On the Relationship of Interoceptive Accuracy and Attention: A Controlled Study With Depressed Inpatients and a Healthy Cohort

Abstract

ObjectivePrevious research has shown reduced interoceptive accuracy (IAcc) in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of IAcc on depression and attention.MethodsThirty-six depressed patients from the Psychosomatic Clinic in Windach were matched with 36 healthy controls according to age and sex and were assessed at Ulm University. All participants completed the Beck Depression Inventory-II, the heartbeat perception task to examine IAcc, and the d2 test assessing selective attention.ResultsDepressed patients showed attention deficits—both for general visual attention and IAcc—compared to healthy controls. The mediation analyses revealed that the relationship between depression and attention is not mediated via IAcc. Furthermore, depression predicts IAcc and attention, but these effects are direct and largely unaffected by the respective other variable.DiscussionThe results of the present study highlight both interoceptive as well as attention deficits in depressed patients. No clear mediation between these variables could be shown in this study. More elaborative research is needed to clarify whether different approaches to improve IAcc are effective for these deficits in depressed patients and could therefore be of importance as an additional aspect of therapy in depression.

Self-reported interoceptive accuracy and interoceptive attention differentially correspond to measures of visual attention and self-regard

“…Complementing and extending previous work ( Ferentzi, Horvath & Koteles, 2019 ; Schultchen et al, 2020 ; Ventura-Bort, Wendt & Weymar, 2021 ), the results of this study suggest that greater scores on the IAS (subjective interoceptive accuracy) corresponded to reduced negative affect and greater self-regard. Thus, as hypothesized, greater subjective accuracy is associated with liking oneself, in addition to reduced negative affect (the latter is discussed further below).…”

“…No other study included measures of well-being or emotion, though Rae et al (2020) measured impulsivity and found no association with interoceptive attention. Schultchen et al (2020) found that visual attention and objectively measured IA were independently associated with depression (the authors did not include self-report measures of interoception). Haustein et al (2023) found similar patterns of associations in a sample of older adults.…”

The Effects of a 3-Week Heartbeat Perception Training on Interoceptive Abilities

“…However, Zamariola et al (2019b) found that interoceptive abilities did not modulate negative affect. In contrast, impaired interoceptive abilities were found in various mental disorders, such as anorexia nervosa ( Pollatos et al, 2008 ; Fischer et al, 2016 ), depression ( Pollatos et al, 2009 ; Eggart et al, 2019 ; Schultchen et al, 2021 ), somatoform disorders ( Weiss et al, 2014 ), obsessive-compulsive disorders ( Schultchen et al, 2019b ), or schizophrenia ( Koreki et al, 2020 ). However, it needs to be noted that evidence concerning the association between interoceptive abilities and somatic symptoms and related disorders (e.g., Mussgay et al, 1999 ; Scholz et al, 2001 ) as well as regarding anxiety or panic disorders (e.g., Domschke et al, 2010 ; Stevens et al, 2011 ; Krautwurst et al, 2016 ) is mixed.…”

Brain–heart dynamics during emotional processing under uncertain conditions: An index of depression risk

“…Altered HEPs and cardiac reactivity to unpredictable negative events may be particularly relevant when modeling the relationships of interoceptive system dysfunction and atypical autonomic regulation with the risk of depression. Abnormal cardiac activity (32, 77, 78) and low interoceptive sensitivity (79–81) have been widely documented in depressed patients, suggesting associations of depression with autonomic imbalance and interoceptive impairment. Our findings enhance understanding of this relationship, revealing that disturbances in autonomic cardiac functioning and the brain interoceptive network were also observed in healthy individuals with high BDI scores.…”