Investigating links between perinatal interoception, body satisfaction and maternal wellbeing.

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Due to the significance of the body for our mental wellbeing it is crucial to improve ourunderstanding of factors that affect our bodily experience, particularly at times of greatbodily changes. To date there is little research investigating the role of visceral bodily signals(referred to as interoception; Craig et al., 2002) during pregnancy on behavioural, cognitiveand emotional outcomes. Interoception in pregnancy extends from regular internal bodilysignals to also include signals that are only present during pregnancy, so there is a need todevelop specific instruments tailored for during pregnancy to capture the internal bodilyexperience women have during this time.Understanding links between interoception during pregnancy and negative perinatalexperiences may help early identification of women at risk of poor postnatal outcomes,allowing for implementation of appropriate proactive interventions.Project questionsQuestion 1: Would a pregnancy specific self-report scale to measure interoceptivesensibility capture components of the interoceptive bodily experience that are unique topregnancy?Question 2: What is the relative contribution of interoception and body dissatisfaction aspredictors of perinatal outcomes including attachment, self-concept, breastfeedingintentions and success, and post-natal depression?Question 3: Are currently validated behavioural measures of interoception such asheartbeat detection tasks and 'probe-caught thought sampling tasks' also valid for pregnantwomen?Question 4: Would neuroimaging (EEG) measures of interoception elicit different neuralresponses for pregnant women? Question 5: Are any aspects of interoception during pregnancy related to perception andexperience during the birth, or experiences postnatally?Research planYEAR ONE:Scale development.Qualitative information about awareness of bodily states during pregnancy will be gatheredfrom focus groups of pregnant women and midwives. Following this there will be two stagesof quantitative analysis using exploratory and confirmatory factor analysis from a largesample of ~600 pregnant women, gathered online.Relationship between body satisfaction, interoception and perinatal outcomes.Using the newly developed scale, various perinatal outcomes will be analysed in the initialsample of pregnant women to see how levels of interoception may predict negativeperinatal experience.YEAR TWO:Behavioural studies.Self-reports may provide understanding of interoceptive sensibility (subjective awareness ofvisceral activity) but not interoceptive accuracy (how accurate an individual is at detectingand interpreting interoceptive signals when compared with objective measures). Thereforebehavioural measures of interoception are important to measure interoception inpregnancy because much visceral activity occurs unconsciously. Twenty-four pregnant and24 non-pregnant women will complete heart beat detection tasks and a 'probe-caughtthought sampling' task (Smallwood and Schooler, 2006).Neuroimaging techniques.Electroencephalograph (EEG) will also be used to measure the cortical activity of the samplewhilst performing the behavioural techniques described above. Comparison of activity inspecific cortical areas of the brain associated with perception of internal feelings, processingof emotion, behaviour regulation and interpretation of sensory information will be madebetween pregnant and non-pregnant women.YEAR THREE:Postnatal follow-up.A subset of around 200 of the original pregnant women will be followed up after the birth oftheir baby to investigate if any aspects of interoception during pregnancy are related toexperience during birth, or experiences postnatally. A small sample will also be invited for ashort semi-structured interview to also gather qualitative data about their experiences.