Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Oct 19, 2024; 14(10): 1484-1494
Published online Oct 19, 2024. doi: 10.5498/wjp.v14.i10.1484
Interoception mediates the association between social support and sociability in patients with major depressive disorder
Wen-Liang Wang, Ji-Kang Liu, Yi-Fan Sun, Xiao-Hong Liu, Yu-Hang Ma, Xue-Zheng Gao, Li-Min Chen, Zhen-He Zhou, Hong-Liang Zhou
Wen-Liang Wang, Xiao-Hong Liu, Yu-Hang Ma, Li-Min Chen, Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
Ji-Kang Liu, Yi-Fan Sun, Xue-Zheng Gao, Zhen-He Zhou, Department of Psychiatry, The Affiliated Mental Health Center of Nanjing Medical University, Wuxi 214151, Jiangsu Province, China
Hong-Liang Zhou, Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi 214151, Jiangsu Province, China
Co-first authors: Wen-Liang Wang and Ji-Kang Liu.
Co-corresponding authors: Zhen-He Zhou and Hong-Liang Zhou.
Author contributions: Zhou ZH and Zhou HL designed the study; Wang WL analyzed the data, and wrote the manuscript; Liu JK and Ma YH collected the relevant data; Zhou ZH provided financial support; Gao XZ, Sun YF, Liu XH, and Chen LM provided technological support; Zhou ZH and Zhou HL edited the manuscript; and all authors have read and approved the final manuscript.
Supported by the Wuxi Municipal Health Commission Major Project, No. 202107.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the affiliated mental health center of Jiangnan University, No. WXMHCIRB2022LLky010.
Informed consent statement: All participants enrolled into this study provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Data used in this study can be available from the corresponding author at zhouzh@njmu.edu.cn.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen-He Zhou, MD, PhD, President, Professor, Department of Psychiatry, The Affiliated Mental Health Center of Nanjing Medical University, No. 156 Qianrong Road, Wuxi 214151, Jiangsu Province, China. zhouzh@nimu.edu.cn
Received: July 4, 2024
Revised: August 20, 2024
Accepted: September 2, 2024
Published online: October 19, 2024
Processing time: 105 Days and 7.9 Hours
Abstract
BACKGROUND

Interoception dysfunction has an important impact on the onset and development of major depressive disorder (MDD). Social support serves as a protective factor against MDD, and sociability also plays a significant role in this condition. These interconnected constructs-social support and sociability-play pivotal roles in MDD. However, no research on the mechanisms underlying the associations between social support and sociability, particularly the potential role of interoception, have been reported.

AIM

To investigate the mediating effect of interoception between social support and social ability and to explore the independent role of social support in sociability.

METHODS

The participants included 292 patients with MDD and 257 healthy controls (HCs). The patient health questionnaire 9, the multidimensional assessment of interoception awareness, version 2 (MAIA-2), the social support rating scale (SSRS), and the Texas social behavior inventory (TSBI) were used to assess depression, interoception, social support, and sociability, respectively. A mediation analysis model for the eight dimensions of interoception (noticing, not distracting, not worrying, attention regulation, emotional awareness, self-regulation, body listening, and trust), social support, and sociability were established to evaluate the mediating effects.

RESULTS

A partial correlation analysis of eight dimensions of the MAIA-2, SSRS, and TSBI scores, with demographic data as control variables, revealed pairwise correlations between the SSRS score and both the MAIA-2 score and TSBI score. In the major depression (MD) group, the SSRS score had a positive direct effect on the TSBI score, while the scores for body listening, emotional awareness, self-regulation, and trust in the MAIA-2C had indirect effects on the TSBI score. In the HC group, the SSRS score had a positive direct effect on the TSBI score, and the scores for attention regulation, emotional awareness, self-regulation, and trust in the MAIA-2C had indirect effects on the TSBI score. The proportion of mediators in the MD group was lower than that in the HC group.

CONCLUSION

Interoceptive awareness is a mediating factor in the association between social support and sociability in both HCs and depressed patients. Training in interoceptive awareness might not only help improve emotional regulation in depressed patients but also enhance their social skills and support networks.

Keywords: Interoception; Social support; Sociability; Major depression; Mediation analysis

Core Tip: Interoception dysfunction is closely related to the development of major depression. Social support and sociability have a vital impact on depressed patients. Our study investigated the mediating effect of interoception between social support and social ability, explored the independent role of social support in sociability, and concluded that interoceptive awareness is a mediating factor between social support and sociability in both healthy controls and depressed patients. The mediating effect was lower in depressed patients than in healthy controls, which may be one of the reasons why patients with depression have reduced social skills.