Interoception and proprioception as an underlying working mechanism of Medically Unexplained Symptoms

Abstract

At least 40-49% of primary health care patients present with symptoms that cannot be (sufficiently) medically explained. It is hypothesized that inadequate interoceptive processes play a crucial role in the development and perpetuation of these Medically Unexplained Symptoms (MUS). In this proposed research project, three different factors of interoceptive abilities in MUS will be investigated: accuracy, sensibility, and awareness. With this research, we aim to investigate the interoceptive abilities of individuals located across the stress continuum (overstrain, burnout, and functional somatic syndromes (FSS)) by asking participants to perform the Respiratory Occlusion Discrimination (ROD) task (=accuracy), to fill out the Interoceptive Sensitivity and Attention Questionnaire (ISAQ) and THree-domain Interoceptive Sensations Questionnaire (THISQ) (=sensibility) and to give confidence ratings on their performance on the ROD task (=awareness). For another study, the effect of a brief interoceptive training procedure on interoceptive accuracy in an FSS population will be investigated. Furthermore, a new broader definition of interoception includes the afferent information that arises from anywhere and everywhere within the body, including proprioceptive functions. That's why we also aim to translate the interoceptive theoretical framework into a proprioceptive framework. This will be done by developing a new measure for proprioceptive accuracy as similar as possible to the ROD task and by validating a proprioceptive sensibility questionnaire. In a final study, we will measure both interoceptive and proprioceptive abilities within healthy participants and FSS patients.