Interoceptive awareness and self-regulation contribute to psychosomatic competence as measured by a new inventory

Abstract

Summary Background The interrelation of interoception, cognitive appraisal of bodily signals and conscious self-regulatory behavior is insufficiently understood although it may be relevant for health and disease. Therefore, it was intended to develop a novel self-report measure targeting this link. Methods Item development was theoretically based on the multidimensional conceptual framework of the psychosomatic intelligence hypothesis and included an iterative process of refinement of items. In a preliminary test a principal components analysis (PROMAX rotation) and item analysis were calculated for item reduction. In the field test an item response theory approach was used for development of final scales and items. For validation purposes, associations with established measures of related constructs were analyzed. Results The final 44-item questionnaire consisted of 6 interrelated scales: (1) interoceptive awareness, (2) mentalization, (3) body-related cognitive congruence, (4) body-related health literacy, (5) general self-regulation, and (6) stress experience and stress regulation. Psychometric properties of this instrument demonstrated good model fit, internal consistency and construct validity. According to the validation, the final instrument measures a form of competence rather than intelligence and was termed the psychosomatic competence inventory. Conclusion Interoceptive awareness and conscious body-related self-regulation seem to jointly contribute to a basic competence which may serve homeostatic/allostatic control; however, further research is needed to confirm the reported preliminary findings in a large-scale test.

Interpreting physical sensations to guide health-related behavior

“…In its probably more common understanding, psychosomatic competence indicates the knowledge and skills of a medical professional to explore, understand and deal with biopsychosocial aspects of disease when interacting with patients [ 10 ]. In this review, however, the term psychosomatic competence refers to the complete set of body-related abilities and skills, which define psychosomatic intelligence but which are unrelated to traditional intelligence test scores [ 8 , 11 , 12 ]. Psychosomatic competence assumes a basic human ability to react consciously and adequately to perceived body signals by means of body-related and health-related behavior.…”

“…In the PSC model self-regulation encompasses general self-regulation and stress-related self-regulation. This distinction was chosen since there is evidence that self-regulation behavior elicited by stressful experiences represents a specific self-regulatory area that differs, to a certain degree, from general self-regulation [ 8 ]. The PSC model is presented in Fig.…”

“…It shows the central feedback-loop between interoception and self-regulation as well as its six components (in italics) which influence the loop. These six components have been conceived based on theoretical considerations but their presence in the model is supported by empirical data [ 8 ].

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“…All six components of psychosomatic competence ( in italics ) influence this feedback-loop: interoceptive awareness, mentalization, body-related cognitive congruence, body-related health literacy, stress experience and stress regulation, and general self-regulation. These six factors are intercorrelated and jointly contribute to psychosomatic competence as measured by the psychosomatic competence inventory (PSCI) [ 8 ]. In addition, the PSC model assumes a mutual influence between the interoception/self-regulation feedback-loop and autoregulation …”

“…It was developed in a clinical context aiming to provide a comprehensive framework to better understand health-related behavior and coping with burdensome physical sensations. It has only been recently introduced in combination with a new assessment tool, termed the psychosomatic competence inventory (PSCI) [ 8 ]. In this review, the underlying theoretical assumptions and components of the concept of PSC as well as the way they are related to other theories and models are outlined.…”