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Baltazar M, Hazem N, Vilarem E, Beaucousin V, Picq JL, Conty L. Eye contact elicits bodily self-awareness in human adults. Cognition 2014; 133:120-7. [PMID: 25014360 DOI: 10.1016/j.cognition.2014.06.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 12/15/2022]
Abstract
Eye contact is a typical human behaviour known to impact concurrent or subsequent cognitive processing. In particular, it has been suggested that eye contact induces self-awareness, though this has never been formally proven. Here, we show that the perception of a face with a direct gaze (that establishes eye contact), as compared to either a face with averted gaze or a mere fixation cross, led adult participants to rate more accurately the intensity of their physiological reactions induced by emotional pictures. Our data support the view that bodily self-awareness becomes more acute when one is subjected to another's gaze. Importantly, this effect was not related to a particular arousal state induced by eye contact perception. Rejecting the arousal hypothesis, we suggest that eye contact elicits a self-awareness process by enhancing self-focused attention in humans. We further discuss the implications of this proposal.
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Affiliation(s)
- Matias Baltazar
- Laboratory of Psychopathology and Neuropsychology (LPN, EA2027), Université Paris 8, Saint-Denis 93526 cedex, France.
| | - Nesrine Hazem
- Laboratory of Psychopathology and Neuropsychology (LPN, EA2027), Université Paris 8, Saint-Denis 93526 cedex, France
| | - Emma Vilarem
- Laboratory of Psychopathology and Neuropsychology (LPN, EA2027), Université Paris 8, Saint-Denis 93526 cedex, France
| | - Virginie Beaucousin
- Laboratory of Psychopathology and Neuropsychology (LPN, EA2027), Université Paris 8, Saint-Denis 93526 cedex, France
| | - Jean-Luc Picq
- Laboratory of Psychopathology and Neuropsychology (LPN, EA2027), Université Paris 8, Saint-Denis 93526 cedex, France
| | - Laurence Conty
- Laboratory of Psychopathology and Neuropsychology (LPN, EA2027), Université Paris 8, Saint-Denis 93526 cedex, France
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Kotozaki Y, Takeuchi H, Sekiguchi A, Yamamoto Y, Shinada T, Araki T, Takahashi K, Taki Y, Ogino T, Kiguchi M, Kawashima R. Biofeedback-based training for stress management in daily hassles: an intervention study. Brain Behav 2014; 4:566-79. [PMID: 25161823 PMCID: PMC4128038 DOI: 10.1002/brb3.241] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 04/24/2014] [Accepted: 05/03/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The day-to-day causes of stress are called daily hassles. Daily hassles are correlated with ill health. Biofeedback (BF) is one of the tools used for acquiring stress-coping skills. However, the anatomical correlates of the effects of BF with long training periods remain unclear. In this study, we aimed to investigate this. METHODS PARTICIPANTS WERE ASSIGNED RANDOMLY TO TWO GROUPS: the intervention group and the control group. Participants in the intervention group performed a biofeedback training (BFT) task (a combination task for heart rate and cerebral blood flow control) every day, for about 5 min once a day. The study outcomes included MRI, psychological tests (e.g., Positive and Negative Affect Schedule, Center for Epidemiologic Studies Depression Scale, and Brief Job Stress Questionnaire), and a stress marker (salivary cortisol levels) before (day 0) and after (day 28) the intervention. RESULTS We observed significant improvements in the psychological test scores and salivary cortisol levels in the intervention group compared to the control group. Furthermore, voxel-based morphometric analysis revealed that compared to the control group, the intervention group had significantly increased regional gray matter (GM) volume in the right lateral orbitofrontal cortex, which is an anatomical cluster that includes mainly the left hippocampus, and the left subgenual anterior cingulate cortex. The GM regions are associated with the stress response, and, in general, these regions seem to be the most sensitive to the detrimental effects of stress. CONCLUSIONS Our findings suggest that our BFT is effective against the GM structures vulnerable to stress.
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Affiliation(s)
- Yuka Kotozaki
- Smart Ageing International Research Center, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
| | - Hikaru Takeuchi
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
| | - Atsushi Sekiguchi
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku UniversitySendai, Japan
| | - Yuki Yamamoto
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
| | - Takamitsu Shinada
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
| | - Tsuyoshi Araki
- Smart Ageing International Research Center, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
| | - Kei Takahashi
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
| | - Yasuyuki Taki
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku UniversitySendai, Japan
- Department of Radiology and Nuclear Medicine, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
| | | | | | - Ryuta Kawashima
- Smart Ageing International Research Center, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku UniversitySendai, Japan
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253
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Koch A, Pollatos O. Cardiac sensitivity in children: Sex differences and its relationship to parameters of emotional processing. Psychophysiology 2014; 51:932-41. [DOI: 10.1111/psyp.12233] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/16/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Anne Koch
- Department of Psychology; Faculty of Human Sciences; University of Potsdam; Potsdam Germany
| | - Olga Pollatos
- Department of Health Psychology; Institute of Psychology and Education; Ulm University; Ulm Germany
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254
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Kojima M, Kojima T, Suzuki S, Takahashi N, Funahashi K, Kato D, Hanabayashi M, Hirabara S, Asai S, Ishiguro N. Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2014; 66:679-86. [DOI: 10.1002/acr.22203] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 10/08/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Masayo Kojima
- Nagoya City University Graduate School of Medical Sciences; Nagoya Japan
| | - Toshihisa Kojima
- Nagoya University Hospital and Nagoya University Graduate School of Medical Sciences; Nagoya Japan
| | - Sadao Suzuki
- Nagoya City University Graduate School of Medical Sciences; Nagoya Japan
| | | | - Koji Funahashi
- Nagoya University Graduate School of Medical Science; Nagoya Japan
| | - Daizo Kato
- Nagoya University Graduate School of Medical Science; Nagoya Japan
| | | | - Shinya Hirabara
- Nagoya University Graduate School of Medical Science; Nagoya Japan
| | - Shuji Asai
- Nagoya University Graduate School of Medical Science; Nagoya Japan
| | - Naoki Ishiguro
- Nagoya University Hospital and Nagoya University Graduate School of Medical Sciences; Nagoya Japan
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255
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Michal M, Reuchlein B, Adler J, Reiner I, Beutel ME, Vögele C, Schächinger H, Schulz A. Striking discrepancy of anomalous body experiences with normal interoceptive accuracy in depersonalization-derealization disorder. PLoS One 2014; 9:e89823. [PMID: 24587061 PMCID: PMC3937420 DOI: 10.1371/journal.pone.0089823] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 01/27/2014] [Indexed: 11/29/2022] Open
Abstract
Background Disembodiment is a core feature of depersonalization disorder (DPD). Given the narratives of DPD patients about their disembodiment and emotional numbing and neurobiological findings of an inhibition of insular activity, DPD may be considered as a mental disorder with specific impairments of interoceptive awareness and body perception. Methods We investigated cardioceptive accuracy (CA) of DPD patients (n = 24) as compared to healthy controls (n = 26) with two different heartbeat detection tasks (“Schandry heartbeat counting task” and “Whitehead heartbeat discrimination task”). Self-rated clearness of body perception was measured by questionnaire. Results Contrary to our hypothesis, DPD patients performed similarly to healthy controls on the two different heartbeat detection tasks, and they had equal scores regarding their self-rated clearness of body perception. There was no correlation of the severity of “anomalous body experiences” and depersonalization with measures of interoceptive accuracy. Only among healthy controls CA in the Schandry task was positively correlated with self-rated clearness of body perception. Depersonalization was unrelated to severity of depression or anxiety, while depression and anxiety were highly correlated. Anxiety and depression did not modify the associations of depersonalization with interoceptive accuracy. Conclusions Our main findings highlight a striking discrepancy of normal interoception with overwhelming experiences of disembodiment in DPD. This may reflect difficulties of DPD patients to integrate their visceral and bodily perceptions into a sense of their selves. This problem may be considered an important target for psychotherapeutic treatment approaches.
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Affiliation(s)
- Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- * E-mail:
| | - Bettina Reuchlein
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Julia Adler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Claus Vögele
- Research Unit INSIDE, Research Group Self-Regulation and Health, University of Luxembourg, Walferdange, Luxembourg
| | - Hartmut Schächinger
- Department of Clinical Psychophysiology, Institute of Psychobiology, University of Trier, Trier, Germany
| | - André Schulz
- Research Unit INSIDE, Research Group Self-Regulation and Health, University of Luxembourg, Walferdange, Luxembourg
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256
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Ainley V, Maister L, Brokfeld J, Farmer H, Tsakiris M. More of myself: Manipulating interoceptive awareness by heightened attention to bodily and narrative aspects of the self. Conscious Cogn 2013; 22:1231-8. [DOI: 10.1016/j.concog.2013.08.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 05/28/2013] [Accepted: 08/01/2013] [Indexed: 12/12/2022]
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Lobel A, Granic I, Engels RCME. Associations between children's video game playing and psychosocial health: Information from both parent and child reports. [corrected]. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 17:222-7. [PMID: 24256133 DOI: 10.1089/cyber.2013.0296] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Healthy emotion regulation is crucial for navigating stressful situations. Interoceptive awareness-the awareness of one's internal states-is important for such healthy regulation. Given the propensity for video games to induce stress, the associations between in-game and real world emotion regulation strategies during duress are worth exploring. We therefore present a method for measuring the interoceptive awareness of negative affect during stressful video game play, and investigate whether individual differences in this ability relate to emotion regulation strategies. Twenty-six proficient video game players were recruited to play a session of the video game Starcraft II in the lab. Players' physiological and subjective states of in-game negative arousal were measured consecutively. A comparison of these measures was used to calculate players' interoceptive awareness of real time in-game arousal. The relation between interoceptive awareness and a suite of emotion regulation strategies was then investigated. We observed a positive relation between in-game interoceptive awareness and the self-reported tendency to actively seek a resolution to negative affect. A positive trend was also observed between interoceptive awareness and the self-reported tendency to seek instrumental social support. Findings are discussed in terms of the relative effectiveness of different emotion regulation strategies for aiding in-game success. We further discuss the benefits and limitations of this pilot testing. In all, we hope to inspire future research into the associations between in-game arousal and emotion regulation strategies used in everyday life.
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Affiliation(s)
- Adam Lobel
- Behavioural Science Institute, Radboud University , Nijmegen, The Netherlands
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258
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Abstract
Health and illness are complex constructs for which a biomedical approach alone is insufficient. The purpose of the present study was to explore how personal attitudes toward health and illness affect health experience. By adopting a constructivist perspective, we carried out individual semistructured interviews with 15 persons enrolled in a yoga class in northern Italy. We analyzed the interview data using interpretative phenomenological analysis and found that participants’ attitudes toward health and wellness were linked to their experiences and perceptions of health and illness, their somatic awareness, and their constructions of themselves and of their relations. The findings point toward the importance of people taking responsibility for their health. In addition, they suggest that health care should be personalized: approaching people as a complex unity and health and illness as inextricable parts of their lives.
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259
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Furman DJ, Waugh CE, Bhattacharjee K, Thompson RJ, Gotlib IH. Interoceptive awareness, positive affect, and decision making in major depressive disorder. J Affect Disord 2013; 151:780-785. [PMID: 23972662 PMCID: PMC3797260 DOI: 10.1016/j.jad.2013.06.044] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 05/17/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Little work has examined the relation between interoceptive awareness and symptoms of Major Depressive Disorder (MDD). Existing research suggests that depressed individuals exhibit impaired heartbeat perception, though the results of this research have been equivocal. Importantly, depressed participants in these studies have had comorbid anxiety disorders, making it difficult to draw inferences about interoceptive awareness in MDD. The current study addresses this issue by assessing heartbeat perception in depressed women without current anxiety disorders and exploring the relation between interoception and perturbations in both affective intensity and decision making, components of MDD postulated to be related to bodily awareness. METHODS Depressed women without concurrent anxiety disorders (n=25) and never-disordered controls (n=36) performed a heartbeat perception task. Participants completed the self-report Affect Intensity Measure (AIM), and decision-making difficulty was assessed in MDD participants using the Structured Clinical Interview for DSM-IV. RESULTS Depressed women exhibited poorer heartbeat perception accuracy than did control participants. Impaired accuracy in MDD participants was associated with reduced positive affectivity and difficulty in decision making. LIMITATIONS Our sample was composed exclusively of females and was heterogeneous with respect to treatment status, thereby limiting our ability to generalize results to depressed males and to exclude the contribution of exogenous factors to the observed group differences. CONCLUSIONS Results of this study suggest that for depressed individuals without anxiety comorbidities, disrupted perception of bodily responses reduces both the experience of positive arousal and the ability to use interoceptive feedback to inform decision making.
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260
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Herbert BM, Blechert J, Hautzinger M, Matthias E, Herbert C. Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite 2013; 70:22-30. [DOI: 10.1016/j.appet.2013.06.082] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 05/29/2013] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
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261
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Hart N, McGowan J, Minati L, Critchley HD. Emotional regulation and bodily sensation: interoceptive awareness is intact in borderline personality disorder. J Pers Disord 2013; 27:506-18. [PMID: 22928847 DOI: 10.1521/pedi_2012_26_049] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Emotional dysregulation is a core component of borderline personality disorder (BPD). Theoretical models suggest that deficits in labeling physiological sensations of emotion contribute to affective instability in BPD. Interoceptive awareness refers to the ability to perceive changes in internal bodily states, and is linked to the subjective experience and control of emotions. The authors tested whether differences in interoceptive awareness accounted for emotional instability in BPD. Patients diagnosed with BPD (n = 24) were compared to healthy controls (n = 30) on two established measures of interoceptive awareness, a heartbeat perception task and a heartbeat monitoring task. Contrary to their hypothesis, the authors observed no significant differences in objective measures of interoceptive awareness. Their findings provide strong evidence against the notion that difficulties in emotional regulation in BPD are connected to differences in interoceptive awareness.
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262
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Herbert C, Sfärlea A, Blumenthal T. Your emotion or mine: labeling feelings alters emotional face perception-an ERP study on automatic and intentional affect labeling. Front Hum Neurosci 2013; 7:378. [PMID: 23888134 PMCID: PMC3719026 DOI: 10.3389/fnhum.2013.00378] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 07/01/2013] [Indexed: 11/25/2022] Open
Abstract
Empirical evidence suggests that words are powerful regulators of emotion processing. Although a number of studies have used words as contextual cues for emotion processing, the role of what is being labeled by the words (i.e., one's own emotion as compared to the emotion expressed by the sender) is poorly understood. The present study reports results from two experiments which used ERP methodology to evaluate the impact of emotional faces and self- vs. sender-related emotional pronoun-noun pairs (e.g., my fear vs. his fear) as cues for emotional face processing. The influence of self- and sender-related cues on the processing of fearful, angry and happy faces was investigated in two contexts: an automatic (experiment 1) and intentional affect labeling task (experiment 2), along with control conditions of passive face processing. ERP patterns varied as a function of the label's reference (self vs. sender) and the intentionality of the labeling task (experiment 1 vs. experiment 2). In experiment 1, self-related labels increased the motivational relevance of the emotional faces in the time-window of the EPN component. Processing of sender-related labels improved emotion recognition specifically for fearful faces in the N170 time-window. Spontaneous processing of affective labels modulated later stages of face processing as well. Amplitudes of the late positive potential (LPP) were reduced for fearful, happy, and angry faces relative to the control condition of passive viewing. During intentional regulation (experiment 2) amplitudes of the LPP were enhanced for emotional faces when subjects used the self-related emotion labels to label their own emotion during face processing, and they rated the faces as higher in arousal than the emotional faces that had been presented in the “label sender's emotion” condition or the passive viewing condition. The present results argue in favor of a differentiated view of language-as-context for emotion processing.
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Affiliation(s)
- Cornelia Herbert
- Department of Psychology, University of Würzburg Würzburg, Germany
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263
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Insula's functional connectivity with ventromedial prefrontal cortex mediates the impact of trait alexithymia on state tobacco craving. Psychopharmacology (Berl) 2013; 228:143-55. [PMID: 23455594 PMCID: PMC3873099 DOI: 10.1007/s00213-013-3018-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 02/01/2013] [Indexed: 10/27/2022]
Abstract
RATIONALE Alexithymia is a personality trait characterized by difficulty indentifying and describing subjective emotional experiences. Decreased aptitude in the perception, evaluation, and communication of affectively laden mental states has been associated with reduced emotion regulation, more severe drug craving in addicts, and structural/functional alterations in insula and anterior cingulate cortex (ACC). The insula and ACC represent sites of convergence between the putative neural substrates of alexithymia and those perpetuating cigarette smoking. OBJECTIVES We examined the interrelations between alexithymia, tobacco craving, and insula/ACC neurocircuitry using resting-state functional connectivity (rsFC). METHODS Overnight-deprived smokers (n = 24) and nonsmokers (n = 20) completed six neuroimaging assessments on different days both in the absence of, and following, varenicline and/or nicotine administration. In this secondary analysis of data from a larger study, we assessed trait alexithymia and state tobacco craving using self-reports and examined the rsFC of bilateral insular subregions (anterior, middle, posterior) and dorsal ACC. RESULTS Higher alexithymia in smokers predicted reduced rsFC strength between the right anterior insula (aI) and ventromedial prefrontal cortex (vmPFC). Higher alexithymia also predicted more severe tobacco craving during nicotine withdrawal. Critically, the identified aI-vmPFC circuit fully mediated this alexithymia-craving relation. That is, elevated alexithymia predicted decreased aI-vmPFC rsFC and, in turn, decreased aI-vmPFC rsFC predicted increased craving during withdrawal. A moderated mediation analysis indicated that this aI-vmPFC mediational effect was not observed following drug administration. CONCLUSIONS These results suggest that a weakened right aI-vmPFC functional circuit confers increased liability for tobacco craving during smoking abstinence. Individual differences in alexithymia and/or aI-vmPFC functional coupling may be relevant factors for smoking cessation success.
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264
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Kapp SK. Empathizing with sensory and movement differences: moving toward sensitive understanding of autism. Front Integr Neurosci 2013; 7:38. [PMID: 23745107 PMCID: PMC3662878 DOI: 10.3389/fnint.2013.00038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 04/30/2013] [Indexed: 01/14/2023] Open
Affiliation(s)
- Steven K. Kapp
- Human Development and Psychology Division, Graduate School of Education and Information Studies, University of California Los AngelesLos Angeles, CA, USA
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265
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Moriguchi Y, Komaki G. Neuroimaging studies of alexithymia: physical, affective, and social perspectives. Biopsychosoc Med 2013; 7:8. [PMID: 23537323 PMCID: PMC3621096 DOI: 10.1186/1751-0759-7-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 03/20/2013] [Indexed: 02/04/2023] Open
Abstract
Alexithymia refers to difficulty in identifying and expressing one's emotions, and it is related to disturbed emotional regulation. It was originally proposed as a personality trait that plays a central role in psychosomatic diseases. This review of neuroimaging studies on alexithymia suggests that alexithymia is associated with reduced neural responses to emotional stimuli from the external environment, as well as with reduced activity during imagery, in the limbic and paralimbic areas (i.e., amygdala, insula, anterior/posterior cingulate cortex). In contrast, alexithymia is also known to be associated with enhanced neural activity in somatosensory and sensorimotor regions, including the insula. Moreover, neural activity in the medial, prefrontal, and insula cortex was lowered when people with alexithymia were involved in social tasks. Because most neuroimaging studies have been based on sampling by self-reported questionnaires, the contrasted features of neural activities in response to internal and external emotional stimuli need to be elucidated. The social and emotional responses of people with alexithymia are discussed and recommendations for future research are presented.
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Affiliation(s)
- Yoshiya Moriguchi
- Department of Psychophysiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-0031, Japan.
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266
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Garfinkel SN, Barrett AB, Minati L, Dolan RJ, Seth AK, Critchley HD. What the heart forgets: Cardiac timing influences memory for words and is modulated by metacognition and interoceptive sensitivity. Psychophysiology 2013; 50:505-12. [PMID: 23521494 DOI: 10.1111/psyp.12039] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 01/07/2013] [Indexed: 11/30/2022]
Abstract
Mental functions are influenced by states of physiological arousal. Afferent neural activity from arterial baroreceptors at systole conveys the strength and timing of individual heartbeats to the brain. We presented words under limited attentional resources time-locked to different phases of the cardiac cycle, to test a hypothesis that natural baroreceptor stimulation influences detection and subsequent memory of words. We show memory for words presented around systole was decreased relative to words at diastole. The deleterious memory effect of systole was greater for words detected with low confidence and amplified in individuals with low interoceptive sensitivity, as indexed using a heartbeat counting task. Our observations highlight an important cardiovascular channel through which autonomic arousal impacts a cognitive function, an effect mitigated by metacognition (perceptual confidence) and interoceptive sensitivity.
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Affiliation(s)
- Sarah N Garfinkel
- Department of Psychiatry, Brighton and Sussex Medical School, University of Sussex, Falmer, UK.
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267
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Ainley V, Tsakiris M. Body conscious? Interoceptive awareness, measured by heartbeat perception, is negatively correlated with self-objectification. PLoS One 2013; 8:e55568. [PMID: 23405173 PMCID: PMC3565964 DOI: 10.1371/journal.pone.0055568] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 12/27/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND 'Self-objectification' is the tendency to experience one's body principally as an object, to be evaluated for its appearance rather than for its effectiveness. Within objectification theory, it has been proposed that self-objectification accounts for the poorer interoceptive awareness observed in women, as measured by heartbeat perception. Our study is, we believe, the first specifically to test this relationship. METHODOLOGY/PRINCIPAL FINDINGS Using a well-validated and reliable heartbeat perception task, we measured interoceptive awareness in women and compared this with their scores on the Self-Objectification Questionnaire, the Self-Consciousness Scale and the Body Consciousness Questionnaire. Interoceptive awareness was negatively correlated with self-objectification. Interoceptive awareness, public body consciousness and private body consciousness together explained 31% of the variance in self-objectification. However, private body consciousness was not significantly correlated with interoceptive awareness, which may explain the many nonsignificant results in self-objectification studies that have used private body consciousness as a measure of body awareness. CONCLUSIONS/SIGNIFICANCE We propose interoceptive awareness, assessed by heartbeat perception, as a measure of body awareness in self-objectification studies. Our findings have implications for those clinical conditions, in women, which are characterised by self-objectification and low interoceptive awareness, such as eating disorders.
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Affiliation(s)
- Vivien Ainley
- Department of Psychology, Royal Holloway University of London, United Kingdom.
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268
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Kano M, Fukudo S. The alexithymic brain: the neural pathways linking alexithymia to physical disorders. Biopsychosoc Med 2013; 7:1. [PMID: 23302233 PMCID: PMC3563604 DOI: 10.1186/1751-0759-7-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 12/13/2012] [Indexed: 01/18/2023] Open
Abstract
Alexithymia is a personality trait characterized by difficulties in identifying and describing feelings and is associated with psychiatric and psychosomatic disorders. The mechanisms underlying the link between emotional dysregulation and psychosomatic disorders are unclear. Recent progress in neuroimaging has provided important information regarding emotional experience in alexithymia. We have conducted three brain imaging studies on alexithymia, which we describe herein. This article considers the role of emotion in the development of physical symptoms and discusses a possible pathway that we have identified in our neuroimaging studies linking alexithymia with psychosomatic disorders. In terms of socio-affective processing, alexithymics demonstrate lower reactivity in brain regions associated with emotion. Many studies have reported reduced activation in limbic areas (e.g., cingulate cortex, anterior insula, amygdala) and the prefrontal cortex when alexithymics attempt to feel other people's feelings or retrieve their own emotional episodes, compared to nonalexithymics. With respect to primitive emotional reactions such as the response to pain, alexithymics show amplified activity in areas considered to be involved in physical sensation. In addition to greater hormonal arousal responses in alexithymics during visceral pain, increased activity has been reported in the insula, anterior cingulate cortex, and midbrain. Moreover, in complex social situations, alexithymics may not be able to use feelings to guide their behavior appropriately. The Iowa gambling task (IGT) was developed to assess decision-making processes based on emotion-guided evaluation. When alexithymics perform the IGT, they fail to learn an advantageous decision-making strategy and show reduced activity in the medial prefrontal cortex, a key area for successful performance of the IGT, and increased activity in the caudate, a region associated with impulsive choice. The neural machinery in alexithymia is therefore activated more on the physiologic, motor-expressive level and less in the cognitive-experiential domains of the emotional response system. Affects may play an important role in alleviating intrinsic physiologic reactions and adapting to the environment. Deficient development of emotional neural structures may lead to hypersensitivity to bodily sensations and unhealthy behaviors, a possible mechanism linking alexithymia to psychosomatic disorders.
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Affiliation(s)
- Michiko Kano
- Behavioral Medicine, Tohoku University Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Shin Fukudo
- Behavioral Medicine, Tohoku University Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
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269
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Borg C, Bedoin N, Peyron R, Bogey S, Laurent B, Thomas-Antérion C. Impaired emotional processing in a patient with a left posterior insula-SII lesion. Neurocase 2013; 19:592-603. [PMID: 22934884 DOI: 10.1080/13554794.2012.713491] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The present case-report investigated the influence of a lesion in the left posterior insula-SII cortices on the processing of emotions. MB and 16 normal controls explicitly rated the valence and the intensity of both facial expressions and emotional words. In addition, they had to perform a number comparison task and a lexical decision task without focusing their attention on emotional components of stimuli. MB identified the valence of emotional words as well as the control group. Nevertheless, she provided higher intensity scores for disgusted words and her responses in the lexical decision task were significantly delayed for these stimuli. In addition, MB's response times were not differently influenced by the presence of irrelevant emotional faces. However, she explicitly identified fewer facial expressions of disgust and she assessed them as significantly less intense. This pattern of results contributes to highlight the psychological and behavioral disorders observed after a left posterior insular stroke.
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Affiliation(s)
- Céline Borg
- a Neurology/Neuropsychology , CMRR Unit, Hospital Nord, 42270 , Saint-Priest-en-Jarez , France
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270
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Strigo IA, Matthews SC, Simmons AN, Oberndorfer T, Klabunde M, Reinhardt LE, Kaye WH. Altered insula activation during pain anticipation in individuals recovered from anorexia nervosa: evidence of interoceptive dysregulation. Int J Eat Disord 2013; 46:23-33. [PMID: 22836447 PMCID: PMC3507323 DOI: 10.1002/eat.22045] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Recent evidence raises the possibility that symptoms of anorexia nervosa (AN) could be related to impaired interoception. Pain is an interoceptive process with well-characterized neuroanatomical pathways that may overlap to a large degree with neural systems that may be dysregulated in individuals with AN, such as the insula. METHOD Functional magnetic resonance imaging (fMRI) was used to assess neural substrates of pain anticipation and processing in 10 healthy control women (CW) and 12 individuals recovered from AN (REC AN) in order to avoid the confounding effects of malnutrition. Painful heat stimuli were applied while different colors signaled the intensity of the upcoming stimuli. RESULTS REC AN compared with CW showed greater activation within right anterior insula (rAI), dorsolateral prefrontal cortex (dlPFC) and cingulate during pain anticipation, and greater activation within dlPFC and decreased activation within posterior insula during painful stimulation. Greater anticipatory rAI activation correlated positively with alexithymic feelings in REC AN participants. DISCUSSION REC AN showed a mismatch between anticipation and objective responses, suggesting altered integration and, possibly, disconnection between reported and actual interoceptive state. Alexithymia assessment provided additional evidence of an altered ability to accurately perceive bodily signals in women recovered from AN.
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Affiliation(s)
- Irina A. Strigo
- Department of Psychiatry, University of California, San Diego, La Jolla, CA,Research Service, VA San Diego Healthcare System, San Diego, CA,VA Center of Excellence for Stress and Mental Health(CESAMH), San Diego, CA,BioCircuits Institute (BCI), La Jolla, CA 92037
| | - Scott C. Matthews
- Department of Psychiatry, University of California, San Diego, La Jolla, CA,Research Service, VA San Diego Healthcare System, San Diego, CA,VA Center of Excellence for Stress and Mental Health(CESAMH), San Diego, CA
| | - Alan N. Simmons
- Department of Psychiatry, University of California, San Diego, La Jolla, CA,Research Service, VA San Diego Healthcare System, San Diego, CA,Psychiatry Service, VA San Diego Healthcare System, San Diego, CA,VA Center of Excellence for Stress and Mental Health(CESAMH), San Diego, CA
| | - Tyson Oberndorfer
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Megan Klabunde
- Department of Child and Adolescent Psychiatry, Stanford University, Stanford, CA
| | | | - Walter H. Kaye
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
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271
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Ainley V, Tajadura-Jiménez A, Fotopoulou A, Tsakiris M. Looking into myself: changes in interoceptive sensitivity during mirror self-observation. Psychophysiology 2012; 49:1504-8. [PMID: 22978299 DOI: 10.1111/j.1469-8986.2012.01468.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 08/07/2012] [Indexed: 11/29/2022]
Abstract
Interoceptive sensitivity is an essential component of recent models of "the self." Increased focus on the self (e.g., self-observation in a mirror) can enhance aspects of self-processing. We examined whether self-observation also enhances interoceptive sensitivity. Participants performed a heartbeat detection task while looking at their own face in a mirror or at a black screen. There was significant improvement in interoceptive sensitivity in the mirror condition for those participants with lower interoceptive sensitivity at baseline. This effect was independent of the order of conditions, gender, age, body mass index, habitual exercise, and changes in heart rate. Our results suggest that self-observation may represent a viable way of manipulating individuals' interoceptive sensitivity, in order to directly test causal relations between interoceptive sensitivity and exteroceptive self-processing.
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Affiliation(s)
- Vivien Ainley
- Department of Psychology, Royal Holloway University of London, Egham, Surrey, UK.
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272
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GRYNBERG DELPHINE, DAVYDOV DMITRYM, VERMEULEN NICOLAS, LUMINET OLIVIER. Alexithymia is associated with an augmenter profile, but not only: Evidence for anticipation to arousing music. Scand J Psychol 2012; 53:375-81. [DOI: 10.1111/j.1467-9450.2012.00962.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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273
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Verdejo-Garcia A, Clark L, Dunn BD. The role of interoception in addiction: A critical review. Neurosci Biobehav Rev 2012; 36:1857-69. [DOI: 10.1016/j.neubiorev.2012.05.007] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 05/13/2012] [Accepted: 05/21/2012] [Indexed: 10/28/2022]
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274
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Grynberg D, Chang B, Corneille O, Maurage P, Vermeulen N, Berthoz S, Luminet O. Alexithymia and the processing of emotional facial expressions (EFEs): systematic review, unanswered questions and further perspectives. PLoS One 2012; 7:e42429. [PMID: 22927931 PMCID: PMC3426527 DOI: 10.1371/journal.pone.0042429] [Citation(s) in RCA: 183] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 07/09/2012] [Indexed: 01/12/2023] Open
Abstract
Alexithymia is characterized by difficulties in identifying, differentiating and describing feelings. A high prevalence of alexithymia has often been observed in clinical disorders characterized by low social functioning. This review aims to assess the association between alexithymia and the ability to decode emotional facial expressions (EFEs) within clinical and healthy populations. More precisely, this review has four main objectives: (1) to assess if alexithymia is a better predictor of the ability to decode EFEs than the diagnosis of clinical disorder; (2) to assess the influence of comorbid factors (depression and anxiety disorder) on the ability to decode EFE; (3) to investigate if deficits in decoding EFEs are specific to some levels of processing or task types; (4) to investigate if the deficits are specific to particular EFEs. Twenty four studies (behavioural and neuroimaging) were identified through a computerized literature search of Psycinfo, PubMed, and Web of Science databases from 1990 to 2010. Data on methodology, clinical characteristics, and possible confounds were analyzed. The review revealed that: (1) alexithymia is associated with deficits in labelling EFEs among clinical disorders, (2) the level of depression and anxiety partially account for the decoding deficits, (3) alexithymia is associated with reduced perceptual abilities, and is likely to be associated with impaired semantic representations of emotional concepts, and (4) alexithymia is associated with neither specific EFEs nor a specific valence. These studies are discussed with respect to processes involved in the recognition of EFEs. Future directions for research on emotion perception are also discussed.
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Affiliation(s)
- Delphine Grynberg
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
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275
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Herbert BM, Pollatos O. The Body in the Mind: On the Relationship Between Interoception and Embodiment. Top Cogn Sci 2012; 4:692-704. [DOI: 10.1111/j.1756-8765.2012.01189.x] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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