Dissociation between the cognitive and interoceptive components of mindfulness in the treatment of chronic worry

J Behav Ther Exp Psychiatry. 2015 Sep;48:192-9. doi: 10.1016/j.jbtep.2015.04.001. Epub 2015 Apr 14.


Objetives: Despite the increasing interest in mindfulness, the basic components and action mechanisms of mindfulness remain controversial. The present study aims at testing the specific contribution of two components of mindfulness -attention to cognitive experience (metacognition) and awareness of interoceptive sensations (metainteroception)- in the treatment of chronic worry.

Method: Forty five female university students with high scores in the Penn State Worry Questionnaire were split into three groups: a mindfulness cognitive training group, a mindfulness interoceptive training group, and a non-intervention control group. Participants were assessed before and after the intervention using physiological indices of autonomic regulation (skin conductance, heart rate, heart rate variability, and respiratory sinus arrhythmia) and self-report indices of mindfulness and clinical symptoms (chronic worry, depression, positive and negative affect, and perceived stress).

Results: Both mindfulness training groups showed significant improvement after the intervention in self-report indices of mindfulness and clinical symptoms. However, the interoceptive training group was superior in also showing significant improvement in the physiological indices of autonomic regulation.

Limitations: The relatively small sample size may have increased the probabilities of type I and II errors. Our Intervention program was relatively short. The participants were all female.

Conclusions: These results support the hypothesis that, in the context of treating chronic worry, the interoceptive and cognitive components can be somewhat dissociated and that, when both components are applied separately, compared to a non-intervention condition, the interoceptive component is more effective.

Keywords: Heart rate variability; Metacognition; Metainteroception; Mindfulness; Respiratory sinus arrhythmia; Worry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / therapy*
  • Autonomic Nervous System / physiology*
  • Autonomic Nervous System / physiopathology
  • Chronic Disease
  • Female
  • Heart Rate / physiology
  • Humans
  • Interoception / physiology*
  • Metacognition / physiology*
  • Mindfulness / methods*
  • Respiratory Sinus Arrhythmia / physiology
  • Treatment Outcome
  • Young Adult