On the relationship between interoceptive awareness, emotional experience, and brain processes

The relationship between mindfulness and cognitive reappraisal: the mediating role of emotional and interoceptive awareness

Mindfulness and cognitive reappraisal have been recognized as two useful ways to regulate emotions. The former tends to cultivate an attitude of being open and accepting of emotional events; whereas the latter involves a top-down process of re-interpreting emotional events. However, it is unclear how mindfulness influences cognitive reappraisal. Hence, the current study mainly addressed this research issue by exploring the mediating role of emotional and interoceptive awareness. 372 participants were asked to report dispositional mindfulness, cognitive reappraisal, emotional awareness, and interoceptive awareness by means of corresponding questionnaires. First, we performed the Pearson Correlations among the four factors, then assessed the mediating role of emotional awareness and interoceptive awareness in the link between mindfulness and cognitive reappraisal in separated models. Last, we used structural equation modeling (SEM) to investigate the link when both emotional and interoceptive awareness acted as the mediating variables. Results showed that mindfulness was negatively correlated with cognitive reappraisal, emotional awareness, and interoceptive awareness; whereas emotional awareness, interoceptive awareness, and cognitive reappraisal were positively correlated with each other. Moreover, increased mindfulness had a significantly negative effect on cognitive reappraisal, by reducing emotional and interoceptive awareness separately or successively. Except for the No-worrying factor, the remaining seven factors of interoceptive awareness were significantly loaded onto the latent variable. The result reveals the negative relationship between mindfulness and cognitive reappraisal. This link is mediated by one's emotional awareness and interoceptive awareness independently or successively, which may reflect the intensity of externally-emotional reactivity that signify the need to regulate emotions by means of cognitive reappraisal.

The role of the somatosensory system in the feeling of emotions: a neurostimulation study

Emotional experiences deeply impact our bodily states, such as when we feel 'anger', our fists close and our face burns. Recent studies have shown that emotions can be mapped onto specific body areas, suggesting a possible role of the primary somatosensory system (S1) in emotion processing. To date, however, the causal role of S1 in emotion generation remains unclear. To address this question, we applied transcranial alternating current stimulation (tACS) on the S1 at different frequencies (beta, theta, and sham) while participants saw emotional stimuli with different degrees of pleasantness and levels of arousal. Results showed that modulation of S1 influenced subjective emotional ratings as a function of the frequency applied. While theta and beta-tACS made participants rate the emotional images as more pleasant (higher valence), only theta-tACS lowered the subjective arousal ratings (more calming). Skin conductance responses recorded throughout the experiment confirmed a different arousal for pleasant versus unpleasant stimuli. Our study revealed that S1 has a causal role in the feeling of emotions, adding new insight into the embodied nature of emotions. Importantly, we provided causal evidence that beta and theta frequencies contribute differently to the modulation of two dimensions of emotions-arousal and valence-corroborating the view of a dissociation between these two dimensions of emotions.

Insights into interoceptive and emotional processing: Lessons from studies on insular HD-tDCS

Interoception, the processing of internal bodily signals, is proposed as the fundamental mechanism underlying emotional experiences. Interoceptive and emotional processing appear distorted in psychiatric disorders. However, our understanding of the neural structures involved in both processes remains limited. To explore the feasibility of enhancing interoception and emotion, we conducted two studies using high-definition transcranial direct current stimulation (HD-tDCS) applied to the right anterior insula. In study one, we compared the effects of anodal HD-tDCS and sham tDCS on interoceptive abilities (sensibility, confidence, accuracy, emotional evaluation) in 52 healthy subjects. Study two additionally included physical activation through ergometer cycling at the beginning of HD-tDCS and examined changes in interoceptive and emotional processing in 39 healthy adults. In both studies, HD-tDCS was applied in a single-blind cross-over online design with two separate sessions. Study one yielded no significant effects of HD-tDCS on interoceptive dimensions. In study two, significant improvements in interoceptive sensibility and confidence were observed over time with physical preactivation, while no differential effects were found between sham and insula stimulation. The expected enhancement of interoceptive and emotional processing following insula stimulation was not observed. We conclude that HD-tDCS targeting the insula does not consistently increase interoceptive or emotional variables. The observed increase in interoceptive sensibility may be attributed to the activation of the interoceptive network through physical activity or training effects. Future research on HD-tDCS involving interoceptive network structures could benefit from protocols targeting larger regions within the network, rather than focusing solely on insula stimulation.

Moderate cardiac vagal tone predicts more cooperation in highly sensitive individuals

Cooperation, as a mutual collaboration, is a defining feature of human social life. Individual characteristics can influence cooperation. Recent studies have shown a quadratic relationship between cardiac vagal tone (CVT), an index of self-regulation, and prosocial behaviors. Individual differences in cooperation might also vary as a function of people's environmental sensitivity (ES), i.e., may be influenced by individual differences in the perception and processing of inner and external stimuli. We tested the direct and interactive effect of CVT and ES on cooperative behaviors in two independent samples. We measured heart rate and engagement in cooperative acts in 80 young adults (M = 23.61; SD = 1.60) who were also asked to self-report on ES. We found an inverted-U relationship between CVT and cooperative behaviors. ES, on the other hand, did not predict differences in cooperative behaviors but moderated the relationships between CVT and cooperation, although the magnitude of this result was small. Specifically, only among individuals with higher ES cooperative behaviors change as a function of CVT. Highly sensitive individuals with lower or higher CVT, were less cooperative than low sensitive ones. Subsequently, we replicated the same study design in a second sample of 88 undergraduate students (M = 23.69; SD = 4.91). Once again, we found evidence supporting the presence of an inverted-U relationship between CVT and cooperative behaviors, and we also found that ES moderated the relationships between the quadratic CVT term and cooperation.

The association between interoception and olfactory affective responses

Odors are known to affect an individual's emotions and physiological states. Recent research has revealed that olfaction is linked to the mental representation of internal sensations, known as interoception. However, little research has examined how interoception relates to emotional responses to odors. This research aimed to fill this gap in the literature. We conducted two studies with a total of 548 Japanese women (n = 500 and n = 48 in Studies 1 and 2, respectively). Study 1 used an online survey to assess the relationship between self-reported interoceptive traits and the intensity of positive emotions in response to daily odors. Study 2 examined how self-reported interoceptive traits modulated the arousal ratings of odors presented in the laboratory and the concordance between these perceived arousal ratings and odor-evoked physiological responses. Study 1 confirmed that self-reported interoceptive traits were significant predictors of positive emotional intensity of odors. In Study 2, individuals with high interoceptive measure scores showed concordance between their perceived emotional arousal and the physiological responses associated with that emotion, whereas individuals with low scores did not. These findings suggest that how people perceive their internal sensations contributes to shaping their olfactory affective experiences, thereby broadening the scope of interoception research and aromachology. The practical implications of these findings for the development of commercial fragrances are discussed.

Common threads: Altered interoceptive processes across affective and anxiety disorders

There is growing attention towards atypical brain-body interactions and interoceptive processes and their potential role in psychiatric conditions, including affective and anxiety disorders. This paper aims to synthesize recent developments in this field. We present emerging explanatory models and focus on brain-body coupling and modulations of the underlying neurocircuitry that support the concept of a continuum of affective disorders. Grounded in theoretical frameworks like peripheral theories of emotion and predictive processing, we propose that altered interoceptive processes might represent transdiagnostic mechanisms that confer common vulnerability traits across multiple disorders. A deeper understanding of the interplay between bodily states and neural processing is essential for a holistic conceptualization of mental disorders.

Heart rate and insula activity increase in response to music in individuals with high interoceptive sensitivity

Interoception plays an important role in emotion processing. However, the neurobiological substrates of the relationship between visceral responses and emotional experiences remain unclear. In the present study, we measured interoceptive sensitivity using the heartbeat discrimination task and investigated the effects of individual differences in interoceptive sensitivity on changes in pulse rate and insula activity in response to subjective emotional intensity. We found a positive correlation between heart rate and valence level when listening to music only in the high interoceptive sensitivity group. The valence level was also positively correlated with music-elicited anterior insula activity. Furthermore, a region of interest analysis of insula subregions revealed significant activity in the left dorsal dysgranular insula for individuals with high interoceptive sensitivity relative to individuals with low interoceptive sensitivity while listening to the high-valence music pieces. Our results suggest that individuals with high interoceptive sensitivity use their physiological responses to assess their emotional level when listening to music. In addition, insula activity may reflect the use of interoceptive signals to estimate emotions.

When virtual reality becomes psychoneuroendocrine reality: A stress(or) review

This review article was awarded the Dirk Hellhammer award from ISPNE in 2023. It explores the dynamic relationship between stressors and stress from a historical view as well as a vision towards the future of stress research via virtual reality (VR). We introduce the concept of a "syncytium," a permeable boundary that blurs the distinction between stress and stressor, in order to understand why the field of stress biology continues to inadequately measure stress alone as a proxy for the force of external stressors. Using Virtual Reality (VR) as an illustrative example to explicate the black box of stressors, we examine the distinction between 'immersion' and 'presence' as analogous terms for stressor and stress, respectively. We argue that the conventional psychological approaches to stress measurement and appraisal theory unfortunately fall short in quantifying the force of the stressor, leading to reverse causality fallacies. Further, the concept of affordances is introduced as an ecological or holistic tool to measure and design a stressor's force, bridging the gap between the external environment and an individual's physiological response to stress. Affordances also serve to ameliorate shortcomings in stress appraisal by integrating ecological interdependencies. By combining VR and psychobiological measures, this paper aims to unravel the complexity of the stressor-stress syncytium, highlighting the necessity of assessing both the internal and external facets to gain a holistic understanding of stress physiology and shift away from reverse causality reasoning. We find that the utility of VR extends beyond presence to include affordance-based measures of immersion, which can effectively model stressor force. Future research should prioritize the development of tools that can measure both immersion and presence, thereby providing a more comprehensive understanding of how external stressors interact with individual psychological states.

The neurobiology of interoception and affect

Scholars have argued for centuries that affective states involve interoception, or representations of the state of the body. Yet, we lack a mechanistic understanding of how signals from the body are transduced, transmitted, compressed, and integrated by the brains of humans to produce affective states. We suggest that to understand how the body contributes to affect, we first need to understand information flow through the nervous system's interoceptive pathways. We outline such a model and discuss how unique anatomical and physiological aspects of interoceptive pathways may give rise to the qualities of affective experiences in general and valence and arousal in particular. We conclude by considering implications and future directions for research on interoception, affect, emotions, and human mental experiences.

Cardio-audio synchronization elicits neural and cardiac surprise responses in human wakefulness and sleep

The human brain can encode auditory regularities with fixed sound-to-sound intervals and with sound onsets locked to cardiac inputs. Here, we investigated auditory and cardio-audio regularity encoding during sleep, when bodily and environmental stimulus processing may be altered. Using electroencephalography and electrocardiography in healthy volunteers (N = 26) during wakefulness and sleep, we measured the response to unexpected sound omissions within three regularity conditions: synchronous, where sound and heartbeat are temporally coupled, isochronous, with fixed sound-to-sound intervals, and a control condition without regularity. Cardio-audio regularity encoding manifested as a heartbeat deceleration upon omissions across vigilance states. The synchronous and isochronous sequences induced a modulation of the omission-evoked neural response in wakefulness and N2 sleep, the former accompanied by background oscillatory activity reorganization. The violation of cardio-audio and auditory regularity elicits cardiac and neural responses across vigilance states, laying the ground for similar investigations in altered consciousness states such as coma and anaesthesia.

Central stress pathways in the development of cardiovascular disease

PURPOSE

Mental stress is of essential consideration when assessing cardiovascular pathophysiology in all patient populations. Substantial evidence indicates associations among stress, cardiovascular disease and aberrant brain-body communication. However, our understanding of the flow of stress information in humans, is limited, despite the crucial insights this area may offer into future therapeutic targets for clinical intervention.

METHODS

Key terms including mental stress, cardiovascular disease and central control, were searched in PubMed, ScienceDirect and Scopus databases. Articles indicative of heart rate and blood pressure regulation, or central control of cardiovascular disease through direct neural innervation of the cardiac, splanchnic and vascular regions were included. Focus on human neuroimaging research and the flow of stress information is described, before brain-body connectivity, via pre-motor brainstem intermediates is discussed. Lastly, we review current understandings of pathophysiological stress and cardiovascular disease aetiology.

RESULTS

Structural and functional changes to corticolimbic circuitry encode stress information, integrated by the hypothalamus and amygdala. Pre-autonomic brain-body relays to brainstem and spinal cord nuclei establish dysautonomia and lead to alterations in baroreflex functioning, firing of the sympathetic fibres, cellular reuptake of norepinephrine and withdrawal of the parasympathetic reflex. The combined result is profoundly adrenergic and increases the likelihood of cardiac myopathy, arrhythmogenesis, coronary ischaemia, hypertension and the overall risk of future sudden stress-induced heart failure.

CONCLUSIONS

There is undeniable support that mental stress contributes to the development of cardiovascular disease. The emerging accumulation of large-scale multimodal neuroimaging data analytics to assess this relationship promises exciting novel therapeutic targets for future cardiovascular disease detection and prevention.

Pain and related suffering reduce attention toward others

BACKGROUND

It has been proposed that the expression of pain-related suffering may lead to an enhanced focus on oneself and reduced attention toward the external world. This study aimed at investigating whether experimentally induced painrelated suffering may lead persons to withdraw into themselves, causing a reduced focus on external stimuli as reflected by impaired performance in a facial recognition task and heightened perception of internal stimuli measured by interoceptive awareness.

METHODS

Thirty-two participants had to recognize different emotional facial expressions (neutral, sad, angry, happy), or neutral geometrical figures under conditions of no pain, low, and high prolonged pain intensities. Interoceptive accuracy was measured using a heartbeat-detection task prior to and following the pain protocol.

RESULTS

Males but not females were slower to recognize facial expressions under the condition of high painful stimulation compared to the condition of no pain. In both, male and female participants, the difficulty in recognizing another person's emotions from a facial expression was directly related to the level of suffering and unpleasantness experienced during pain. Interoceptive accuracy was higher after the pain experiment. However, neither the initial interoceptive accuracy nor the change were significantly related to the pain ratings.

CONCLUSIONS

Our results suggest that long-lasting and intense painful stimuli, which induce suffering, lead to attentional shifts leading to withdrawal from others. These findings contribute to a better understanding of the social dynamics of pain and pain-related suffering.

[Interoceptive difficulties in children and adolescents with severe form of somatic symptom disorder: A pilot study with nineteen participants]

INTRODUCTION

Despite the high rate of somatic symptom disorder (TSS) in the pediatric population, etiological mechanisms remain poorly understood. Previous studies conducted in youths with anxiety, eating disorder, or autistic disorder support a relation between difficulties in the perception of sensory signals (i.e., interoception) and difficulties in identifying emotions.

METHOD

A cross-sectional study was carried out at the University Hospital of Amiens-Picardie in 19 young people aged 9 to 17 hospitalized in the pediatric ward for TSS. A mental heartbeat tracking task was used to assess interoceptive accuracy, awareness and sensibility. The Porges Body Perception Questionnaire (PBPQ) was used to assess interoceptive attention. Other questionnaires were used to assess associated clinical dimensions such as depression, anxiety, emotional dysregulation and alexithymia.

RESULTS

The mean interoceptive accuracy score was lower in TSS subjects compared to expected scores in the general population (33% error vs. 20%). A statistically significant correlation was found between, on the one hand, interoceptive sensibility and the "avoidance" subscore of the ECAP (r=0.51) and, on the other hand, between interoceptive awareness and the total score of the Child Depression Inventory (r=0.51). A significant relationship was found between the PBPQ scale total score and the Children-Toronto Alexithymia Scale total score (r=0.42), in particular with the "difficulty expressing emotions" subscore (r=0.62).

CONCLUSION

This study confirms that interoceptive difficulties occur in young patients with severe TSS. Our finding adds empirical evidence supporting the relations between interoceptive difficulties, alexithymia and somatic symptoms in children and adolescents.

The early negative bias of social semantics: evidence from behavioral and ERP studies

BACKGROUND

Compared to nonsocial information, the human brain is more highly sensitive to social information. As a kind of typical social semantic information, the words describing person traits differ from the nonsocial semantic information describing inanimate objects in many ways. It remains to be seen whether the processing of trait words has a valence asymmetric and whether it differs from the processing of nonsocial semantic information in terms of behavioral responses and neural temporal processes.

METHOD

Taking person and object names as priming stimuli and adjective words only used for describing humans or objects as target stimuli, the present study aimed to investigate the processing characteristics of social and nonsocial semantic information by recording both behavioral and ERP data.

RESULTS

Behavioral results showed that the response times for negative words were significantly slower than those for positive words whether for social or nonsocial semantic information. The accuracy rates of negative words were significantly lower than those of positive words when the targets were social words which is contrary to the nonsocial words. The ERP results indicated that there was a negative bias effect on the processing of both types of information during the whole time course of brain neural activity; that is, the P2, N400, and LPP amplitudes elicited by negative words were larger than those elicited by positive words; However, the negative bias effect of social semantic information started at the early perceptual stage which was significantly earlier than the onset of negative bias of nonsocial semantic information, and was significantly affected by the prime type. In addition, there was a significant semantic conflict N400 effect only for nonsocial semantic information.

CONCLUSIONS

Overall, the present study revealed the existence of an early negative bias of social information and provided evidence for the specificity of social information.

The impact of interoceptive accuracy and stimulation type on the out-of-body experience

People tend to perceive a virtual body standing in front of them as their own if it is either stroked or moving synchronously with their own real body-the out-of-body experience (OBE). We combined synchrony manipulation with two other factors of theoretical interest: the kind of stimulation, visuotactile stimuli or visuomotor correlations, being synchronised and the interoceptive accuracy (IA) of participants, assessed by means of the heartbeat counting task. Results showed that explicit measures of embodiment were systematically affected by synchrony, and this synchrony effect was more pronounced for visuomotor than for visuotactile conditions. The walking drift was affected by IA: In visuotactile conditions, the synchrony effect was pronounced in individuals with low IA, presumably reflecting a stronger impact of the visual information. In visuomotor conditions, however, the synchrony effect was stronger in individuals with high IA, presumably reflecting a stronger impact of re-afferent information generated by the participants' own movements.

Interoceptive accuracy is associated with benefits in decision making in children

Introduction

Decision making results not only from logical analyses, but seems to be further guided by the ability to perceive somatic information (interoceptive accuracy). Relations between interoceptive accuracy and decision making have been exclusively studied in adults and with regard to complex, uncertain situations (as measured by the Iowa Gambling Task, IGT).

Methods

In the present study, 1454 children (6-11 years) were examined at two time points (approximately 1 year apart) using an IGT as well as a delay-of-gratification task for sweets-items and toy-items. Interoceptive accuracy was measured using a child-adapted version of the Heartbeat Perception Task.

Results

The present results revealed that children with higher, as compared to lower, interoceptive accuracy showed more advantageous choices in the IGT and delayed more sweets-items, but not toy-items, in a delay-of-gratification task at time point 2 but not at time point 1. However, no longitudinal relation between interoceptive accuracy and decision making 1 year later could be shown.

Discussion

Results indicate that interoceptive accuracy relates to decision-making abilities in situations of varying complexity already in middle childhood, and that this link might consolidate across the examined 1-year period. Furthermore, the association of interoceptive accuracy and the delay of sweets-items might have implications for the regulation of body weight at a later age.

Interoceptive attention facilitates emotion regulation strategy use

Background

Method

Results

Conclusions

Interoception in Old Age

Emotion regulation in old age was found to be more efficient; seniors seem to focus less on the negative aspects of experiences. Here, we ask, do older individuals regulate their emotions more efficiently or are they numb to the physiological changes that modulate these emotions? Interoception, the perception of physical feelings, influences a person’s mood, emotions, and sense of well-being, and was hardly tested among older adults. We examined the awareness of physiological changes (physiological arousal—blood pressure and heart rate) of 47 older adults, compared to 18 young adults, and their subjective reports of emotional experiences while viewing emotional stimuli. Interoception was decreased in old age. Blood pressure medications had a partial role in this reduction. Moreover, interoception mediated emotional experience, such that low interoception led to lower experiences of changes in physiological arousal. These findings may account for the emotional changes in old age, suggesting a decline in sensitivity with age, which leads to a positive interpretation of information.

Knowing what you feel: Inferior frontal gyrus-based structural and functional neural patterns underpinning adaptive body awareness

BACKGROUND

Heightened body awareness (BA) is conducive for increasing understanding of bodily state and improves individuals' health and well-being. Although there has been cumulative research concentrating on the self-perceived tendency to focus on negatively valenced interoceptive sensations, the specific structural and functional neural patterns underlying BA and their role in the relationship between BA and individual well-being remain unclear.

METHODS

Voxel-based morphometry and whole brain functional connectivity analyses were conducted to examine the structural and functional neural patterns, respectively, in 686 healthy subjects. BA and subjective well-being were assessed using questionnaires.

RESULTS

BA was inversely related to gray matter volume of the right inferior frontal gyrus, opercular part (IFGoperc). Higher BA was correlated with enhanced IFGoperc-precuneus and IFGoperc-anterior supramarginal gyrus connectivities, and with decreased IFGoperc-lateral occipital cortex and IFGoperc-medial frontal cortex connectivities. The inferior frontal gyrus, triangular part (in the fronto-parietal task control network) acted as the hub that linked the sensory/somatomotor network, the default mode network, and the dorsal and ventral attention network. The IFGoperc-precuneus connectivity moderated the association between BA and subjective well-being.

LIMITATIONS

We were unable to rank all the networks by their relative importance, because the absolute weighted value in each module was not calculated.

CONCLUSION

Our findings demonstrated that BA was reflected by specific neural patterns mainly involved in cognitive-affective control, attentional and self-referential processing, as well as multisensory integration, which could offer some references for current therapies (e.g., mindfulness, yoga training) that are dedicated to solving health problems and improving individual well-being.

Relations among parent-reported physical activity and interoception in children

BACKGROUND

Interoception is the sense of one's internal body and emotional state; it plays a critical role in guiding self-regulatory behaviors. Physical activity (PA) can support interoceptive processes, but limited research has examined the association in children. This study explored the relations among parent-reported PA and several interoceptive domains in children aged 3 - 10 years old.

METHODS

Baseline data were analyzed from a cluster-randomized controlled study examining a yoga intervention (N = 122). Parents completed a questionnaire that included the Caregiver Questionnaire for Interoceptive Awareness, Second Edition (CQIA-2) and two measures of PA, the PROMIS Parent-Proxy Short Form (PROMIS-PA) and the adapted Burdette Proxy Report (aBPR-PA). Psychometrics of the CQIA-2 subscales were assessed and then used in subsequent analyses to examine the association between PA and interoceptive sensibility.

RESULTS

Seventy percent of the surveys were completed by mothers (30% by fathers), and their children (56% female, M_age = 5.81 ± 1.7 years) were predominately white. Across all children, PA had a significant positive relationship with interoceptive domains related to emotion and physical energy (p < 0.01). Children who met the PROMIS-PA "good" cutoff had a clearer sense of emotion and physical energy (F(2,115) = 4.30, p = 0.016, R² = 0.070), compared to children who did not. Children's age predicted interoceptive sensibility of illness and toileting needs (F(1,116) = 14.16, p < 0.001, R² = 0.109).

CONCLUSION

Children with higher PA levels were perceived to have better interoceptive sensibility of emotion and physical energy. Children's age was predictive of interoceptive domains representing the awareness of illness and toileting needs. Future work should consider incorporating direct measures of PA and child-reported interoceptive sensibility. A better understanding of their relationship will likely help guide the design of more effective interventions for health behavior development.

Embodied feelings-A meta-analysis on the relation of emotion intensity perception and interoceptive accuracy

Emotion theories emphasize the relevance of (predicted) bodily changes for the construction of one's own emotions and an extensive overlap of brain regions involved during emotion intensity perception and somatosensory processing. The ability to accurately perceive bodily changes and its impact on the perception of emotion intensity has been studied for at least 40 years. The results of previous studies were summarized in a meta-analysis to examine how closely interoceptive accuracy and emotion intensity are related. After a systematic literature search, 4036 studies were screened for eligibility. Only studies assessing adults from general population samples were considered. Samples recruited to examine mental disorders or neurological conditions were excluded. Thirty studies with a quantifiable measure for the relation of interoceptive accuracy and emotion intensity perception were included in the meta-analysis. Interoceptive accuracy was significantly related with emotion intensity perception, when emotions were experimentally induced (k= 22, r= 0.15). However, the relationship was only found when IAPS images (k= 9, r= 0.33) or facial expressions (k= 3, r= 0.24) were used for emotion induction. No significant relation was found in studies without emotion induction (k= 19, r = -0.007). There was considerable bias, varying dependent on bias assessment method, study protocol and examined risk of bias dimension. We discuss the impact of differences in study protocols, review the operationalization of interoceptive accuracy critically and derive directions for future research.

Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity

The COVID-19 pandemic is associated with an increased prevalence of mental health problems and addictive behaviors. There is a growing theoretical and empirical evidence that individual differences in interoceptive anxiety-related processes are a one set of vulnerability factors that are important in understanding the impact of pandemic-related mental health problems and addictive behavior. However, there has not been a comprehensive effort to explore this rapidly growing body of research and its implications for public health. In this paper, we discuss why interoceptive anxiety-related processes are relevant to understanding mental health and addictive behaviors during the COVID-19 pandemic. We then provide a narrative review of the available COVID-19 literature linking interoceptive fear and anxiety-related processes (e.g., anxiety sensitivity, health anxiety, and COVID-19 anxiety, fear, and worry) to mental health and addictive behaviors. We then propose a novel transdiagnostic theoretical model that highlights the role of interoceptive anxiety-related processes in mental health and addictive behavior in the context of the present and future pandemics. In the final section, we utilize this conceptualization to underscore clinical implications and provide guidance for future research initiatives in the management of COVID-19 mental health and addictive behaviors and inform the public health field for future pandemics.

What counts when heartbeats are counted

Schandry's mental heartbeat tracking task is a widely used measure of interoception, assessing heartbeat perception. We classify the factors that contribute to performance on the task as (i) trait-like characteristics, (ii) expectation-related factors, and (iii) factors showing participants' task set. We recommend conducting further research to better understand what exactly the task measures.

Interindividual differences in interoception modulate behavior and brain responses in emotional inference

Emotional experiences are proposed to arise from contextualized perception of bodily responses, also referred to as interoceptive inferences. The recognition of emotions benefits from adequate access to one's own interoceptive information. However, direct empirical evidence of interoceptive inferences and their neural basis is still lacking. In the present fMRI study healthy volunteers performed a probabilistic emotion classification task with videotaped dynamically unfolding facial expressions. In a first step, we aimed to determine functional areas involved in the processing of dynamically unfolding emotional expressions. We then tested whether individuals with higher interoceptive accuracy (IAcc), as assessed by the Heartbeat detection task (HDT), or higher interoceptive sensitivity (IS), as assessed by the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), benefit more from the contextually given likelihood of emotional valence and whether brain regions reflecting individual IAcc and/or IS play a role in this. Individuals with higher IS benefitted more from the biased probability of emotional valence. Brain responses to more predictable emotions elicited a bilateral activity pattern comprising the inferior frontal gyrus and the posterior insula. Importantly, individual IAcc scores positively covaried with brain responses to more surprising and less predictable emotional expressions in the insula and caudate nucleus. We show for the first time that IAcc score is associated with enhanced processing of interoceptive prediction errors, particularly in the anterior insula. A higher IS score seems more likely to be associated with a stronger weighting of attention to interoceptive changes processed by the posterior insula and ventral prefrontal cortex.

The Scale of Body Connection: A Multisample Study to Examine Sensitivity to Change Among Mind-Body and Bodywork Interventions

Purpose: The purpose of this measurement study was to examine the Scale of Body Connection (SBC) sensitivity to change among mind-body or bodywork interventions and to explore the concurrent validity in relation to emotion dysregulation and mindfulness skills. Methods: This study was based on multiple clinical trials that had used the SBC to evaluate changes in body awareness (BA) and bodily dissociation (BD) in response to a mind-body or bodywork intervention. To test for sensitivity to change, t tests were used to examine change and estimate effect sizes. To explore convergent validity, Pearson's product-moment correlations between the SBC subscales and Five-Facet Mindfulness Questionnaire (FFMQ) and Difficulties in Emotion Regulation Scale (DERS) were calculated among a subset of the studies, which also included these measures. Results: The BA and BD scales consistently detected significant positive responses to a range of intervention types (yoga, mindfulness meditation, BA, multimodal therapy, and bodywork), demonstrating SBC sensitivity to change. With a few exceptions, the effect sizes across studies for BA were above 0.35, indicating near moderate-to-large effect sizes. The effect sizes for BD, as a measure of responsiveness, were much smaller than for BA; however, four of the studies had effect sizes between 0.54 and 0.86. Concurrent validity with the DERS was supported by moderate-to-large correlations, and with the FFMQ, it was significant with the BA scale in one included study. Conclusions: The results of this study further establish SBC validity and sensitivity to change across a range of mind-body therapies and confirm prior findings of moderate-to-strong internal consistency reliability. The findings support the use of this brief scale to assess key dimensions of BA and BD in practice and research.

The Effects of a 3-Week Heartbeat Perception Training on Interoceptive Abilities

Recent studies showed promising short-term effects of heartbeat perception training on interoceptive abilities. Research on the effects of heartbeat perception training on interoceptive abilities over time is sparse. Therefore, the aim of this study was to examine the short-term effects and the effects of a 3-week heartbeat perception training over time on interoceptive abilities, namely, cardiac interoceptive accuracy (IAc) and interoceptive sensibility (IS). A total of 40 healthy participants were randomized to the intervention group (n = 20) or the control group (n = 20). The intervention group conducted three cardiac biofeedback sessions (one per week) at the laboratory, whereas the control group watched a documentary instead. Interoceptive abilities were assessed via the heartbeat perception task (IAc) and confidence ratings (IS) at baseline, after each laboratory session, and 1 week after the last session (post-measurement). IAc was significantly increased in the intervention group compared to the control group after the first training session (short-term effect). There were no significant improvements in IS due to the first session, and neither on IAc nor IS over time. Descriptive trends of improved interoceptive abilities over time were found in both groups. Single session of heartbeat perception training seems to be a promising approach to improve IAc. Future research should further investigate the long-term effects of diverse heartbeat perception training varying in frequency and intensity of the training sessions in diverse samples aiming to improve interoceptive abilities.

A Neuroscientific and Cognitive Literary Approach to the Treatment of Time in Calderón's Autos sacramentales

Time processing is a fundamental subject in cognitive sciences and neuroscience. Current research is deepening how our brains process time, revealing its essential role in human functionality and survival. In his autos sacramentales, Early Modern Spanish playwright Pedro Calderón de la Barca portrays the relationships between human inner workings and the Christian concept of time. These plays portray the experience of the present, the perception of the flow of time, the measure of time raging from seconds to eternity, and the mental travel necessary to inhabit the past and future with the help of memory and imagination. Calderón explores how the dramatic form can portray all these temporal phenomena and how that portrait of time can constrain the dramatic structure. The different parts of the brain in charge of executive decisions, projections, memories, computation, and calibration are the basis that leads these characters to make the choices that will take them to the future they have cast for themselves. This paper analyzes how the processes that Calderón ascribed to the soul of his characters in the 17th century relate to ongoing cognitive and neuroscientific findings.

Steady-state visual evoked potentials differentiate between internally and externally directed attention

While attention to external visual stimuli has been extensively studied, attention directed internally towards mental contents (e.g., thoughts, memories) or bodily signals (e.g., breathing, heartbeat) has only recently become a subject of increased interest, due to its relation to interoception, contemplative practices and mental health. The present study aimed at expanding the methodological toolbox for studying internal attention, by examining for the first time whether the steady-state visual evoked potential (ssVEP), a well-established measure of attention, can differentiate between internally and externally directed attention. To this end, we designed a task in which flickering dots were used to generate ssVEPs, and instructed participants to count visual targets (external attention condition) or their heartbeats (internal attention condition). We compared the ssVEP responses between conditions, along with alpha-band activity and the heartbeat evoked potential (HEP) - two electrophysiological measures associated with internally directed attention. Consistent with our hypotheses, we found that both the magnitude and the phase synchronization of the ssVEP decreased when attention was directed internally, suggesting that ssVEP measures are able to differentiate between internal and external attention. Additionally, and in line with previous findings, we found larger suppression of parieto-occipital alpha-band activity and an increase of the HEP amplitude in the internal attention condition. Furthermore, we found a trade-off between changes in ssVEP response and changes in HEP and alpha-band activity: when shifting from internal to external attention, increase in ssVEP response was related to a decrease in parieto-occipital alpha-band activity and HEP amplitudes. These findings suggest that shifting between external and internal directed attention prompts a re-allocation of limited processing resources that are shared between external sensory and interoceptive processing.

Room to breathe: Using adaptive architecture to examine the relationship between alexithymia and interoception

OBJECTIVE

Individuals with alexithymia experience difficulties interpreting emotional states in self and others, which has been associated with interoceptive impairment. Current theories are primarily based on subjective and conscious measures of interoceptive sensitivity, such as heartrate detection, but it is unclear whether similar observations would be found for objective or implicit psychophysiological measures. The present exploratory study assesses the potential of a novel assay through the use of adaptive immersive architecture [ExoBuilding].

METHODS

N = 88 participants were screened for alexithymic traits and N = 27 individuals, representing the range of scores, were sampled to participate in the behavioural task. In a repeated-measures design, participants were placed within ExoBuilding and asked to match their respiration to its movement. Performance was compared to a two-dimensional pacer condition. Behavioural (accuracy) and psychophysiological (Respiratory Sinus Arrhythmia [RSA] and heartrate) measures were compared across conditions, and also related to individual alexithymic traits.

RESULTS

Participants with higher levels of alexithymia performed less accurately than participants with lower levels, in both conditions. High-alexithymia participants showed a smaller reduction in heartrate over the course of the ExoBuilding condition than low-alexithymia participants, although there were no differences in RSA between conditions or participants.

CONCLUSION

Alexithymia extends beyond conscious interoceptive activities and is also observed in immersive contexts that usually exert psychophysiological effects on typical occupants. These initial findings highlight the importance of considering both conscious and implicit measures of interoception, and we suggest ways in which theories of alexithymia might benefit from capturing this distinction.

Interoceptive awareness and beliefs about health and the body as predictors of the intensity of emotions experienced at the beginning of the pandemic

Background

The COVID-19 pandemic is a type of stressful event which might have an impact on psychological state. A prolonged threat of getting a serious, contagious illness is expected to be associated with an increase of negative emotions and, conversely, with a decrease of positive emotions. As the stressor is strongly linked to health and the body, we decided to investigate what types of factors related to body perception and appraisal are associated with different types of reported emotions. The purpose of the study was to verify the associations between three types of variables: interoceptive awareness as described by Mehling and colleagues (2012a, 2018), negative beliefs about health and body, and different types of emotions.

Methodology

A Multidimensional Assessment of Interoceptive Awareness questionnaire was applied to evaluate interoceptive awareness. The declared emotional state was diagnosed with a list of 20 emotions-divided by valence and origin. Additionally, a list of 10 negative beliefs about health and body was used. The study was held in a correlational schema with 299 subjects recruited via the social media platform Facebook who took part in an online survey.

Results

The study revealed that the scales of Self-Regulation and Trusting are primarily associated with negative automatic and reflective emotions and positive automatic emotions. Furthermore, the Self-Regulation, Trusting dimensions of interoceptive awareness predict an intensity of emotions categorised on the basis of valence and origin. In addition, negative beliefs about health and the body provided an adequate explanation of the variance of most of the types of emotions experienced during the pandemic.

Conclusions

Factors related to body perception, such as interoceptive awareness and negative beliefs about health and body provide a significant contribution to explaining emotional state at the beginning of the pandemic.

Interoceptive accuracy does not predict emotion perception in daily life

Peripheral emotion theories suggest a crucial role of interoception for emotion perception, which in turn facilitates emotion regulation. Laboratory studies found positive relations between interoceptive accuracy and perceived emotion intensity and arousal. Studies in natural settings are largely missing, but seem important by virtue of emotional experience and regulation diversity.

On hundred seven participants underwent a cardiovascular interoceptive accuracy task. Afterwards, participants provided detailed information on perceived emotions and emotion regulation strategies in an ecological momentary assessment (EMA). Multilevel models were calculated. In consideration of valence, emotion intensity, arousal, intensity of body sensations and, emotion regulation success were modeled as a function of centered interoceptive accuracy.

Interoceptive accuracy did not predict any emotion perception criterion. Lower accuracy was related to a slightly stronger decrease of perceived arousal after regulation.

Differences in emotion categories, intensity, and sample collection might explain divergences to laboratory studies.

Similar brains blend emotion in similar ways: Neural representations of individual difference in emotion profiles

Our daily emotional experience is a complex construct that usually involves multiple emotions blended in a context-dependent manner. However, the co-occurring and context-dependent nature of human emotions was understated in previous studies when addressing the individual difference in emotional experiences. The present study proposed a situated and blended 'profile' perspective to characterize individualized emotional experiences. Eighty participants watched a series of emotional videos with their EEG recorded, and the individual differences in their emotion profiles were measured as the vector distances between their multidimensional emotion ratings for these video stimuli. This measure was found to be a reliable descriptor of individualized emotional experiences and could efficiently predict classical emotional complexity indices. More importantly, inter-subject representational analyses revealed that similar emotion profiles were associated with similar delta-band activities over the prefrontal and temporo-parietal regions and similar theta-band activities over the frontal regions. Furthermore, left- and right-lateralized temporo-parietal representations were observed for positive and negative emotion profiles, respectively. Our findings demonstrate the potential of taking a 'profile' perspective for understanding individual differences in human emotions.

Sex differences in interoceptive accuracy: A meta-analysis

Interoceptive accuracy, the ability to correctly perceive internal signals arising from the body, is thought to be disrupted in numerous mental and physical health conditions. Whilst evidence suggests poorer interoceptive accuracy in females compared to males, raising the possibility that interoceptive differences may relate to sex differences in mental and physical health, results concerning sex differences in interoceptive accuracy are mixed. Given such ambiguity, this meta-analysis aimed to establish the presence or absence of sex differences in interoceptive accuracy across cardiac, respiratory, and gastric domains. A review of 7956 abstracts resulted in 93 eligible studies. Results demonstrated superior accuracy in males across cardiac, but not gastric, tasks, while findings on respiratory tasks were mixed. Effect sizes were consistent across cardiac tasks, but instability and/or moderate heterogeneity was observed across other domains, likely due to the small number of eligible studies. Despite such limitations, results indicate the possibility of sex differences across interoception tasks and domains. Methodological limitations concerning the influence of physiological factors, and directions for future research are discussed.

The Role of Interoceptive Sensibility and Emotional Conceptualization for the Experience of Emotions

The theory of constructed emotions suggests that different psychological components, including core affect (mental and neural representations of bodily changes), and conceptualization (meaning-making based on prior experiences and semantic knowledge), are involved in the formation of emotions. However, little is known about their role in experiencing emotions. In the current study, we investigated how individual differences in interoceptive sensibility and emotional conceptualization (as potential correlates of these components) interact to moderate three important aspects of emotional experiences: emotional intensity (strength of emotion felt), arousal (degree of activation), and granularity (ability to differentiate emotions with precision). To this end, participants completed a series of questionnaires assessing interoceptive sensibility and emotional conceptualization and underwent two emotion experience tasks, which included standardized material (emotion differentiation task; ED task) and self-experienced episodes (day reconstruction method; DRM). Correlational analysis showed that individual differences in interoceptive sensibility and emotional conceptualization were related to each other. Principal Component Analysis (PCA) revealed two independent factors that were referred to as sensibility and monitoring. The Sensibility factor, interpreted as beliefs about the accuracy of an individual in detecting internal physiological and emotional states, predicted higher granularity for negative words. The Monitoring factor, interpreted as the tendency to focus on the internal states of an individual, was negatively related to emotional granularity and intensity. Additionally, Sensibility scores were more strongly associated with greater well-being and adaptability measures than Monitoring scores. Our results indicate that independent processes underlying individual differences in interoceptive sensibility and emotional conceptualization contribute to emotion experiencing.

How Does Information Overload Affect Consumers' Online Decision Process? An Event-Related Potentials Study

One of the advantages of e-retailers is their capability to provide a large amount of information to consumers. However, when the amount of information exceeds consumers' information processing capacities, it will lead to worse decision quality and experience, causing the information overload effect. In this study, the event-related potentials (ERPs) were applied to examine the hidden neural mechanism of the impact of information overload on consumers' decision processes. Behavioral data showed that people would spend more time making decisions when faced with information overload. Neurophysiologically, consumers would invest less attentional resources in the high amount of information (HAI) condition than those in the low amount of information (LAI) condition and lead to less positive P2 amplitudes. The HAI condition would increase decision difficulty than would the LAI condition and result in smaller P3 amplitudes. In addition, an increased late positive component (LPC) was observed for the HAI condition in contrast to the LAI condition, indicating that consumers were more inclined to have decision process regret when consumers were overloaded. We further investigated the dynamic information processing when consumers got over information overload by mining the brain's time-varying networks. The results revealed that during the decision process and the neural response stage, the central area controlled other brain regions' activities for the HAI condition, suggesting that people may still consider and compare other important information after the decision process when faced with information overload. In general, this study may provide neural evidence of how information overload affects consumers' decision processes and ultimately damages decision quality.

Neuroarchitecture Assessment: An Overview and Bibliometric Analysis

Research on the relationship between architecture and neuroscience has increased in number and significance since the 1990s. Although a growing number of studies revolve around this field of research, there are very limited studies that have reviewed and assessed the field and there is a gap in the literature to address the overall analysis of neuroarchitecture literature and its evolution. Additionally, neuroarchitecture literature is now challenging to manage because of its multidisciplinary scope and wide range spread within different themes and journals. The primary aim of this study is to present a bibliometric analysis of three decades of research on neuroarchitecture. This provides an overall picture of the field and its research landscape. Two hundred and ninety-five publications were included in the final database of the study after screening processes. Next, a science mapping tool, VOSviewer, was utilized to detect major topics as well as influential authors, countries, publications, and prominent journals using different network analysis techniques such as term co-citation, term co-occurrence, and bibliographic coupling. Next, a similar co-occurrence analysis was conducted to identify the major themes and the evolution of the intellectual basis of the field. SciMAT was also used to detect how the intellectual base of the knowledge in the field has evolved over time. It also assisted to identify the major themes that have contributed to this evolution. The results show that this field has initially been mainly focused on few themes but has later become more diversified to acknowledge the multi-faceted characteristics of neuroarchitecture; over time, the intellectual base of the field of neuroarchitecture started to grow, particularly from 2016. Major progress in the development of theoretical and methodological approaches has been achieved and there has been a paradigm shift toward major keywords in neuroarchitecture such as EEG, fMRI, and virtual reality.

Interoceptive sensibility predicts the ability to infer others' emotional states

Emotional sensations and inferring another's emotional states have been suggested to depend on predictive models of the causes of bodily sensations, so-called interoceptive inferences. In this framework, higher sensibility for interoceptive changes (IS) reflects higher precision of interoceptive signals. The present study examined the link between IS and emotion recognition, testing whether individuals with higher IS recognize others' emotions more easily and are more sensitive to learn from biased probabilities of emotional expressions. We recorded skin conductance responses (SCRs) from forty-six healthy volunteers performing a speeded-response task, which required them to indicate whether a neutral facial expression dynamically turned into a happy or fearful expression. Moreover, varying probabilities of emotional expressions by their block-wise base rate aimed to generate a bias for the more frequently encountered emotion. As a result, we found that individuals with higher IS showed lower thresholds for emotion recognition, reflected in decreased reaction times for emotional expressions especially of high intensity. Moreover, individuals with increased IS benefited more from a biased probability of an emotion, reflected in decreased reaction times for expected emotions. Lastly, weak evidence supporting a differential modulation of SCR by IS as a function of varying probabilities was found. Our results indicate that higher interoceptive sensibility facilitates the recognition of emotional changes and is accompanied by a more precise adaptation to emotion probabilities.

At the Heart of Neurological Dimensionality: Cross-Nosological and Multimodal Cardiac Interoceptive Deficits

OBJECTIVE

Neurological nosology, based on categorical systems, has largely ignored dimensional aspects of neurocognitive impairments. Transdiagnostic dimensional approaches of interoception (the sensing of visceral signals) may improve the descriptions of cross-pathological symptoms at behavioral, electrophysiological, and anatomical levels. Alterations of cardiac interoception (encompassing multidimensional variables such as accuracy, learning, sensibility, and awareness) and its neural correlates (electrophysiological markers, imaging-based anatomical and functional connectivity) have been proposed as critical across disparate neurological disorders. However, no study has examined the specific impact of neural (relative to autonomic) disturbances of cardiac interoception or their differential manifestations across neurological conditions.

METHODS

Here, we used a computational approach to classify and evaluate which markers of cardiac interoception (behavioral, metacognitive, electrophysiological, volumetric, or functional) offer the best discrimination between neurological conditions and cardiac (hypertensive) disease (model 1), and among neurological conditions (Alzheimer's disease, frontotemporal dementia, multiple sclerosis, and brain stroke; model 2). In total, the study comprised 52 neurological patients (mean [standard deviation] age = 55.1 [17.3] years; 37 women), 25 cardiac patients (age = 66.2 [9.1] years; 13 women), and 72 healthy controls (age = 52.65 [17.1] years; 50 women).

RESULTS

Cardiac interoceptive outcomes successfully classified between neurological and cardiac conditions (model 1: >80% accuracy) but not among neurological conditions (model 2: 53% accuracy). Behavioral cardiac interoceptive alterations, although present in all conditions, were powerful in differentiating between neurological and cardiac diseases. However, among neurological conditions, cardiac interoceptive deficits presented more undifferentiated and unspecific disturbances across dimensions.

CONCLUSIONS

Our result suggests a diffuse pattern of interoceptive alterations across neurological conditions, highlighting their potential role as dimensional, transdiagnostic markers.

Mental heartbeat tracking and rating of emotional pictures are not related

Our aim was to conceptually replicate the findings of previous empirical studies showing that people with higher cardiac interoceptive accuracy experience more intense emotions. Apart of the mental heartbeat tracking task of Schandry, Hungarian (n = 46, 76.0% female, mean age 22.28 ± 2.228) and Norwegian (n = 50, 60.0% female, mean age 24.66 ± 3.048) participants rated the arousal and valence evoked by positive, neutral and negative pictures. Multivariate repeated analysis of variance (applying both frequentist and Bayesian approaches) did not reveal any connection between heartbeat perception scores and the subjective ratings (i.e., arousal and valence) of the pictures in any of the two groups. The lack of the expected association between cardioceptive accuracy and arousal might partly be explained by the methodological differences between previous studies and this one; for example, we did not split or preselected the sample based on the performance on the Schandry task and applied a relatively strict instruction (i.e., by encouraging to count felt heartbeats only, and to report zero if no sensations were detected).

Effects of interoceptive accuracy in autonomic responses to external stimuli based on cardiac rhythm

Interoceptive accuracy is an index of the ability to perceive an individual’s internal bodily state, including heartbeat and respiration. Individual differences in interoceptive accuracy influence emotional recognition through autonomic nervous activity. However, the precise mechanism by which interoceptive accuracy affects autonomic reactivity remains unclear. Here, we investigated how cardiac reactivity induced by a non-affective external rhythm differed among individuals, using a heartbeat counting task. Because individuals with poor interoceptive accuracy cannot distinguish an external rhythm from their cardiac cycles, it has been hypothesized that the interoceptive effect on heart rate works differently in individuals with good interoceptive accuracy and those with poor interoceptive accuracy. Study participants observed a visual or auditory stimulus presented at a rhythm similar to the participants’ resting heart rates. The stimulus rhythm was gradually changed from that of their resting heart rate, and we recorded electrocardiographs while participants were exposed to the stimuli. Individuals with good interoceptive accuracy exhibited a deceleration in heart rate when the rhythm of the auditory stimulus changed. In contrast, in the group with poor interoceptive accuracy, the heart rate decreased only when the stimulus became faster. They were unable to distinguish the rhythm of their own heartbeat from that of the external rhythm; therefore, we propose that such individuals recognize the stimuli at the pace of their heart rate. Individuals with good interoceptive accuracy were able to distinguish their heart rates from the external rhythm. A modality difference was not observed in this study, which suggests that both visual and auditory stimuli help mimic heart rate. These results may provide physiological evidence that autonomic reactivity influences the perception of the internal bodily state, and that interoception and the autonomic state interact to some degree.

Somatosensory Deviance Detection ERPs and Their Relationship to Analogous Auditory ERPs and Interoceptive Accuracy

Abstract. Automatic deviance detection has been widely explored in terms of mismatch responses (mismatch negativity or mismatch response) and P3a components of event-related potentials (ERPs) under a predictive coding framework; however, the somatosensory mismatch response has been investigated less often regarding the different types of changes than its auditory counterpart. It is not known whether the deviance detection responses from different modalities correlate, reflecting a general prediction error mechanism of the central nervous system. Furthermore, interoceptive functions have been associated with predictive coding theory, but whether interoceptive accuracy correlates with deviance detection brain responses has rarely been investigated. Here, we measured ERPs to changes in somatosensory stimuli’s location and intensity and in sound intensity in healthy adults ( n = 34). Interoceptive accuracy was measured with a heartbeat discrimination task, where participants indicated whether their heartbeats were simultaneous or non-simultaneous with sound stimuli. We found a mismatch response and a P3a response to somatosensory location and auditory intensity changes, but for somatosensory intensity changes, only a P3a response was found. Unexpectedly, there were neither correlations between the somatosensory location deviance and intensity deviance brain responses nor between auditory and somatosensory brain responses. In addition, the brain responses did not correlate with interoceptive accuracy. The results suggest that although deviance detection in the auditory and somatosensory modalities are likely based on similar neural mechanisms at a cellular level, their ERP indexes do not indicate a linear association in sensitivity for deviance detection between the modalities. Furthermore, although sensory deviance detection and interoceptive detection are both associated with predictive coding functions, under these experimental settings, functional relationships were not observed. These results should be taken into account in the future development of theories related to human sensory functions and in extensions of the predictive coding theory in particular.

Interoception and Obsessive-Compulsive Disorder: A Review of Current Evidence and Future Directions

Disrupted interoceptive processes are present in a range of psychiatric conditions, and there is a small but growing body of research on the role of interoception in obsessive-compulsive disorder (OCD). In this review, we outline dimensions of interoception and review current literature on the processing of internal bodily sensations within OCD. Investigations in OCD utilizing objective measures of interoception are limited and results mixed, however, the subjective experience of internal bodily sensations appears to be atypical and relate to specific patterns of symptom dimensions. Further, neuroimaging investigations suggest that interoception is related to core features of OCD, particularly sensory phenomena and disgust. Interoception is discussed in the context of treatment by presenting an overview of existing interventions and suggesting how modifications aimed at better targeting interoceptive processes could serve to optimize outcomes. Interoception represents a promising direction for multi-method research in OCD, which we expect, will prove useful for improving current interventions and identifying new treatment targets.

The effect of haptic stimulation simulating heartbeats on the regulation of physiological responses and prosocial behavior under stress: The influence of interoceptive accuracy

Research has discovered the modulatory effect of peripheral stimulation simulating altered bodily signals on emotion. Whether such an effect varies depending on one's interoceptive accuracy (IAc) remains unclear. Therefore, we provided haptic stimulation simulating participants' slowed-down heartbeats or no stimulation while they engaged in socially stressful tasks to examine whether participants reacted differently depending on their IAc. Results showed that haptic stimulation exhibited the opposite effect on participants with different levels of IAc for both heart rate and heart rate variability (HRV). When receiving the stimulation, participants with higher IAc showed less increased heart rate and more elevated HF than participants with lower IAc. In contrast, in the absence of stimulation, an opposite pattern of response depending on participants' IAc was observed. The modulatory effect of stimuli and IAc on prosocial behavior was not significant. Individual differences in IAc were shown to affect how one perceives/responds to altered bodily signals.

L'inconscio digitale: la sfida di una clinica senza soggetti

Appena ci siamo abituati a pensare la nostra epoca in termini di "modernità liquida" con Bauman (2000) e di "ipermodernità" con Lipovetsky (2004), la nascita di Internet 2.0, sempre nel 2004, ci proietta già in una nuova era, resettando radicalmente i parametri biopsicosociali. Le nuove tecno-logie privano il reale della sua consistenza, sostituendolo con la realtà virtuale dei social media. Nel mondo di Facebook, di Instagram e di WhatsApp, la dimensione del non-conscio si sta spo-stando sempre più su una polarità lontana da coordinate simboliche, verso la deriva di un corpo disabitato dalla soggettività e posseduto dai meccanismi occulti di reward-addiction del web. Co-me questa alba del post-human (Braidotti, 2013) sta cambiando la clinica? Gli adolescenti (e non) "digitalmente modificati" rappresentano la sfida a ripensare le categorie cliniche e le logiche della cura?

Structural covariance of the salience network associated with heart rate variability

The salience network (SN) anchored by the anterior insula and cingulate is crucial for the autonomic control of body homeostasis. Resting-sate fMRI studies have linked intrinsic SN connectivity with multiple autonomic measures, but little is known about the structural organization of this system relating to cardiac vagal function. To address the above issue, the current study used covariance analysis of MRI-based gray matter volume (GMV) to map structural covariance of SN with two independent datasets, and then determined whether interregional structural connections within SN related to individual differences in vagally-mediated heart rate variability (HRV). The results showed a significant positive association between structural covariance of the SN and vagal component of HRV in two independent samples. More importantly, the conjunction and pooled data analysis revealed that structural correlation from left anterior insula to dorsal anterior cingulate cortex positively interacted with vagally-mediated HRV. The current results demonstrated a crucial role of the SN in the cortical modulation of efferent vagal activity to the heart, and provided new insight into structural neural network implicated in cardiac vagal control.

Behavioral and neurophysiological signatures of interoceptive enhancements following vagus nerve stimulation

An accruing body of research has shown that interoception (the sensing of signals from the body's internal milieu) relies on both a direct route (afforded by the vagus nerve) and a secondary route (supported by somatosensory mechanisms). However, no study has causally tested the differential role of these pathways, let alone via direct stimulation. To bridge this gap, we tested whether multidimensional signatures of interoception are modulated by noninvasive vagus nerve stimulation (nVNS). Sixty-three participants were divided into an nVNS and a sham-stimulation group. Before and after stimulation, both groups performed a validated heartbeat detection (HBD) task including a genuinely interoceptive condition (monitoring one's own heartbeat) and a control exteroceptive condition (tracking an aurally presented heartbeat). Electroencephalographic signals were obtained during both conditions to examine modulations of the heartbeat-evoked potential (HEP). Moreover, before and after stimulation, participants were asked to complete a somatosensory heartbeat localization task. Results from the interoceptive condition revealed that, after treatment, only the nVNS group exhibited improved performance and greater HEP modulations. No behavioral differences were found for the exteroceptive control condition, which was nonetheless associated with significant HEP modulations. Finally, no between-group differences were observed regarding the localization of the heartbeat sensations or relevant cardiodynamic variables (heart rate and or heart rate variability). Taken together, these results constitute unprecedented evidence that the vagus nerve plays a direct role in neurovisceral integration during interoception. This finding can constrain mechanistic models of the domain while informing a promising transdiagnostic agenda for interoceptive impairments across neuropsychiatric conditions.

The effects of vibrotactile masking on heartbeat detection: Evidence that somatosensory mechanoreceptors transduce heartbeat sensations

The ability to detect heartbeat sensations is the most common basis for inferring individual differences in sensitivity to the interoceptive stimuli generated by the visceral activity. While the sensory sources of heartbeat sensations have yet to be identified, there is a growing consensus that visceral sensation, in general, is supported not only by the interoceptive system but also by the somatosensory system, and even by exteroception. The current experiment sought evidence on this issue by exploring the effects of masking the functions of somatosensory Pacinian and non-Pacinian mechanoreceptors on the ability to detect heartbeat sensations. Twelve verified heartbeat detectors completed a multi-session experiment in which they judged heartbeat-tone and light-tone simultaneity under two vibrotactile masking conditions involving the stimulation of the sternum: (a) using 250 Hz vibrotactile stimuli to mask the Pacinian channel, and (b) using 6 Hz vibrotactile stimuli to mask the non-Pacinian channel. A no-vibration control condition in which no masking stimuli were presented was also implemented. Presentation of both the 250 Hz and the 6 Hz masking stimuli impaired the ability to judge the simultaneity of heartbeats and tones but did not influence the ability to judge the simultaneity of stimuli presented to different exteroceptive modalities (lights and tones). Our findings reinforce the view that the somatosensory system is involved in cardioception and support the conclusion that both Pacinian and non-Pacinian somatosensory mechanoreceptors are implicated in heartbeat detection.

The conceptualization of emotions across cultures: a model based on interoceptive neuroscience

Mental processes are recognized to be embodied, hence dependent upon functions of the body. Interoception (i.e., the sense of the internal bodily physiology) underpinning motivational states and emotional feelings, however, are mostly ignored within present sensory-motor accounts of embodiment. The inclusion of interoception within models of embodiment is important both for health psychology and for theories of cognition. Here, we deduce that reference to visceral organs, in language describing emotion concepts, should be viewed as metonymy (i.e., the mental mapping wherein a component is used to describe the whole), rather than metaphor (i.e., one familiar and concrete concept used to describe another unfamiliar and/or abstract concept that shares some similarities). This view contrasts with a dominant assumption within cognitive linguistics. We further argue that conceptual differences in the assumption about the body-mind-emotion relationship or emotional somatization, evident when comparing Chinese to standard English, is culturally and cognitively determined (e.g., by divergent Western and Chinese philosophical, medical traditions and meaning systems). We propose a new model in which two contending variables, bodily transparency and cognitive granularity, define cultural differences in emotion conceptualization, capturing the dynamic multidimensional interaction between body, mind, brain, language, and society.

Effects of insular resection on interactions between cardiac interoception and emotion recognition

The insular cortex is considered an important region for feeling emotions through interoception. Most studies that report the role of the insula in integrating interoception and emotion have used neuroimaging techniques such as functional magnetic resonance imaging (fMRI); however, there are limited neuropsychological studies. The effects of insular lesions on emotion and interoception have not been suitably investigated. In this study, we examined the role of the insular cortex in cardiac interoception and recognizing emotions from facial expressions by comparing them pre- and post-operatively in patients with glial tumors or brain metastases associated with the insular lobe. Although no significant difference in interoceptive accuracy was observed between the two phases, there were significant associations between the changes in interoceptive accuracy and sensitivity to expressions of anger and happiness. An increased error rate in the heartbeat counting task in the post-operation phase was associated with a decreased accuracy in recognizing anger and happiness. Since most patients had left insula lesions, generalizability of the findings to patients with right lesions is a future subject. To the best of our knowledge, this is the first study to examine the change in interoception and emotion after insular resection in humans. The study results indicate that removal of the insula affects the recognition of emotions such as anger and happiness through interoceptive processing.