Factor Structure and Psychometric Properties of the Body Perception Questionnaire-Short Form (BPQ-SF) Among Chinese College Students

Interoception, somatic symptoms, and somatization tendency in Chinese individuals with subsyndromal depression: A follow-up study

Interoception refers to the sensation and perception of internal bodily sensations, and may be related to depressive symptoms. Schemata concerning the body vary across different cultures and may influence interoception and symptom presentations of depression. This study explored the relationship between interoception, depressive symptoms, and schema of somatic focus in Chinese people with subsyndromal depression. Thirty-nine individuals with subsyndromal depression (SD) and 40 healthy controls (HCs) were assessed at baseline and after 3 months. Participants completed the self-report questionnaires for assessing interoceptive sensibility, somatic and psychological symptoms of depression, and somatization tendency. They also completed the heartbeat perception behavioral task for estimating interoceptive accuracy. The results showed that both the SD and the HC groups showed similar interoceptive accuracy, although the SD group showed heightened interoceptive sensibility. The discrepancy between interoceptive sensibility and interoceptive accuracy is termed the interoceptive trait prediction error (ITPE). The ITPE was positive in SD participants but was negative in HCs. In the entire sample, interoceptive sensibility and the ITPE were correlated with somatic symptoms rather than with psychological symptoms of depression. Interoceptive sensibility partially mediated the relationship between somatization tendency and somatic symptoms, after controlling for psychological symptoms of depression. These results remained stable after 3 months. The shortcomings of the present study were a lack of clinical interview to ascertain diagnosis and a short follow-up duration. In conclusion, our study suggests that altered interoception occurs in subsyndromal depression. Interoception is related to somatic symptoms of depression. The schema of body was related to depressive symptoms, partially through interoception, in Chinese people with subsyndromal depression.

Subjective Sensitivity to Exteroceptive and Interoceptive processing in Highly Sensitive Person

A highly sensitive person is known to have greater levels of sensory processing sensitivity (SPS) referring to a personality trait to exhibit high stimulation and arousal while processing subtle sensory signals. However, how SPS levels reflect the profile of sensitivity in exteroceptive and interoceptive sensory processing remains inadequately understood. Thus, we collected data using the Highly Sensitive Person Scale (HSPS), the Glasgow Sensory Questionnaire (GSQ), and the Body Perception Questionnaire-Short Form (BPQ-SF) from 600 Japanese adults, and examined their relationships. The results revealed that SPS levels, assessed by the HSPS, were significantly, positively correlated with hypersensitivity scores of the GSQ in several exteroceptive sensory domains. Further, SPS levels were positively correlated with sensitivity in interoceptive awareness assessed by the BPQ-SF; however, it does so scarcely. Our findings suggest that SPS levels reflect a subjective sensitivity to exteroceptive sensory processing regardless of sensory domains and narrowly to the interoceptive sensory processing.

Association of Self-Reported Autonomic Symptoms With Sensor-Based Physiological Measures

OBJECTIVE

Autonomic regulation of organ and tissues may give rise to disruptions of typical functions. The Body Perception Questionnaire Short Form (BPQ-SF) includes items that were developed to assess autonomic symptoms in daily life. This pair of studies aimed to establish previously unexplored psychometric properties of the BPQ-SF autonomic symptoms scale, develop normative values for clinical and research use, and assess the convergence of self-reports with sensor-based measures.

METHODS

Study 1 reports exploratory and confirmatory factor analysis on BPQ-SF autonomic symptom items from a large US population-based online study ( n = 2048). In study 2, BPQ-SF scores were examined for associations with heart period, respiratory sinus arrhythmia, and skin conductance during seated leg lifts in a community sample ( n = 62).

RESULTS

Study 1 results supported a two-factor supradiaphragmatic and subdiaphragmatic autonomic symptom solution (confirmatory factor analysis: root mean squared error of approximation = 0.040, Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99), although a one-factor solution also fit the data well (root mean squared error of approximation = 0.080, Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99). In study 2, heart period responses to leg lifts and rests were demonstrated at all autonomic symptom levels. However, low autonomic symptoms were associated with optimal autonomic nervous system patterns of activation and recovery to baseline levels. Moderate symptoms were associated with prolonged sympathetic activation. The highest symptom levels were associated with impaired autonomic nervous system coordination across activation and recovery.

CONCLUSIONS

Results support the utility of self-reports of autonomic symptoms in research and clinical applications, with higher symptoms likely indicating autonomic impairment.

Predicting postpartum depressive symptoms by evaluating self-report autonomic nervous system reactivity during pregnancy

OBJECTIVE

Altered self-reported autonomic reactivity is associated with worse mental health in the general population. Although dysfunctional changes in ANS during pregnancy have been investigated in relation to depressive symptoms, no studies addressed the relationship between self-report autonomic reactivity during pregnancy and depressive symptoms after the delivery. The present study aimed to assess the impact of prepartum self-reported autonomic reactivity on the development of postpartum depressive symptoms.

METHODS

In this longitudinal study, 170 women were assessed during pregnancy (i.e., second or third trimester) and after childbirth (i.e., one month after the delivery). Self-reported autonomic reactivity was assessed through the Body Perception Questionnaire - Short Form that evaluates the autonomic functions related to organs above (i.e., supradiaphragmatic reactivity) and below (i.e., subdiaphragmatic reactivity) the diaphragm. In addition, prepartum and postpartum depressive symptoms were evaluated using the Patient Health Questionnaire - 9.

RESULTS

Findings showed that higher prepartum supradiaphragmatic reactivity predicted higher depressive symptoms in the postpartum period (β = 0.112, p = 0.009) after controlling for prepartum depressive symptomatology and other potential covariates.

CONCLUSIONS

Evaluation of self-reported autonomic activity may be a useful tool to identify antenatally women at risk of postpartum depressive symptoms. Future studies are needed to evaluate the effectiveness of interventions aimed at reducing the threat-responsive autonomic reactivity at rest and improving adaptive autonomic regulation to prevent postpartum depression.

The Effects of a Standardized Cognitive-Behavioural Therapy and an Additional Mindfulness-Based Training on Interoceptive Abilities in a Depressed Cohort

BACKGROUND

Interoceptive accuracy and sensibility are decreased in depressive samples. However, different studies showed that cognitive-behavioural therapy (CBT) and mindfulness interventions are promising approaches to improve interoceptive abilities. Based on these findings, the study aims to investigate the pre-post effect of CBT in a depressive sample. Additionally, we examined the effect of mindfulness-based stress reduction (MBSR) training in the context of CBT.

METHODS

Sixty depressive patients were investigated over four weeks, with two conditions-CBT vs. CBT + MBSR. Further, the changes in interoceptive abilities (interoceptive accuracy and sensibility) of the depressive patients were compared to baseline data of healthy controls.

RESULTS

The depressive patients showed significantly higher levels of depression and lower mindfulness and interoceptive abilities than healthy controls. The depressive sample showed a significant decrease in depressive symptoms and increased mindfulness and interoceptive abilities after CBT. Lastly, depressive patients of the CBT + MBSR condition did not differ from those who only received CBT in the levels of depression, mindfulness or interoceptive abilities over the time course.

DISCUSSION

This study demonstrates a positive effect of CBT on interoceptive abilities in a depressive sample. It is shown that the depressive sample did not profit from additional mindfulness training. It can be concluded that CBT is an efficient treatment, resulting in increased interoceptive abilities. Unexpectedly, the combination of CBT and MBSR has no additional effect on these changes. Future studies should investigate the effect of MBSR as a stand-alone therapy.

Cross-cultural adaptation and psychometric properties of the Italian version of the Body Perception Questionnaire

BACKGROUND/OBJECTIVE

The purpose of this study was to cross-culturally adapt the Body Perception Questionnaire Short Form (BPQ-SF) into Italian and to assess its psychometric properties in a sample of Italian subjects.

METHODS

A forward-backward method was used for translation. 493 adults were recruited for psychometric analysis. Structural validity was assessed with confirmatory factor analysis and a hypothesis testing approach. Internal consistency was assessed by Cronbach's alpha and McDonald's omega. Measurement invariance analysis was applied with an age-matched American sample.

RESULTS

The single-factor structure fit the awareness subscale (RMSEA = .036, CFI = .983, TLI = .982). Autonomic reactivity (ANSR) was well-described by supra- and sub-diaphragmatic subscales (RMSEA = .041, CFI = .984, TLI = .982). All subscales were positively correlated (r range: .50-.56) and had good internal consistency (McDonald's Omega range: .86-.92, Cronbach's alpha range: .88-.91). Measurement invariance analysis for the Awareness model showed significant results (p<0.001) in each step (weak, strong and strict) whereas the ANSR showed significant results (p<0.001) only for the strong and strict steps.

CONCLUSIONS

Our results support the Italian version of the BPQ as having consistent psychometric properties in comparison with other languages.

Item Reduction, Psychometric and Biometric Properties of the Italian Version of the Body Perception Questionnaire-Short Form (BPQ-SF): The BPQ-22

Body awareness disorders and reactivity are mentioned across a range of clinical problems. Constitutional differences in the control of the bodily state are thought to generate a vulnerability to psychological symptoms. Autonomic nervous system dysfunctions have been associated with anxiety, depression, and post-traumatic stress. Though interoception may be a transdiagnostic mechanism promoting the improvement of clinical symptomatology, few psychometrically sound, symptom-independent, self-report measures, informed by brain-body circuits, are available for research and clinical use. We validated the Italian version of the body perception questionnaire (BPQ)-short form and found that response categories could be collapsed from five to three and that the questionnaire retained a three-factor structure with items reduced from 46 to 22 (BPQ-22). The first factor was loaded by body awareness items; the second factor comprised some items from the body awareness scale and some from the subdiaphragmatic reactivity scale (but all related to bloating and digestive issues), and the third factor by supradiaphragmatic reactivity items. The BPQ-22 had sound psychometric properties, good convergent and discriminant validity and test-retest reliability and could be used in clinical and research settings in which the body perception assessment is of interest. Psychometric findings in light of the polyvagal theory are discussed.