New research provides evidence that anxiety is related to altered interoception, the perception of one’s own internal bodily states. The new study, published in the journal Neuron, examined the relationship between anxiety and the perception of breathing.
“Anxiety is one of the most common mental health disorders, and we are seeing an increase in the prevalence of anxiety amongst the current worldwide pandemic,” said study author Olivia Harrison, a Rutherford Discovery Research Fellow and senior lecturer at the University of Otago.
“Anxiety is something that affects everyone – whether it be personally, via a loved one, or in our everyday interactions. What’s more, it’s really normal to have feelings of anxiety when something scary happens. It’s when these anxieties become disproportional and disabling that we might need to think about treatments or techniques that can be used to help someone in their everyday life, and also in people who might be ‘at risk’ before things become problematic.”
The study involved 30 individuals with low anxiety and 30 individuals with moderate levels of anxiety. The participants were assigned to the groups based on their scores on the Spielberger Trait Anxiety Inventory.
The participants completed scientific questionnaires and two tasks in which the researchers used devices to create differing levels of resistance to breathing. One of these tasks was completed as the researchers used functional magnetic resonance imaging (fMRI) to record the participants’ brain activity.
Those in the moderate anxiety group tended to report elevated levels of breathing-related catastrophizing compared to the low anxiety group. In other words, those in the moderate anxiety group were more likely to agree with statements such as “I become afraid that the breathlessness will get worse.”
The moderate anxiety group also exhibited reduced “positively minded” interoceptive awareness, meaning they were less likely to agree with statements such as “I can pay attention to my breath without being distracted by things happening around me” and “When I am tense I notice where the tension is located in my body.”
The researchers also found significant differences between the moderate and low anxiety groups when it came to performance on the breathing tasks. Participants with moderate anxiety were less sensitive to variations in resistance to their breathing and displayed altered brain activity while predicting changes in breathing resistance.
“While lots of really important work around anxiety considers the cause and thought processes that occur when someone is anxious, our research team focuses on how the symptoms of anxiety that end up in our body (like having a racing heart, sweaty palms, fast breathing…) can feed back and possibly start a negative spiral of emotions and create even more anxiety,” Harrison told PsyPost.
“What we find is that people who have higher levels of anxiety have altered perceptions of their breathing compared to people with lower anxiety – they are actually less sensitive to changes in their breathing, they have reduced ‘insight’ into how well they are able to perceive their body, and they have altered brain activity when they are predicting what will happen to their breathing in the future.”
“These results, therefore, are just the beginning of our understanding as to how the communication between the brain and body can start to break down with anxiety, and we hope to use these to help improve treatments by giving people the tools to perceive their body better, and break the negative cycle of anxiety -> symptoms -> more anxiety.”
But the study — like all research — includes some caveats.
“This study is a cross-sectional study – meaning that it cannot distinguish whether anxiety causes changes in breathing perceptions, or if differences in breathing perceptions may contribute to different levels of anxiety,” Harrison explained. “A cross-sectional study such as this can only show us that there are differences in breathing perceptions associated with different levels of anxiety.”
“Next we are hoping to look at how strategies such as exercise or anti-anxiety medication may help to change both anxiety and breathing perceptions, allowing us to better understand how this relationship may change across interventions targeting anxiety.”
“Running this research requires a fantastic team of people, and we are so grateful to our funders – The European Commission’s Horizon 2020, the Royal Society Te Apārangi and L’Oreal-UNESCO For Women in Science,” Harrison added. “And of course for our wonderful volunteers who participate in our studies – without them this research is simply not possible.”
The study, “Interoception of breathing and its relationship with anxiety“, was authored by Olivia K. Harrison, Laura Kochli, Stephanie Marino, Roger Luechinger, Franciszek Hennel, Katja Brand, Alexander J. Hess, Stefan Fr€assle, Sandra Iglesias, Fabien Vinckier, Frederike H. Petzschner, Samuel J. Harrison, and Klaas E. Stephan.