Obésité et conscience de soi intéroceptive : étude qualitative préliminaire chez des adolescentes hospitalisées présentant une obésité

Abstract

ObjectivesChildhood obesity has increased tenfold over the past 40 years. People with obesity present alterations of their bodily perceptions and a discrepancy between their actual body and their perceived body. One of the explanations advanced by neuroscience is the difficulty of integrating and processing sensory information, particularly the interoceptive interformation. There has been little research on this question in adolescent populations, although it is suggested that an atypical interoceptive mechanism is positively associated with the onset of psychopathologies and decreased socio-emotional skills in adulthood. We present here the first results of a qualitative research study that explores the experiential dimension of interception by obese adolescent girls in a hospitalization context and that assesses the main factors that influence interoceptive self-awareness: anxiety and pain. MethodExploratory qualitative research. T0 (30min): Initial assessments: State trait anxiety Inventory for Children (STAIC Scale), visual analog scale for pain and Multidimensional Assessment of Interoceptive Awareness (MAIA Self-Questionnaire). T1 and T2 (60min): perform three simple poses, each 1min (T1) alternated with an explanatory interview exploring the interoceptive experience (T2). ResultsThe first results of this study highlights that: i) the severity of obesity is not positively associated with the level of interoceptive awareness; ii) the correlation of influencing factors (pain and anxiety) and the level of awareness interoceptive is weak; iii) the thematic categorization according to Mehling's eight interoceptive criteria demonstrates, for the participants: 1/the ability to identify their bodily perceptions by the majority of them; 2/the uneven capacity to maintain a level of attention on the body in its ensemble; 3/the ability not to worry about feelings of discomfort is influenced by hyper-rationalization or the negation of perceptions; 4/breathing appears to be the most mobilized lever to regulate attention; 5/the links between bodily perceptions and felt emotions are influenced by rationalization, bodily experience, or mood decline; 6/self-regulation is influenced by bodily experience, which enables awareness and postural readjustment; 7/listening to the body is influenced by the transfer of past bodily practices; 8/the notion of confidence in one's bodily perceptions is not always well understood and is not related to subjects’ ability to identify their internal manifestations, while perceived confidence is related to the level of rationalization and can be improved through postural practice. DiscussionAs reported in the literature, the interoceptive level of patients interviewed is generally low on the rating scales, but it appears that the MAIA results do not always reveal the perceived reality of body-self of the adolescent girls interviewed; guiding the participants in explaining their bodily experience reveals a much greater interoceptive dimension. We qualify this guided field of exploration as an interoceptive proximal zone or an interoceptive preconception zone. ConclusionWe suggest that a better understanding of the interoceptive mechanisms experienced by obese people helps guide patients towards a safer experiential dimension of their body. Future research should enrich this qualitative perspective of interoception and open up more embodied dimensions of care.