A Pilot Feasibility Study of Reconnecting to Internal Sensations and Experiences (RISE), a Mindfulness-Informed Intervention to Reduce Interoceptive Dysfunction and Suicidal Ideation, among University Students in India

Abstract

Although 20% of the world’s suicides occur in India, suicide prevention efforts in India are lagging (Vijayakumar et al., 2021). Identification of risk factors for suicide in India, as well as the development of accessible interventions to treat these risk factors, could help reduce suicide in India. Interoceptive dysfunction—or an inability to recognize internal sensations in the body—has emerged as a robust correlate of suicidality among studies conducted in the United States. Additionally, a mindfulness-informed intervention designed to reduce interoceptive dysfunction, and thereby suicidality, has yielded promising initial effects in pilot testing (Smith et al., 2021). The current studies sought to replicate these findings in an Indian context. Study 1 (n = 276) found that specific aspects of interoceptive dysfunction were related to current, past, and future likelihood of suicidal ideation. Study 2 (n = 40) was a small, uncontrolled pre-post online pilot of the intervention, Reconnecting to Internal Sensations and Experiences (RISE). The intervention was rated as highly acceptable and demonstrated good retention. Additionally, the intervention was associated with improvements in certain aspects of interoceptive dysfunction and reductions in suicidal ideation and eating pathology. These preliminary results suggest further testing of the intervention among Indian samples is warranted.

Feeling the urge: Using ecological momentary assessment to test the relationship of interoception with disordered eating and nonsuicidal self-injury.

“…Mindfulness-based interventions appear to improve interoception across many physical and mental health conditions (Farb et al, 2015;Fischer et al, 2017;Khoury et al, 2018). In recent studies, multiple interoceptive interventions (e.g., progressive muscle relaxation, a body functionality writing exercise, and interoception psychoeducation) produced improvements in interoception and reductions in suicidality, disordered eating, and general psychological symptoms (Smith et al, 2021(Smith et al, , 2022. Interoception interventions may "smooth out" interoceptive experience-improving the consistency of IA, such that variability in physical sensations might cause fewer or weaker prediction errors-thereby reducing the fluctuations that this study identified as problematic.…”

Diminished body trust uniquely predicts suicidal ideation and nonsuicidal self‐injury among people with recent self‐injurious thoughts and behaviors

“…For example, Smith et al (2021) developed an online interoception intervention that includes psychoeducation, progressive muscle relaxation, body functionality, emotional awareness, and intuitive eating exercises. The intervention was associated with improved self‐reported interoception and decreased suicidal ideation (Smith et al, 2021, 2022). Thus, the clinical implication of the current findings is that interventions that normalize interoceptive processing may have clinical utility in reducing SITBs.…”

Mindfulness, Interoception, and the Body

“…Finally, Smith and colleagues [ 27 ] present two studies that build upon previous research from their group, which has identified interoceptive deficits as a correlate and possible risk factor for suicidal ideation and behaviour in various samples from the United States (e.g., [ 28 , 29 , 30 ]). Here, Smith and colleagues [ 27 ] found that their previous findings can be extended to a non-Western context, by identifying associations between interoceptive deficits and the current, past, and future likelihood of suicidal ideation in a sample of Indian adults.…”

“…Finally, Smith and colleagues [ 27 ] present two studies that build upon previous research from their group, which has identified interoceptive deficits as a correlate and possible risk factor for suicidal ideation and behaviour in various samples from the United States (e.g., [ 28 , 29 , 30 ]). Here, Smith and colleagues [ 27 ] found that their previous findings can be extended to a non-Western context, by identifying associations between interoceptive deficits and the current, past, and future likelihood of suicidal ideation in a sample of Indian adults. Furthermore, Smith and colleagues [ 27 ] found that Reconnecting to Internal Sensations and Experiences (RISE)—a four-session mindfulness-informed intervention designed to reduce suicidal ideation by improving interoception (first tested in US adults; [ 31 ])—had good levels of acceptability, and was associated with improvements in interoceptive dysfunction and reductions in suicidal ideation in a sample of Indian adults.…”