본문 바로가기
KERD
논문KCI 등재

The Relationship Between Interoceptive Awareness, Emotion Regulation and Clinical Symptoms Severity of Depression, Anxiety and Somatization

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류정신과학

초록

Objective The primary objective of this study was to examine the associations among emotion regulation strategies, interoceptive awareness, and psychological distress measures—namely, depression, anxiety, and somatization. Additionally, we aimed to explore the predictive power of various facets of interoceptive awareness in determining the severity of symptoms for each mental disorder.Methods A cohort of 130 outpatients diagnosed with depression/anxiety disorder were recruited, and 20 subjects exhibiting incomplete responses were excluded from the dataset, leading to a final sample size of 110 outpatients. The clinical symptoms were measured by Patient Health Questionnaire-9, State–Trait Anxiety Inventory Form Y, and Symptom Checklist-90-Revised, and the usage of emotion-regulation strategies and interoceptive awareness was assessed with Emotion Regulation Questionnaire and Multidimensional Assessment of Interoceptive Awareness (MAIA), respectively. A hierarchical regression analysis was performed to examine whether emotion-regulation strategies and interoceptive awareness explain the statistically significant variance in each of the symptoms.Results In the depression model, cognitive reappraisal, accept, and attention regulation showed significant associations, while in the anxiety model, cognitive reappraisal, attention regulation, trust, and notice emerged as significant factors. Lastly, cognitive reappraisal and attention regulation were found to be significant contributors to the final model for somatization.Conclusion The inclusion of MAIA subscales improved the predictive ability of the regression model, highlighting the independent association between interoceptive awareness—particularly attention regulation—and clinical symptoms of anxiety and depression. Additionally, the study underscores the relevance of considering the specific pathological context when implementing interventions, as evidenced by the positive associations between the accept subscale and depression and between the notice subscale and anxiety, respectively.

Abstract

Objective The primary objective of this study was to examine the associations among emotion regulation strategies, interoceptive awareness, and psychological distress measures—namely, depression, anxiety, and somatization. Additionally, we aimed to explore the predictive power of various facets of interoceptive awareness in determining the severity of symptoms for each mental disorder.Methods A cohort of 130 outpatients diagnosed with depression/anxiety disorder were recruited, and 20 subjects exhibiting incomplete responses were excluded from the dataset, leading to a final sample size of 110 outpatients. The clinical symptoms were measured by Patient Health Questionnaire-9, State–Trait Anxiety Inventory Form Y, and Symptom Checklist-90-Revised, and the usage of emotion-regulation strategies and interoceptive awareness was assessed with Emotion Regulation Questionnaire and Multidimensional Assessment of Interoceptive Awareness (MAIA), respectively. A hierarchical regression analysis was performed to examine whether emotion-regulation strategies and interoceptive awareness explain the statistically significant variance in each of the symptoms.Results In the depression model, cognitive reappraisal, accept, and attention regulation showed significant associations, while in the anxiety model, cognitive reappraisal, attention regulation, trust, and notice emerged as significant factors. Lastly, cognitive reappraisal and attention regulation were found to be significant contributors to the final model for somatization.Conclusion The inclusion of MAIA subscales improved the predictive ability of the regression model, highlighting the independent association between interoceptive awareness—particularly attention regulation—and clinical symptoms of anxiety and depression. Additionally, the study underscores the relevance of considering the specific pathological context when implementing interventions, as evidenced by the positive associations between the accept subscale and depression and between the notice subscale and anxiety, respectively.

참고문헌 (66)

  1. Mauss IB, "The tie that binds? Coherence among emotion experience, behavior, and phys iology", Emotion, 5, pp.175~190 (2005)
  2. Lazarus RS, "Psychological stress and the coping process" (1966), McGraw-Hill
  3. Levenson RW, "The intrapersonal functions of emotion", Cogn Emot, 13, pp.481~504 (1999)
  4. Joormann J, "Handbook of emotion regulation", pp.413~427 (2013), Guilford Press
  5. Gross JJ, "Handbook of emotion regulation", pp.3~20 (2013), Guilford Press
  6. Urry HL, "Using reappraisal to regulate unpleasant emotional episodes : goals and timing matter", Emotion, 9, pp.782~797 (2009)
  7. Aldao A, "Emotion-regulation strate gies across psychopathology : a meta-analytic review", Clin Psychol Rev, 30, pp.217~237 (2010)
  8. Aldao A, "Paradoxical cardiovascular effects of imple menting adaptive emotion regulation strategies in generalized anxiety disorder", Behav Res Ther, 50, pp.122~130 (2012)
  9. Liverant GI, "Rumination in clini cal depression : a type of emotional suppression?", Cogn Ther Res, 35, pp.253~265 (2011)
  10. Feldner MT, "Emotional avoidance : an experimental test of individual differences and response suppres sion using biological challenge", Behav Res Ther, 41, pp.403~411 (2003)
  11. Joormann J, "Emotion regulation in depression : relation to cognitive inhibition", Cogn Emot, 24, pp.281~298 (2010)
  12. Critchley HD, "Interoception and emotion", Curr Opin Psychol, 17, pp.7~14 (2017)
  13. James W, "What is an emotion?", Mind, 9, pp.188~205 (1884)
  14. "The mechanism of the emotions"[URL]
  15. Craig AD, "How do you feel? Interoception : the sense of the physiologi cal condition of the body", Nat Rev Neurosci, 3, pp.655~666 (2002)
  16. Craig AD, "Interoception : the sense of the physiological condition of the body", Curr Opin Neurobiol, 13, pp.500~505 (2003)
  17. Critchley HD, "Neural sys tems supporting interoceptive awareness", Nat Neurosci, 7, pp.189195~ (2004)
  18. Damasio A, "The nature of feelings : evolutionary and neurobiological origins", Nat Rev Neurosci, 14, pp.143~152 (2013)
  19. Dunn BD, "Listening to your heart. How interoception shapes emotion experience and intuitive decision making", Psychol Sci, 21, pp.1835~1844 (2010)
  20. Schulz A, "Interoception and stress", Front Psychol, 6, pp.993~ (2015)
  21. Khalsa SS, "Can interoception improve the pragmatic search for biomarkers in psychiatry?", Front Psychiatry, 7, pp.121~ (2016)
  22. Terhaar J, "Heartbeat evoked potentials mirror altered body perception in depressed patients", Clin Neuro physiol, 123, pp.1950~1957 (2012)
  23. Ehlers A, "Increased cardiac awareness in panic disorder", J Abnorm Psychol, 101, pp.371~382 (1992)
  24. Farb N, "Intero ception, contemplative practice, and health", Front Psychol, 6, pp.763~ (2015)
  25. Mehling WE, "T he multidimensional assessment of interoceptive awareness(MAIA)", PLoS One, 7, pp.e48230~ (2012)
  26. Dunne J, "Losing trust in body sensations : interoceptive awareness and depression symptom se verity among primary care patients", J Affect Disord, 282, pp.12101219~ (2021)
  27. Solano López AL, "Dimensions of body-awareness and de pressed mood and anxiety", West J Nurs Res, 41, pp.834~853 (2019)
  28. Flasinski T, "Altered interoceptive awareness in high habitual symptom report ers and patients with somatoform disorders", Front Psychol, 11, pp.1859~ (2020)
  29. Mallorquí-Bagué N, "Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and intero ception in people with joint hypermobility", Front Psychol, 5, pp.1162~ (2014)
  30. Calì G, "Investi gating the relationship between interoceptive accuracy, interoceptive awareness, and emotional susceptibility", Front Psychol, 6, pp.1202~ (2015)
  31. Khalsa SS, "Interoceptive awareness declines with age", Psychophysiology, 46, pp.1130~1136 (2009)
  32. McRae K, "Bottom-up and top down emotion generation : implications for emotion regulation", Soc Cogn Affect Neurosci, 7, pp.253~262 (2012)
  33. Herwig U, "Self-related awareness and emotion regulation", Neuroimage, 50, pp.734~741 (2010)
  34. First MB, "Structured clinical inter view for DSM-5 disorders clinician version" (2017), Hakjisa
  35. Gim WS, "Korean multidimensional assessment of interoceptive awareness(K-MAIA) : development and validation", Korean J Stress Res, 24, pp.177~192 (2016)
  36. Gross JJ, "Emotional suppression : physiology, self-report and expressive behavior", J Pers Soc Psychol, 64, pp.970~986 (1993)
  37. Shon JM, "Individual differences in two regulation strategies: cognitive reappraisal vs. emotion suppressor", pp.2005
  38. An JY, "Standardization of the Ko rean version of screening tool for depression(patient health question naire-9, PHQ-9)", J Korean Soc Biol Ther Psychiatry, 19, pp.47~56 (2013)
  39. Endler NS, "State and trait anxiety revisited", J Anxiety Disord, 15, pp.231~245 (2001)
  40. Hahn D, "Korean adaptation of Spielberger’s STAI(K STAI)", Korean J Health Psychol, 1, pp.1~14 (1996)
  41. Derogatis LR, "administration, scoring & procedures manu al-II, for the R (revised) version and other instruments of the psycho pathology rating scale series" (1992), Clinical Psychometric Research, Inc
  42. Kim KI, "Korean manual of symptom checklist 90-revision" (1984), Chungang Aptitude Pubulishing Co
  43. Im KH, "Reliability of Symptom Checklist-90-Revised(SCL-90-R)", Korean J Edu Psychol, 1, pp.157~189 (1997)
  44. Kline RB, "Principles and practice of structural equation modeling" (2005), Guilford Press
  45. Campbell-Sills L, "Handbook of emotion regulation", pp.393~412 (2014), Guilford Press
  46. Cutuli D, "Cognitive reappraisal and expressive suppression strategies role in the emotion regulation : an overview on their modulatory effects and neural correlates", Front Syst Neurosci, 8, pp.175~ (2014)
  47. Ehring T, "Emotion regulation and vulnerability to depression : spontaneous versus in structed use of emotion suppression and reappraisal", Emotion, 10, pp.563~572 (2010)
  48. Soto JA, "Is expressive sup pression always associated with poorer psychological functioning? A cross-cultural comparison between European Americans and Hong Kong Chinese", Emotion, 11, pp.1450~1455 (2011)
  49. van der Velden AM, "A systematic review of mechanisms of change in mind fulness-based cognitive therapy in the treatment of recurrent major depressive disorder", Clin Psychol Rev, 37, pp.26~39 (2015)
  50. Wadlinger HA, "Fixing our focus : training attention to regulate emotion", Pers Soc Psychol Rev, 15, pp.75~102 (2011)
  51. Derryberry D, "Anxiety-related attentional biases and their regulation by attentional control", J Abnorm Psychol, 111, pp.225~236 (2002)
  52. Tan Y, "Interoceptive attention facilitates emotion regulation strategy use", Int J Clin Health Psychol, 23, pp.100336~ (2023)
  53. Hofmann SG, "The effect of mindfulness based therapy on anxiety and depression : a meta-analytic review", J Consult Clin Psychol, 78, pp.169~183 (2010)
  54. de Jong M, "Effects of mindfulness-based cognitive therapy on body awareness in patients with chronic pain and comorbid depression", Front Psychol, 7, pp.967~ (2016)
  55. Desdentado L, "Disentangling the role of interoceptive sensibility in alexithymia, emotion dysregulation, and depression in healthy individuals", Curr Psychol, 42, pp.2057020582~ (2023)
  56. Barsky AJ, "The somatosensory amplification scale and its relationship to hypochondriasis", J Psychiatr Res, 24, pp.323~334 (1990)
  57. Köteles F, "The many faces of somatosensory amplifica tion : the relative contribution of body awareness, symptom labeling, and anxiety", J Health Psychol, 21, pp.2903~2911 (2016)
  58. Domschke K, "Interoceptive sensi tivity in anxiety and anxiety disorders : an overview and integration of neurobiological findings", Clin Psychol Rev, 30, pp.1~11 (2010)
  59. Flor H, "Effect of sensory discrimina tion training on cortical reorganisation and phantom limb pain", Lancet, 357, pp.1763~1764 (2001)
  60. Gibson J, "Mindfulness, interoception, and the body : a contemporary perspective", Front Psychol, 10, pp.2012~ (2019)
  61. Clark DM, "Misinterpretation of body sensations in panic disorder", J Consult Clin Psychol, 65, pp.203~213 (1997)
  62. Chambless DL, "Relationship of cog nitions to fear of somatic symptoms : a test of the cognitive theory of panic", Depress Anxiety, 11, pp.1~9 (2000)
  63. Suzuki N, "Effects of interoceptive sensibility on mental health during the coronavirus disease 2019 pan demic", Int J Environ Res Public Health, 18, pp.4616~ (2021)
  64. Yoon HM, "The mediating effect of self-focused attention be tween decentering and somatization symptoms", J Korean Assoc Psychother, 8, pp.59~80 (2016)
  65. Wolters C, "Interoceptive accuracy and bias in so matic symptom disorder, illness anxiety disorder, and functional syn dromes : a systematic review and meta-analysis", PLoS One, 17, pp.e0271717~ (2022)
  66. Lee YG, "The effects of the Korean mindfulness based stress reduction(K-MBSR)program on self-absorption, emo tional regulation, psychological symptom and mindfulness level in de fensive self-focused attention individuals", Korean J Health Psychol, 18, pp.35~52 (2013)

관련 논문AI추천

이 간행물의 다른 논문 (9건)