Change starts with the body: Interoceptive appreciation mediates the effect of mindfulness training on behavior change - an effect moderated by depression severity.
Zev Schuman-Olivier, Richa Gawande, Timothy B Creedon, Alexandra Comeau, Todd Griswold, Lydia B Smith, My Ngoc To, Caitlyn L Wilson, Eric B Loucks, Benjamin Le Cook
Psychiatry research December 1, 2024 DOI: 10.1016/j.psychres.2024.116230 via PubMed
Summary
AI-generated from the abstractMindfulness training helps people change health behaviors partly by improving how they listen to and trust internal bodily signals, a process called interoceptive appreciation. In a randomized trial with 274 primary care patients who had depression, anxiety, or stress disorders related to chronic illness, those who received Mindfulness Training for Primary Care showed greater initiation of a chosen health behavior action plan compared to a low-dose mindfulness group. The effect was mediated by interoceptive appreciation: among patients without depression, listening to bodily signals played a key role; among those with moderate-to-severe depression, trusting bodily signals was more important. Regaining body trust may be a crucial step for behavior change in depression.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 274 |
| Population | Primary care patients with depression, anxiety, or stress disorders related to chronic illness |
| Interventions | Mindfulness Training for Primary Care (MTPC) using the Mindful Behavior Change curriculum low-dose mindfulness comparator |
| Duration | 8-week intervention, weeks 8-10 for action plan initiation reporting |
| Topics | Depression Meditation |
| Keywords | Adherence Behavior change Behavioral intervention Chronic disease |
| Citations | 10 |
| Key finding | Interoceptive appreciation, specifically body listening and trusting, mediated the effect of mindfulness training on health behavior action plan initiation, with different subcomponents important depending on depression severity. |
Abstract
Mindfulness catalyzes health behavior change. Yet, interoception is dysregulated in depression, potentially impairing behavioral activation. We examined the mediating role of interoceptive appreciation, as measured by how much one trusts and listens to internal bodily signals, on behavior change. Primary care patients with depression, anxiety, or stress disorders related to chronic illness were randomized to Mindfulness Training for Primary Care (MTPC) using the Mindful Behavior Change curriculum or a low-dose mindfulness comparator. Participants (N = 274) completed the Multidimensional Assessment of Interoceptive Awareness (MAIA) at 0 and 8 weeks. At week 7, participants chose a health behavior action plan. During weeks 8-10, participants reported their action plan initiation (API) level. We investigated the effect of MTPC on API level (MTPC-API), the mediating role of interoceptive appreciation (Body Listening [MAIA-BL] + Trusting [MAIA-T]), and baseline depression severity as a moderator. MTPC had a significant direct effect on API. Interoceptive appreciation (MAIA-BL + MAIA-T) had a significant indirect effect on API (CI=0.15-0.56). Without depression (n = 76), MAIA-BL partially mediated MTPC-API (CI=0.02-0.87). With moderate-to-severe depression (n = 132), MAIA-T partially mediated MTPC-API (CI=0.01-0.85). Interoceptive appreciation helps people listen to motivating bodily signals. In depression, regaining body trust may be an important step on a mindful path towards change.