Interoceptive accuracy and cravings in a cue reactivity task

Introduction and Aims: Craving involves interoception; individuals
detect sensations and emotions that provoke a desire for alcohol.
Using anxiety sensitivity and elaborated intrusion theories, the
present study tested the effect of cravings on individuals’ internal
awareness. Enhanced interoceptive abilities while craving and
increased craving following an interoceptive task would indicate
support for sensitivity models, such as anxiety sensitivity. Diminished
interoceptive abilities and a decrease in craving following the
interoceptive task would indicate support for Elaborated Intrusion
Theory, which describes limitations on cognitive resources.
Design and Methods: Forty-four participants completed heart rate
detection and cue reactivity tasks, provided saliva samples and completed
measures of anxiety sensitivity, somatosensory amplification
and elaborated intrusions.
Results: While exposure to alcohol did not change individuals’
internal sensitivity, it did increase their craving, which in turn predicted
interoceptive accuracy. Interoceptive accuracy subsequently
predicted self-reported craving, and changes were observed in cravings
before and after the internal sensitivity task. However, self-report
measures of anxiety sensitivity, somatosensory amplification and
elaborated intrusion do not provide additional explanation of these
phenomena.
Discussion and Conclusions: The relationship between
interoceptive abilities and cravings is manifestly complex. The
findings of this study are consistent with some aspects Elaborated
Intrusion Theory, in that distraction from internal symptoms
provided competition for attentional resources and a subsequent
reduction in subjective craving. This finding is inconsistent with
models of internal sensitivity. However, those with greater reactivity
to alcohol cues became more internally sensitive; indicating that
additional research is needed into the relationships between internal
sensitivity and craving.