Mind-Body Interactions in Anxiety and Somatic Symptoms
Open accessAbstract
Anxiety and somatic symptoms have a high prevalence in the general population. A mechanistic understanding of how different factors contribute to the development and maintenance of these symptoms, which are highly associated with anxiety disorders, is crucial to optimize treatments. In this article, we review recent literature on this topic and present a redefined model of mind-body interaction in anxiety and somatic symptoms, with an emphasis on both bottom-up and top-down processes. Consideration is given to the role played in this interaction by predisposing physiological and psychological traits (e.g., interoception, anxiety sensitivity, and trait anxiety) and to the levels at which mindfulness approaches may exert a therapeutic benefit. The proposed model of mind-body interaction in anxiety and somatic symptoms is appraised in the context of joint hypermobility syndrome, a constitutional variant associated with autonomic abnormalities and vulnerability to anxiety disorders.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
High-state anxiety and depression can induce physiological changes, an intensified attention to the body and an alteration of the cognitive processing of physical sensations, representing important precipitating factors.
“This might due to the fact that high-state anxiety and depression can induce physiological changes, an intensified attention to the body and an alteration of the cognitive processing of physical sensations, representing important precipitating factors (Mayou and Farmer, 2002; Janssens et al., 2010; Mallorquí-bagué et al., 2016).”
From Does the practice of mindfulness reduce somatic symptoms and COVID-19-related anxiety? A community-based survey (2022) · cites this paper as Mallorquí-bagué et al., 2016
Cites
Mindfulness training as a clinical intervention: a conceptual and empirical review
Baer, R. A. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bpg015 · Cited by 4,577 · see citing works
Mindfulness training as a clinical intervention: A conceptual and empirical review.
Baer, R. A. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/bpg015 · Cited by 4,576 · see citing works
The effect of mindfulness based therapy on anxiety and depression: A meta analytic review
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0018555 · Cited by 3,846 · see citing works
Neural systems supporting interoceptive awareness
Critchley, H. D., Wiens, S., Rotshtein, P., Öhman, A., & Dolan, R. J. (2004) · Nature Neuroscience · doi:10.1038/nn1176 · Cited by 3,406 · cited 3× · see citing works
“These functional and structural analyses also link the right insula to individual experiences of anxiety, which is consistent with this region as the substrate throughwhich interoceptive representations emerge as consciously accessible emotional feeling states.(26) This proposal has been supported.”
BackgroundResultSelf-citationThe somatic marker hypothesis and the possible functions of the prefrontal cortex
Damasio, A. R. (1996) · Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences · doi:10.1098/rstb.1996.0125 · Cited by 2,847 · see citing works
Interoception: the sense of the physiological condition of the body
(Bud) Craig, A. (2003) · Current Opinion in Neurobiology · doi:10.1016/s0959-4388(03)00090-4 · Cited by 2,556 · see citing works
Clark, D. M. (1986) · Behaviour Research and Therapy · doi:10.1016/0005-7967(86)90011-2 · Cited by 2,422 · see citing works
The James-Lange Theory of Emotions: A Critical Examination and an Alternative Theory
Cannon, W. B. (1927) · The American Journal of Psychology · doi:10.2307/1415404 · Cited by 1,899 · see citing works
Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness
Garfinkel, S. N., Seth, A. K., Barrett, A. B., Suzuki, K., & Critchley, H. D. (2015) · Biological Psychology · doi:10.1016/j.biopsycho.2014.11.004 · Cited by 1,624 · see citing works
Self-citationSelf-focused attention and negative affect: A meta-analysis.
Mor, N., & Winquist, J. (2002) · Psychological Bulletin · doi:10.1037/0033-2909.128.4.638 · Cited by 1,069 · see citing works
An Interoceptive Predictive Coding Model of Conscious Presence
Seth, A. K., Suzuki, K., & Critchley, H. D. (2012) · Frontiers in Psychology · doi:10.3389/fpsyg.2011.00395 · Cited by 950 · cited 2× · see citing works
“In motor control, motor commands can be viewed as predictions for active inference about the environment,(41) whereas interoceptive predictive coding proposes that similar mechanisms underpin a hierarchy of processes, including preconscious homeostatic regulation, behavioral biases in response to the conscious experie…”
BackgroundResultSelf-citationQuality-of-Life Impairment in Depressive and Anxiety Disorders
Rapaport, M. H., Clary, C., Fayyad, R., & Endicott, J. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.6.1171 · Cited by 914 · see citing works
Bohlmeijer, E., Prenger, R., Taal, E., & Cuijpers, P. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.10.005 · Cited by 822 · see citing works
Fjorback, L. O., Arendt, M., Ørnbøl, E., Fink, P., & Walach, H. (2011) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2011.01704.x · Cited by 803 · see citing works
Predictions not commands: Active inference in the motor system
Adams, R. A., Shipp, S., & Friston, K. J. (2013) · Brain Structure and Function · doi:10.1007/s00429-012-0475-5 · Cited by 765 · see citing works
Overview: hypochondriasis, bodily complaints, and somatic styles
BARSKY, A. J., & Klerman, G. L. (1983) · American Journal of Psychiatry · doi:10.1176/ajp.140.3.273 · Cited by 605 · see citing works
Domschke, K., Stevens, S., Pfleiderer, B., & Gerlach, A. L. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.08.008 · Cited by 580 · see citing works
Listening to Your Heart: How Interoception Shapes Emotion Experience and Intuitive Decision Making
Dunn, B. D., Galton, H. C., Morgan, R., Evans, D., Oliver, C., Meyer, M., Cusack, R., Lawrence, A. D., & Dalgleish, T. (2010) · Psychological Science · doi:10.1177/0956797610389191 · Cited by 566 · see citing works
Tsakiris, M., Jiménez, A. T., & Costantini, M. (2011) · Proceedings of the Royal Society B: Biological Sciences · doi:10.1098/rspb.2010.2547 · Cited by 528 · see citing works
Overlapping activity in anterior insula during interoception and emotional experience
Zaki, J., Davis, J. I., & Ochsner, K. N. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2012.05.012 · Cited by 462 · see citing works
Dysautonomia in the joint hypermobility syndrome
Gazit, Y., Nahir, A. M., Grahame, R., & Jacob, G. (2003) · The American Journal of Medicine · doi:10.1016/s0002-9343(03)00235-3 · Cited by 390 · see citing works
Garfinkel, S. N., & Critchley, H. D. (2013) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nss140 · Cited by 386 · see citing works
Self-citationWells, A., & Carter, K. (2001) · Behavior Therapy · doi:10.1016/s0005-7894(01)80045-9 · Cited by 373 · see citing works
Misinterpretation of body sensations in panic disorder.
Clark, D. M., Salkovskis, P. M., Öst, L., Breitholtz, E., Koehler, K. A., Westling, B. E., Jeavons, A., & Michael, G. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.65.2.203 · Cited by 372 · see citing works
Postural tachycardia syndrome (POTS)
LOW, P. A., SANDRONI, P., JOYNER, M., & SHEN, W. (2009) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2008.01407.x · Cited by 358 · see citing works
The body in the mind: On the relationship between interoception and embodiment
Herbert, B. M., & Pollatos, O. (2012) · Topics in Cognitive Science · doi:10.1111/j.1756-8765.2012.01189.x · Cited by 338 · see citing works
Insular cortex and neuropsychiatric disorders: A review of recent literature
Nagai, M., Kishi, K., & Kato, S. (2007) · European Psychiatry · doi:10.1016/j.eurpsy.2007.02.006 · Cited by 332 · see citing works
Misinterpretation of body sensations in panic disorder.
Clark, D. M., Salkovskis, P. M., Öst, L., et al. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.65.2.203 · Cited by 300 · see citing works
Herbert, B. M., Muth, E. R., Pollatos, O., & Herbert, C. (2012) · PLoS ONE · doi:10.1371/journal.pone.0036646 · Cited by 287 · see citing works
Postural tachycardia syndrome—current experience and concepts
Mathias, C. J., Low, D. A., Iodice, V., Owens, A. P., Kirbis, M., & Grahame, R. (2012) · Nature Reviews Neurology · doi:10.1038/nrneurol.2011.187 · Cited by 251 · see citing works
Anxiety and arousal: physiological changes and their perception
Hoehn-Saric, R., & McLeod, D. R. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00339-6 · Cited by 235 · see citing works
How does interoceptive awareness interact with the subjective experience of emotion? An fMRI Study
Terasawa, Y., Fukushima, H., & Umeda, S. (2013) · Human Brain Mapping · doi:10.1002/hbm.21458 · Cited by 228 · see citing works
Pollatos, O., Traut-Mattausch, E., Schroeder, H., & Schandry, R. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.12.004 · Cited by 211 · see citing works
Garfinkel, S. N., Barrett, A. B., Minati, L., Dolan, R. J., Seth, A. K., & Critchley, H. D. (2013) · Psychophysiology · doi:10.1111/psyp.12039 · Cited by 176 · see citing works
Self-citationMOORE, M. (1976) · The Lancet · doi:10.1016/s0140-6736(76)92514-9 · Cited by 167 · see citing works
Current status of brain imaging in anxiety disorders
Damsa, C., Kosel, M., & Moussally, J. (2009) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328319bd10 · Cited by 160 · see citing works
Delgado, L. C., Guerra, P., Perakakis, P., Vera, M. N., Reyes del Paso, G., & Vila, J. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.05.012 · Cited by 156 · see citing works
Heartbeat perception in panic disorder: a reanalysis
Van der Does, A. J. W., Antony, M. M., Ehlers, A., & Barsky, A. J. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00184-3 · Cited by 152 · see citing works
Fjorback, L. O., Arendt, M., Ørnbøl, E., Walach, H., Rehfeld, E., Schröder, A., & Fink, P. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.09.006 · Cited by 144 · see citing works
Association Between Joint Hypermobility Syndrome and Panic Disorder
Martín‐Santos, R., Bulbena, A., Porta, M. S., Gago, J., Balaguer, L. M., & Duró, J. C. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.11.1578 · Cited by 137 · see citing works
Self-citationAn update on mindfulness meditation as a self-help treatment for anxiety and depression
Edenfield, T. M., & Saeed, S. A. (2012) · Psychology Research and Behavior Management · doi:10.2147/prbm.s34937 · Cited by 127 · see citing works
Exploring the relationship between mindfulness and cardiac perception
Parkin, L., Morgan, R., Rosselli, A., Howard, M., Sheppard, A., Evans, D., Hawkins, A., Martinelli, M., Golden, A.-M., Dalgleish, T., et al. (2014) · Mindfulness · doi:10.1007/s12671-012-0181-7 · Cited by 122 · see citing works
Bulbena, A., Gago, J., Pailhez, G., Sperry, L., Fullana, M. A., & Vilarroya, O. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2011.03.004 · Cited by 113 · see citing works
Self-citationThe Relationship among Metacognitions, Attentional Control, and State Anxiety
Spada, M. M., Georgiou, G. A., & Adrian Wells, A. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070902991791 · Cited by 109 · see citing works
ROSS, J. L., & Grahame, R. (2011) · BMJ · doi:10.1136/bmj.c7167 · Cited by 108 · see citing works
MallorquÃ-Bagué, N., Garfinkel, S. N., Engels, M., Eccles, J. A., Pailhez, G., Bulbena, A., & Critchley, H. D. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.01162 · Cited by 97 · see citing works
Self-citationBrain structure and joint hypermobility: Relevance to the expression of psychiatric symptoms
Eccles, J. A., Beacher, F. D. C., Gray, M. A., Jones, C. L., Minati, L., Harrison, N. A., & Critchley, H. D. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.bp.111.092460 · Cited by 96 · see citing works
Self-citationHypermobility: an important but often neglected area within rheumatology
Grahame, R. (2008) · Nature Clinical Practice Rheumatology · doi:10.1038/ncprheum0907 · Cited by 92 · see citing works
Heartbeat awareness and heart rate reactivity in anxiety sensitivity: a further investigation.
Stewart, S. H., Buffett-Jerrott, S. E., & Kokaram, R. (2001) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(01)00080-9 · Cited by 84 · see citing works
Psychological and Perceptual Factors Associated With Arrhythmias and Benign Palpitations
Ehlers, A., Mayou, R., Sprigings, D. C., & Birkhead, J. S. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200009000-00014 · Cited by 82 · see citing works
JOINT HYPERMOBILITY SYNDROME AND ANXIETY DISORDERS
Bulbena, A., Duró, J. C., Mateo, A., Porta, M. S., & Vallejo, J. (1988) · The Lancet · doi:10.1016/s0140-6736(88)90514-4 · Cited by 77 · see citing works
Self-citationExploring the role of metacognition in obsessive–compulsive and anxiety symptoms
Irak, M., & Tosun, A. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.01.012 · Cited by 73 · see citing works
Social anxiety modulates amygdala activation during social conditioning
Pejic, T., Hermann, A., Vaitl, D., & Stark, R. M. (2011) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsr095 · Cited by 61 · see citing works
Hilchey, C. A., & Clark, D. A. (2014) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9594-4 · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Psychiatric and psychological aspects in the Ehlers–Danlos syndromes
Bulbena, A., Baeza‐Velasco, C., Bulbena‐Cabré, A., Pailhez, G., Critchley, H., Chopra, P., Mallorquí‐Bagué, N., Frank, C., & Porges, S. (2017) · American Journal of Medical Genetics Part C: Seminars in Medical Genetics · doi:10.1002/ajmg.c.31544 · Cited by 149 · see citing works
Self-citationIncreasing Our Insular World View: interoception and Psychopathology for Psychotherapists.
Duquette, P. (2017) · Frontiers in Neuroscience · doi:10.3389/fnins.2017.00135 · Cited by 54 · see citing works
Cui, H., Zhang, B., Li, W., Li, H., Pang, J., Hu, Q., Zhang, L., Tang, Y., Yang, Z., Wang, J., et al. (2020) · Depression and Anxiety · doi:10.1002/da.23009 · Cited by 38 · see citing works
Sharp, H. E. C., Critchley, H. D., & Eccles, J. A. (2021) · World Journal of Psychiatry · doi:10.5498/wjp.v11.i10.805 · Cited by 32 · see citing works
Self-citationEffect of Social Stimuli on Postural Responses in Individuals with Autism Spectrum Disorder
Ghanouni, P., Memari, A.-H., Gharibzadeh, S., Eghlidi, J., & Moshayedi, P. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3032-5 · Cited by 14 · see citing works
Ebrahimi, S., Moheb, N., & Alivani Vafa, M. (2024) · Practice in Clinical Psychology · doi:10.32598/jpcp.12.1.922.1 · Cited by 7 · see citing works
Micheli, N., Porcelli, P., Barrault-Couchouron, M., & Dantzer, C. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.996559 · Cited by 3 · see citing works
- Authors
- Mallorquí-Bagué, N., Bulbena, A., Pailhez, G., Garfinkel, S. N., & Critchley, H. D.
- Affiliations
- Brighton and Sussex Medical School (GB)
- Venue
- Harvard Review of Psychiatry
- Published
- 2016-01
- Volume
- 24
- Issue
- 1
- Pages
- 53-60
- ISSN
- 1067-3229 (ISSN-L)
- OpenAlex
- W2291646204
- Cited by
- 96
- References
- 54
- Citations by year
- 2026: 16 · 2025: 13 · 2024: 11 · 2023: 9 · 2022: 10 · 2021: 10 · 2020: 11 · 2019: 5 · 2018: 4 · 2017: 7
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by
- Locations
- Harvard Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- mind-body problem, anxiety, somatic symptoms, interoception, anxiety sensitivity, trait anxiety, mindfulness, top-down and bottom-up processes, joint hypermobility syndrome, anxiety disorders
- MeSH terms
- Anxiety, Humans, Models, Biological, Mind-Body Relations, Metaphysical, Somatosensory Disorders, Interoception
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
