Changes in interoception and well-being during the quarantine for the Covid-19 pandemic

OBJECTIVES: Interoception refers to the processing of the internal state of the body and has been consistently tied to well-being. Deficits in interoceptive processing caused by stressful events have been associated with altered psychological states, such as depression, anxiety, and sleep disturbance. Given the important role of interoception in determining well-being and considering the relevance of focusing on visceral signals in order to check for symptoms of COVID-19 infection (e.g., breathing, and body temperature) we ran a longitudinal study. Specifically, we tested if interoception and well-being changed before and during different stages of the pandemic and if and to which extend the former influenced the latter. MATERIALS AND METHODS: 245 Italian participants who had completed the Multidimensional Assessment of Interoceptive Awareness (MAIA) prior to the onset of the pandemic, repeated the questionnaire during the first quarantine in Italy (11th March – 3rd May 2020), and three months after the restrictions (1st -31th September 2020). They also completed survey measures of depression (PHQ-9), anxiety (STAI), and sleep disturbance (PSQI). A sub-sample of 28 participants, who had completed the heartbeat counting task (HCT) and a measure of heart rate variability (HRV) before the pandemic, was also tested remotely during the pandemic using two mobile applications (Cardiograph and HRV CAMERA). RESULTS: We found that while performance in the HCT (interoceptive accuracy) remained unvaried, MAIA scores (interoceptive sensibility) consistently increased from before the pandemic to the quarantine and remained unvaried three months after. HRV decreased significantly following the onset of the pandemic and remained unvaried three months later. Depression, anxiety, and sleep deprivation scores were higher during the quarantine with respect to three months after. Interestingly, we also found that well-being during the pandemic was negatively predicted by pre-pandemic level of specific components of interoceptive sensibility (e.g., the ability to regulate distress by attention to body sensations and the experience of one’s body as safe and trustworthy). DISCUSSION AND CONCLUSIONS: Our findings suggest that while interoceptive accuracy is a stable ability, the onset of the COVID-19 pandemic is associated to an increased attention towards visceral signals and to a general decrease in the well-being measured subjectively (questionnaires) and objectively (HRV). Moreover, we found that specific pre-pandemic components of interoceptive sensibility predicted participants’ levels of depression, anxiety, and sleep disturbance during the pandemic. These results highlight the role of interoception in contributing to well-being and protecting against stressful events and can ultimately provide insight for novel well-being interventions.