller, F., & Kuehner, C. (2009). Beck Depressionsinventar Revision. Frankfurt: Pearson Assessment.

    Google Scholar 

  • Hayes, A.F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: Guilford Press

  • Herbert, B. M., & Pollatos, O. (2014). Attenuated interoceptive sensitivity in overweight and obese individuals. Eating Behaviors, 15(3), 445–448. doi:10.1016/j.eatbeh.2014.06.002.

    Article  PubMed  Google Scholar 

  • Herbert, B. M., Pollatos, O., & Schandry, R. (2007). Interoceptive sensitivity and emotion processing: an EEG study. International Journal of Psychophysiology : Official Journal of the International Organization of Psychophysiology, 65(3), 214–227. doi:10.1016/j.ijpsycho.2007.04.007.

    Article  Google Scholar 

  • Herbert, B. M., Herbert, C., & Pollatos, O. (2011). On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness? Journal of Personality, 79(5), 1149–1175. doi:10.1111/j.1467-6494.2011.00717.x.

    Article  PubMed  Google Scholar 

  • Herbert, B. M., Blechert, J., Hautzinger, M., Matthias, E., & Herbert, C. (2013). Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index, Appetite, 70, 22–30. doi:10.1016/j.appet.2013.06.082.

    PubMed  Google Scholar 

  • Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537–559. doi:10.1177/1745691611419671.

    Article  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta Trade Paperbacks.

    Google Scholar 

  • Kerr, C. E., Sacchet, M. D., Lazar, S. W., Moore, C. I., & Jones, S. R. (2013). Mindfulness starts with the body: somatosensory attention and top-down modulation of cortical alpha rhythms in mindfulness meditation, Frontiers in Human Neuroscience, 7(JAN), 12. doi:10.3389/fnhum.2013.00012

  • Mehling, W. E., Wrubel, J., Daubenmier, J. J., Price, C. J., Kerr, C. E., Silow, T., & Stewart, A. L. (2011). Body awareness: a phenomenological inquiry into the common ground of mind-body therapies. Philosophy, Ethics, and Humanities in Medicine : PEHM, 6(1), 6. doi:10.1186/1747-5341-6-6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mehling, W. E., Price, C., Daubenmier, J. J., Acree, M., Bartmess, E., & Stewart, A. (2012). The multidimensional assessment of interoceptive awareness (MAIA). PloS One, 7(11), e48230. doi:10.1371/journal.pone.0048230.

    Article  PubMed  PubMed Central  Google Scholar 

  • Parkin, L., Morgan, R., Rosselli, A., Howard, A., Sheppard, A., Evans, D., Hawkins, A., Martinelli, M., Golden, A.-M., Dalgleish, T., & Dunn, B. (2014). Exploring the relationship between mindfulness and cardiac perception. Mindfulness, 5(3), 298–313.

    Article  Google Scholar 

  • Paulus, M. P., & Stein, M. B. (2010). Interoception in anxiety and depression. Brain Structure & Function, 214(5–6), 451–463.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.

    Article  Google Scholar 

  • Sanfey, A. G., Rilling, J. K., Aronson, J. A., Nystrom, L. E., & Cohen, J. D. (2003). The neural basis of economic decision-making in the ultimatum game. Science, 300(5626), 1755–1758. doi:10.1126/science.1082976.

    Article  Google Scholar 

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Teasdale, J. D. (1999a). Emotional processing, three modes of mind and the prevention of relapse in depression. Behaviour Research and Therapy, 37(Suppl 1), S53–S77. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10402696.

    Article  PubMed  Google Scholar 

  • Teasdale, J. D. (1999b). Metacognition, mindfulness and the modification of mood disorders. Clinical Psychology & Psychotherapy, 6(2), 146–155. doi:10.1002/(SICI)1099-0879(199905)6:2<146::AID-CPP195>3.0.CO;2-E.

    Article  Google Scholar 

  • Terhaar, J., Viola, F. C., Bär, K.-J., & Debener, S. (2012). Heartbeat evoked potentials mirror altered body perception in depressed patients. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 123(10), 1950–1957. doi:10.1016/j.clinph.2012.02.086.

    Article  Google Scholar 

  • Watkins, E. (2004). Adaptive and maladaptive ruminative self-focus during emotional processing. Behaviour Research and Therapy, 42(9), 1037–1052. doi:10.1016/j.brat.2004.01.009.

    Article  PubMed  Google Scholar 

  • Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134(2), 163–206. doi:10.1037/0033-2909.134.2.163.

    Article  PubMed  PubMed Central  Google Scholar 

  • Werner, N. S., Schweitzer, N., Meindl, T., Duschek, S., Kambeitz, J., & Schandry, R. (2013). Interoceptive awareness moderates neural activity during decision-making. Biological Psychology, 94(3), 498–506. doi:10.1016/j.biopsycho.2013.09.002.

    Article  PubMed  Google Scholar 

  • Williams, J. M. G., Crane, C., Barnhofer, T., Brennan, K., Duggan, D. S., Fennell, M. J. V, … Russell, I. T. (2014). Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: A randomized dismantling trial, Journal of Consulting and Clinical Psychology, 82(2), 275–86. doi:10.1037/a0035036

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Acknowledgments

This research was funded by the German Research Foundation Grant BA2255 3-1, awarded to Thorsten Barnhofer. The funders had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article to Mindfulness. Thorsten Barnhofer is supported by a Heisenberg Fellowship from the German Research Foundation (BA2255 2-1).

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Correspondence to Thorsten Barnhofer.

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Conflict of Interest

Thorsten Barnhofer has received honoraria or fees for lectures, workshops, courses, and educational presentations on mindfulness or mindfulness-based cognitive therapy as well as royalties for a book on mindfulness-based cognitive therapy. All other authors declare no conflicts of interest.

Ethical Approval

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

Funding

This research was funded by the German Research Foundation Grant BA2255 3-1, awarded to Thorsten Barnhofer. Thorsten Barnhofer is supported by a Heisenberg Fellowship from the German Research Foundation (BA2255 2-1). The funders had no role in study design; in the collection, analysis, and interpretation of data; in the writing of this report; and in the decision to submit the article.

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Maria Fissler and Emilia Winnebeck contributed equally to this paper. Julia M. Huntenburg is now at the Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, Max-Planck Group for Neuroanatomy and Connectivity. Matti Gaertner is now at Charité University Medicine Berlin, Clinic for Psychiatry and Psychotherapy.

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Fissler, M., Winnebeck, E., Schroeter, T. et al. An Investigation of the Effects of Brief Mindfulness Training on Self-Reported Interoceptive Awareness, the Ability to Decenter, and Their Role in the Reduction of Depressive Symptoms. Mindfulness 7, 1170–1181 (2016). https://doi.org/10.1007/s12671-016-0559-z

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