(PS13-D82) Interoceptive Awareness, Stress, and Distress from Psychotic-like Experiences

Background: Psychotic-like experiences (PLEs; e.g., perceptual abnormalities, ideas of persecution or grandiosity, magical thinking) are not uncommon in the general population and are sometimes associated with increased distress and poor functioning. Previous research by the authors has indicated that individuals with anxiety and depression tend to experience PLEs at a higher rate, suggesting that general distress levels may affect how much distress one experiences from PLEs. Interoceptive awareness is a construct that involves many facets, including one’s tendency to notice physiological sensations and self-regulate physiological distress. Previous research has indicated that higher interoceptive awareness is associated with lower distress from PLEs. However, it is currently unknown how much of general distress associated with anxiety and depression accounts for the distress experienced from PLEs.

 

Methods: Participants with and without anxiety and depressive disorders (N = 199; M_age = 19.62, SD = 3.38; 39.2% female; 71.4% white) were recruited from a midwestern university and completed four questionnaires online assessing interoceptive awareness (MAIA), past week depression, anxiety, and stress levels (DASS-21), frequency and distress from PLEs (CAPE), and signs of schizotypy (MSS). Participants also completed demographics questions and reported on whether they have an anxiety and/or depressive disorder.

 

Results: Individuals who reported having an anxiety and/or a depressive disorder tended to experience PLEs more often (M = 1.98, SD = 0.39) than individuals with no reported disorders (M = 1.64, SD = 0.38), t(88.18) = 5.487, p < .001. They also reported greater distress from PLEs (M = 2.10, SD = 0.64) than individuals with no reported disorders (M = 1.76, SD = 0.55), t(80.37) = 3.445, p < .001. Five of the eight facets of interoceptive awareness significantly predicted distress from PLEs across the total sample (Noticing, r = 0.18; Not Distracting, r = -0.25; Not Worrying, r = -0.32; Emotional Awareness, r = 0.19; Body Trust, r = -0.18). However, when controlling for past week levels of anxiety, depression, and stress, these facets of interoceptive awareness no longer significantly predicted distress from PLEs. The only exception was Not Worrying, which was still a significant predictor of PLE distress (b = -0.087, p = .032). In every case, stress level was a significant predictor of PLE distress.

 

Discussion: These results suggest that general levels of stress play a role in the amount of distress an individual feels from PLEs.  Although different facets of interoceptive awareness were associated with distress from PLEs, only the tendency to not worry about physiological sensations significantly predicted lower PLE distress when controlling for past week depression, anxiety, and stress levels. The results of this study combine with previous research to suggest that although increased interoceptive awareness is associated with less distress from PLEs, it is important to consider general levels of stress and how they may influence specific distress from PLEs. In addition, results tentatively suggest that fostering a tendency to not worry about physiological sensations can act as a protective factor against distress from PLEs.