Change starts with the body: Interoceptive appreciation mediates the effect of mindfulness training on behavior change - an effect moderated by depression severity.
Zev Schuman-Olivier, Richa Gawande, Timothy B. Creedon, Alexandra Comeau, Todd Griswold, Lydia Smith, My Ngoc To, Caitlyn L Wilson, Eric B Loucks, Benjamin Le Cook
Psychiatry Research December 1, 2024 DOI: 10.1016/j.psychres.2024.116230 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 274 |
| Population | Primary care patients with depression, anxiety, or stress disorders related to chronic illness |
| Interventions | Mindfulness Training for Primary Care (MTPC) using the Mindful Behavior Change curriculum low-dose mindfulness comparator |
| Duration | 8-week intervention, weeks 8-10 for action plan initiation reporting |
| Topics | Depression Meditation |
| Keywords | Adherence Behavior change Behavioral intervention Chronic disease Group psychotherapy Interoception Interoceptive awareness Interoceptive sensibility Primary care Self-care Self-management |
| Citations | 10 |
| Key findings | Interoceptive appreciation, specifically body listening and trusting, mediated the effect of mindfulness training on health behavior action plan initiation, with different subcomponents important depending on depression severity. |
Abstract
Mindfulness catalyzes health behavior change. Yet, interoception is dysregulated in depression, potentially impairing behavioral activation. We examined the mediating role of interoceptive appreciation, as measured by how much one trusts and listens to internal bodily signals, on behavior change. Primary care patients with depression, anxiety, or stress disorders related to chronic illness were randomized to Mindfulness Training for Primary Care (MTPC) using the Mindful Behavior Change curriculum or a low-dose mindfulness comparator. Participants (N = 274) completed the Multidimensional Assessment of Interoceptive Awareness (MAIA) at 0 and 8 weeks. At week 7, participants chose a health behavior action plan. During weeks 8-10, participants reported their action plan initiation (API) level. We investigated the effect of MTPC on API level (MTPC-API), the mediating role of interoceptive appreciation (Body Listening [MAIA-BL] + Trusting [MAIA-T]), and baseline depression severity as a moderator. MTPC had a significant direct effect on API. Interoceptive appreciation (MAIA-BL + MAIA-T) had a significant indirect effect on API (CI=0.15-0.56). Without depression (n = 76), MAIA-BL partially mediated MTPC-API (CI=0.02-0.87). With moderate-to-severe depression (n = 132), MAIA-T partially mediated MTPC-API (CI=0.01-0.85). Interoceptive appreciation helps people listen to motivating bodily signals. In depression, regaining body trust may be an important step on a mindful path towards change.
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cited by 4
- A meta-analysis of the effects of mindfulness meditation training on self-reported interoception Scientific Reports November 6, 2025
- Neural regulation of pain anticipation is associated with mindful behavior change in patients with anxiety or depression: A pilot study. Psychiatry Research Neuroimaging March 1, 2025
- Minding the Body: A Meta-analysis of the Effects of Mindfulness Meditation Training on Self-reported Interoception. Research Square June 4, 2025
- Fostering life hope in urban green spaces through brief online mindfulness: findings from four studies with park visitors. Frontiers in Psychology July 23, 2025
Cites 22
- Interoceptive inference, emotion, and the embodied self Trends in Cognitive Sciences October 12, 2013
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
- Interoception, contemplative practice, and health Frontiers in Psychology June 9, 2015
- Mindfulness meditation training alters cortical representations of interoceptive attention Social Cognitive and Affective Neuroscience June 11, 2012
- Interoceptive awareness in experienced meditators Psychophysiology May 22, 2008
and 17 more in the library