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. 2020 Oct:27:100584.
doi: 10.1016/j.jocrd.2020.100584. Epub 2020 Sep 10.

Dimensions of interoception in obsessive-compulsive disorder

Goi Khia Eng  1   2 , Katherine A Collins  2   3 , Carina Brown  1   2 , Molly Ludlow  2 , Russell H Tobe  2 , Dan V Iosifescu  1   2 , Emily R Stern  1   2
Affiliations

Dimensions of interoception in obsessive-compulsive disorder

Goi Khia Eng et al. J Obsessive Compuls Relat Disord. 2020 Oct.

Abstract

Interoceptive sensibility (IS) refers to the subjective experience of perceiving and being aware of one's internal body sensations, and is typically evaluated using self-report questionnaires or confidence ratings. Here we evaluated IS in 81 patients with OCD and 76 controls using the Multidimensional Scale of Interoceptive Awareness (MAIA), which contains 8 subscales assessing adaptive and maladaptive responses to sensation. Compared to controls, OCD patients showed hyperawareness of body sensations. Patients also demonstrated a more maladaptive profile of IS characterized by greater distraction from and worry about unpleasant sensations, and reduced tendency to experience the body as safe and trustworthy. These findings were independent of medication status and comorbidities in the patient group. Correlational analyses showed that subscales of the MAIA were differentially associated with OCD symptom dimensions. These findings indicate that patients with OCD show abnormality of IS that is independent of confounding factors related to medication and comorbidities and associated with different OCD symptom dimensions. Future work would benefit from examining neural correlates of these effects and evaluating whether dimensions of IS are impacted by treatments for the disorder.

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Figures

Figure 1:
Figure 1:
Average scores on all eight subscales of the MAIA in 76 healthy controls and 81 patients with OCD. Demographic variables (age, biological sex, education) were included as covariates for subscales that were significantly associated with these variables. Marginal means are presented for subscales where covariates were applied. Significant group differences are indicated with asterisks. *p < .05, **p < .001. A Covariates include age. B Covariates include biological sex and education.
Figure 2:
Figure 2:
Average scores in OCD patients on the six subscales of the MAIA that showed group differences based on medication and comorbidity status. Sample sizes: Med− Comorbid− (n = 17), Med− Comorbid+ (n = 21), Med+ Comorbid− (n = 9), Med+ Comorbid+ (n = 34), Controls (n = 76). Abbreviations: Med−, unmedicated; Med+, medicated; Comorbid−, without Axis 1 comorbidity; Comorbid+, with at least an Axis 1 comorbidity. ** p < .001 for the main effect of comorbidity.
Figure 3:
Figure 3:
Scatterplots showing the associations between MAIA subscales and obsessive-compulsive symptom dimensions using the DOCS within the patient sample (n = 81). Only significant correlations are presented (all p < .05). Partial regression plots display the relationship between MAIA subscale and DOCS dimension after regressing out effects of demographic variables where necessary. Abbreviations: MAIA, Multidimensional Assessment of Interoceptive Awareness; DOCS. Dimensional Obsessive-Compulsive Scale.
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