Wiśniewski Paweł, Jakubczyk Andrzej, Trucco Elisa M, Kobyliński Paweł, Suszek Hubert, Zaorska Justyna, Rydzewska Małgorzata, Kopera Maciej
Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, United States.
Front Psychiatry. 2023 Sep 22;14:1229985. doi: 10.3389/fpsyt.2023.1229985. eCollection 2023.
Interoception (i.e., the ability to recognize bodily signals), alexithymia (i.e., the inability to recognize emotional states) and negative affect (i.e., unpleasant feelings such as anxiety) have been associated with alcohol use disorder (AUD). Previous research suggests that interoception may underlie alexithymia, which in turn may be associated with negative affectivity. However, this remains to be empirically tested. This study investigates whether alexithymia mediates the association between interoception and anxiety and whether this association differs across individuals with AUD and a healthy control (HC) comparison group.
The AUD group consisted of 99 participants enrolled in an 8-week abstinence-based inpatient treatment program. The HC group included 103 healthy individuals. The heartbeat counting task (HCT) was used to assess interoception (cardiac interoceptive accuracy). The Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia. The Brief Symptom Inventory (BSI) was used to assess anxiety.
The moderated mediation model with interoception as the predictor, alexithymia as the mediator, and negative affect (i.e., state anxiety) as the dependent variable was tested. The analysis showed that the conditional indirect effect of interoception on anxiety via alexithymia was significant for individuals with AUD [ = -0.300, bootstrap 95% CI = (-0.618, -0.088)], as well as for HCs [ = -0.088, bootstrap 95% CI = (-0.195, -0.014)]; however, the conditional indirect effect significantly differed across HCs and individuals with AUD. Namely, the mediated effect was greater among individuals with AUD compared to the HC group.
The results suggests that interoceptive impairment contributes to greater negative affect (i.e., state anxiety) via alexithymia especially for individuals with AUD. Improving emotion recognition via therapeutic methods focused on strengthening interoceptive abilities could improve outcomes for individuals receiving treatment for AUD.
内感受（即识别身体信号的能力）、述情障碍（即无法识别情绪状态）和消极情绪（如焦虑等不愉快的感受）与酒精使用障碍（AUD）有关。先前的研究表明，内感受可能是述情障碍的基础，而述情障碍反过来可能与消极情感有关。然而，这仍有待实证检验。本研究调查述情障碍是否介导内感受与焦虑之间的关联，以及这种关联在患有酒精使用障碍的个体和健康对照（HC）比较组之间是否存在差异。
酒精使用障碍组由99名参加为期8周的基于戒酒的住院治疗项目的参与者组成。健康对照组包括103名健康个体。心跳计数任务（HCT）用于评估内感受（心脏内感受准确性）。多伦多述情障碍量表（TAS - 20）用于评估述情障碍。简明症状量表（BSI）用于评估焦虑。
对内感受作为预测变量、述情障碍作为中介变量、消极情绪（即状态焦虑）作为因变量的调节中介模型进行了检验。分析表明，内感受通过述情障碍对焦虑的条件间接效应在患有酒精使用障碍的个体中显著[β = -0.300，自助法95%置信区间 = （-0.618，-0.088）]，在健康对照组中也显著[β = -0.088，自助法95%置信区间 = （-0.195，-0.014）]；然而，健康对照组和患有酒精使用障碍的个体之间的条件间接效应存在显著差异。也就是说，与健康对照组相比，酒精使用障碍个体的中介效应更大。
结果表明，内感受障碍尤其通过述情障碍导致酒精使用障碍个体产生更大的消极情绪（即状态焦虑）。通过专注于增强内感受能力的治疗方法来改善情绪识别，可能会改善接受酒精使用障碍治疗的个体的治疗效果。
