The Role of Interoception in Reducing Trauma-associated Distress: a Feasibility Study

Overview

Journal Eur J Psychotraumatol

Date 2024 Jan 30

PMID 38289065

Authors

Daria Shatrova

Pablo F Cancer

Jose Manuel Caperos

Affiliations

Soon will be listed here.

Abstract

Altered interoception plays an important role in chronic stress and posttraumatic stress disorder. The aim of this study was to evaluate the feasibility of a Trauma Sensitive Yoga (TSY) intervention for improving emotional distress and psychological discomfort in women living under circumstances of social and gender vulnerability. We assessed the effect of the treatment on the interoceptive mechanisms, and whether the psychological improvements were mediated by the changes in these mechanisms. The study involved a sample of 62 women who attended public community centres dedicated to supporting women victims of gender-based violence or who were socially and economically disadvantaged because of their gender. Participants underwent a six-week TSY programme. We evaluated dropout rate, adherence, and intervention satisfaction. We measured emotional distress, psychological discomfort, interoceptive mechanisms, and two nonequivalent dependent variables to enhance internal validity. We compared pre-post differences using paired samples -test and a structural equation model (SEM) analysis was performed to compare the changes in the outcomes with the changes in the nonequivalent dependent variables. Mediation models were adjusted to evaluate the role of changes in interoception on outcome changes. Fourteen (23%) women dropped out, mainly after the first intervention session. Intervention adherence (mean attendance 5.3 over 6 sessions) and acceptability were high (mean satisfaction 3.4 over 4). We observed post-intervention improvements in anxiety, depression, psychological discomfort, body responsiveness, and interoceptive awareness. The changes in the outcomes were larger than the changes in the nonequivalent dependent variables. Additionally, we found that the changes in body responsiveness partially mediated the change in anxiety and psychological discomfort but not in depression. TSY could be an interesting therapeutic approach for women experiencing chronic posttraumatic stress symptomatology. Our findings underscore the role of interoceptive mechanisms in traumatic stress and emphasize the importance of addressing these aspects.

Citing Articles

Interoception as a key node in the multidimensional psychological structural model of depression: a structural equation model analysis of integrating environmental, cognitive and behavioral-emotional factors.

Liu J, Li J, Wang T, Wu Y, Liu X, Gao X BMC Psychiatry. 2025; 25(1):205.

PMID: 40050850 PMC: 11887121. DOI: 10.1186/s12888-025-06648-z.

References

Clark C, Lewis-Dmello A, Anders D, Parsons A, Nguyen-Feng V, Henn L . Trauma-sensitive yoga as an adjunct mental health treatment in group therapy for survivors of domestic violence: a feasibility study. Complement Ther Clin Pract. 2014; 20(3):152-8. PMC: 4215954. DOI: 10.1016/j.ctcp.2014.04.003. View

Park C . Meaning Making Following Trauma. Front Psychol. 2022; 13:844891. PMC: 8984472. DOI: 10.3389/fpsyg.2022.844891. View

Resick P, Bovin M, Calloway A, Dick A, King M, Mitchell K . A critical evaluation of the complex PTSD literature: implications for DSM-5. J Trauma Stress. 2012; 25(3):241-51. DOI: 10.1002/jts.21699. View

Kinser P, Bourguignon C, Whaley D, Hauenstein E, Taylor A . Feasibility, acceptability, and effects of gentle Hatha yoga for women with major depression: findings from a randomized controlled mixed-methods study. Arch Psychiatr Nurs. 2013; 27(3):137-47. PMC: 3664951. DOI: 10.1016/j.apnu.2013.01.003. View

Brewer R, Murphy J, Bird G . Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev. 2021; 130:470-508. PMC: 8522807. DOI: 10.1016/j.neubiorev.2021.07.036. View

Brown R . Psychological mechanisms of medically unexplained symptoms: an integrative conceptual model. Psychol Bull. 2004; 130(5):793-812. DOI: 10.1037/0033-2909.130.5.793. View

Cattie J, Allbaugh L, Visser K, Ander I, Kaslow N . Tailoring Trauma-Sensitive Yoga for High-Risk Populations in Public-Sector Settings. Int J Yoga Therap. 2021; 31(1). DOI: 10.17761/2021-D-20-00035. View

Mehling W, Acree M, Stewart A, Silas J, Jones A . The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLoS One. 2018; 13(12):e0208034. PMC: 6279042. DOI: 10.1371/journal.pone.0208034. View

Ravindran A, McKay M, Silva T, Tindall C, Garfinkel T, Paric A . Breathing-focused Yoga as Augmentation for Unipolar and Bipolar Depression: A Randomized Controlled Trial: Le yoga axé sur la respiration comme traitement d'appoint pour la dépression unipolaire et bipolaire: Un essai randomisé contrôlé. Can J Psychiatry. 2020; 66(2):159-169. PMC: 7918867. DOI: 10.1177/0706743720940535. View

10.

Bobes J, Calcedo-Barba A, Garcia M, Francois M, Rico-Villademoros F, Gonzalez M . [Evaluation of the psychometric properties of the Spanish version of 5 questionnaires for the evaluation of post-traumatic stress syndrome]. Actas Esp Psiquiatr. 2000; 28(4):207-18. View

11.

Gupta M . Review of somatic symptoms in post-traumatic stress disorder. Int Rev Psychiatry. 2013; 25(1):86-99. DOI: 10.3109/09540261.2012.736367. View

12.

Eggart M, Lange A, Binser M, Queri S, Muller-Oerlinghausen B . Major Depressive Disorder Is Associated with Impaired Interoceptive Accuracy: A Systematic Review. Brain Sci. 2019; 9(6). PMC: 6627769. DOI: 10.3390/brainsci9060131. View

13.

Mehling W, Chesney M, Metzler T, Goldstein L, Maguen S, Geronimo C . A 12-week integrative exercise program improves self-reported mindfulness and interoceptive awareness in war veterans with posttraumatic stress symptoms. J Clin Psychol. 2017; 74(4):554-565. DOI: 10.1002/jclp.22549. View

14.

Zucker M, Spinazzola J, Blaustein M, van der Kolk B . Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress. J Trauma Dissociation. 2006; 7(1):19-31. DOI: 10.1300/J229v07n01_03. View

15.

Danielsson L, Papoulias I, Petersson E, Carlsson J, Waern M . Exercise or basic body awareness therapy as add-on treatment for major depression: a controlled study. J Affect Disord. 2014; 168:98-106. DOI: 10.1016/j.jad.2014.06.049. View

16.

Harshaw C . Interoceptive dysfunction: toward an integrated framework for understanding somatic and affective disturbance in depression. Psychol Bull. 2014; 141(2):311-363. PMC: 4346391. DOI: 10.1037/a0038101. View

17.

Heim N, Bobou M, Tanzer M, Jenkinson P, Steinert C, Fotopoulou A . Psychological interventions for interoception in mental health disorders: A systematic review of randomized-controlled trials. Psychiatry Clin Neurosci. 2023; 77(10):530-540. PMC: 7615164. DOI: 10.1111/pcn.13576. View

18.

Cramer H, Anheyer D, Saha F, Dobos G . Yoga for posttraumatic stress disorder - a systematic review and meta-analysis. BMC Psychiatry. 2018; 18(1):72. PMC: 5863799. DOI: 10.1186/s12888-018-1650-x. View

19.

Turner L, McLaren S . Social support and sense of belonging as protective factors in the rumination-depressive symptoms relation among Australian women. Women Health. 2011; 51(2):151-67. DOI: 10.1080/03630242.2011.558004. View

20.

OShea M, Capon H, Evans S, Agrawal J, Melvin G, OBrien J . Integration of hatha yoga and evidence-based psychological treatments for common mental disorders: An evidence map. J Clin Psychol. 2022; 78(9):1671-1711. PMC: 9546402. DOI: 10.1002/jclp.23338. View