Altered interoceptive awareness in high habitual symptom reporters and patients with somatoform disorders

in Frontiers in Psychology (2020), 11(1), 1859

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they ... [more ▼]

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they are limited to the interpretation of signals. We investigated whether individuals with MUS differ in interoceptive awareness as assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. Methods. Study 1: 486 individuals completed the Screening for Somatoform Disorders (SOMS-2). 32 individuals each of the upper and lower decile of the SOMS distribution (low symptom reporters/LSR, high symptom reporters/HSR) completed the MAIA. Study 2: MAIA scores of individuals diagnosed with somatoform disorder (SFD; n = 26) were compared to individuals with major depressive disorder (MDD; n = 25) and healthy controls (HC; n = 26). Results. HSR had lower scores than LSR on the MAIA scales Not-Distracting and Not-Worrying. The SFD and MDD groups showed lower scores than HC on the MAIA scales Not-Distracting, Self-Regulation, and Trusting. The MDD group scored lower than the other two groups on the scales Body Listening and Attention Regulation. There were no group differences on the scale Noticing. Conclusion. HSR, SFD and MDD patients do not differ from HC in the awareness of noticing of interoceptive signal processing, whereas cognitive facets of interoception, such as distraction or self-regulation are differentially affected. This highlights the necessity of including specifically targeted interventions, which improve interoceptive awareness, in the prevention and treatment of SFDs. [less ▲]

Towards a cross-cultural assessment of binge-watching: Psychometric evaluation of the “watching TV series motives” and “binge-watching engagement and symptoms” questionnaires across nine languages

in Computers in Human Behavior (2020), 111

In view of the growing interest regarding binge-watching (i.e., watching multiple episodes of television (TV) series in a single sitting) research, two measures were developed and validated to assess ... [more ▼]

In view of the growing interest regarding binge-watching (i.e., watching multiple episodes of television (TV) series in a single sitting) research, two measures were developed and validated to assess binge-watching involvement (“Binge-Watching Engagement and Symptoms Questionnaire”, BWESQ) and related motivations (“Watching TV Series Motives Questionnaire”, WTSMQ). To promote international and cross-cultural binge-watching research, the present article reports on the validation of these questionnaires in nine languages (English, French, Spanish, Italian, German, Hungarian, Persian, Arabic, Chinese). Both questionnaires were disseminated, together with additional self-report measures of happiness, psychopathological symptoms, impulsivity and problematic internet use among TV series viewers from a college/university student population (N = 12,616) in 17 countries. Confirmatory factor, measurement invariance and correlational analyses were conducted to establish structural and construct validity. The two questionnaires had good psychometric properties and fit in each language. Equivalence across languages and gender was supported, while construct validity was evidenced by similar patterns of associations with complementary measures of happiness, psychopathological symptoms, impulsivity and problematic internet use. The results support the psychometric validity and utility of the WTSMQ and BWESQ for conducting cross-cultural research on binge-watching. [less ▲]

Community- and mHealth-based integrated management of diabetes in primary healthcare in Rwanda: the protocol of a mixed-methods study including a cluster randomised controlled trial (D²Rwanda)

in BMJ Open (2019), 9(7), 028427

Introduction In Rwanda, diabetes mellitus prevalence is estimated between 3.1% and 4.3%. To address non-communicable diseases and the shortage of health workforce, the Rwandan Ministry of Health has ... [more ▼]

Introduction In Rwanda, diabetes mellitus prevalence is estimated between 3.1% and 4.3%. To address non-communicable diseases and the shortage of health workforce, the Rwandan Ministry of Health has introduced the home-based care practitioners (HBCPs) programme: laypeople provide longitudinal care to chronic patients after receiving a six-month training. Leveraging technological mobile solutions may also help improve health and healthcare. The D²Rwanda study aims at: (a) determining the efficacy of an integrated programme for the management of diabetes in Rwanda, which will provide monthly patient assessments by HBCPs, and an educational and self-management mHealth patient tool, and; (b) exploring qualitatively the ways the interventions will have been enacted, their challenges and effects, and changes in the patients’ health behaviours and HBCPs’ work satisfaction. Methods and analysis This is a mixed-methods sequential explanatory study. First, there will be a one-year cluster randomised controlled trial including two interventions ((1) HBCPs’ programme; (2) HBCPs’ programme + mobile health application) and usual care (control). Currently, nine hospitals run the HBCPs’ programme. Under each hospital, administrative areas implementing the HBCPs’ programme will be randomised to receive intervention 1 or 2. Eligible patients from each area will receive the same intervention. Areas without the HBCPs’ programme will be assigned to the control group. The primary outcome will be changes in glycated haemoglobin. Secondary outcomes include medication adherence, mortality, complications, health-related quality of life, diabetes-related distress and health literacy. Second, at the end of the trial, focus group discussions will be conducted with patients and HBCPs. Financial support was received from the Karen Elise Jensens Fond, and the Universities of Aarhus and Luxembourg. Ethics and dissemination Ethics approval was obtained from the Rwanda National Ethics Committee and the Ethics Review Panel of the University of Luxembourg. Findings will be disseminated via peer-reviewed publications and conference presentations. Trial registration number NCT03376607; Pre-results. [less ▲]

Social Media as an Opportunity for Public Health Interventions: The #Metoo Movement as an Exemplar

in Journal of the International Society for Telemedicine and EHealth (2019), 7(e5), 1-7

Background: Social media have been used exponentially and globally, providing a means for billions of users to connect, interact, share opinions and criticise, becoming one of the main channels of ... [more ▼]

Background: Social media have been used exponentially and globally, providing a means for billions of users to connect, interact, share opinions and criticise, becoming one of the main channels of communication for users around the world. One of the most popular free social media networks is Twitter, with more than 100 million active users per day worldwide. Purpose: The aim of this study was to analyse a sample of the public conversations generated, using the hashtag #MeToo, around the topic of sexual abuse on Twitter. Methods: Using social media marketing software, the use of the #MeToo hashtag was analysed over a period of 60 days (14 September 2017 to 13 November of 2017). Results: The #MeToo conversation was mainly in English (79.3%), located in the United States (48.2% of cases), but with global repercussions. The volume of mentions of the #MeToo hashtag was far greater (97.7%), compared with other hashtags related to violence over this period of time, using mostly Twitter (96.2%). Conclusions: These results suggest that it is possible to describe different groups using the social media, and analyse their conversations to identify opportunities for successful public health interventions. If the topic is relevant for the general public, it will generate interest and conversations at the global level, supported by a universal and borderless channel such as Twitter. [less ▲]

Herzschlag-evozierte Potenziale bei Bulimia nervosa

Poster (2019)

Die ursprüngliche Annahme, dass Essstörungspatient/innen unter einem umfassenden Defizit der interozeptiven Wahrnehmung leiden, wird inzwischen differenzierter betrachtet. Unterschiedliche Befunde ergeben ... [more ▼]

Die ursprüngliche Annahme, dass Essstörungspatient/innen unter einem umfassenden Defizit der interozeptiven Wahrnehmung leiden, wird inzwischen differenzierter betrachtet. Unterschiedliche Befunde ergeben sich je nach betrachtetem Organsystem (Herz, Magen), Verarbeitungsebene (neuronal, Selbstbericht) und Diagnose. Die bisherige Befundlage ist jedoch unübersichtlich und widersprüchlich. Für Bulimia nervosa (BN) wurde sowohl reduzierte, als auch unveränderte Herzschlagwahrnehmung berichtet. Mit dem vorliegenden Beitrag steuern wir weitere Ergebnisse zur Herzschlagwahrnehmung bei und ergänzen diese um einen physiologischen Indikator der kortikalen Verarbeitung kardio-afferenter Signale (Herzschlag-evozierte Potenziale, HEPs). Es wurden 22 Frauen mit akuter oder teilremittierter BN (BMI 23,94±3,61; Alter 31,86±11,20) und 22 gesunde Frauen untersucht (BMI 24,24±3,37; Alter 31,00±10,15). Die Stichproben wurden nach Alter und BMI parallelisiert. Die Teilnehmerinnen führten eine Herzschlagwahrnehmungsaufgabe nach Schandry durch, während ein 64-Kanal-EEG aufgezeichnet wurde. HEPs wurden als mittlere EEG-Amplitude von 455ms bis 595ms nach der R-Zacke berechnet. Die Ergebnisse zeigen keine signifikanten Gruppenunterschiede in Herzschlagwahrnehmung, HEPs und Herzrate. Dies bestätigt vorherige Befunde einer intakten Herzschlagwahrnehmung bei BN. Zusätzlich können wir von einer intakten kortikalen Verarbeitung kardio-afferenter Reize ausgehen. Die Wahrnehmung des Herzschlags ist insbesondere für die Verarbeitung und Regulation von Emotionen relevant. Auf Basis der vorliegenden und früheren Befunde ist davon auszugehen, dass defizitäre Emotionsregulation bei BN nicht auf veränderte Herzschlagwahrnehmung zurückzuführen ist. [less ▲]

Interoception in Bulimia Nervosa: Evidence at cortical and self-report levels

in Psychophysiology (2019), 56(S1), 117

Bulimia nervosa (BN) is characterized by recurrent episodes of binge eating and compensatory behaviors, such as self- induced vomiting. Body image disturbance is also prominent in BN. Current research is ... [more ▼]

Bulimia nervosa (BN) is characterized by recurrent episodes of binge eating and compensatory behaviors, such as self- induced vomiting. Body image disturbance is also prominent in BN. Current research is trying to determine which dimensions and sensory domains of body perception are affected in BN. Regarding heartbeat perception, findings are inconclusive, with some studies reporting reduced and others reporting unaltered interoceptive accuracy in BN. The current study contributes further data on heartbeat perception by using an indicator of the cortical processing of cardio- afferent signals (heartbeat evoked potentials, HEPs). We investigated 22 women with current or partially remitted BN (BMI 23.94[3.61]; age 31.86[11.20]) and 22 healthy women (HC; BMI 24.24[3.37]; age 31.00[10.15]). Participants performed a heartbeat perception task (according to Schandry) with concurrent 64- channel- EEG and ECG recording. HEPs were calculated as mean EEG amplitudes in the interval 455- 595ms after the R- peak of the ECG. Results show no significant differences between the BN and HC groups, neither for heartbeat perception, HEPs, or mean heartrate. These results confirm previous findings of intact heartbeat perception in BN. In addition, cortical processing of cardio- afferent signals is unaltered. Heartbeat perception is particularly relevant for emotion processing and regulation. The previously reported emotion- regulation deficits in BN appear not to be based on altered CNS processing of cardiac signals [less ▲]

The role of alexithymia in parent-child interaction and in the emotional ability of children with autism spectrum disorder

in Autism Research (2019)

Children with autism spectrum disorder (ASD) have more emotional difficulties than typically developing (TD) children. Of all the factors that impact children’s emotional development, parents, and the way ... [more ▼]

Children with autism spectrum disorder (ASD) have more emotional difficulties than typically developing (TD) children. Of all the factors that impact children’s emotional development, parents, and the way they interact with their children, are of crucial importance. The present study compared the amount of parent-child interactions among 35 dyads of parents and their children with ASD and 41 dyads of parents and their TD children, aged between 3 and 13 years, during a frustration-eliciting situation. We further examined whether children’s alexithymia is linked to parent-child interactions and whether parent-child interactions are linked to children’s emotional difficulties. We found that parents of children with ASD interacted significantly less with their children than parents of TD children. This reduced interaction was better explained by children’s alexithymia than by children’s ASD diagnosis. Finally, parent-child interaction mediated the relationship between children’s ASD diagnosis and children’s emotion regulation ability, as well as some aspects of children’s emotional reactivity but only if not accounting for children’s alexithymia levels. Our results demonstrate the determinant role children’s alexithymia plays on parent-child interactions and on how these interactions are linked to children’s difficulties in emotion regulation and emotional reactivity. Results are discussed in light of how parent-child interactions and the emotional ability of children with ASD can be improved by targeting children’s alexithymia. [less ▲]

Surgery

in Llewellyn, C.D.; Ayers, S.; McManus, C. (Eds.) et al Cambridge Handbook of Psychology, Health and Medicine (2019)

Family Violence Curricula in Europe (FAVICUE): a cross-sectional descriptive study protocol

in BMJ Open (2019), 9

Introduction. Family violence (FV) is a widespread public health problem of epidemic proportions and serious consequences. Doctors may be the first or only point of contact for victims who may be hesitant ... [more ▼]

Introduction. Family violence (FV) is a widespread public health problem of epidemic proportions and serious consequences. Doctors may be the first or only point of contact for victims who may be hesitant or unable to seek other sources of assistance, and they tend not to disclose abuse to doctors if not specifically asked. A comprehensive healthcare response is key to a coordinated community-wide approach to FV, but most of the practising physicians have received either no or insufficient education or training in any aspect of FV. Training of medical students concerning FV is often delivered in an inconsistent or ad hoc manner. The main aim of this project, Family Violence Curricula in Europe (FAVICUE), is to (1) describe current FV education delivery in European medical universities (undergraduate period) and during the specialist training in general practice (GP)/family medicine (FM) (postgraduate residency programme), and (2) compare it with WHO recommendations for FV curriculum. Methods and analysis. This is the protocol of a cross-sectional descriptive study consisting of two self-report online surveys (for undergraduate and postgraduate training, respectively) with 40 questions each. For both surveys, general practitioners, residents, medical students and professionals involved in their education from countries of the European region will be identified through the European Regional Branch of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA Europe) and will be invited to provide information regarding the training on FV. Descriptive tests will be carried out and a thematic analysis will be conducted on the open-ended questions. Ethics and dissemination Ethics approval has been obtained by the University of Luxembourg (ERP 17–015 FAVICUE). The results will provide important information concerning current curricula on FV, and can be used for mapping the educational needs and planning the implementation of future training interventions. They will be published and disseminated through WONCA Europe and its networks. [less ▲]

Zur Validität zweier Herzschlagwahrnehmungsaufgaben: Höheres zentrales Blutvolumen durch Kipptischmanipulation verbessert interozeptive Genauigkeit, aber nicht die Genauigkeit zur Schätzung von Zeitintervallen

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

Kardiale Interozeption wird typischerweise mittels Herzschlagzählaufgaben (Schandry, 1981) oder Herzschlagdiskriminationsaufgaben (Whitehead et al., 1977) erfasst. Jedoch sind die Determinanten der ... [more ▼]

Kardiale Interozeption wird typischerweise mittels Herzschlagzählaufgaben (Schandry, 1981) oder Herzschlagdiskriminationsaufgaben (Whitehead et al., 1977) erfasst. Jedoch sind die Determinanten der Herzschlagwahrnehmung hinsichtlich Aktivitätsindizes des kardiovaskulären Systems bisher ungeklärt. Die vorliegende Studie untersucht, ob die experimentelle Manipulation kardiovaskulärer Aktivität durch die Variation der Körperposition mittels Kipptisch einen Einfluss auf interozeptive Genauigkeit in Herzschlagzählaufgaben und Herzschlagdiskriminierungsaufgaben hat. Studierende (N=43) führten beide Herzschlagwahrnehmungsaufgaben in drei Körperpositionen (-10°,0° und 10°) durch. Zusätzlich wurde die Fähigkeit zur Einschätzung von Zeitintervallen geprüft (Kontrollaufgabe), da oft kritisiert wurde, dass interozeptive Genauigkeit basierend auf der Herzschlagzählaufgabe mit dieser Fähigkeit konfundiert ist. Die interozeptive Genauigkeit in der Herzschlagzählaufgabe war signifikant höher bei einem Neigungswinkel von -10° (über Kopf), sowie geringer bei 10° (Kopf aufrecht), jeweils im Vergleich zu 0° (horizontale Position). Deskriptiv ist das gleiche Muster bei der Herzschlagdiskriminationssaufgabe zu erkennen, jedoch statistisch nicht signifikant. Die Einschätzungsgenauigkeit von Zeitintervallen bleibt unabhängig von der Körperposition konstant. Regressionsanalysen zeigen, dass die Fähigkeit zur Diskriminierung von Herzschlägen signifikant die Herzschlagzählgenauigkeit vorhersagt und 32% der Gesamtvarianz aufklärt. Herzrate sowie die Einschätzungsgenauigkeit von Zeitintervallen tragen nicht signifikant als Prädiktoren in der Aufklärung der Zählgenauigkeit bei. Die Ergebnisse weisen darauf hin, dass kardiodynamische Parameter, wie z.B. Schlagvolumen, die durch die Variation der Körperposition manipuliert wurden, unabhängig von Variationen der Herzrate, eine Determinante interozeptiver Genauigkeit in Herzschlagzählaufgaben darstellen. Die Einschätzung von Zeitintervallen hat keinen Einfluss auf die Zähl- und Diskriminationsgenauigkeit von Herzschlägen und wird außerdem nicht von der Körperposition beeinflusst. Die Ergebnisse weisen auf gute konvergente und diskriminante Validität der Herzschlagwahrnehmungsaufgaben zur Erfassung kardialer Interozeption hin. [less ▲]