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Article

Examining Relationships Between Interoceptive Sensibility and Body Image in a Non-Western Context

A Study With Malaysian Adults

Published Online:September 23, 2021https://doi.org/10.1027/2157-3891/a000022

Abstract

Abstract. Previous research has indicated that there are significant associations between interoception and body image, with lower interoceptive sensibility (IS) associated with more negative body image and higher IS associated with more positive body image. However, it is unclear whether these relationships are replicable in populations outside of North America and Western Europe. To address this issue, we asked a sample of 815 Malaysian Malay adults to complete the Multidimensional Assessment of Interoceptive Awareness, the Body Appreciation Scale-2, the Functionality Appreciation Scale, the Photographic Figure Rating Scale (women only), and the Drive for Muscularity Scale (men only), using online survey software. There were significant positive correlations between IS and the positive body image indices for both women and men, but the associations between IS and negative body image were generally below thresholds for statistical significance. After controlling for body mass index, age, and gender identity, we identified significant associations between IS and all four indices of body image. Overall, these findings demonstrate that relationships between IS and facets of positive and negative body image are present in a non-Western setting. Furthermore, the direction and strength of relationships identified in the present study were consistent with previous findings from Western samples.

Impact and Implications.

The present work examines whether the perception of internal bodily stimuli (interoception) is associated with body image in a sample of Malaysian Malay adults. The key novel finding is that associations between interoceptive sensibility and body image are present in a non-Western sample, suggesting that existing models can be generalized to populations that are more demographically diverse than the Western samples that have been considered previously. Specifically, we identify several significant associations between facets of interoception and positive body image, which could have important therapeutic applications. As such, the work falls within Sustainable Development Goal 3.

References

  • Alleva, J. M., Diedrichs, P. C., Halliwell, E., Martijn, C., Stuijfzand, B. G., Treneman-Evans, G., & Rumsey, N. (2018a). A randomised-controlled trial investigating potential underlying mechanisms of a functionality-based approach to improving women’s body image. Body Image, 25, 85–96. 10.1016/j.bodyim.2018.02.009 First citation in articleCrossref, Google Scholar

  • Alleva, J. M., Diedrichs, P. C., Halliwell, E., Peters, M. L., Dures, E., Stuijfzand, B. G., & Rumsey, N. (2018b). More than my RA: A randomized trial investigating body image improvement among women with rheumatoid arthritis using a functionality-focused intervention program. Journal of Consulting and Clinical Psychology, 86(8), 666–676. 10.1037/ccp0000317 First citation in articleCrossref, Google Scholar

  • Alleva, J. M., Sheeran, P., Webb, T. L., Martijn, C., & Miles, E. (2015). A meta-analytic review of stand-alone interventions to improve body image. PLoS One, 10(9), Article e0139117. 10.1371/journal.pone.0139177 First citation in articleCrossref, Google Scholar

  • Andrew, R., Tiggemann, M., & Clark, L. (2016). Positive body image and young women’s health: Implications for sun protection, cancer screening, weight loss and alcohol consumption behaviours. Journal of Health Psychology, 21(1), 28–39. 10.1177/1359105314520814 First citation in articleCrossref, Google Scholar

  • Babusa, B., & Túry, F. (2012). Muscle dysmorphia in Hungarian non-competitive male bodybuilders. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 17(1), e49–e53. 10.1007/BF03325327 First citation in articleCrossref, Google Scholar

  • Badoud, D., & Tsakiris, M. (2017). From the body's viscera to the body's image: Is there a link between interoception and body image concerns? Neuroscience and Biobehavioral Reviews, 77, 237–246. 10.1016/j.neubiorev.2017.03.017 First citation in articleCrossref, Google Scholar

  • Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B (Methodological), 57(1), 289–300. 10.1111/j.2517-6161.1995.tb02031.x First citation in articleCrossref, Google Scholar

  • Bray, G. A. (1978). Definition, measurement, and classification of the syndromes of obesity. International Journal of Obesity, 2(2), 99–112. First citation in articleGoogle Scholar

  • Brown, T. A., Berner, L. A., Jones, M. D., Reilly, E. E., Cusack, A., Anderson, L. K., Kaye, W. H., & Wierenga, C. E. (2017). Psychometric evaluation and norms for the multidimensional assessment of interoceptive awareness (MAIA) in a clinical eating disorders sample. European Eating Disorders Review, 25(5), 411–416. 10.1002/erv.2532 First citation in articleCrossref, Google Scholar

  • Cash, T. F. (2004). Body image: Past, present, and future. Body Image, 1(1), 1–5. 10.1016/s1740-1445(03)00011-1 First citation in articleCrossref, Google Scholar

  • Cash, T. F., & Smolak, L. (Eds.). (2012). Body image: A handbook of science, practice, and prevention (2nd ed.). Guildford Press. First citation in articleGoogle Scholar

  • Chen, W. G., Schloesser, D., Arensdorf, A. M., Simmons, J. M., Cui, C., Valentino, R., Gnadt, J. W., Nielsen, L., Hillaire-Clarke, C. S., Spruance, V., Horowitz, T. S., Vallejo, Y. F., & Langevin, H. M. (2021). The emerging science of interoception: Sensing, integrating, interpreting, and regulating signals within the self. Trends in Neurosciences, 44(1), 3–16. 10.1016/j.tins.2020.10.007 First citation in articleCrossref, Google Scholar

  • Chentsova-Dutton, Y. E., & Dzokoto, V. (2014). Listen to your heart: The cultural shaping of interoceptive awareness and accuracy. Emotion, 14(4), 666–678. 10.1037/a0036193 First citation in articleCrossref, Google Scholar

  • Conceição, P. (2019). Human Development Report 2019. Beyond income, beyond averages, beyond today: Inequalities in human development in the 21st century. United Nations Development Programme. First citation in articleGoogle Scholar

  • Cook-Cottone, C. (2018). Mindful self-care and positive body image. In E. A. DanielsM. M. GillenC. H. Markey (Eds.), Body positive: Understanding and improving body image in science and practice (pp. 135–159). Cambridge University Press. First citation in articleCrossref, Google Scholar

  • Damasio, A. R. (2010). Self comes to mind: Constructing the conscious brain. Heinemann. First citation in articleGoogle Scholar

  • Daubenmier, J. J. (2005). The relationship of yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychology of Women Quarterly, 29(2), 207–219. 10.1111/j.1471-6402.2005.00183.x First citation in articleCrossref, Google Scholar

  • Davis, L. L., Fowler, S. A., Best, L. A., & Both, L. E. (2020). The role of body image in the prediction of life satisfaction and flourishing in men and women. Journal of Happiness Studies, 21, 505–524. 10.1007/s10902-019-00093-y First citation in articleCrossref, Google Scholar

  • Department of Statistics Malaysia. (2017). Current population estimates, Malaysia, 2016–2017. Department of Statistics Malaysia. First citation in articleGoogle Scholar

  • Dunn, T. J., Baguley, T., & Brunsden, V. (2014). From alpha to omega: A practical solution to the pervasive problem of internal consistency estimation. British Journal of Psychology, 105(3), 399–412. 10.1111/bjop.12046 First citation in articleCrossref, Google Scholar

  • Eshkevari, E., Rieger, E., Longo, M. R., Haggard, P., & Treasure, J. (2012). Increased plasticity of the bodily self in eating disorders. Psychological Medicine, 42(4), 819–828. 10.1017/S0033291711002091 First citation in articleCrossref, Google Scholar

  • Eshkevari, E., Rieger, E., Longo, M. R., Haggard, P., & Treasure, J. (2014). Persistent body image disturbance following recovery from eating disorders. International Journal of Eating Disorders, 47(4), 400–409. 10.1002/eat.22219 First citation in articleCrossref, Google Scholar

  • Ferguson, C. J. (2009). An effect size primer: A guide for clinicians and researchers. Professional Psychology, 40(5), 532–538. 10.1037/a0015808 First citation in articleCrossref, Google Scholar

  • Freedman, A. G., Hu, H., Liu, I.-T., Stewart, A. L., Adler, S. R., & Mehling, W. (2021). Similarities and differences in interoceptive bodily awareness between US-American and Japanese cultures: A focus-group study in bicultural Japanese Americans. Culture, Medicine, and Psychiatry, 45, 234–267. 10.1007/s11013-020-09684-4 First citation in articleCrossref, Google Scholar

  • Fournier, T., Tibère, L., Laporte, C., Mognard, E., Ismail, M. N., Sharif, S. P., & Poulain, J.-P. (2016). Eating patterns and prevalence of obesity: Lessons learned from the Malaysian food barometer. Appetite, 107, 362–371. 10.1016/j.appet.2016.08.009 First citation in articleCrossref, Google Scholar

  • Fuller, W. A. (1987). Measurement error models. John Wiley & Sons. First citation in articleCrossref, Google Scholar

  • Garfinkel, S. N., Seth, A. K., Barrett, A. B., Suzuki, K., & Critchley, H. D. (2015). Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology, 104, 65–74. 10.1016/j.biopsycho.2014.11.004 First citation in articleCrossref, Google Scholar

  • Goddard, C. (1997). Cultural values and ‘cultural scripts’ of Malay (Bahasa Melayu). Journal of Pragmatics, 27(2), 183–201. 10.1016/S0378-2166(96)00032-X First citation in articleCrossref, Google Scholar

  • Grabauskaitė, A., Baranauskas, M., & Griškova-Bulanova, I. (2017). Interoception and gender: What aspects should we pay attention to? Consciousness and Cognition, 48, 129–137. 10.1016/j.concog.2016.11.002 First citation in articleCrossref, Google Scholar

  • Hair, J. F., Jr., Anderson, R. E., Tatham, R. L., & Black, W. C. (1995). Multivariate data analysis (3rd ed.). Macmillan. First citation in articleGoogle Scholar

  • Institute of Public Health. (2015). National health and morbidity survey 2015: Non-communicable diseases, risk factors, and other health problems (Vol. 2). Ministry of Health. First citation in articleGoogle Scholar

  • Jenkinson, P. M., Taylor, L., & Laws, K. R. (2018). Self-reported interoceptive deficits in eating disorders: A meta-analysis of studies using the eating disorder inventory. Journal of Psychosomatic Research, 110, 38–45. 10.1016/j.jpsychores.2018.04.005 First citation in articleCrossref, Google Scholar

  • Khalsa, S. S., Adolphs, R., Cameron, O. G., Critchley, H. D., Davenport, P. W., Feinstein, J. S., Feusner, J. D., Garfinkel, S. N., Lane, R. D., Mehling, W. E., Meuret, A. E., Nemeroff, C. B., Oppenheimer, S., Petzschner, F. H., Pollatos, O., Rhudy, J. L., Schramm, L. P., Simmons, W. K., Stein, M. B., …, Paulus, M. P.; and the Interoception Summit 2016 participants. (2018). Interoception and mental health: A roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(6), 501–513. 10.1016/j.bpsc.2017.12.004 First citation in articleCrossref, Google Scholar

  • Lilenfeld, L. R. R., Wonderlich, S., Riso, L. P., Crosby, R., & Mitchell, J. (2006). Eating disorders and personality: A methodological and empirical review. Clinical Psychology Review, 26(3), 299–320. 10.1016/j.cpr.2005.10.003 First citation in articleCrossref, Google Scholar

  • Ma-Kellams, C. (2014). Cross-cultural differences in somatic awareness and interoceptive accuracy: A review of the literature and directions for future research. Frontiers in Psychology, 5, Article 1379. 10.3389/fpsyg.2014.01379 First citation in articleCrossref, Google Scholar

  • Malaysian Communications and Multimedia Commission. (2017). Internet users survey 2017 (Statistical Brief No. 21). Malaysian Communications and Multimedia Commission. First citation in articleGoogle Scholar

  • Mehling, W. (2016). Differentiating attention styles and regulatory aspects of self-reported interoceptive sensibility. Philosophical Transactions of the Royal Society B: Biological Sciences, 371(1708), Article 20160013. 10.1098/rstb.2016.0013 First citation in articleCrossref, Google Scholar

  • Mehling, W. E., Price, C., Daubenmier, J. J., Acree, M., Bartmess, E., & Stewart, A. (2012). The multidimensional assessment of interoceptive awareness (MAIA). PLOS One, 7(11), Article e48230. 10.1371/journal.pone.0048230 First citation in articleCrossref, Google Scholar

  • Murphy, J., Geary, H., Millgate, E., Catmur, C., & Bird, G. (2018). Direct and indirect effects of age on interoceptive accuracy and awareness across the adult lifespan. Psychonomic Bulletin & Review, 25, 1193–1202. 10.3758/s13423-017-1339-z First citation in articleCrossref, Google Scholar

  • Mussap, A. J., & Salton, N. (2006). A ‘rubber-hand’ illusion reveals a relationship between perceptual body image and unhealthy body change. Journal of Health Psychology, 11(4), 627–639. 10.1177/1359105306065022 First citation in articleCrossref, Google Scholar

  • Oswald, A., Chapman, J., & Wilson, C. (2017). Do interoceptive awareness and interoceptive responsiveness mediate the relationship between body appreciation and intuitive eating in young women? Appetite, 109, 66–72. 10.1016/j.appet.2016.11.019 First citation in articleCrossref, Google Scholar

  • Ricciardelli, L. A., Caltabiano, M. L., & D’Antuono, L. D. (2018). Positive body image by gender and across the lifespan. In E. A. DanielsM. M. GillenC. H. Markey (Eds.), Body positive: Understanding and improving body image in science and practice (pp. 34–58). Cambridge University Press. First citation in articleCrossref, Google Scholar

  • Suzuki, N., Yamamoto, T., Uchiumi, C., & Sugaya, N. (2021). Effects of interoceptive sensibility on mental health during the coronavirus disease 2019 pandemic. International Journal of Environmental Research and Public Health, 18(9), Article 4616. 10.3390/ijerph18094616 First citation in articleCrossref, Google Scholar

  • Swami, V. (2006). Female physical attractiveness and body image disorders in Malaysia. Malaysian Journal of Psychiatry, 14, 3–7. First citation in articleGoogle Scholar

  • Swami, V. (2015). Cultural influences on body size ideals. European Psychologist, 20(1), 44–51. 10.1027/1016-9040/a000150 First citation in articleLink, Google Scholar

  • Swami, V. (2018). Considering positive body image through the lens of culture and minority social identities. In E. A. DanielsM. M. GillenC. H. Markey (Eds.), Body positive: Understanding and improving body image in science and practice (pp. 59–91). Cambridge University Press. First citation in articleCrossref, Google Scholar

  • Swami, V., Barron, D., Lau, P. L., & Jaafar, J. L. (2016). Psychometric properties of the drive for muscularity scale in Malay men. Body Image, 17, 111–116. 10.1016/j.bodyim.2016.03.004 First citation in articleCrossref, Google Scholar

  • Swami, V., Frederick, D. A., Aavik, T., Alcalay, L., Allik, J., Anderson, D., Andrianto, S., Arora, A., Brännström, Å., Cunningham, J., Danel, D., Doroszewicz, K., Forbes, G. B., Furnham, A., Greven, C. U., Halberstadt, J., Shuang Hao, S., Haubner, T., Choon Sup Hwang, C. S., … Zivcic-Becirevic, I. (2010). The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: Results of the international body project I. Personality and Social Psychology Bulletin, 36(3), 309–325. 10.1177/0146167209359702 First citation in articleCrossref, Google Scholar

  • Swami, V., Mohd. Khatib, N. A., Toh, E., Zahari, H. S., Todd, J., & Barron, D. (2019). Factor structure and psychometric properties of a Bahasa Malaysia (Malay) translation of the body appreciation scale-2 (BAS-2). Body Image, 28, 66–75. 10.1016/j.bodyim.2018.12.006 First citation in articleCrossref, Google Scholar

  • Swami, V., Todd, J., Aspell, J. E., Mohd. Khatib, N. A., Toh, E. K. L., Zahari, H. S., & Barron, D. (2019). Translation and validation of a Bahasa Malaysia (Malay) version of the functionality appreciation scale. Body Image, 30, 114–120. 10.1016/j.bodyim.2019.06.001 First citation in articleCrossref, Google Scholar

  • Swami, V., & Tovée, M. J. (2005). Male physical attractiveness in Britain and Malaysia: A cross-cultural study. Body Image, 2(4), 383–393. 10.1016/j.bodyim.2005.08.001 First citation in articleCrossref, Google Scholar

  • Swami, V., Tovée, M., & Harris, A. S. (2013). An examination of ethnic differences in actual–ideal weight discrepancy and its correlates in a sample of Malaysian women. International Journal of Culture and Mental Health, 6(2), 96–107. 10.1080/17542863.2011.643315. First citation in articleCrossref, Google Scholar

  • Thomas, E. V., & Warren-Findlow, J. (2019). Body image, self-esteem, and behavioral risk for chronic disease among college students: Additional evidence for integrated prevention. Journal of American College Health, 68(6), 658–665. 10.1080/07448481.2019.1590370 First citation in articleCrossref, Google Scholar

  • Tiggemann, M. (2015). Considerations of positive body image across various social identities and special populations. Body Image, 14, 168–176. 10.1016/j.bodyim.2015.03.002 First citation in articleCrossref, Google Scholar

  • Todd, J., Aspell, J. E., Barron, D., & Swami, V. (2019a). Multiple dimensions of interoceptive awareness are associated with facets of body image in British adults. Body Image, 29, 6–16. 10.1016/j.bodyim.2019.02.003 First citation in articleCrossref, Google Scholar

  • Todd, J., Aspell, J. E., Barron, D., & Swami, V. (2019b). An exploration of the associations between facets of interoceptive awareness and body image in adolescents. Body Image, 31, 171–180. 10.1016/j.bodyim.2019.10.004 First citation in articleCrossref, Google Scholar

  • Todd, J., Aspell, J. E., Barron, D., Toh, E. K. L., Zahari, H. S., Mohd. Khatib, N. A., Laughton, R., & Swami, V. (2020). Greater gastric interoception is associated with more positive body image: Evidence from adults in Malaysia and the United Kingdom. Body Image, 34, 101–111. 10.1016/j.bodyim.2020.05.011 First citation in articleCrossref, Google Scholar

  • Todd, J., Barron, D., Aspell, J. E., Mohd. Khatib, N. A., Toh, E. K. L., Zahari, H. S., & Swami, V. (2020). Translation and validation of a Bahasa Malaysia (Malay) version of the multidimensional assessment of interoceptive awareness (MAIA). PLoS One, 15(4), Article e0231048. 10.1371/journal.pone.0231048 First citation in articleCrossref, Google Scholar

  • Todd, J., & Swami, V. (2020). Assessing the measurement invariance of two positive body image instruments in adults from Malaysia and the United Kingdom. Body Image, 34, 112–116. 10.1016/j.bodyim.2020.05.009 First citation in articleCrossref, Google Scholar

  • Tovée, M. J., Maisey, D. S., Emery, J. L., & Cornelissen, P. L. (1999). Visual cues to female physical attractiveness. Proceedings of the Royal Society of London. Series B: Biological Sciences, 266(1415), 211–218. 10.1098/rspb.1999.0624 First citation in articleCrossref, Google Scholar

  • Tylka, T. L. (2018). Overview of the field of positive body image. In E. A. DanielsM. M. GillenC. H. Markey (Eds.), Body positive: Understanding and improving body image in science and practice (pp. 6–33). Cambridge University Press. First citation in articleCrossref, Google Scholar

  • World Health Organisation. (2018). Mean body mass index trends among adults, crude (kg/m2). https://www.who.int/data/gho/data/indicators/indicator-details/GHO/mean-bmi-(kg-m-)-(crude-estimate) First citation in articleGoogle Scholar