Evaluation of Interoceptive Awareness in Alcohol-Addicted Patients

Interoceptive awareness (IA) is defined as an ability to accurately perceive interoceptive processes, which comprise receiving, processing, and integrating body-relevant signals together with external stimuli. Interoceptive processes affect the motivated approach or avoidance behavior toward stimuli. Alcohol and other substances have effects on the autonomic system that result in altered interoceptive processes. Individuals who have disturbed IA may be at a higher risk of addiction because they are not able to utilize sufficiently body-relevant signals to guide their decision-making. The hypothesis that IA in alcohol-addicted patients would be affected and that the disturbed IA would be associated with alcohol craving was tested in this study. The study was conducted with 55 patients diagnosed with alcohol addiction according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and who had been sober for at least two weeks and 52 non-addicted healthy controls. IA measurements were performed using the heartbeat perception performance method, which determines participants' awareness of their own heartbeat by comparing the number of subjectively perceived heartbeats with an objective heart rate measure recorded with ECG during four separate intervals. In addition, the Alcohol Use Disorders Identification Test (AUDIT), Penn Alcohol Craving Scale (PACS), and Obsessive Compulsive Drinking Scale (OCDS) were performed on the alcohol-addicted patient group. IA scores were significantly lower in the alcohol-addicted patients than the control subjects. IA scores of alcohol-addicted patients were negatively correlated with the levels of alcohol craving sensations according to the PACS results. Our results corroborate the suggestion that IA in alcohol-addicted patients would be affected and that poor IA would be associated with alcohol craving and could be a maintaining factor for drinking behavior.