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Stephenson ES, Koltermann K, Zhou G, Stevens JA. Cardiac interoception in the museum: A novel measure of experience. Front Psychol 2024; 15:1385746. [PMID: 38962234 PMCID: PMC11221354 DOI: 10.3389/fpsyg.2024.1385746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
Interoception is the perception of the body's internal signals in response to various external and internal stimuli. The present study uses a novel method adapted from the CARdiac Elevation Detection Task to examine cardiac interoception objectively and subjectively in a unique context-in the presence of art. Self-report questionnaires were used to measure subjective interoceptive awareness, subjective interoceptive accuracy, and aesthetic appreciation. For objective interoceptive accuracy and sensibility, a wearable device (Shimmer) measured heart rate (HR) and connected to a mobile application to prompt two questions: "Is your heart beating faster than usual?" and "How confident are you in your previous response?" Participants explored an art gallery for 40 minutes while the Shimmer measured their HR and randomly prompted them to answer the questions. Using a Generalized Estimating Equation model, interoceptive sensibility was not found to predict the odds of submitting a correct response. It was also found that art does not improve participants' perceptions of their HR. Finally, there was no relation between aesthetic appreciation and subjective or objective cardiac interoception. Despite lack of statistical significance, the current study's method presents an improved method by examining interoceptive accuracy in the moment under ecological conditions. To date, findings and methods used in interoception are inconsistent or flawed; the value in the current study lies in the development and demonstration of a method to examine how the environment influences the body and self-awareness across a wide variety of contexts, thereby offering a possible standardized measure of interoception for investigators to adopt.
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Affiliation(s)
- Emma S. Stephenson
- Department of Psychological Sciences, College of William & Mary, Williamsburg, VA, United States
| | - Kenneth Koltermann
- Department of Computer Science, College of William & Mary, Williamsburg, VA, United States
| | - Gang Zhou
- Department of Computer Science, College of William & Mary, Williamsburg, VA, United States
| | - Jennifer A. Stevens
- Department of Psychological Sciences, College of William & Mary, Williamsburg, VA, United States
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Horváth Á, Ferentzi E, Moravetz O, Köteles F. A multichannel investigation of proprioceptive accuracy. Biol Psychol 2024; 191:108829. [PMID: 38878953 DOI: 10.1016/j.biopsycho.2024.108829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 05/27/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
Proprioceptive accuracy (PAc), i.e., the acuity of perception of the state of different parts of the motor system, shows substantial intraindividual differences, and is often considered a general ability. However, it is questionable whether there is an association between accuracies measured with different tests at different body sites. PAc with respect to both knee and elbow joints (joint position reproduction) and the flexors of the upper arms (weight discrimination) was measured in 87 young healthy individuals with regular physical activity across multiple indices. Expected and perceived performance was also assessed for each behavioral task. Frequentist and Bayesian analysis largely supported the idea that PAc with respect to various parts of the motor system are unrelated. No dominant-subdominant differences for actual performance were found; however, PAc for the dominant and subdominant limb were associated in many cases. Finally, perceived performance was related to expected but not to actual performance for all three proprioceptive modalities. In conclusion, actual accuracy of perception of the actual state of a part (i.e., joint, muscle) of the motor system cannot be generalized to other parts. Perceived accuracy, dominantly shaped by expectations, is independent from actual accuracy.
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Affiliation(s)
- Áron Horváth
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary; Ádám György Psychophysiology Research Group, Budapest, Hungary
| | - Eszter Ferentzi
- Ádám György Psychophysiology Research Group, Budapest, Hungary; Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Moravetz
- Doctoral School of Sport Sciences, Hungarian University of Sports Science, Hungary
| | - Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary; Ádám György Psychophysiology Research Group, Budapest, Hungary.
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Petzke TM, Elspaß L, Köteles F, Van den Bergh O, Witthöft M. "And how did that make you feel?" - Repeated symptom queries enhance symptom reports elicited by negative affect. J Psychosom Res 2024; 181:111634. [PMID: 38453590 DOI: 10.1016/j.jpsychores.2024.111634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Negative affect, alexithymia, and other predisposing traits (such as health anxiety) can influence an individual's symptom perception. In this study, we used the affective picture paradigm (APP, Bogaerts et al., 2010) to induce symptoms using affective picture stimuli. We aimed to cross-sectionally test the effect of high vs low-frequency symptom queries and analyze the time course of the APP, including interactions with health anxiety and somatic symptom distress. METHODS Participants (N = 124) completed a modified APP and filled out various questionnaires. In the APP, participants were randomized to either a highly-frequent-query condition (18 symptom checklists) or a less-frequent-query condition (6 checklists). Data were analyzed using ANOVAs, cross-lagged panel models, moderation models, and multilevel models. RESULTS Both groups had comparable symptom baseline values, but people in the highly frequent as opposed to less frequent condition reported significantly higher symptom levels once the experiment started (F (1,120) = 14.319, p < .001, η2=.107). Symptom levels stayed stable over the course of the experiment and were best predicted by symptom levels at earlier timepoints in the experiment (β = 0.43 and β = 0.68, both p < .001). Health anxiety levels significantly predicted symptom levels (F(1,121) = 10.054, p = .002, η2=.077) and moderated the relation between condition and symptom levels (F(2,121) = 16.253, p < .001, η2=.212). CONCLUSION In terms of the predictive processing model (e.g.,[1]), repeated symptom queries following negative affective cues may activate prior beliefs about symptoms, resulting in elevated levels of symptom reports in interaction with health anxiety.
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Affiliation(s)
- Tara M Petzke
- Department of Clinical Psychology, Psychotherapy, or Experimental Psychopathology, Johannes-Gutenberg University Mainz, Mainz, Germany.
| | - Lina Elspaß
- Department of Clinical Psychology, Psychotherapy, or Experimental Psychopathology, Johannes-Gutenberg University Mainz, Mainz, Germany.
| | - Ferenc Köteles
- Department of General Psychology and Methodology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | | | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, or Experimental Psychopathology, Johannes-Gutenberg University Mainz, Mainz, Germany.
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Petzke TM, Köteles F, Pohl A, Witthöft M. Somatic symptom distress is not related to cardioceptive accuracy. J Psychosom Res 2024; 181:111655. [PMID: 38609776 DOI: 10.1016/j.jpsychores.2024.111655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE (Cardiac) interoception was long considered a key mechanism behind symptom perception in persistent somatic symptoms (PSS). In this study, we aimed to extend earlier findings to clarify this potential interoceptive mechanisms of PSS. METHODS A cross-sectional sample of 251 participants (23.1% with self-reported functional somatic syndrome) completed a laboratory study with two cardioceptive accuracy tasks (Schandry task and a new cardiac signal detection task) and multiple questionnaires. Somatic symptom distress and associated constructs were assessed with the PHQ-15, as well as with a novel multidimensional questionnaire measure (HiTOP-SF1) derived from the somatoform spectrum of the Hierarchical Taxonomy of Psychopathology (HiTOP). Correlations (frequentist and Bayesian) and structural equation modelling (SEM) helped further investigate the interplay between these variables. RESULTS There were no significant correlations between measures of interoception and somatic symptom distress. Self-report and behavioral cardioceptive accuracy measures did not correlate significantly. No significant covariances emerged between diagnostic tools and cardioceptive accuracy; Bayesian analyses supported the lack of association between interoception and symptom perception. CONCLUSIONS Cardiac interoception (specifically cardioceptive accuracy) unlikely represents a key mechanism in PSS etiology. We recommend investigating other factors in PSS.
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Affiliation(s)
- Tara M Petzke
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes-Gutenberg-University Mainz, Wallstraße 3, 55122 Mainz, Germany.
| | - Ferenc Köteles
- Department of General Psychology and Methodology, Károli Gáspár University of the Reformed Church in Hungary, Kálvin tér 9, 1091 Budapest, Hungary.
| | - Anna Pohl
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, University of Cologne, Pohligstraße 1, 50969 Cologne, Germany.
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes-Gutenberg-University Mainz, Wallstraße 3, 55122 Mainz, Germany.
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Nagy T, Ipacs H, Ferentzi E, Köteles F. Heart rate perception and expectation impact laboratory-induced perceived stress. Int J Psychophysiol 2024; 199:112326. [PMID: 38460676 DOI: 10.1016/j.ijpsycho.2024.112326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/16/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
Previous studies have shown that the human capacity to gauge one's own physiological state is notoriously flawed. The cause for the mismatch between perceived and physiological stress has not yet been properly identified. In this study, we assumed that cardioceptive accuracy (CAc) is positively associated with cardiovascular reactivity, and CAc and expectation about stress might account for the discrepancy between perceived and physiological stress. In a crossover experiment, we assessed cardioceptive accuracy in two ways (mental heartbeat tracking task and perception of heart rate), and induced physiological (handgrip exercise) and mental (N-back task) stress in 64 university students (51 % male, mean age 22.2). We assessed cardiac and electrodermal activity, and expected and perceived stress. We found that indicators of cardioceptive accuracy were not associated with cardiovascular reactivity. However, heart rate perception moderated the association between the change in heart rate and perceived stress in the physical but not in the mental task. Whereas heartbeat tracking accuracy was not associated with perceived stress. Moreover, perceived stress was predicted by the expected stress but not by the change in heart rate and electrodermal activity in the mental stress task. In conclusion, heart rate perception and expectation of stress may shape perceived stress more than actual physiological changes in moderate acute stress.
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Affiliation(s)
- Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Henriett Ipacs
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Eszter Ferentzi
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary; Ádám György Psychophysiology Research Group, Budapest, Hungary.
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary; Ádám György Psychophysiology Research Group, Budapest, Hungary
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Parrotta E, Bach P, Perrucci MG, Costantini M, Ferri F. Heart is deceitful above all things: Threat expectancy induces the illusory perception of increased heartrate. Cognition 2024; 245:105719. [PMID: 38278039 DOI: 10.1016/j.cognition.2024.105719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 11/24/2023] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
It has been suggested that our perception of the internal milieu, or the body's internal state, is shaped by our beliefs and previous knowledge about the body's expected state, rather than being solely based on actual interoceptive experiences. This study investigated whether heartbeat perception could be illusorily distorted towards prior subjective beliefs, such that threat expectations suffice to induce a misperception of heartbeat frequency. Participants were instructed to focus on their cardiac activity and report their heartbeat, either tapping along to it (Experiment 1) or silently counting (Experiment 2) while ECG was recorded. While completing this task, different cues provided valid predictive information about the intensity of an upcoming cutaneous stimulation (high- vs. low- pain). Results showed that participants expected a heart rate increase over the anticipation of high- vs. low-pain stimuli and that this belief was perceptually instantiated, as suggested by their interoceptive reports. Importantly, the perceived increase was not mirrored by the real heart rate. Perceptual modulations were absent when participants executed the same task but with an exteroceptive stimulus (Experiment 3). The findings reveal, for the first time, an interoceptive illusion of increased heartbeats elicited by threat expectancy and shed new light on interoceptive processes through the lenses of Bayesian predictive processes, providing tantalizing insights into how such illusory phenomena may intersect with the recognition and regulation of people's internal states.
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Affiliation(s)
- Eleonora Parrotta
- School of Psychology, University of Aberdeen, UK; School of Psychology, University of Plymouth, UK.
| | - Patric Bach
- School of Psychology, University of Aberdeen, UK; School of Psychology, University of Plymouth, UK
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies - ITAB, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marcello Costantini
- Department of Psychological, Health and Territorial Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies - ITAB, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Francesca Ferri
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies - ITAB, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Körmendi J, Ferentzi E. Heart activity perception: narrative review on the measures of the cardiac perceptual ability. Biol Futur 2024; 75:3-15. [PMID: 37747684 DOI: 10.1007/s42977-023-00181-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023]
Abstract
Measures of cardiac perceptual ability (also called cardiac accuracy) are methods of cardiac interoception, the perception of bodily sensation related to heart activity. This narrative review aims to provide an overview of these methods. We differentiate between three main measurement types: (1) change detection, i.e., when the task is to notice the change in the heart rate; also called: heart rate perception tasks, (2) discrimination tasks, i.e., when the task is to compare the internal sensations with external signal(s); also called: heartbeat detection tasks and (3) tracking tasks, i.e., when the task is to follow and report heartbeats via tapping or counting. We describe some of the new methods under "mixed methods," as they share features with more than one of the large measurement types described above. Specific measures differ in various aspects, such as their focus (heart rhythm vs. single beats), their sensitivity to non-conscious sensations and the calculated indices (e.g., whether significance level by hypothesis test is provided). When a measure of cardiac perceptual ability is chosen, it is advisable to take its characteristics into consideration in light of the planned research.
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Affiliation(s)
- János Körmendi
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- Ádám György Psychophysiology Research Group, Budapest, Hungary
| | - Eszter Ferentzi
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
- Ádám György Psychophysiology Research Group, Budapest, Hungary.
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Mai-Lippold SA, Schultze J, Pollatos O. Interoceptive abilities impairment correlates with emotional eating and taste abnormalities in children with overweight and obesity. Appetite 2024; 194:107182. [PMID: 38154574 DOI: 10.1016/j.appet.2023.107182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/28/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023]
Abstract
Weight problems in children are associated with emotional eating, which has been linked to interoceptive abilities. Previous research also shows altered olfactory and gustatory perception in children with obesity and overweight. Therefore, we aimed to investigate the connection of alterations in olfactory and gustatory perception to interoceptive abilities and emotional eating among children with obesity and overweight. 23 children with overweight and obesity and age-matched controls with normal weight (12-16 years old) underwent olfactory and gustatory testing. Interoceptive abilities were assessed, focusing on interoceptive accuracy and interoceptive sensibility. Children with overweight and obesity showed significantly higher accuracy for detection of sweet taste, but descriptively lower accuracy for all other taste qualities compared to normal weight children. We found no changes in olfactory abilities in children with overweight and obesity. Emotional eating scores were elevated for children with overweight and obesity, and interoceptive accuracy scores were significantly lower. In both groups, interoceptive accuracy was inversely correlated with emotional eating. Our results support prior findings of altered gustatory abilities in children with overweight and obesity. The observed link between impaired interoceptive processes and heightened emotional eating in this group implies that interventions for overweight in children could benefit from targeting interoceptive abilities. This study provides meaningful grounds for further investigations into the roles of taste, emotional eating, and interoceptive abilities for overweight in children and adolescents.
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Affiliation(s)
- Sandra A Mai-Lippold
- Clinical and Health Psychology, Institute of Psychology, Ulm University, Germany
| | - Jasmin Schultze
- Clinical and Health Psychology, Institute of Psychology, Ulm University, Germany
| | - Olga Pollatos
- Clinical and Health Psychology, Institute of Psychology, Ulm University, Germany.
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Köteles F. Vague sensations. About the background and consequences of discordance between actual and perceived physiological changes. Clin Psychol Rev 2024; 108:102382. [PMID: 38218123 DOI: 10.1016/j.cpr.2024.102382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/28/2023] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Empirical evidence consistently shows that discordance, also called dissociation or discrepancy, between actual physiological (mainly visceral) events and their perceived counterparts is substantial. On the one hand, we typically do not perceive actual visceral events occurring in our bodies; on the other hand, sometimes we do perceive bodily changes that do not really take place. This narrative review presents the available empirical findings on the discordance, and summarizes possible explanations that approach the phenomenon from the viewpoint of evolution, cognitive development, and predictive processing. Also, the role of top-down factors, such as expectations and experiences is discussed. Finally, practically relevant consequences of the discordance are presented using the examples of mind-body practices, the placebo and nocebo phenomenon, and medically unexplained symptoms. It is concluded that the discordance between actual and perceived body changes can have a negative impact on health, mainly through issues with adherence and other behavioral factors. The existence of actual-perceived discordance should be taught and demonstrated in the elementary and high school, as well as in many areas of higher education.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary; Ádám György Psychophysiology Research Group, Budapest, Hungary.
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10
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Parfenov EA, Duncan NW. Increasing familiarity with the heartbeat counting task does not affect performance. Biol Psychol 2023; 183:108662. [PMID: 37598881 DOI: 10.1016/j.biopsycho.2023.108662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/21/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Interoception is typically defined as the processing and perception of internal signals. A common evaluation of interoceptive abilities is the heartbeat counting task, during which participants count their heartbeats over a period of time. It has been argued recently, however, that performance in this task may reflect processes other than cardiac sensation. OBJECTIVE This study aimed to: 1) observe heartbeat counting task performance changes across multiple repetitions of the task; and 2) compare performance in the heartbeat counting task with that for a visual counting task to investigate generalised propensities for how uncertain stimuli are reported. METHODS Seventy-nine healthy participants performed seven blocks each of the heartbeat and visual counting tasks. Scores for each of the tasks were compared across blocks to identify any change in performance. Performance in the two tasks was then correlated. The study was preregistered at https://doi.org/10.17605/OSF.IO/GWAB7. RESULTS Heartbeat counting task performance did not change over blocks. In contrast, scores for the visual counting task reduced over time. A positive correlation was seen between performance in the two tasks (ρ(79) = .27). CONCLUSION Heartbeat counting task performance is stable across repetitions of the task, not changing with increasing familiarity. This suggests that non-interoceptive factors, such as beliefs, may be involved. The correlation between the heartbeat and visual counting tasks may point to a general propensity in counting uncertain stimuli across sensory domains. Together, these results raise questions about the interpretation of the heartbeat counting task as a measure of interoception.
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Affiliation(s)
- Evgeny A Parfenov
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Niall W Duncan
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
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Lernia DDI, Serino S, Tuena C, Cacciatore C, Polli N, Riva G. Mental health meets computational neuroscience: A predictive Bayesian account of the relationship between interoception and multisensory bodily illusions in anorexia nervosa. Int J Clin Health Psychol 2023; 23:100383. [PMID: 36937547 PMCID: PMC10017360 DOI: 10.1016/j.ijchp.2023.100383] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/21/2023] [Indexed: 03/09/2023] Open
Abstract
Mental health disorders pose a significant challenge to society. The Bayesian perspective on the mind offers unique insights and tools that may help address a variety of mental health conditions. Psychopathological dysfunctions are often connected to altered predictive and active inference processes, in which cognitive and physiological pathogenic beliefs shape the clinical condition and its symptoms. However, there is a lack of general empirical models that integrate cognitive beliefs, physiological experience, and symptoms in healthy and clinical populations. In this study, we examined the relationship between altered predictive mechanisms, interoception, and pathological bodily distortions in healty individuals and in individuals suffering from anorexia nervosa (AN). AN patients (N=15) completed a Virtual Reality Full-Body Illusion along with interoceptive tasks twice: at hospital admission during an acute symptomatological phase (Time 1) and after a 12-week outpatient clinical weight-restoring rehabilitative program (Time 2). Results were compared to a healthy control group. Our findings indicated that higher levels of interoceptive metacognitive awareness were associated with a greater embodiment. However, unlike in healthy participants, AN patients' interoceptive metacognition was linked to embodiment even in multisensory mismatching (asynchronous) conditions. In addition, unlike in healthy participants, higher interoceptive metacognition in AN patients was related to prior abnormal bodily distortions during the acute symptomatology phase. Prediction errors in bodily estimates predicted posterior bodily estimate distortions after the illusion, but while this relationship was only significant in the synchronous condition in healthy participants, there was no significant difference between synchronous and asynchronous conditions in AN patients. Despite the success of the rehabilitation program in restoring some dysfunctional patterns in the AN group, prediction errors and posterior estimate distortions were present at hospital discharge. Our findings suggest that individuals with AN prioritize interoceptive metacognitive processes (i.e., confidence in their own perceived sensations rather than their actual perceptions), disregarding bottom-up bodily inputs in favour of their prior altered top-down beliefs. Moreover, even if the rehabilitative program partially mitigated these alterations, the pathological condition impaired the patients' ability to coherently update their prior erroneous expectations with real-time multisensory bottom-up bodily information, possibly locking the patients in the experience of a distorted prior top-down belief. These results suggest new therapeutic perspectives and introduce the framework of regenerative virtual therapy (RVT), which aims at utilizing technology-based somatic modification techniques to restructure the maladaptive priors underlying a pathological condition.
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Affiliation(s)
- Daniele DI Lernia
- Humane Technology Lab, Università Cattolica del Sacro Cuore di Milano, Italy
| | - Silvia Serino
- Humane Technology Lab, Università Cattolica del Sacro Cuore di Milano, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Cacciatore
- UO di Endocrinologia e Malattie Metaboliche, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nicoletta Polli
- UO di Endocrinologia e Malattie Metaboliche, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore di Milano, Italy
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Körmendi J, Ferentzi E, Petzke T, Gál V, Köteles F. Do we need to accurately perceive our heartbeats? Cardioceptive accuracy and sensibility are independent from indicators of negative affectivity, body awareness, body image dissatisfaction, and alexithymia. PLoS One 2023; 18:e0287898. [PMID: 37406011 DOI: 10.1371/journal.pone.0287898] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
Assessment of the acuity of heartbeat perception, dubbed cardioceptive accuracy, as well as its association with various psychological characteristics are hot topics of interoception research. In this study, we aimed (1) to replicate previously reported findings on the association between the mental tracking task and a novel motor tracking task that eliminates disturbing tactile sensations; and (2) to explore associations between performance in the latter task and indicators of negative affectivity (anxiety, depression, anxiety sensitivity, somatic symptom distress), alexithymia, body focus, and dissatisfaction with body image. 102 young people (age = 20.8±5.08 yrs) participated in the study. Mental tracking score was significantly higher than motor tracking scores, although they were strongly associated. Frequentist correlation analysis showed no significant associations between indicators of cardioceptive accuracy and questionnaire scores; Bayesian analysis indicated the lack of association for the majority of the cases. Similarly, detectors and non-detectors showed no differences in any of the assessed characteristics and Bayesian results typically supported the lack of associations. In conclusion, cardioceptive accuracy, as assessed with different tracking methods, is not associated with the aforementioned self-reported characteristics in young individuals.
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Affiliation(s)
- János Körmendi
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- Ádám György Psychophysiology Research Group, Budapest, Hungary
| | - Eszter Ferentzi
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- Ádám György Psychophysiology Research Group, Budapest, Hungary
| | - Tara Petzke
- Psychological Institute, Johannes Gutenberg University, Mainz, Germany
| | - Vera Gál
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- Ádám György Psychophysiology Research Group, Budapest, Hungary
| | - Ferenc Köteles
- Ádám György Psychophysiology Research Group, Budapest, Hungary
- Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary
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Wallman-Jones A, Palser ER, Benzing V, Schmidt M. Acute physical-activity related increases in interoceptive ability are not enhanced with simultaneous interoceptive attention. Sci Rep 2022; 12:15054. [PMID: 36064565 PMCID: PMC9445090 DOI: 10.1038/s41598-022-19235-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/25/2022] [Indexed: 01/23/2023] Open
Abstract
Interoception, the sense of the internal body, is proposed to support self-regulation, and consequently influence mental health. Researchers have therefore shown interest in improving the ability to accurately monitor internal signals (i.e., interoceptive accuracy, IAcc). Research suggests that cardiac IAcc is modifiable by both manipulations of interoceptive attention (guided attention towards the internal body), and interoceptive exposure (strategically inducing somatic signals e.g., via physical activity). Whilst successful in isolation, it is unclear whether a combined approach (i.e., directing attention towards the internal body when signals are more salient) could elicit greater benefits. In a 2 × 2 within-subject design, 48 healthy adults (Mage = 25.98 ± 4.73 years, 50% female) completed four 20-min conditions varying in both attentional focus (interoceptive vs exteroceptive) and physical activity (active vs rest), with cardiac IAcc measured immediately after. Results revealed a main effect for physical activity (p < 0.001), however, there was no effect for attentional focus (p = 0.397), and no interaction effect (p = 0.797). Differential analyses showed that a higher sporting background increased sensitivity to physical activity-related increases in cardiac IAcc (p = 0.031). Findings indicate that (irrespective of attentional focus) moderate-vigorous physical activity-based interventions have the potential to increase cardiac IAcc, with certain individuals potentially benefiting more.
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Affiliation(s)
- A Wallman-Jones
- Institute of Sport Science, University of Bern, 145 Bremgartenstrasse, 3012, Bern, Switzerland.
| | - E R Palser
- Department of Neurology, University of California, San Francisco, CA, 94158, USA
| | - V Benzing
- Institute of Sport Science, University of Bern, 145 Bremgartenstrasse, 3012, Bern, Switzerland
| | - M Schmidt
- Institute of Sport Science, University of Bern, 145 Bremgartenstrasse, 3012, Bern, Switzerland
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Körmendi J, Ferentzi E, Köteles F. A heartbeat away from a valid tracking task. An empirical comparison of the mental and the motor tracking task. Biol Psychol 2022; 171:108328. [PMID: 35452781 DOI: 10.1016/j.biopsycho.2022.108328] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]
Abstract
Individuals' ability to perceive their heartbeats, called cardioceptive accuracy, is assessed with various paradigms. Performance in the mental and a novel motor tracking task that eliminates disturbing tactile sensations was assessed at rest and during walking with the participation of 45 young people. Significantly higher scores in the mental tracking task than in the motor tracking task were found. Scores obtained at rest were consistently higher than their walking counterparts. Motor responses showed no temporal association with heartbeats for 84% of participants at rest and 95% during walking. Overall, participants' cardioceptive accuracy at rest and under slight physical activity was poor. Even if people rely on their heartbeat-related sensations during their daily activity, it is either not the ability that is assessed by the tracking tasks, or it is a relatively poor source of information about the actual state of the body.
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Affiliation(s)
- János Körmendi
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Eszter Ferentzi
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
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