Intolerable feelings of uncertainty within the body: Associations between interoceptive awareness, intolerance of uncertainty, and body dissatisfaction.
adolescent girls
body dissatisfaction
interoceptive awareness
intolerance of uncertainty
Journal
Journal of adolescence
ISSN: 1095-9254
Titre abrégé: J Adolesc
Pays: England
ID NLM: 7808986
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
15
08
2023
received:
19
01
2023
accepted:
17
08
2023
medline:
7
12
2023
pubmed:
1
9
2023
entrez:
1
9
2023
Statut:
ppublish
Résumé
Adolescence is a period marked by important physical and social changes, which often leads to an increase of body dissatisfaction. Recent studies have shown an association between interoception and body dissatisfaction in female adolescents. One variable that may contribute to the association between interoceptive awareness and body dissatisfaction is intolerance of uncertainty (IU). This study aims to investigate multiple facets of interoceptive awareness, IU, and their relations with body dissatisfaction in adolescent girls. In a cross-sectional study, a convenience sample of 307 adolescent girls (mean age = 17.73; SD = 1.02) was recruited in the Netherlands in 2022. Three questionnaires were completed measuring interoceptive awareness, IU, and body dissatisfaction. A moderation analyses using a multiple hierarchical regression was used to investigate associations between variables. Correlation analyses indicated that several facets of lower interoceptive awareness (Not distracting, Not worrying and Trusting) were related to higher levels of body dissatisfaction. IU only marginally moderated the relationship between several domains of interoceptive awareness (Notice, Attention regulation and Emotional awareness) and body dissatisfaction. Findings suggest that experiencing bodily signals as ambiguous and uncertain may result in more complex body image issues. Within certain domains of interoceptive awareness, IU may affect the process of appraising bodily signals. Furthermore, adolescent girls who do not feel safe in their body and who find it difficult to distract their thoughts when experiencing pain or discomfort in their body may be particularly at risk for developing more complex body image disturbances and may benefit from interventions improving both interoceptive awareness and IU. Moreover, future research should focus on interoceptive awareness and IU as potential underlying mechanisms for body image issues.
Sections du résumé
BACKGROUND
BACKGROUND
Adolescence is a period marked by important physical and social changes, which often leads to an increase of body dissatisfaction. Recent studies have shown an association between interoception and body dissatisfaction in female adolescents. One variable that may contribute to the association between interoceptive awareness and body dissatisfaction is intolerance of uncertainty (IU). This study aims to investigate multiple facets of interoceptive awareness, IU, and their relations with body dissatisfaction in adolescent girls.
METHODS
METHODS
In a cross-sectional study, a convenience sample of 307 adolescent girls (mean age = 17.73; SD = 1.02) was recruited in the Netherlands in 2022. Three questionnaires were completed measuring interoceptive awareness, IU, and body dissatisfaction. A moderation analyses using a multiple hierarchical regression was used to investigate associations between variables.
RESULTS
RESULTS
Correlation analyses indicated that several facets of lower interoceptive awareness (Not distracting, Not worrying and Trusting) were related to higher levels of body dissatisfaction. IU only marginally moderated the relationship between several domains of interoceptive awareness (Notice, Attention regulation and Emotional awareness) and body dissatisfaction.
DISCUSSION
CONCLUSIONS
Findings suggest that experiencing bodily signals as ambiguous and uncertain may result in more complex body image issues. Within certain domains of interoceptive awareness, IU may affect the process of appraising bodily signals. Furthermore, adolescent girls who do not feel safe in their body and who find it difficult to distract their thoughts when experiencing pain or discomfort in their body may be particularly at risk for developing more complex body image disturbances and may benefit from interventions improving both interoceptive awareness and IU. Moreover, future research should focus on interoceptive awareness and IU as potential underlying mechanisms for body image issues.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1678-1688Informations de copyright
© 2023 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.
Références
Ainley, V., & Tsakiris, M. (2013). Body conscious? Interoceptive awareness, measured by heartbeat perception, is negatively correlated with self-objectification. PLoS ONE, 8(2), e55568. https://doi.org/10.1371/journal.pone.0055568
Alleva, J. M., Sheeran, P., Webb, T. L., Martijn, C., & Miles, E. (2015). A meta-analytic review of stand-alone interventions to improve body image. PLoS ONE, 10(9), e0139177. https://doi.org/10.1371/journal.pone.0139177
Andersen, N., & Swami, V. (2021). Science mapping research on body image: A bibliometric review of publications in Body Image, 2004-2020. Body Image, 38, 106-119. https://doi.org/10.1016/j.bodyim.2021.03.015
Badoud, D., & Tsakiris, M. (2017). From the body's viscera to the body's image: Is there a link between interoception and body image concerns? Neuroscience & Biobehavioral Reviews, 77, 237-246. https://doi.org/10.1016/j.neubiorev.2017.03.017
Beesdo-Baum, K., & Knappe, S. (2012). Developmental epidemiology of anxiety disorders. Child and Adolescent Psychiatric Clinics of North America, 21(3), 457-478. https://doi.org/10.1016/j.chc.2012.05.001
Van den Berg, P., Thompson, J. K., Obremski-Brandon, K., & Coovert, M. (2002). The Tripartite Influence model of body image and eating disturbance: A covariance structure modeling investigation testing the mediational role of appearance comparison. Journal of Psychosomatic Research, 53(5), 1007-1020. https://doi.org/10.1016/S0022-3999(02)00499-3
Bijsterbosch, J. M., Keizer, A., Boelen, P. A., van den Brink, F., Danner, U. N., & Sternheim, L. C. (2021). How deep is your thought? The relations between intolerance of uncertainty, worry and weight and shape concerns in adolescent girls with anorexia nervosa. Journal of Eating Disorders, 9(1), 164. https://doi.org/10.1186/s40337-021-00523-4
Bijsterbosch, J. M., Keizer, A., Boelen, P. A., van den Brink, F., & Sternheim, L. C. (2022). Understanding relations between intolerance of uncertainty and body checking and body avoiding in anorexia nervosa. Journal of Eating Disorders, 10(1), 122. https://doi.org/10.1186/s40337-022-00647-1
Bijsterbosch, J. M., van den Brink, F., Vollmann, M., Boelen, P. A., & Sternheim, L. C. (2020). Understanding relations between intolerance of uncertainty, social anxiety, and body dissatisfaction in women. The Journal of Nervous and Mental Disease, 208(10), 833-835.
Boelen, P. A., & Reijntjes, A. (2009). Intolerance of uncertainty and social anxiety. Journal of Anxiety Disorders, 23(1), 130-135. https://doi.org/10.1016/j.janxdis.2008.04.007
Boswell, J. F., Thompson-Hollands, J., Farchione, T. J., & Barlow, D. H. (2013). Intolerance of uncertainty: A common factor in the treatment of emotional disorders. Journal of Clinical Psychology, 69(6), 630-645.
Brockmeyer, T., Anderle, A., Schmidt, H., Febry, S., Wünsch-Leiteritz, W., Leiteritz, A., & Friederich, H. C. (2018). Body image related negative interpretation bias in anorexia nervosa. Behaviour Research and Therapy, 104, 69-73. https://doi.org/10.1016/j.brat.2018.03.003
Brown, T. A., Berner, L. A., Jones, M. D., Reilly, E. E., Cusack, A., Anderson, L. K., Kaye, W. H., & Wierenga, C. E. (2017). Psychometric evaluation and norms for the Multidimensional Assessment of Interoceptive Awareness (MAIA) in a clinical eating disorders sample. European Eating Disorders Review, 25, 411-416. https://doi.org/10.1002/erv.2532
Brown, T. A., Vanzhula, I. A., Reilly, E. E., Levinson, C. A., Berner, L. A., Krueger, A., Lavender, J. M., Kaye, W. H., & Wierenga, C. E. (2020). Body mistrust bridges interoceptive awareness and eating disorder symptoms. Journal of Abnormal Psychology, 129(5), 445-456. https://doi.org/10.1037/abn0000516
Carey, R. N., Donaghue, N., & Broderick, P. (2014). Body image concern among Australian adolescent girls: The role of body comparisons with models and peers. Body Image, 11(1), 81-84. https://doi.org/10.1016/j.bodyim.2013.09.006
Carleton, R. N. (2012). The intolerance of uncertainty construct in the context of anxiety disorders: Theoretical and practical perspectives. Expert Review of Neurotherapeutics, 12(8), 937-947. https://doi.org/10.1586/ern.12.82
Carleton, R. N. (2016). Fear of the unknown: One fear to rule them all? Journal of Anxiety Disorders, 41, 5-21. https://doi.org/10.1016/j.janxdis.2016.03.011
Carleton, R. N., Norton, M. A. P. J., & Asmundson, G. J. G. (2007). Fearing the unknown: A short version of the Intolerance of Uncertainty Scale. Journal of Anxiety Disorders, 21(1), 105-117. https://doi.org/10.1016/j.janxdis.2006.03.014
Cash, T. F. (2004). Body image: Past, present, and future. Body Image, 1(1), 1-5. https://doi.org/10.1016/S1740-1445(03)00011-1
Cash, T. F., & Fleming, E. C. (2002). The impact of body image experiences: Development of the body image quality of life inventory. International Journal of Eating Disorders, 31(4), 455-460. https://doi.org/10.1002/eat.10033
Centers for Disease Control and Prevention (CDC). (2023, January 7). BMI percentile calculator for child and teen. https://www.cdc.gov/healthyweight/bmi/calculator.htm
Dekkers, L. M. S., Jansen, B. R. J., Salemink, E., & Huizenga, H. M. (2017). Intolerance of Uncertainty Scale: Measurement invariance among adolescent boys and girls and relationships with anxiety and risk taking. Journal of Behavior Therapy and Experimental Psychiatry, 55, 57-65. https://doi.org/10.1016/j.jbtep.2016.11.009
Dion, J., Blackburn, M. E., Auclair, J., Laberge, L., Veillette, S., Gaudreault, M., Vachon, P., Perron, M., & Touchette, É. (2015). Development and aetiology of body dissatisfaction in adolescent boys and girls. International Journal of Adolescence and Youth, 20(2), 151-166. https://doi.org/10.1080/02673843.2014.985320
Dugas, M. J., Sexton, K. A., Hebert, E. A., Bouchard, S., Gouin, J. P., & Shafran, R. (2022). Behavioral experiments for intolerance of uncertainty: A randomized clinical trial for adults with generalized anxiety disorder. Behavior Therapy, 53(6), 1147-1160. https://doi.org/10.1016/j.beth.2022.05.003
Emanuelsen, L., Drew, R., & Köteles, F. (2015). Interoceptive sensitivity, body image dissatisfaction, and body awareness in healthy individuals. Scandinavian Journal of Psychology, 56(2), 167-174. https://doi.org/10.1111/sjop.12183
Eshkevari, E., Rieger, E., Longo, M. R., Haggard, P., & Treasure, J. (2012). Increased plasticity of the bodily self in eating disorders. Psychological Medicine, 42(4), 819-828. https://doi.org/10.1017/S0033291711002091
Eshkevari, E., Rieger, E., Longo, M. R., Haggard, P., & Treasure, J. (2014). Persistent body image disturbance following recovery from eating disorders. International Journal of Eating Disorders, 47(4), 400-409. https://doi.org/10.1002/eat.22219
Feinstein, J. S., Khalsa, S. S., Yeh, H., Al Zoubi, O., Arevian, A. C., Wohlrab, C., Pantino, M. K., Cartmell, L. J., Simmons, W. K., Stein, M. B., & Paulus, M. P. (2018). The elicitation of relaxation and interoceptive awareness using floatation therapy in individuals with high anxiety sensitivity. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(6), 555-562. https://doi.org/10.1016/j.bpsc.2018.02.005
Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7(2), 117-140. https://doi.org/10.1177/001872675400700
Frank, G. K. W., Roblek, T., Shott, M. E., Jappe, L. M., Rollin, M. D. H., Hagman, J. O., & Pryor, T. (2012). Heightened fear of uncertainty in anorexia and bulimia nervosa. International Journal of Eating Disorders, 45(2), 227-232. https://doi.org/10.1002/eat.20929
Fredrickson, B. L., & Roberts, T. A. (1997). Objectification theory: Toward understanding women's lived experiences and mental health risks. Psychology of Women Quarterly, 21, 173-206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x
Garfinkel, S. N., Seth, A. K., Barrett, A. B., Suzuki, K., & Critchley, H. D. (2015). Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology, 104, 65-74.
Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002). The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review. International Journal of Eating Disorders, 31(1), 1-16. https://doi.org/10.1002/eat.10005
Halldorsdottir, T., Thorisdottir, I. E., Meyers, C. C. A., Asgeirsdottir, B. B., Kristjansson, A. L., Valdimarsdottir, H. B., Allegrante, J. P., & Sigfusdottir, I. D. (2021). Adolescent well-being amid the COVID-19 pandemic: Are girls struggling more than boys. JCPP Advances, 1(2), e12027. https://doi.org/10.1002/jcv2.12027
Harter, S. (2006). The self. In N. Eisenberg, W. Damon, & R. M. Lerner (Eds.), Handbook of child psychology: Social, emotional, and personality development (pp. 505-570). John Wiley & Sons, Inc.
Helsen, K., Van den Bussche, E., Vlaeyen, J. W. S., & Goubert, L. (2013). Confirmatory factor analysis of the Dutch Intolerance of Uncertainty Scale: Comparison of the full and short version. Journal of Behavior Therapy and Experimental Psychiatry, 44, 21-29. https://doi.org/10.1016/j.jbtep.2012.07.004
Herbert, B. M., & Pollatos, O. (2012). The body in the mind: On the relationship between interoception and embodiment. Topics in Cognitive Science, 4(4), 692-704. https://doi.org/10.1111/j.1756-8765.2012.01189.x
IBM Corp. (2019). Released. IBM SPSS Statistics for Windows, Version 26.0.
Khalsa, S. S., Adolphs, R., Cameron, O. G., Critchley, H. D., Davenport, P. W., Feinstein, J. S., Zucker, N., Garfinkel, S. N., Lane, R. D., Mehling, W. E., Meuret, A. E., Nemeroff, C. B., Oppenheimer, S., Petzschner, F. H., Pollatos, O., Rhudy, J. L., Schramm, L. P., Simmons, W. K., Stein, M. B., … Zucker, N. (2018). Interoception and mental health: A roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(6), 501-513. https://doi.org/10.1016/j.bpsc.2017.12.004
Legrand, N., Nikolova, N., Correa, C., Braendholt, M., Stuckert, A., Kildahl, N., Vejlø, M., Fardo, F., & Allen, M. (2022). The heart rate discrimination task: A psychophysical method to estimate the accuracy and precision of interoceptive beliefs. Biological Psychology, 168, 108239. https://doi.org/10.1016/j.biopsycho.2021.108239
Levine, M. P., & Smolak, L. (2002). Body image development in adolescence. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice (pp. 74-82). Guilford Press.
McCabe, M. P., & Ricciardelli, L. A. (2005). A prospective study of pressures from parents, peers, and the media on extreme weight change behaviors among adolescent boys and girls. Behaviour Research and Therapy, 43(5), 653-668. https://doi.org/10.1016/j.brat.2004.05.004
McEvoy, P. M., & Mahoney, A. E. J. (2012). To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behavior Therapy, 43(3), 533-545. https://doi.org/10.1016/j.beth.2011.02.007
Mehling, W. (2016). Differentiating attention styles and regulatory aspects of self-reported interoceptive sensibility. Philosophical Transactions of the Royal Society B: Biological Sciences, 371(1708), 20160013.
Mehling, W. E., Acree, M., Stewart, A., Silas, J., & Jones, A. (2018). The multidimensional assessment of interoceptive awareness, version 2 (MAIA-2). PLoS ONE, 13(12), e0208034. https://doi.org/10.1371/journal.pone.0208034
Mehling, W. E., Price, C., Daubenmier, J. J., Acree, M., Bartmess, E., & Stewart, A. (2012). The multidimensional assessment of interoceptive awareness (MAIA). PloS ONE, 7(11), e48230.
Murphy, J., Catmur, C., & Bird, G. (2019). Classifying individual differences in interoception: Implications for the measurement of interoceptive awareness. Psychonomic Bulletin & Review, 26, 1467-1471.
Murphy, J., Brewer, R., Catmur, C., & Bird, G. (2017). Interoception and psychopathology: A developmental neuroscience perspective. Developmental Cognitive Neuroscience, 23, 45-56. https://doi.org/10.1016/j.dcn.2016.12.006
Mussap, A. J., & Salton, N. (2006). A ‘rubber-hand’ illusion reveals a relationship between perceptual body image and unhealthy body change. Journal of Health Psychology, 11(4), 627-639. https://doi.org/10.1177/1359105306065022
Myers, T. A., & Crowther, J. H. (2009). Social comparison as a predictor of body dissatisfaction: A meta-analytic review. Journal of Abnormal Psychology, 118(4), 683-698. https://doi.org/10.1037/a0016763
Paxton, S. J., Neumark-Sztainer, D., Hannan, P. J., & Eisenberg, M. E. (2006). Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. Journal of Clinical Child & Adolescent Psychology, 35(4), 539-549. https://doi.org/10.1207/s15374424jccp3504_5
Pennebaker, J. W., & Lightner, J. M. (1980). Competition of internal and external information in an exercise setting. Journal of Personality and Social Psychology, 39(1), 165. https://doi.org/10.1037/0022-3514.39.1.165
Price, C. J., & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: Theory and approach of mindful awareness in body-oriented therapy (MABT). Frontiers in Psychology, 9, 798. https://doi.org/10.3389/fpsyg.2018.00798
Probst, M., Pieters, G., & Vanderlinden, J. (2008). Evaluation of body experience questionnaires in eating disorders in female patients (AN/BN) and nonclinical participants. International Journal of Eating Disorders, 41(7), 657-665. https://doi.org/10.1002/eat.20531
Probst, M., Vandereycken, W., & Van Coppenolle, H. (1997). Body-Size estimation in eating disorders using video distortion on a life-size screen. Psychotherapy and Psychosomatics, 66(2), 87-91. https://doi.org/10.1159/000289114
Probst, M., Vandereycken, W., Coppenolle, H. V., & Vanderlinden, J. (1995). The Body Attitude Test for patients with an eating disorder: Psychometric characteristics of a new questionnaire. Eating Disorders, 3, 133-144. https://doi.org/10.1080/10640269508249156
Riboli, G., Nese, M., Brighetti, G., & Borlimi, R. (2022). Multidimensional interoceptive awareness, psychosomatic symptoms, and risk for eating disorders in a female at birth adolescent sample. Current Research in Psychology and Behavioral Science (CRPBS), 3(2), 1-4. https://doi.org/10.54026/CRPBS/1040
Riva, G., & Dakanalis, A. (2018). Altered processing and integration of multisensory bodily representations and signals in eating disorders: A possible path toward the understanding of their underlying causes. Frontiers in Human Neuroscience, 12, 49. https://doi.org/10.3389/fnhum.2018.00049
Schuck, K., Munsch, S., & Schneider, S. (2018). Body image perceptions and symptoms of disturbed eating behavior among children and adolescents in Germany. Child and Adolescent Psychiatry and Mental Health, 12(1), 10. https://doi.org/10.1186/s13034-018-0216-5
Senín-Calderón, C., Rodríguez-Testal, J. F., Perona-Garcelán, S., & Perpiñá, C. (2017). Body image and adolescence: A behavioral impairment model. Psychiatry Research, 248, 121-126. https://doi.org/10.1016/j.psychres.2016.12.003
Sternheim, L., Startup, H., & Schmidt, U. (2011). An experimental exploration of behavioral and cognitive-emotional aspects of intolerance of uncertainty in eating disorder patients. Journal of Anxiety Disorders, 25(6), 806-812. https://doi.org/10.1016/j.janxdis.2011.03.020
Stice, E., & Shaw, H. E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings. Journal of Psychosomatic Research, 53(5), 985-993. https://doi.org/10.1016/S0022-3999(02)00488-9
Tajadura-Jiménez, A., & Tsakiris, M. (2014). Balancing the “inner” and the “outer” self: Interoceptive sensitivity modulates self-other boundaries. Journal of Experimental Psychology: General, 143(2), 736-744. https://doi.org/10.1037/a0033171
Talbot, A., Hay, P., Buckett, G., & Touyz, S. (2015). Cognitive deficits as an endophenotype for anorexia nervosa: An accepted fact or a need for re-examination? International Journal of Eating Disorders, 48(1), 15-25. https://doi.org/10.1002/eat.22332
Todd, J., Aspell, J. E., Barron, D., & Swami, V. (2019). An exploration of the associations between facets of interoceptive awareness and body image in adolescents. Body Image, 31, 171-180. https://doi.org/10.1016/j.bodyim.2019.10.004
Vall-Roqué, H., Andrés, A., & Saldaña, C. (2021). The impact of COVID-19 lockdown on social network sites use, body image disturbances and self-esteem among adolescent and young women. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 110, 110293. https://doi.org/10.1016/j.pnpbp.2021.110293
Vannucci, A., & Ohannessian, C. M. (2018). Body image dissatisfaction and anxiety trajectories during adolescence. Journal of Clinical Child & Adolescent Psychology, 47(5), 785-795. https://doi.org/10.1080/15374416.2017.1390755
Vartanian, L. R., & Dey, S. (2013). Self-concept clarity, thin-ideal internalization, and appearance-related social comparison as predictors of body dissatisfaction. Body Image, 10(4), 495-500. https://doi.org/10.1016/j.bodyim.2013.05.004
Wang, S. B., Haynos, A. F., Wall, M. M., Chen, C., Eisenberg, M. E., & Neumark-Sztainer, D. (2019). Fifteen-year prevalence, trajectories, and predictors of body dissatisfaction from adolescence to middle adulthood. Clinical Psychological Science, 7(6), 1403-1415. https://doi.org/10.1177/2167702619859331
Wiese, A. D. (2021). Intolerance of uncertainty and the physiological correlates of anticipation and appraisal of affective stimuli. University of Missouri-Kansas City.
Wilson, E. J., Stapinski, L., Dueber, D. M., Rapee, R. M., Burton, A. L., & Abbott, M. J. (2020). Psychometric properties of the Intolerance of Uncertainty Scale-12 in generalized anxiety disorder: Assessment of factor structure, measurement properties and clinical utility. Journal of Anxiety Disorders, 76, 102309. https://doi.org/10.1016/j.janxdis.2020.102309