Body image dissatisfaction and interoceptive sensibility significantly predict postpartum depressive symptoms

Body understanding measure for pregnancy scale (BUMPs): Cross-cultural adaptation and psychometric properties among Brazilian pregnant women

The Body Understanding Measure for Pregnancy Scale (BUMPs) is a scale developed and validated for British pregnant women to assess body satisfaction during pregnancy. The aim of this study was to perform a cross-cultural adaptation and verify the psychometric properties of BUMPs for Brazilian adult pregnant women. The cross-cultural adaptation was performed using translation, back-translation, expert committee, expert analysis, and pre-testing, which showed easy comprehension by pregnant women. Psychometric analyses were evaluated in a sample of 618 pregnant women (31.08 ± 4.94 years old). Exploratory and confirmatory factor analyses resulted in 19 items and three factors, with satisfactory fit indices. BUMPs presented an invariant measurement across white vs. nonwhite women and across the three gestational trimesters. BUMPs showed good indicators of convergent, internal consistency, and test-retest reproducibility validity. It was concluded that the Brazilian version of BUMPs has adequate psychometric properties for Brazilian pregnant women, being an excellent instrument for analyzing body satisfaction in this population, facilitating additional investigations into these constructs.

The role of bodily experiences during pregnancy on mother and infant outcomes

Pregnancy is a transformative time for women and their bodies, and therefore thoughts and feelings and about one's own body and internal bodily sensations may understandably change during this period. Body satisfaction and interoception have been found to influence factors such as antenatal attachment (AA) and maternal mental health. However, mixed results in the literature suggest complex relationships between the bodily experience during pregnancy and outcomes, necessitating a broader investigative approach. We aim to examine the relationship between the pregnancy bodily experience and multiple mother-infant outcomes. It is hypothesised that poor bodily experiences during pregnancy will have negative impacts on these outcomes. Cross-sectional online survey data was collected from individuals at various gestations throughout pregnancy as part of a larger longitudinal study (N = 253, mean age = 32). We analysed validated measures of pregnancy body satisfaction, interoceptive sensibility, AA and mood, as well as intentions to breastfeed. Linear regressions were used to confirm findings from previous literature and a network analysis allowed for a more exploratory approach to understanding the importance of the bodily experience during pregnancy. Multiple regressions found low body satisfaction predicts higher levels of anxiety, depression and AA. A network analysis revealed relationships between body satisfaction and interoception during pregnancy and mother-infant outcomes, including depression and AA. Our results highlight the far-reaching effects of poor bodily experiences during pregnancy on a variety of outcomes. Understanding the impact of the pregnant bodily experience can help identify at-risk individuals and inform interventions.

Probing corporeal awareness in women through virtual reality induction of embreathment illusion

We capitalized on the respiratory bodily illusion that we discovered in a previous study and called 'Embreathment' where we showed that breathing modulates corporeal awareness in men. Despite the relevance of the issue, no such studies are available in women. To bridge this gap, we tested whether the synchronization of avatar-participant respiration patterns influenced females' bodily awareness. We collected cardiac and respiratory interoceptive measures, administered body (dis)satisfaction questionnaires, and tracked participants' menstrual cycles via a mobile app. Our approach allowed us to characterize the 'Embreathment' illusion in women, and explore the relationships between menstrual cycle, interoception and body image. We found that breathing was as crucial as visual appearance in eliciting feelings of ownership and held greater significance than any other cue with respect to body agency in both women and men. Moreover, a positive correlation between menstrual cycle days and body image concerns, and a negative correlation between interoceptive sensibility and body dissatisfaction were found, confirming that women's body dissatisfaction arises during the last days of menstrual cycle and is associated with interoception. These findings have potential implications for corporeal awareness alterations in clinical conditions like eating disorders and schizophrenia.

Bonding with bump: Interoceptive sensibility moderates the relationship between pregnancy body satisfaction and antenatal attachment

PROBLEM

There is limited understanding and contradictory results regarding the contribution of the pregnant bodily experience to antenatal attachment.

BACKGROUND

Antenatal attachment is an important aspect of pregnancy, which has been linked with positive maternal and infant outcomes. Given the profound physical process of pregnancy, it is likely that bodily experience is implicated in antenatal attachment, with research supporting the involvement of pregnancy body (dis)satisfaction. However, previous research reveals conflicting results and has only focused on exteroceptive bodily experience (appearance) rather than internal physiological sensations (interoception).

AIM

To examine the relative contributions of both external and internal bodily experience in antenatal attachment.

METHODS

This cross-sectional study collected online survey data from 159 pregnant participants with measures capturing interoceptive sensibility (subjective experience of interoception), pregnancy body dissatisfaction and antenatal attachment.

FINDINGS

We replicated previous findings that pregnancy body dissatisfaction is related to antenatal attachment. However, the relationship between pregnancy body dissatisfaction and antenatal attachment was moderated by worry about interoceptive signals. The interoceptive construct of body trust was most strongly associated with antenatal attachment.

DISCUSSION

The results suggest that interoception is important for antenatal attachment, particularly feelings of body trust. Moreover, for individuals who were less worried about bodily sensations, high levels of body dissatisfaction were associated with low attachment scores, whilst for those who were more concerned about these sensations, the relationship between body dissatisfaction and antenatal attachment was mitigated.

CONCLUSION

The results suggest that focusing on internal sensations may be a protective strategy against pregnancy body dissatisfaction to strengthen maternal bonds.

Postpartum depression and its relationship with the positive and negative perfectionism

BACKGROUND

Depression is a common mental disorder after childbirth, which has serious consequences for the mother, baby, and family. A wide range of causes, including some personality traits of mothers, are involved in its etiology. Therefore, this study was conducted aiming to determine the factors related to postpartum depression (PPD) and its relationship with positive and negative perfectionism in Qom, Iran.

MATERIALS AND METHODS

This cross-sectional analytical study was conducted on 162 mothers who had been referred to health centers in Qom during 6-8 weeks after normal vaginal delivery (NVD) in 2020. After randomly classifying the health centers, the convenience sampling method was carried out. Data collection tools included social-individual information form, Edinburg Postnatal Depression Scale (EPDS), and Positive and Negative Perfectionism Questionnaire of Terry-Short. The data were analyzed using the Chi-square and Pearson correlation tests and multivariate logistic regression analysis.

RESULT

The prevalence of PPD in this study was 29.6%. The results showed that with the increase in the negative dimension of perfectionism, the chance of PPD in people increases by 14% (OR = 1.14, CI = 1.06-1.21), while there was no significant correlation between the positive dimension of perfectionism and PPD (r = 0.006, P > 0.05). Furthermore, the chance of PPD was higher in student mothers, mothers who had a history of PPD, and unintended pregnancy. Moreover, some factors such as multigravidity, breastfeeding, and not worrying about body image reduce the chance of occurrence.

CONCLUSION

Since mothers' negative perfectionism is associated with PPD, it is recommended to identify perfectionist individuals during pregnancy and after delivery and provide counseling service to them.

Interoceptive and Affective Alterations in Body Integrity Dysphoria: An Online Self-Reporting Study

INTRODUCTION

Body integrity dysphoria (BID) is a rare condition in which individuals experience a long-lasting desire to achieve a specific physical disability. In this study, we tested the hypothesis of interoceptive and affective abnormalities in BID, in line with the evidence of structural and functional alteration of the interoceptive-affective neural system in these individuals.

METHOD

Our study involved 68 participants with BID (mean age: 35.6, SD: 16.4). Among these participants, 47 expressed a desire for amputation, 14 desired paralysis, 3 sought sensory deprivation, and 3 desired a combination of these forms. For comparisons, we recruited a control group of 79 participants (mean age: 35.2, SD: 15.8). We administered assessment measures to investigate alexithymia level (TAS-20), disgust sensitivity (DS-R), interoceptive awareness (MAIA-2), and (affective and cognitive) empathy (QCAE). We also administered the Short Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) to identify psychiatric comorbidities. Subgroups with low O-LIFE scores (BID = 31; controls = 43) and subgroups with high O-LIFE scores (BID = 37; controls = 36) were derived through a median-split procedure.

RESULTS

Within the BID low O-LIFE group, we found reduced interoceptive sensibility, reduced disgust sensitivity, and increased difficulty in identifying feelings, which refers to a dimension of the alexithymia trait. Within the BID high O-LIFE group, we observed a reduced disgust sensitivity and interoceptive sensibility, accompanied by a diminished score in cognitive empathy.

CONCLUSION

Our study suggests that BID can be associated with altered interoceptive and affective processing.

Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum

PURPOSE

Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity.

METHODS

In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake.

RESULTS

Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy.

DISCUSSION

The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies.

LEVEL OF EVIDENCE

Level I-Evidence obtained from: systematic reviews and meta-analyses.

Longitudinal associations between mindfulness and changes to body image in first-time parent couples

Pregnancy and postpartum are associated with declines in body image. Research on postpartum body image focuses almost exclusively on the person who gave birth and studies examining protective factors for postpartum body image are scarce. We assessed 257 new-parent couples from mid-pregnancy to 6-months postpartum to examine whether mindfulness-a recognized contributor to psychological well-being-buffered against declines in both partners' perceptions of mothers' body. Mothers' positive body image and partners' perception of mothers' body were collected at four time-points (second and third trimester; 3- and 6-months postpartum); both partners' mindfulness facets-observing, describing, awareness acting, non-judgement, and non-reactivity-were assessed in the second trimester. Dyadic latent growth curve modeling revealed that both partners' perceptions of mothers' body were positively correlated at all moments; however, mothers' positive body image worsened over time, whereas partners' perception of mothers' body remained stable. Mindfulness facets were positively associated with mothers' positive body image (observe, describe, and non-judging) and fathers' (non-judging) perceptions of mothers' body in pregnancy. Mothers' mindfulness facets (acting with awareness, non-judging) were associated with subsequent trajectories of their own body image. By identifying mindfulness facets as targetable protective factors during pregnancy, these findings have implications for future research and interventions focused on perinatal body image.

A longitudinal study of interoception changes in the times of COVID-19: Effects on psychophysiological health and well-being

Background

Interoception - the processing of the internal state of the body - has been consistently tied to well-being and mental health, which in turn have been severely challenged by the COVID-19 pandemic. Moreover, the fact that symptoms of COVID-19 (high temperature, shortness of breath, fatigue, and even gastro-intestinal problems) directly alter interoceptive signals has fueled people's tendency to constantly check their internal bodily state.

Objectives

In this longitudinal study we tested for changes in interoception and psychophysiological health and well-being during different stages of the pandemic in 2020 and assessed their potential association. To highlight this association, we combined both subjective (i.e., self-reported questionnaires) and objective (i.e., measures of heart rate variability, HRV and of interoceptive accuracy) measures.

Methods

245 Italian participants who had completed the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) prior to the onset of the pandemic, repeated the questionnaire during the first national lockdown in Italy, and four months after restrictions. Participants also completed survey measures of depression (PHQ-9), anxiety (STAI), and sleep disturbance (PSQI). A sub-sample of 28 participants, who had completed the heartbeat counting task (HCT) and a measure of heart rate variability (HRV), was tested again remotely, in the same time windows, using phone applications and photoplethysmography.

Results

While performance in the HCT remained unvaried, MAIA-2 scores consistently increased from before the pandemic to the national lockdown, and remained largely unvaried after four months. The national lockdown was associated with the lowest psychophysiological health and well-being, as evidenced by a decrease in HRV compared to before the pandemic and by higher scores in self-reported depression, anxiety, and sleep disturbance compared to four months after the lockdown. Interestingly, psychophysiological health and well-being were predicted by specific regulatory components of interoception (e.g., the ability to regulate distress by focusing on body sensations and experiencing one's body as safe and trustworthy).

Conclusions

Our results suggest an increased attention towards visceral signals during the COVID-19 pandemic, and highlight the positive role of specific components of interoception in contributing to well-being, suggesting that novel interventions aimed at increasing interoception may be developed to protect against stressful life events such as COVID-19.

Interoceptive sensibility and body satisfaction in pregnant and non-pregnant women with and without children

Pregnancy is a time of great physical and psychological change. As well as prominent changes in the external appearance of the body, such as the baby bump, there are also substantial changes taking place within the body. Our awareness of, and attention towards, internal bodily signals (interoception) is thought to have a direct impact on how we feel about our bodies. Therefore, understanding how our experience of these interoceptive signals might change during pregnancy may have important implications for maternal wellbeing. This study examined body satisfaction and interoceptive sensibility (subjective experience of interoception) in pregnant and non-pregnant women with and without children. Feelings towards pregnancy-specific changes in body satisfaction and interoceptive sensibility were also examined in women in their first pregnancy (primigravida) and subsequent pregnancies (multigravida). It was found that pregnancy did not directly impact levels of body satisfaction, instead pregnant and non-pregnant women with children reported less satisfaction with their bodies compared to those without children. Primigravida women were more satisfied with the appearance of pregnancy specific bodily changes compared to multigravida women. Interestingly, these differences in body satisfaction in those with children (pregnant and non-pregnant) were mediated by the extent to which women trusted their bodies (measure of interoceptive sensibility). All other pregnancy related changes in interoceptive sensibility and body satisfaction were either non-significant or had small effect sizes. These results may suggest body trust as an important factor to support during the transition to parenthood in order to improve body satisfaction in mothers.