Interoceptive awareness mediated the effects of a 15-minute diaphragmatic breathing on empathy for pain: A randomized controlled trial

Author: Yaping He1,2, Likun Ge1,2, Jiajin Yuan3, Yingying Wang4, Danni Zheng4, An Rui4, Jun Song5, Li Hu1,2, Gao-Xia Wei1,2
1 CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
2 Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
3 Sichuan Key Laboratory of Psychology and Behavior of Discipline Inspection and Supervision, Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China.
4 School of Psychology, Beijing Sport University, Beijing, China.
5 Experimental Research Center of China Academy of Chinese Medical Sciences, National Chinese Medicine Experts Inheritance Office, Beijing, China.
Conference/Journal: Psychophysiology
Date published: 2024 Mar 26
Other: Pages: e14573 , Special Notes: doi: 10.1111/psyp.14573. , Word Count: 284

Although empathy for pain plays an important role in positive interpersonal relationships and encourages engagement in prosocial behavior, it remains largely unknown whether empathy for pain could be effectively altered by psychophysiological techniques. This study aimed to investigate the impact of a single session of diaphragmatic breathing practice on empathy for pain and examine the potential mechanism involving interoceptive awareness. A total of 66 healthy participants were randomly assigned to the intervention group or the control group. The intervention group received a 15-minute diaphragmatic breathing (DB) practice with real-time biofeedback, while the control group was to gaze at a black screen at rest and not engaged in any other activities. Before and after the invention, all participants were instructed to evaluate the intensity and unpleasantness of empathy for pain while watching different pictures with pain or non-pain conditions. The Multidimensional Assessment of Interoceptive Awareness (MAIA) was then administered to measure interoceptive awareness. The results indicated a significant interaction between group and time with regard to empathy for pain and MAIA. The DB group showed a statistically significant decrease in both pain intensity and unpleasantness during the pain picture condition, as well as a noteworthy increase in MAIA scores. The control group did not demonstrate any substantial changes. More importantly, the regulation of attention, a dimension of MAIA, had a significant mediating effect on the impact of diaphragmatic breathing on reported unpleasantness. Diaphragmatic breathing could serve as a simple, convenient, and practical strategy to optimize human empathy for pain that warrants further investigation, which has important implications not only for individuals with impaired empathy for pain but also for the improvement of interoceptive awareness.

Keywords: diaphragmatic breathing; empathy for pain; interoceptive awareness; unpleasantness.

PMID: 38530127 DOI: 10.1111/psyp.14573