(PS1-49) Impact of Interoceptive Awareness on Anxiety and Number of Health Conditions in a Multi-Site Comparative Effectiveness Study for Hatha Yoga and Behavioral Activation Therapy

Abstract Text:

Background: Interoceptive awareness, or one’s ability to attend to internal bodily sensations, is increasingly recognized as a key factor in mental and physical health. Moreover, there is often an association between anxiety and physical health, such that anxiety is higher for those with more health conditions. However, it is possible that greater interoceptive awareness, specifically the facet of trust in one’s body and body listening, could be associated with reduced anxiety about physical health. We examined the association between anxiety symptoms and physical health in a sample of adults with elevated depressive symptoms, to evaluate if the strength of this relationship is different depending on two facets of interoceptive awareness.

Methods: Baseline data from a non-inferiority multi-site randomized clinical trial comparing the treatment effectiveness of yoga and behavioral activation psychotherapy in depression symptoms were used in this analysis. Participants (N=402) primarily identified as women (n=302, 75%), White (n=267, 67%), and non-Hispanic (n=328, 82%). Individuals completed a baseline survey that included the Multidimensional Assessment of Interoceptive Awareness-2 (MAIA-2), PROMIS-Anxiety scale, and presence of a variety of health conditions (with total number being a proxy for overall physical health). Using linear regression, we examined whether the total number of health conditions predicted anxiety severity, and also entered interoceptive awareness scales into the regression as an interaction term to test moderation hypotheses.

Results: We found that participants reported mild anxiety (M=64.4, SD=6.4), few health conditions at baseline (M=1; SD=1.9), and average levels of body trusting (M=2.59; SD=1.26) and body listening (M=2.55; SD=1.13). The number of health conditions did not predict anxiety levels. Higher levels of body listening were associated with increased anxiety; trust in one’s body was not associated with anxiety severity. These aspects of interoceptive awareness did not moderate the association between the number of health conditions and anxiety .

Conclusions: Our findings suggest that greater body interoception, particularly body listening, is associated with heightened anxiety symptoms. This suggests that those more attuned to bodily sensations may be more sensitive to feelings of anxiety or distress. Body trusting was not associated with anxiety, and facets of interoceptive awareness did not moderate the relationship between physical health conditions and anxiety. These findings may be due to floor effects – i.e., the sample had relatively few health conditions . Additionally, this was a sample with elevated depressive symptoms, where factors such as anhedonia may play a stronger role in shaping anxiety than physical health alone. Future research should examine potential mediators that play a role in determining whether body awareness leads to distress and anxiety.