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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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2
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Bodart A, Invernizzi S, De Leener M, Lefebvre L, Rossignol M. The duration discrimination respiratory task: A new test to measure respiratory interoceptive accuracy. Psychophysiology 2024:e14632. [PMID: 38886914 DOI: 10.1111/psyp.14632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 05/17/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
Interoception, which refers to the perception of body's internal state, is implicated in emotional processes and psychopathological disorders. Over the last decades, different tools have been developed to measure interoceptive accuracy, or the ability to accurately perceive physiological signals. Most of these tools have focused on cardiac interoception, but respiratory interoception has been less investigated due to the more complex and less portable equipment required. In this study, we suggest a new duration discrimination respiratory (DDR) task that does not require complex equipment. Using an adaptive staircase procedure, this task aims to determine an individual's ability to detect exhalation longer than their resting reference duration. One hundred and twenty-three healthy subjects completed the DDR task, an interoceptive task of heart rate discrimination, and filled out questionnaires on interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness), alexithymia (Toronto Alexithymia Scale [TAS]), affects (Positive and Negative Affect Scale [PANAS]), and anamnestic. Results demonstrated a good internal consistency (Cronbach's alpha = .93) of the DDR task. On average, subjects needed 99.22% (SD = 36.38) of their reference exhalation time in addition to reference exhalation to detect a prolonged exhalation. Higher self-reported fitness levels, not counting during the DDR task and lower difficulty in describing feelings (TAS subscale), predicted higher respiratory discrimination duration. In conclusion, this study demonstrates the utility of the DDR task as a valid measure of interoception.
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Affiliation(s)
- Alice Bodart
- Cognitive Psychology and Neuropsychology Laboratory, Department of Psychology and Educational Sciences, University of Mons, Mons, Belgium
| | - Sandra Invernizzi
- Cognitive Psychology and Neuropsychology Laboratory, Department of Psychology and Educational Sciences, University of Mons, Mons, Belgium
| | - Mélanie De Leener
- Cognitive Psychology and Neuropsychology Laboratory, Department of Psychology and Educational Sciences, University of Mons, Mons, Belgium
| | - Laurent Lefebvre
- Cognitive Psychology and Neuropsychology Laboratory, Department of Psychology and Educational Sciences, University of Mons, Mons, Belgium
| | - Mandy Rossignol
- Cognitive Psychology and Neuropsychology Laboratory, Department of Psychology and Educational Sciences, University of Mons, Mons, Belgium
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3
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Lavalley CA, Hakimi N, Taylor S, Kuplicki R, Forthman KL, Stewart JL, Paulus MP, Khalsa SS, Smith R. Transdiagnostic failure to adapt interoceptive precision estimates across affective, substance use, and eating disorders: A replication and extension of previous results. Biol Psychol 2024; 191:108825. [PMID: 38823571 DOI: 10.1016/j.biopsycho.2024.108825] [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: 11/09/2023] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Abstract
Recent Bayesian theories of interoception suggest that perception of bodily states rests upon a precision-weighted integration of afferent signals and prior beliefs. In a previous study, we fit a computational model of perception to behavior on a heartbeat tapping task to test whether aberrant precision-weighting could explain misestimation of cardiac states in psychopathology. We found that, during an interoceptive perturbation designed to amplify afferent signal precision (inspiratory breath-holding), healthy individuals increased the precision-weighting assigned to ascending cardiac signals (relative to resting conditions), while individuals with anxiety, depression, substance use disorders, and/or eating disorders did not. In this pre-registered study, we aimed to replicate and extend our prior findings in a new transdiagnostic patient sample (N = 285) similar to the one in the original study. As expected, patients in this new sample were also unable to adjust beliefs about the precision of cardiac signals - preventing the ability to accurately perceive changes in their cardiac state. Follow-up analyses combining samples from the previous and current study (N = 719) also afforded power to identify group differences between narrower diagnostic categories, and to examine predictive accuracy when logistic regression models were trained on one sample and tested on the other. With this confirmatory evidence in place, future studies should examine the utility of interceptive precision measures in predicting treatment outcomes and test whether these computational mechanisms might represent novel therapeutic targets.
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Affiliation(s)
- Claire A Lavalley
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA
| | - Navid Hakimi
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA
| | - Samuel Taylor
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA
| | | | - Jennifer L Stewart
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA; Oxley College of Health & Natural Sciences, The University of Tulsa, 800 S Tucker Dr, Tulsa, OK 74104, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA; Oxley College of Health & Natural Sciences, The University of Tulsa, 800 S Tucker Dr, Tulsa, OK 74104, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA; Oxley College of Health & Natural Sciences, The University of Tulsa, 800 S Tucker Dr, Tulsa, OK 74104, USA
| | - Ryan Smith
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA; Oxley College of Health & Natural Sciences, The University of Tulsa, 800 S Tucker Dr, Tulsa, OK 74104, USA.
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4
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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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5
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Murphy J. Interoception: Where do we go from here? Q J Exp Psychol (Hove) 2024; 77:223-229. [PMID: 37082986 PMCID: PMC10798007 DOI: 10.1177/17470218231172725] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023]
Abstract
In recent years, there has been a significant rise in interest in interoception, the processing of internal bodily signals. This interest has been coupled by increased concerns regarding the measurement and conceptualisation of interoception. Focusing on cardiac interoceptive accuracy, I outline what I believe to be the most pressing issues in the field of interoception-specifically the continued reliance on the heartbeat counting task. I then provide an overview of what I believe to be more general limitations concerning how we measure and conceptualise individual differences in interoception and suggestions for a way forward. Specifically, I believe that by moving beyond single measurements, establishing optimal levels of interoceptive accuracy, and refocusing from accuracy to propensity, we may be able to uncover the real-life relevance of interoceptive abilities.
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Affiliation(s)
- Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, Egham, UK
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6
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Crucianelli L, Radziun D, Ehrsson HH. Thermosensation and emotion: Thermosensory accuracy in a dynamic thermal matching task is linked to depression and anxiety symptomatology. Physiol Behav 2024; 273:114407. [PMID: 37967806 DOI: 10.1016/j.physbeh.2023.114407] [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: 06/13/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023]
Abstract
Interoception is related to the generation of bodily feelings and the awareness of ourselves as 'sentient beings', informing the organism about its bodily needs to guarantee survival. Previous studies have reported links among interoception, emotion processing, and mental health. For example, the alignment of interoceptive dimensions (i.e., accuracy, sensibility, awareness) can predict emotional symptoms, such as anxiety. Here, we aimed to investigate the relationship between the perception of a certain type of skin-mediated interoceptive signal, i.e., thermosensation, and self-reported depression, anxiety, and stress. One hundred seventy participants completed the Depression Anxiety Stress Scale (DASS-21) and a dynamic thermal matching task, a static temperature detection task, and a heartbeat counting task. Our results revealed that self-reported anxiety and depression were related to the perception of temperature on hairy and non-hairy skin, respectively: higher anxiety was related to better performance on the thermal matching task on the forearm, while higher depression was related to poorer performance on dynamic and static temperature tasks on the palm. Discrepancies between thermosensory accuracy and sensibility measures ('trait prediction error') were related to heightened anxiety, in line with previous studies. No significant correlations were found between DASS-21 scores and heartbeat counting accuracy. In conclusion, this study suggests that individual differences in thermosensory perception in different areas of the body are associated with self-reported anxiety and depression.
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Affiliation(s)
- Laura Crucianelli
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, UK.
| | - Dominika Radziun
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - H Henrik Ehrsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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7
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Schulz A, Vögele C. Why Desmedt et al.'s commentary does not apply to the findings of Schulz et al. (2021) concerning the validity of the heartbeat counting task. Biol Psychol 2023; 184:108689. [PMID: 37769938 DOI: 10.1016/j.biopsycho.2023.108689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023]
Affiliation(s)
- André Schulz
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Institute for Cognitive and Affective Neuroscience, Trier University, Trier, Germany.
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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8
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Lavalley CA, Hakimi N, Taylor S, Kuplicki R, Forthman KL, Stewart JL, Paulus MP, Khalsa SS, Smith R. Transdiagnostic failure to adapt interoceptive precision estimates across affective, substance use, and eating disorders: A replication study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.11.23296870. [PMID: 37873454 PMCID: PMC10593015 DOI: 10.1101/2023.10.11.23296870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Recent computational theories of interoception suggest that perception of bodily states rests upon an expected reliability- or precision-weighted integration of afferent signals and prior beliefs. The computational psychiatry framework further suggests that aberrant precision-weighting may lead to misestimation of bodily states, potentially hindering effective visceral regulation and promoting psychopathology. In a previous study, we fit a Bayesian computational model of perception to behavior on a heartbeat tapping task to test whether aberrant precision-weighting was associated with misestimation of bodily states. We found that, during an interoceptive perturbation designed to amplify afferent signal precision (inspiratory breath-holding), healthy individuals increased the precision-weighting assigned to ascending cardiac signals (relative to resting conditions), while individuals with symptoms of anxiety, depression, substance use disorders, and/or eating disorders did not. A second study also replicated the pattern observed in healthy participants. In this pre-registered study, we aimed to replicate our prior findings in a new transdiagnostic patient sample (N=285) similar to the one in the original study. These new results successfully replicated those found in our previous study, indicating that, transdiagnostically, patients were unable to adjust beliefs about the reliability of interoceptive signals - preventing the ability to accurately perceive changes in their bodily state. Follow-up analyses combining samples from the previous and current study (N=719) also afforded the power to identify group differences within narrower diagnostic groups and to examine predictive accuracy when logistic regression models were trained on one sample and tested on the other. Given the increased confidence in the generalizability of these effects, future studies should examine the utility of interceptive precision measures in predicting treatment outcomes or identify whether these computational mechanisms might represent novel therapeutic targets for improving visceral regulation.
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Affiliation(s)
| | - Navid Hakimi
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Samuel Taylor
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | - Jennifer L. Stewart
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health & Natural Sciences, The University of Tulsa, Tulsa, OK
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health & Natural Sciences, The University of Tulsa, Tulsa, OK
| | - Sahib S. Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health & Natural Sciences, The University of Tulsa, Tulsa, OK
| | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health & Natural Sciences, The University of Tulsa, Tulsa, OK
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9
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Vabba A, Panasiti MS, Scattolin M, Spitaleri M, Porciello G, Aglioti SM. The thermoception task: a thermal imaging-based procedure for measuring awareness of changes in peripheral body temperature. J Neurophysiol 2023; 130:1053-1064. [PMID: 37529855 PMCID: PMC10635420 DOI: 10.1152/jn.00014.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/03/2023] Open
Abstract
Although thermal body signals provide crucial information about the state of an organism and changes in body temperature may be a sign of affective states (e.g., stress, pain, sexual arousal), research on thermal awareness is limited. Here we developed a task measuring awareness of changes in peripheral body temperature (thermal interoception) and compared it to the classical heartbeat counting task (cardiac interoception). With an infrared light bulb we delivered stimuli of different temperature intensities to the right hand of 31 healthy participants. Thermal interoceptive accuracy, i.e., the difference between participants' real and perceived change in hand temperature, showed good interindividual variability. We found that thermal interoception did not correlate with (and was generally higher than) cardiac interoception, suggesting that different interceptive channels provide separate contributions to awareness of bodily states. Moreover, the results hint at the great salience of thermal signals and the need for thermoregulation in day-to-day life. Finally, thermal interoceptive accuracy was associated with self-reported awareness of body temperature changes and with the ability to regulate distress by focusing on body sensations. Our task has the potential to significantly increase current knowledge about the role of interoception in cognition and behavior, particularly in social and emotional contexts.NEW & NOTEWORTHY We developed a novel task measuring awareness of changes in peripheral body temperature (i.e., thermal interoception). To avoid tactile confounds present in existing thermoceptive tasks, we used an infrared light bulb to deliver stimuli of different temperature intensities to the hand of participants and asked them to judge the perceived change in their hand temperature. Performance in the task showed good interindividual variability, did not correlate with cardiac interoceptive tasks, and was associated with self-reported thermosensitivity.
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Affiliation(s)
- Alisha Vabba
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
| | - Maria Serena Panasiti
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Marina Scattolin
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Marco Spitaleri
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Giuseppina Porciello
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Salvatore Maria Aglioti
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
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10
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Desmedt O, Luminet O, Walentynowicz M, Corneille O. The new measures of interoceptive accuracy: A systematic review and assessment. Neurosci Biobehav Rev 2023; 153:105388. [PMID: 37708919 DOI: 10.1016/j.neubiorev.2023.105388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/10/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023]
Abstract
Conscious interoception, the perception of internal bodily states, is thought to contribute to fundamental human abilities (e.g., decision-making and emotional regulation). One of its most studied dimensions is interoceptive accuracy: the objective capacity to detect internal bodily signals. In the past few years, several labs across the world have started developing new tasks aimed at overcoming limitations inherent in classical measures of interoceptive accuracy. In this systematic review, we identified these tasks (since 2015) for the cardiac, respiratory, and gastrointestinal domains. For each identified task, we discuss their strengths and weaknesses, and make constructive suggestions for further improvement. In the general discussion, we discuss the (potentially elusive) possibility of reaching high validity in the measurement of interoceptive accuracy. We also point out that interoceptive accuracy may not be the most critical dimension for informing current theories, and we encourage researchers to investigate other dimensions of conscious interoception.
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Affiliation(s)
- Olivier Desmedt
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Fund for Scientific Research (FRS-FNRS), Belgium.
| | - Olivier Luminet
- Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Fund for Scientific Research (FRS-FNRS), Belgium
| | - Marta Walentynowicz
- Centre for the Psychology of Learning and Experimental Psychopathology, KULeuven, Belgium
| | - Olivier Corneille
- Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
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11
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Desmedt O, Luminet O, Maurage P, Corneille O. Discrepancies in the Definition and Measurement of Human Interoception: A Comprehensive Discussion and Suggested Ways Forward. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023:17456916231191537. [PMID: 37642084 DOI: 10.1177/17456916231191537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Interoception has been the subject of renewed interest over the past 2 decades. The involvement of interoception in a variety of fundamental human abilities (e.g., decision-making and emotional regulation) has led to the hypothesis that interoception is a central transdiagnostic process that causes and maintains mental disorders and physical diseases. However, interoception has been inconsistently defined and conceptualized. In the first part of this article, we argue that the widespread practice of defining interoception as the processing of signals originating from within the body and limiting it to specific physiological pathways (lamina I spinothalamic afferents) is problematic. This is because, in humans, the processing of internal states is underpinned by other physiological pathways generally assigned to the somatosensory system. In the second part, we explain that the consensual dimensions of interoception are empirically detached from existing measures, the latter of which capture loosely related phenomena. This is detrimental to the replicability of findings across measures and the validity of interpretations. In the general discussion, we discuss the main insights of the current analysis and suggest a more refined way to define interoception in humans and conceptualize its underlying dimensions.
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Affiliation(s)
- Olivier Desmedt
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- The Swiss National Science Foundation, Berne, Switzerland
| | - Olivier Luminet
- Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Fund for Scientific Research, Brussels, Belgium
| | - Pierre Maurage
- Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Fund for Scientific Research, Brussels, Belgium
| | - Olivier Corneille
- Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
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12
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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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13
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Sadeghi S, Wittmann M, De Rosa E, Anderson AK. Wrinkles in subsecond time perception are synchronized to the heart. Psychophysiology 2023:e14270. [PMID: 36864822 DOI: 10.1111/psyp.14270] [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: 09/25/2022] [Revised: 01/06/2023] [Accepted: 01/14/2023] [Indexed: 03/04/2023]
Abstract
The role of the heart in the experience of time has been long theorized but empirical evidence is scarce. Here, we examined the interaction between fine-grained cardiac dynamics and the momentary experience of subsecond intervals. Participants performed a temporal bisection task for brief tones (80-188 ms) synchronized with the heart. We developed a cardiac Drift-Diffusion Model (cDDM) that embedded contemporaneous heart rate dynamics into the temporal decision model. Results revealed the existence of temporal wrinkles-dilation or contraction of short intervals-in synchrony with cardiac dynamics. A lower prestimulus heart rate was associated with an initial bias in encoding the millisecond-level stimulus duration as longer, consistent with facilitation of sensory intake. Concurrently, a higher prestimulus heart rate aided more consistent and faster temporal judgments through more efficient evidence accumulation. Additionally, a higher speed of poststimulus cardiac deceleration, a bodily marker of attention, was associated with a greater accumulation of sensory temporal evidence in the cDDM. These findings suggest a unique role of cardiac dynamics in the momentary experience of time. Our cDDM framework opens a new methodological avenue for investigating the role of the heart in time perception and perceptual judgment.
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Affiliation(s)
- Saeedeh Sadeghi
- Department of Psychology, Cornell University, Ithaca, New York, USA
| | - Marc Wittmann
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
| | - Eve De Rosa
- Department of Psychology, Cornell University, Ithaca, New York, USA
| | - Adam K Anderson
- Department of Psychology, Cornell University, Ithaca, New York, USA
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14
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Uraguchi M, Maulina VVR, Ohira H. Interoceptive accuracy correlates with precision of time perception in the millisecond range. Front Neurosci 2022; 16:993491. [PMID: 36452334 PMCID: PMC9701738 DOI: 10.3389/fnins.2022.993491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2023] Open
Abstract
It has been proposed that accuracy in time perception is related to interoceptive accuracy and vagal activity. However, studies investigating time perception in the supra-second range have provided mixed results, and few studies have investigated the sub-second range. Moreover, there is a lack of studies investigating the relationship between precision in time perception and interoceptive accuracy. A recent meta-analytic review of neuroimaging studies proposed a dynamic interaction between two types of timing processing-an endogenous time keeping mechanism and the use of exogenous temporal cues. Interoceptive accuracy may affect both accuracy and precision of primary temporal representations, as they are generated based on the endogenous time keeping mechanism. Temporal accuracy may vary when adapted to the environmental context. In contrast, temporal precision contains some constant noise, which may maintain the relationship with interoceptive accuracy. Based on these assumptions, we hypothesized that interoceptive accuracy would be associated with temporal precision in the sub-second range, while vagal activity would be associated with temporal accuracy. We used the temporal generalization task, which allowed us to calculate the indices of temporal accuracy and temporal precision in line with the existing research, and also compute the index of participants' sensitivity according to the signal detection theory. Specifically, we investigated whether (1) interoceptive accuracy would correlate with temporal accuracy, temporal precision, or sensitivity and (2) resting-state vagal activity would correlate with temporal accuracy, temporal precision, or sensitivity. The results indicated that interoceptive accuracy was positively correlated with temporal precision as well as sensitivity, but not with temporal accuracy, in the sub-second range time perception. Vagal activity was negatively correlated only with sensitivity. Furthermore, we found a moderation effect of sensitivity on the relationship between vagal activity and perceived duration, which affected the association between vagal activity and temporal accuracy. These findings suggest the importance of precision as an aspect of time perception, which future studies should further explore in relation to interoception and vagal activity, and of the moderation effects of factors such as participants' sensitivity in this context.
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Affiliation(s)
- Maki Uraguchi
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | - Venie Viktoria Rondang Maulina
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
- Department of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Hideki Ohira
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
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15
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The impact of a brief mindfulness training on interoception: A randomized controlled trial. PLoS One 2022; 17:e0273864. [PMID: 36070308 PMCID: PMC9451078 DOI: 10.1371/journal.pone.0273864] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/15/2022] [Indexed: 11/26/2022] Open
Abstract
Interoception is a collection of different representations of signals originating within the body. The way of perceiving these signals seems to be related to both emotion regulation and dysregulation, and its dysfunction is implicated across a variety of affective disorders. There is a growing body of research investigating the relationship between mindfulness meditation practices and interoception showing an increase in interoceptive processes with regular training. In this study, we assessed the effects of a three-day mindfulness training on interoceptive accuracy and sensibility in a young healthy adult sample. Moreover, we also performed a mediation analysis on interoceptive sensibility and anxiety. Healthy participants (n = 40) naive to mindfulness practices were randomized to a brief mindfulness training (MT) (n = 20, females = 10) or to an active control group (n = 20, females = 10). Participants were assessed before and after the 3-days intervention for both groups on measures of interoception and anxiety in a modified intention-to-treat approach. The brief mindfulness training group increased interoceptive sensibility while active control had no effects on this variable. Five out of eight subdomains of interoceptive sensibility were significantly improved after mindfulness training. There was no significant difference in interoceptive accuracy after training. The effect of a brief mindfulness training on interoceptive sensibility mediated changes in the anxiety state. To date, this is the first study showing a plausible mechanism of a brief mindfulness training to explain the anxiolytic effects of meditation practices. Trial registration:RBR-7b8yh8, March 28th 2017 http://www.ensaiosclinicos.gov.br/rg/RBR-7b8yh8/.
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16
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Zaccaro A, Perrucci MG, Parrotta E, Costantini M, Ferri F. Brain-heart interactions are modulated across the respiratory cycle via interoceptive attention. Neuroimage 2022; 262:119548. [PMID: 35964864 DOI: 10.1016/j.neuroimage.2022.119548] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/17/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Respiration and heartbeat continuously interact within the living organism at many different levels, representing two of the main oscillatory rhythms of the body and providing major sources of interoceptive information to the brain. Despite the modulatory effect of respiration on exteroception and cognition has been recently established in humans, its role in shaping interoceptive perception has been scarcely investigated so far. In two independent studies, we investigated the effect of spontaneous breathing on cardiac interoception by assessing the Heartbeat Evoked Potential (HEP) in healthy humans. In Study 1, we compared HEP activity for heartbeats occurred during inhalation and exhalation in 40 volunteers at rest. We found higher HEP amplitude during exhalation, compared to inhalation, over fronto-centro-parietal areas. This suggests increased brain-heart interactions and improved cortical processing of the heartbeats during exhalation. Further analyses revealed that this effect was moderated by heart rate changes. In Study 2, we tested the respiratory phase-dependent modulation of HEP activity in 20 volunteers during Exteroceptive and Interoceptive conditions of the Heartbeat Detection (HBD) task. In these conditions, participants were requested to tap at each heartbeat, either listened to or felt, respectively. Results showed higher HEP activity and higher detection accuracy at exhalation than inhalation in the Interoceptive condition only. Direct comparisons of Interoceptive and Exteroceptive conditions confirmed stronger respiratory phase-dependent modulation of HEP and accuracy when attention was directed towards the interoceptive stimuli. Moreover, HEP changes during the Interoceptive condition were independent of heart physiology, but were positively correlated with higher detection accuracy at exhalation than inhalation. This suggests a link between optimization of cortical processing of cardiac signals and detection of heartbeats across the respiratory cycle. Overall, we provide data showing that respiration shapes cardiac interoception at the neurophysiological and behavioural levels. Specifically, exhalation may allow attentional shift towards the internal bodily states.
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Affiliation(s)
- Andrea Zaccaro
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - 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
| | - Eleonora Parrotta
- School of Psychology, University of Aberdeen, Aberdeen, United Kingdom
| | - 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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17
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Adams KL, Edwards A, Peart C, Ellett L, Mendes I, Bird G, Murphy J. The association between anxiety and cardiac interoceptive accuracy: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 140:104754. [DOI: 10.1016/j.neubiorev.2022.104754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
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18
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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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19
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Adams KL, Murphy J, Catmur C, Bird G. The role of interoception in the overlap between eating disorders and autism: Methodological considerations. EUROPEAN EATING DISORDERS REVIEW 2022; 30:501-509. [PMID: 35411642 PMCID: PMC9543236 DOI: 10.1002/erv.2905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/24/2022] [Accepted: 03/31/2022] [Indexed: 01/10/2023]
Abstract
Significant comorbidity has been demonstrated between feeding and eating disorders and autism. Atypical interoception (perception of bodily signals) may, at least in part, be responsible for this association, as it has been implicated in the aetiology of both conditions. However, significant methodological limitations are impeding progress in this area. This paper provides a brief overview of how interoception has been linked to autism and feeding and eating disorders in both adolescent and adult populations before identifying several issues with current measures of interoception. We suggest that methodological issues may be contributing to the inconsistency in the empirical literature, and provide suggestions for future research. Atypical interoception is linked to both feeding and eating disorders, and autism and may contribute to the comorbidity between the two. Existing measures of interoception across cardiac, gastric and respiratory domains are severely limited. Novel and better‐validated measures of interoception will allow us to better understand the clinical potential of interoceptive training.
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Affiliation(s)
| | | | - Caroline Catmur
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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20
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Davey S, Halberstadt J, Bell E. Where is emotional feeling felt in the body? An integrative review. PLoS One 2021; 16:e0261685. [PMID: 34936672 PMCID: PMC8694467 DOI: 10.1371/journal.pone.0261685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
Contemporary research on "embodied emotion" emphasizes the role of the body in emotional feeling. The evidence base on interoception, arguably the most prominent strand of embodied emotion research, places emphasis on the cardiac, respiratory and gastrointestinal systems. In turn, interoception has evidence-based links with improved emotion regulation. Despite the focus on separate bodily systems, it is unclear whether particular interoceptive locations play a greater role in emotional feeling and emotion regulation. Further, according to Gross' "process model", the sooner that regulation of an emotion occurs, the better; hence, it is additionally important to identify the first body areas to activate. These issues are investigated in a two-stage integrative review. The first stage was preliminary, giving an overview of the evidence base to highlight the distribution of measured body areas. This indicated that 86% of publications (n = 88) measured cardiac activity, 26% measured the respiratory system, and six percent the gastrointestinal system. Given the emphasis placed on all three systems in interoception theory and research on emotion, this suggests a dearth of comprehensive findings pertaining to feeling locations. The second stage investigated the core issues of where emotional feelings are felt in the body and time-related implications for regulation. This was based on ten texts, which together suggested that the head, throat and chest are the most consistently detected locations across and within numerous emotional contexts. Caution is required, however, since-among other reasons discussed-measurement was not time-restricted in these latter publications, and direct physiological measurement was found in only a minority of cases.
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Affiliation(s)
- Steven Davey
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
| | | | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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21
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Legrand N, Nikolova N, Correa C, Brændholt M, Stuckert A, Kildahl N, Vejlø M, Fardo F, Allen M. The heart rate discrimination task: a psychophysical method to estimate the accuracy and precision of interoceptive beliefs. Biol Psychol 2021; 168:108239. [PMID: 34902450 DOI: 10.1016/j.biopsycho.2021.108239] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/19/2021] [Accepted: 12/02/2021] [Indexed: 11/02/2022]
Abstract
Interoception - the physiological sense of our inner bodies - has risen to the forefront of psychological and psychiatric research. Much of this research utilizes tasks that attempt to measure the ability to accurately detect cardiac signals. Unfortunately, these approaches are confounded by well-known issues limiting their validity and interpretation. At the core of this controversy is the role of subjective beliefs about the heart rate in confounding measures of interoceptive accuracy. Here, we recast these beliefs as an important part of the causal machinery of interoception, and offer a novel psychophysical "heart rate discrimination" method to estimate their accuracy and precision. By applying this task in 223 healthy participants, we demonstrate that cardiac interoceptive beliefs are more biased, less precise, and are associated with poorer metacognitive insight relative to an exteroceptive control condition. Our task, provided as an open-source python package, offers a robust approach to quantifying cardiac beliefs.
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Affiliation(s)
- Nicolas Legrand
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark
| | - Niia Nikolova
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark
| | - Camile Correa
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark
| | - Malthe Brændholt
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark
| | - Anna Stuckert
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark
| | - Nanna Kildahl
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark
| | - Melina Vejlø
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark
| | - Francesca Fardo
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark; Danish Pain Research Center
| | - Micah Allen
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark; Aarhus Institute of Advanced Studies, Aarhus University, Denmark; Cambridge Psychiatry, University of Cambridge, United Kingdom
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22
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Rominger C, Weber B, Aldrian A, Berger L, Schwerdtfeger AR. Short-term fasting induced changes in HRV are associated with interoceptive accuracy: Evidence from two independent within-subjects studies. Physiol Behav 2021; 241:113558. [PMID: 34411572 DOI: 10.1016/j.physbeh.2021.113558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
Previous research suggested increased cardiac interoceptive accuracy after 24-h food-deprivation by means of the heartbeat tracking task. The present study investigated if 16-h of voluntary fasting shows similar effects and whether changes in interoceptive accuracy are accompanied by changes in autonomic function. In two independent within-subjects studies two measures of interoceptive accuracy, the heartbeat tracking task and the heartbeat discrimination task were applied. In study 1 (n = 24) and study 2 (n = 72) vagally-mediated HRV increases and heart rate decreases were observed. Stronger effects of fasting on vagally-mediated HRV went along with a higher interoceptive accuracy increase in the heartbeat tracking task. Furthermore, the fasting associated changes in interoceptive accuracy in both tasks were significantly associated, suggesting that these tasks are suitable to track changes in cardiac interoception. Taken together, fasting of 16-h might be suitable to increase participants' parasympathetic efference, thereby facilitating interoception.
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23
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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24
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Larsson DEO, Esposito G, Critchley HD, Dienes Z, Garfinkel SN. Sensitivity to changes in rate of heartbeats as a measure of interoceptive ability. J Neurophysiol 2021; 126:1799-1813. [PMID: 34669507 DOI: 10.1152/jn.00059.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Individuals vary in their ability to perceive, as conscious sensations, signals like the beating of the heart. Tests of such interoceptive ability are, however, constrained in nature and reliability. Performance of the heartbeat tracking task, a widely used test of cardiac interoception, often corresponds well with individual differences in emotion and cognition, yet is susceptible to reporting bias and influenced by higher-order knowledge, e.g., of expected heart rate. The present study introduces a new way of assessing cardiac interoceptive ability, focusing on sensitivity to short-term, naturalistic changes in frequency of heartbeats. At rest, such heart rate variability typically reflects the dominant influence of respiration on vagus parasympathetic control of the sinoatrial pacemaker. We observed an overall tendency of healthy participants to report feeling fewer heartbeats during increases in heart rate, which we speculate reflects a reduction in heartbeat strength and salience during inspiratory periods when heart rate typically increases to maintain a stable cardiac output. Within-participant performance was more variable on this measure of cardiac interoceptive sensitivity relative to the "classic" heartbeat tracking task. Our findings indicate that cardiac interoceptive ability, rather than reflecting the veridical monitoring of subtle variations in physiology, appears to involve more interpolation wherein interoceptive decisions are informed by dynamic working estimates derived from the integration of afferent signaling and higher-order predictions.NEW & NOTEWORTHY This study presents a new method for evaluating cardiac interoceptive ability, measuring sensitivity to naturalistic changes in the number of heartbeats over time periods. Results show participants have an overall tendency toward sensing fewer heartbeats during higher heart rates. This likely reflects the influence of changing heartbeat strength on cardiac interoception at rest, which should be taken into account when evaluating cardiac interoceptive ability and its relationship to anxiety and psychosomatic conditions.
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Affiliation(s)
- Dennis E O Larsson
- Department of Psychology, grid.12082.39University of Sussex, Falmer, United Kingdom.,Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, United Kingdom
| | - Giulia Esposito
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, United Kingdom.,Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, United Kingdom.,Sackler Centre for Consciousness Science, University of Sussex, Falmer, United Kingdom.,Sussex Partnership NHS Foundation Trust, Swandean, Worthing, West Sussex, United Kingdom
| | - Zoltan Dienes
- Department of Psychology, grid.12082.39University of Sussex, Falmer, United Kingdom.,Sackler Centre for Consciousness Science, University of Sussex, Falmer, United Kingdom
| | - Sarah N Garfinkel
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, United Kingdom.,Sussex Partnership NHS Foundation Trust, Swandean, Worthing, West Sussex, United Kingdom.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom
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25
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Rosati A, Belcari I, Santarcangelo EL, Sebastiani L. Interoceptive Accuracy as a Function of Hypnotizability. Int J Clin Exp Hypn 2021; 69:441-452. [PMID: 34313546 DOI: 10.1080/00207144.2021.1954859] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study aimed to measure the interoceptive accuracy (IA) of individuals with high (highs), medium (mediums), and low hypnotizability (lows) through the heartbeat-counting task during 3 relaxation trials. Participants completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), ECG and skin conductance (SC) were monitored, and the experienced difficulty in counting was reported. Results showed similar counting difficulty and number of actual heartbeats in highs, mediums, and lows. SC decreased in highs during all trials, in mediums and lows only in the third trial. IA measured as [1 - (ǀrecorded heartbeats-counted heartbeatsǀ)/recorded heartbeats] was negatively correlated with hypnotizability and not correlated with interoceptive sensitivity (IS) measured by MAIA scales. Among mediums, IA was higher in males than in females.
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Affiliation(s)
- Anna Rosati
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Iacopo Belcari
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
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26
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Mental heartbeat tracking and rating of emotional pictures are not related. PSYCHOLOGICAL RESEARCH 2021; 86:1487-1494. [PMID: 34557988 PMCID: PMC9177488 DOI: 10.1007/s00426-021-01593-4] [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: 04/12/2021] [Accepted: 09/02/2021] [Indexed: 12/03/2022]
Abstract
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).
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27
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Ponzo S, Morelli D, Suksasilp C, Cairo M, Plans D. Measuring Interoception: The CARdiac Elevation Detection Task. Front Psychol 2021; 12:712896. [PMID: 34489814 PMCID: PMC8416769 DOI: 10.3389/fpsyg.2021.712896] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Abstract
Interoception has increasingly been the focus of psychiatric research, due to its hypothesized role in mental health. Existing interoceptive tasks either suffer from important methodological limitations, impacting their validity, or are burdensome and require specialized equipment, which limits their usage in vulnerable populations. We report on the development of the CARdiac Elevation Detection (CARED) task. Participants' heart rate is recorded by a wearable device connected to a mobile application. Notifications are sent to participants' mobile throughout the day over a period of 4 weeks. Participants are asked to state whether their heart rate is higher than usual, rate their confidence and describe the activity they were involved in when the notification occurred. Data (N = 30) revealed that 1/3 of the sample was classified as interoceptive and that participants presented overall good insight into their interoceptive abilities. Given its ease of administration and accessibility, the CARED task has the potential to be a significant asset for psychiatric and developmental research.
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Affiliation(s)
- Sonia Ponzo
- Huma Therapeutics Ltd., London, United Kingdom
| | - Davide Morelli
- Huma Therapeutics Ltd., London, United Kingdom.,Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Chatrin Suksasilp
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | | | - David Plans
- Huma Therapeutics Ltd., London, United Kingdom.,Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.,INDEX Group, Department of Science, Innovation, Technology, and Entrepreneurship, University of Exeter, Exeter, United Kingdom
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28
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Smith R, Mayeli A, Taylor S, Al Zoubi O, Naegele J, Khalsa SS. Gut inference: A computational modelling approach. Biol Psychol 2021; 164:108152. [PMID: 34311031 PMCID: PMC8429276 DOI: 10.1016/j.biopsycho.2021.108152] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 12/22/2022]
Abstract
Neurocomputational theories have hypothesized that Bayesian inference underlies interoception, which has become a topic of recent experimental work in heartbeat perception. To extend this approach beyond cardiac interoception, we describe the application of a Bayesian computational model to a recently developed gastrointestinal interoception task completed by 40 healthy individuals undergoing simultaneous electroencephalogram (EEG) and peripheral physiological recording. We first present results that support the validity of this modelling approach. Second, we provide a test of, and confirmatory evidence supporting, the neural process theory associated with a particular Bayesian framework (active inference) that predicts specific relationships between computational parameters and event-related potentials in EEG. We also offer some exploratory evidence suggesting that computational parameters may influence the regulation of peripheral physiological states. We conclude that this computational approach offers promise as a tool for studying individual differences in gastrointestinal interoception.
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Affiliation(s)
- Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, United States.
| | - Ahmad Mayeli
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Samuel Taylor
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Obada Al Zoubi
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Jessyca Naegele
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States.
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Plans D, Ponzo S, Morelli D, Cairo M, Ring C, Keating CT, Cunningham AC, Catmur C, Murphy J, Bird G. Measuring interoception: The phase adjustment task. Biol Psychol 2021; 165:108171. [PMID: 34411620 DOI: 10.1016/j.biopsycho.2021.108171] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 02/03/2023]
Abstract
Interoception, perception of one's bodily state, has been associated with mental health and socio-emotional processes. However, several interoception tasks are of questionable validity, meaning associations between interoception and other variables require confirmation with new measures. Here we describe the novel, smartphone-based Phase Adjustment Task (PAT). Tones are presented at the participant's heart rate, but out of phase with heartbeats. Participants adjust the phase relationship between tones and heartbeats until they are synchronous. Data from 124 participants indicates variance in performance across participants which is not affected by physiological or strategic confounds. Associations between interoception and anxiety, depression and stress were not significant. Weak associations between interoception and mental health variables may be a consequence of testing a non-clinical sample. A second study revealed PAT performance to be moderately stable over one week, consistent with state effects on interoception.
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Affiliation(s)
- D Plans
- INDEX Group, Department of Science, Innovation, Technology, and Entrepreneurship, University of Exeter, United Kingdom; Huma Therapeutics Ltd, London, United Kingdom; Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.
| | - S Ponzo
- Huma Therapeutics Ltd, London, United Kingdom.
| | - D Morelli
- Huma Therapeutics Ltd, London, United Kingdom; Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - M Cairo
- Huma Therapeutics Ltd, London, United Kingdom
| | - C Ring
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - C T Keating
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | | | - C Catmur
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - J Murphy
- Department of Psychology, Royal Holloway University of London, London, United Kingdom
| | - G Bird
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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30
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Körmendi J, Ferentzi E, Köteles F. Expectation predicts performance in the mental heartbeat tracking task. Biol Psychol 2021; 164:108170. [PMID: 34400273 DOI: 10.1016/j.biopsycho.2021.108170] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/25/2021] [Accepted: 08/11/2021] [Indexed: 01/10/2023]
Abstract
The mental heartbeat tracking task by Schandry is sensitive to non-interoceptive (top-down) influences, e.g., estimation of heart rate and expectation. The two studies reported here investigated the impact of these factors on the outcome of the task. In Study 1, performance-related expectation was assessed between the training interval and the real trials. Performance was strongly related (β = .595, p < .001) to expectation even after controlling for sex, body fat, resting heart rate and estimation of heart rate. In Study 2, expectation was assessed before and after the training interval for Group 1 and 2, respectively. The strong association (r = 0.78, p < .001) between performance and expectation was replicated for Group 2; however, a moderate association (r = 0.39, p < .01) was also found in Group 1. People with high expectation may be prone to categorize and count vague sensations, such as attention evoked sensations, as heartbeats; this can lead to an inflated Schandry-score.
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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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31
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Knapp-Kline K, Ring C, Emmerich D, Brener J. The effects of vibrotactile masking on heartbeat detection: Evidence that somatosensory mechanoreceptors transduce heartbeat sensations. Psychophysiology 2021; 58:e13817. [PMID: 33772799 DOI: 10.1111/psyp.13817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Kelley Knapp-Kline
- Department of Psychology, Florida State University, Panama City Campus, Panama City, FL, USA
| | - Christopher Ring
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - David Emmerich
- Department of Psychology, SUNY Stony Brook, Stony Brook, NY, USA
| | - Jasper Brener
- Department of Psychology, SUNY Stony Brook, Stony Brook, NY, USA
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32
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Rominger C, Graßmann TM, Weber B, Schwerdtfeger AR. Does contingent biofeedback improve cardiac interoception? A preregistered replication of Meyerholz, Irzinger, Withöft, Gerlach, and Pohl (2019) using the heartbeat discrimination task in a randomised control trial. PLoS One 2021; 16:e0248246. [PMID: 33725020 PMCID: PMC7963047 DOI: 10.1371/journal.pone.0248246] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 02/19/2021] [Indexed: 12/23/2022] Open
Abstract
Meyerholz, Irzinger, Withöft, Gerlach, and Pohl (2019) reported on a comparably large effect (d = 1.21) of a contingent biofeedback procedure on cardiac accuracy as assessed by the heartbeat tracking task. However, this task has recently been criticized as a measure of interoceptive accuracy. We aimed to replicate this finding by using the well-validated heartbeat discrimination task and to compare the biofeedback with a deep breathing and a control condition (viewing a film clip). The trial was preregistered at open science framework (https://osf.io/9fxn6). Overall, 93 participants were randomized to one of the three conditions and the heartbeat discrimination task was presented prior and after the 20-minutes training sessions. The study had a power of .86 to detect a medium-sized effect in the biofeedback group and a power of .96 to detect a medium-sized interaction of intervention group and time. A general tendency for improvement in heartbeat detection accuracy was found across intervention groups (d = 0.19, p = .08); however, groups did not differ significantly. In particular, there was no significant interaction of intervention group and time (f = .00, p = .98) and no reliable effect for the biofeedback group (d = 0.15, p = .42). One limitation is that a different, but well-validated task was used to quantify interoceptive accuracy. This study suggests that biofeedback might not improve interoceptive accuracy in the cardiac domain, but effects seem to depend on the specific task applied.
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Affiliation(s)
- Christian Rominger
- Institute of Psychology, University of Graz, Graz, Austria
- Otto Loewi Research Center, Section of Physiology, Medical University of Graz, Graz, Austria
- * E-mail:
| | | | - Bernhard Weber
- Institute of Psychology, University of Graz, Graz, Austria
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Smith R, Feinstein JS, Kuplicki R, Forthman KL, Stewart JL, Paulus MP, Khalsa SS. Perceptual insensitivity to the modulation of interoceptive signals in depression, anxiety, and substance use disorders. Sci Rep 2021; 11:2108. [PMID: 33483527 PMCID: PMC7822872 DOI: 10.1038/s41598-021-81307-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/28/2020] [Indexed: 01/18/2023] Open
Abstract
This study employed a series of heartbeat perception tasks to assess the hypothesis that cardiac interoceptive processing in individuals with depression/anxiety (N = 221), and substance use disorders (N = 136) is less flexible than that of healthy individuals (N = 53) in the context of physiological perturbation. Cardiac interoception was assessed via heartbeat tapping when: (1) guessing was allowed; (2) guessing was not allowed; and (3) experiencing an interoceptive perturbation (inspiratory breath hold) expected to amplify cardiac sensation. Healthy participants showed performance improvements across the three conditions, whereas those with depression/anxiety and/or substance use disorder showed minimal improvement. Machine learning analyses suggested that individual differences in these improvements were negatively related to anxiety sensitivity, but explained relatively little variance in performance. These results reveal a perceptual insensitivity to the modulation of interoceptive signals that was evident across several common psychiatric disorders, suggesting that interoceptive deficits in the realm of psychopathology manifest most prominently during states of homeostatic perturbation.
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Affiliation(s)
- Ryan Smith
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA
| | - Justin S Feinstein
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA
| | | | - Jennifer L Stewart
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA.
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA.
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Mendoza-Medialdea MT, Ruiz-Padial E. Understanding the capture of exogenous attention by disgusting and fearful stimuli: The role of interoceptive accuracy. Int J Psychophysiol 2021; 161:53-63. [PMID: 33453302 DOI: 10.1016/j.ijpsycho.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 11/16/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
The aim of the study was to explore the role of interoceptive accuracy (IA) on exogenous attention to disgusting and fearful distractors of a main concurrent task. Participants were thirty university students previously identified as high (N = 16) or normal IA according their performance in a heartbeat detection task. Event-related potentials and behavioural responses were recorded. The results showed that disgusting stimuli capture exogenous attention in a first stage as reflected by the augmented amplitude of the P100 component of the ERPs in high IA participants. Fearful distractors may capture attention in a later moment in all participants as revealed by a marginally significant effect on the amplitude of N200. At behavioural level, disgusting distractors provoked a higher number of errors than neutral in normal IA participants. The time course of the effect of disgust and fearful eliciting distractors on exogenous attention appeared to depend on the individual characteristic of participants.
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35
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Coll MP, Hobson H, Bird G, Murphy J. Systematic review and meta-analysis of the relationship between the heartbeat-evoked potential and interoception. Neurosci Biobehav Rev 2021; 122:190-200. [PMID: 33450331 DOI: 10.1016/j.neubiorev.2020.12.012] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 02/07/2023]
Abstract
The Heartbeat Evoked Potential (HEP) has been proposed as a neurophysiological marker of interoceptive processing. Despite its use to validate interoceptive measures and to assess interoceptive functioning in clinical groups, the empirical evidence for a relationship between HEP amplitude and interoceptive processing, including measures of such processing, is scattered across several studies with varied designs. The aim of this systematic review and meta-analysis was to examine the body of HEP-interoception research, and consider the associations the HEP shows with various direct and indirect measures of interoception, and how it is affected by manipulations of interoceptive processing. Specifically, we assessed the effect on HEP amplitude of manipulating attention to the heartbeat; manipulating participants' arousal; the association between the HEP and behavioural measures of cardiac interoception; and comparisons between healthy and clinical groups. Following database searches and screening, 45 studies were included in the systematic review and 42 in the meta-analyses. We noted variations in the ways individual studies have attempted to address key confounds, particularly the cardiac field artefact. Meta-analytic summaries indicated there were moderate to large effects of attention, arousal, and clinical status on the HEP, and a moderate association between HEP amplitude and behavioural measures of interoception. Problematically, the reliability of the meta-analytic effects documented here remain unknown, given the lack of standardised protocols for measuring the HEP. Thus, it is possible effects are driven by confounds such as cardiac factors or somatosensory effects.
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Affiliation(s)
- Michel-Pierre Coll
- Department of Psychology, McGill University, 2001 McGill College, Montreal, H3A1G1, Canada.
| | - Hannah Hobson
- Department of Psychology, University of York, York, YO10 5DD, UK.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2, UK.
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK.
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Smith R, Kuplicki R, Feinstein J, Forthman KL, Stewart JL, Paulus MP, Khalsa SS. A Bayesian computational model reveals a failure to adapt interoceptive precision estimates across depression, anxiety, eating, and substance use disorders. PLoS Comput Biol 2020; 16:e1008484. [PMID: 33315893 PMCID: PMC7769623 DOI: 10.1371/journal.pcbi.1008484] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/28/2020] [Accepted: 10/31/2020] [Indexed: 12/16/2022] Open
Abstract
Recent neurocomputational theories have hypothesized that abnormalities in prior beliefs and/or the precision-weighting of afferent interoceptive signals may facilitate the transdiagnostic emergence of psychopathology. Specifically, it has been suggested that, in certain psychiatric disorders, interoceptive processing mechanisms either over-weight prior beliefs or under-weight signals from the viscera (or both), leading to a failure to accurately update beliefs about the body. However, this has not been directly tested empirically. To evaluate the potential roles of prior beliefs and interoceptive precision in this context, we fit a Bayesian computational model to behavior in a transdiagnostic patient sample during an interoceptive awareness (heartbeat tapping) task. Modelling revealed that, during an interoceptive perturbation condition (inspiratory breath-holding during heartbeat tapping), healthy individuals (N = 52) assigned greater precision to ascending cardiac signals than individuals with symptoms of anxiety (N = 15), depression (N = 69), co-morbid depression/anxiety (N = 153), substance use disorders (N = 131), and eating disorders (N = 14)-who failed to increase their precision estimates from resting levels. In contrast, we did not find strong evidence for differences in prior beliefs. These results provide the first empirical computational modeling evidence of a selective dysfunction in adaptive interoceptive processing in psychiatric conditions, and lay the groundwork for future studies examining how reduced interoceptive precision influences visceral regulation and interoceptively-guided decision-making.
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Affiliation(s)
- Ryan Smith
- Laureate Institute for Brain Research, Tulsa, Oklahoma, United States of America
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, Oklahoma, United States of America
| | - Justin Feinstein
- Laureate Institute for Brain Research, Tulsa, Oklahoma, United States of America
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma, United States of America
| | | | - Jennifer L. Stewart
- Laureate Institute for Brain Research, Tulsa, Oklahoma, United States of America
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma, United States of America
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma, United States of America
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma, United States of America
| | | | - Sahib S. Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma, United States of America
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma, United States of America
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Nusser L, Pollatos O, Zimprich D. Age-Related Effects on Interoceptive Accuracy, General Interoceptive Sensibility, and Specific Interoceptive Sensibility. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: The current research into interoception distinguishes between interoceptive accuracy (IAcc), the accurate detection of internal sensations (e.g., heartbeats) as measured by performance on objective IAcc tasks, and interoceptive sensibility (IS), the subjective belief concerning one’s own experience of internal sensations as measured either through self-report questionnaires or through one’s confidence in the accuracy during an IAcc task. Aims: As the two measures of IS, however, are usually uncorrelated and show differential relationships to IAcc, we suggest different types of IS, a general IS and a specific IS. Further, based on a growing body of research linking IAcc and IS to physical and mental diseases, the development of interoception across the adult lifespan is of importance. Methods: Using Structural Equation Modeling the present paper investigates the relationships among IAcc assessed by a heartbeat counting task, and the two proposed dimensions of IS in 138 participants ( Mage = 42.67, SDage = 18.77). Furthermore, we examine age-related differences in IAcc, as well as in general and specific IS. Results: In terms of the relationship between the three dimensions, general and specific IS were weakly correlated and exhibited different relationships to IAcc. Further, we found different age effects on the three interoceptive dimensions. Whereas IAcc decreased with age, specific IS tend to increase with age, and general IS remained unaffected by age. Conclusion: The findings provide further empirical support for a dissociation between general and specific IS and raised important questions concerning the relation between interoceptive accuracy and the emergence of physical diseases in older age.
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Affiliation(s)
- L. Nusser
- Department of Developmental Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - O. Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - D. Zimprich
- Department of Developmental Psychology, Institute of Psychology and Education, Ulm University, Germany
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Hickman L, Seyedsalehi A, Cook JL, Bird G, Murphy J. The relationship between heartbeat counting and heartbeat discrimination: A meta-analysis. Biol Psychol 2020; 156:107949. [PMID: 32911018 DOI: 10.1016/j.biopsycho.2020.107949] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
Interoception concerns the perception of the body's internal state. Despite the importance of this ability for health and aspects of higher-order cognition, its measurement remains problematic. Most studies of interoception employ one of two tasks: the heartbeat counting or heartbeat discrimination task. These tasks are thought to index common abilities, an assertion often used to justify the use of a single measure of cardiac interoception. However, mixed findings regarding the relationship between performance on these tasks raises the question of whether they can be used interchangeably to assess interoceptive accuracy, confidence and awareness ('metacognition'). The present study employed a meta-analytical approach to assess the association between these tasks. Pooled findings from 22 studies revealed a small relationship between accuracy scores on the measures. Additional analyses demonstrated a moderate relationship between confidence ratings but no association between measures of interoceptive awareness. These findings question the interchangeable use of the two tasks.
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Affiliation(s)
- Lydia Hickman
- School of Psychology, University of Birmingham, United Kingdom.
| | - Aida Seyedsalehi
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Jennifer L Cook
- School of Psychology, University of Birmingham, United Kingdom
| | - Geoffrey Bird
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom
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39
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Desmedt O, Corneille O, Luminet O, Murphy J, Bird G, Maurage P. Contribution of Time Estimation and Knowledge to Heartbeat Counting Task Performance under Original and Adapted Instructions. Biol Psychol 2020; 154:107904. [DOI: 10.1016/j.biopsycho.2020.107904] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 05/09/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
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40
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Paulus MP, Feinstein JS, Khalsa SS. An Active Inference Approach to Interoceptive Psychopathology. Annu Rev Clin Psychol 2020; 15:97-122. [PMID: 31067416 DOI: 10.1146/annurev-clinpsy-050718-095617] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Interoception refers to the process by which the nervous system senses and integrates signals originating from within the body, providing a momentary mapping of the body's internal landscape and its relationship to the outside world. Active inference is based on the premise that afferent sensory input to the brain is constantly shaped and modified by prior expectations. In this review we propose that interoceptive psychopathology results from two primary interoceptive dysfunctions: First, individuals have abnormally strong expectations of the situations that elicit bodily change (i.e., hyperprecise priors), and second, they have great difficulty adjusting these expectations when the environment changes (i.e., context rigidity). Here we discuss how these dysfunctions potentially manifest in mental illness and how interventions aimed at altering interoceptive processing can help the brain create a more realistic model of its internal state.
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Affiliation(s)
- Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma 74136, USA;
| | - Justin S Feinstein
- Laureate Institute for Brain Research, Tulsa, Oklahoma 74136, USA; .,Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma 74119, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma 74136, USA; .,Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma 74119, USA
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41
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Corneille O, Desmedt O, Zamariola G, Luminet O, Maurage P. A heartfelt response to Zimprich et al. (2020), and Ainley et al. (2020)’s commentaries: Acknowledging issues with the HCT would benefit interoception research. Biol Psychol 2020; 152:107869. [DOI: 10.1016/j.biopsycho.2020.107869] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
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42
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Fittipaldi S, Abrevaya S, Fuente ADL, Pascariello GO, Hesse E, Birba A, Salamone P, Hildebrandt M, Martí SA, Pautassi RM, Huepe D, Martorell MM, Yoris A, Roca M, García AM, Sedeño L, Ibáñez A. A multidimensional and multi-feature framework for cardiac interoception. Neuroimage 2020; 212:116677. [PMID: 32101777 DOI: 10.1016/j.neuroimage.2020.116677] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/04/2020] [Accepted: 02/21/2020] [Indexed: 11/18/2022] Open
Abstract
Interoception (the sensing of inner-body signals) is a multi-faceted construct with major relevance for basic and clinical neuroscience research. However, the neurocognitive signatures of this domain (cutting across behavioral, electrophysiological, and fMRI connectivity levels) are rarely reported in convergent or systematic fashion. Additionally, various controversies in the field might reflect the caveats of standard interoceptive accuracy (IA) indexes, mainly based on heartbeat detection (HBD) tasks. Here we profit from a novel IA index (md) to provide a convergent multidimensional and multi-feature approach to cardiac interoception. We found that outcomes from our IA-md index are associated with -and predicted by- canonical markers of interoception, including the hd-EEG-derived heart-evoked potential (HEP), fMRI functional connectivity within interoceptive hubs (insular, somatosensory, and frontal networks), and socio-emotional skills. Importantly, these associations proved more robust than those involving current IA indexes. Furthermore, this pattern of results persisted when taking into consideration confounding variables (gender, age, years of education, and executive functioning). This work has relevant theoretical and clinical implications concerning the characterization of cardiac interoception and its assessment in heterogeneous samples, such as those composed of neuropsychiatric patients.
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Affiliation(s)
- Sol Fittipaldi
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina
| | - Sofía Abrevaya
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina
| | - Alethia de la Fuente
- National Scientific and Technical Research Council (CONICET), Argentina; Buenos Aires Physics Institute (IFIBA) and Physics Department, University of Buenos Aires, Buenos Aires, Argentina; Laboratory of Neuropsychology (LNPS), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Guido Orlando Pascariello
- National Scientific and Technical Research Council (CONICET), Argentina; Multimedia Signal Processing Group - Neuroimage Division, French-Argentine International Center for Information and Systems Sciences (CIFASIS), National Scientific and Technical Research Council (CONICET), Argentina; Laboratory of Neuroimaging and Neuroscience (LANEN), INECO Foundation Rosario, Argentina
| | - Eugenia Hesse
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; Departamento de Matemática y Ciencias, Universidad de San Andrés, Buenos Aires, Argentina
| | - Agustina Birba
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina
| | - Paula Salamone
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina
| | - Malin Hildebrandt
- Chair for Addiction Research, Institute for Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Sofía Alarco Martí
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Ricardo Marcos Pautassi
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Investigación Médica M. y M. Ferreyra, INIMEC-CONICET-UNC, Córdoba, Argentina
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Miquel Martorell Martorell
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina
| | - Adrián Yoris
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina
| | - María Roca
- National Scientific and Technical Research Council (CONICET), Argentina; Laboratory of Neuropsychology (LNPS), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina
| | - Lucas Sedeño
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile; Universidad Autónoma Del Caribe, Barranquilla, Colombia; ARC Excellence Center of Cognition and its Disorders, Sydney, Australia.
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My body, your emotions: Viscerosomatic modulation of facial expression discrimination. Biol Psychol 2019; 149:107779. [PMID: 31644926 DOI: 10.1016/j.biopsycho.2019.107779] [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: 02/12/2019] [Revised: 09/28/2019] [Accepted: 09/28/2019] [Indexed: 11/24/2022]
Abstract
Interoception reflects the ability to observe one's innermost bodily states. Here, we assessed whether interoceptive accuracy (IA) is related to the empathic ability to discriminate others' emotions. Participants (N = 111) completed a heartbeat tracking task, as well as an emotional go/no-go task with fearful and disgusted faces. Empathic facial mimicry during the go/no-go task was measured using electromyography (EMG) of the Corrugator Supercilii muscle. Higher IA was associated with higher perceptual sensitivity for emotional faces but was unrelated to response bias. Individuals higher in IA had stronger coupling between facial EMG and task performance. IA and facial EMG were associated with Go but not with NoGo trials, consistent with a specific modulation of perceptual sensitivity. These results suggest that tuning into one's own viscerosomatic signals relates to empathic mimicry and perception of others' emotional states.
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Khalsa SS, Rudrauf D, Hassanpour MS, Davidson RJ, Tranel D. The practice of meditation is not associated with improved interoceptive awareness of the heartbeat. Psychophysiology 2019; 57:e13479. [PMID: 31573689 DOI: 10.1111/psyp.13479] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 12/19/2022]
Abstract
Meditation is commonly assumed to be associated with enhanced interoceptive accuracy. We previously found that experienced meditators did not exhibit a greater ability than nonmeditators to detect heartbeat sensations at rest, despite the meditators' reported subjective ratings of higher accuracy and lower difficulty. Here, attempting to overcome previous methodological limitations, we assessed interoceptive awareness of heartbeat and breathing sensations across physiological arousal levels using infusions of isoproterenol, a beta-adrenergic agonist similar to adrenaline. We hypothesized that meditators would display greater interoceptive awareness than nonmeditators, as evidenced by higher interoceptive detection rates, increased interoceptive accuracy, and differences in localization of heartbeat sensations. We studied 15 meditators and 15 nonmeditators, individually matched on age, gender, and body mass index, using randomized, double-blinded, and placebo-controlled bolus infusions of isoproterenol. Participants reported their experience of heartbeat and breathing sensations using a dial during infusions and the location of heartbeat sensations on a two-dimensional manikin afterward. There was no evidence of higher detection rates or increased accuracy across any dose, although meditators showed a tendency to report cardiorespiratory sensation changes sooner at higher doses. Relative to nonmeditators, meditators exhibited prominent geographical differences in heartbeat localization, disproportionally reporting sensations throughout central regions of the chest, abdomen, neck, back, and head. To further assess indications of potential differences in cardiac interoceptive accuracy between meditators and nonmeditators, we conducted a meta-analysis including 724 participants and found little evidence for such differences. We conclude that the practice of meditation is not associated with improved cardiac interoceptive awareness.
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Affiliation(s)
- Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma.,Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - David Rudrauf
- CISA/CUI/FAPSE/Campus Biotech, University of Geneva, Geneva, Switzerland
| | - Mahlega S Hassanpour
- Laureate Institute for Brain Research, Tulsa, Oklahoma.,Department of Ophthalmology, The University of Utah School of Medicine, Salt Lake City, Utah
| | - Richard J Davidson
- Department of Psychology and Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin.,Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin
| | - Daniel Tranel
- Department of Neurology, University of Iowa, Iowa City, Iowa.,Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa
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45
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Wang X, Wu Q, Egan L, Gu X, Liu P, Gu H, Yang Y, Luo J, Wu Y, Gao Z, Fan J. Anterior insular cortex plays a critical role in interoceptive attention. eLife 2019; 8:e42265. [PMID: 30985277 PMCID: PMC6488299 DOI: 10.7554/elife.42265] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/13/2019] [Indexed: 12/11/2022] Open
Abstract
Accumulating evidence indicates that the anterior insular cortex (AIC) mediates interoceptive attention which refers to attention towards physiological signals arising from the body. However, the necessity of the AIC in this process has not been demonstrated. Using a novel task that directs attention toward breathing rhythm, we assessed the involvement of the AIC in interoceptive attention in healthy participants using functional magnetic resonance imaging and examined the necessity of the AIC in interoceptive attention in patients with AIC lesions. Results showed that interoceptive attention was associated with increased AIC activation, as well as enhanced coupling between the AIC and somatosensory areas along with reduced coupling between the AIC and visual sensory areas. In addition, AIC activation was predictive of individual differences in interoceptive accuracy. Importantly, AIC lesion patients showed disrupted interoceptive discrimination accuracy and sensitivity. These results provide compelling evidence that the AIC plays a critical role in interoceptive attention.
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Affiliation(s)
- Xingchao Wang
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Qiong Wu
- Beijing Key Lab of Learning and Cognition, School of PsychologyCapital Normal UniversityBeijingChina
- School of Psychological and Cognitive SciencesPeking UniversityBeijingChina
| | - Laura Egan
- Department of Psychology, Queens CollegeThe City University of New YorkNew YorkUnited States
| | - Xiaosi Gu
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUnited States
- Nash Family Department of NeuroscienceIcahn School of Medicine at Mount SinaiNew YorkUnited States
- The Mental Illness Research, Education, and Clinical CenterThe James J. Peter Veterans Affairs Medical CenterNew YorkUnited States
| | - Pinan Liu
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Hong Gu
- Neuroimaging Research Branch, Intramural Research ProgramNational Institute on Drug AbuseBaltimoreUnited States
| | - Yihong Yang
- Neuroimaging Research Branch, Intramural Research ProgramNational Institute on Drug AbuseBaltimoreUnited States
| | - Jing Luo
- Beijing Key Lab of Learning and Cognition, School of PsychologyCapital Normal UniversityBeijingChina
| | - Yanhong Wu
- School of Psychological and Cognitive SciencesPeking UniversityBeijingChina
- Beijing Key Laboratory of Behavior and Mental HealthPeking UniversityBeijingChina
| | - Zhixian Gao
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Jin Fan
- Department of Psychology, Queens CollegeThe City University of New YorkNew YorkUnited States
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUnited States
- Nash Family Department of NeuroscienceIcahn School of Medicine at Mount SinaiNew YorkUnited States
- Friedman Brain InstituteIcahn School of Medicine at Mount SinaiNew YorkUnited States
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46
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Schaan L, Schulz A, Nuraydin S, Bergert C, Hilger A, Rach H, Hechler T. Interoceptive accuracy, emotion recognition, and emotion regulation in preschool children. Int J Psychophysiol 2019; 138:47-56. [DOI: 10.1016/j.ijpsycho.2019.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/07/2019] [Accepted: 02/02/2019] [Indexed: 11/28/2022]
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47
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Tabor A, Vollaard N, Keogh E, Eccleston C. Predicting the consequences of physical activity: An investigation into the relationship between anxiety sensitivity, interoceptive accuracy and action. PLoS One 2019; 14:e0210853. [PMID: 30921331 PMCID: PMC6438567 DOI: 10.1371/journal.pone.0210853] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 01/03/2019] [Indexed: 11/18/2022] Open
Abstract
The ability to predict the consequences of our actions is imperative for the everyday success of our interactions. From negotiating an uneven surface, to mounting an immune response, we continually infer the limits of our body. The current investigation considered the impact that the inferred consequences of action has on the placement of limits. We hypothesised that the performance of individuals in a novel, sprint task would reflect both their ability to accurately detect changes in bodily arousal (Interoceptive Accuracy) and the inferred consequences associated with heightened arousal signals (Anxiety Sensitivity). We found that individuals who demonstrated accuracy associated with physiological arousal changes, and who showed a heightened fear of the consequences of arousal symptoms, modified their actions by decreasing their power output (mean Watts•kg-1) in a sprint task (ΔR2 = 0.19; F(1,34) = 19.87); p<0.001). These findings provide a basis for understanding the varying actions taken as we encounter bodily perturbation.
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Affiliation(s)
- Abby Tabor
- Centre for Pain Research, Department for Health, University of Bath, Bath, United Kingdom
- * E-mail:
| | - Niels Vollaard
- Department for Health, University of Bath, Bath, United Kingdom
| | - Edmund Keogh
- Centre for Pain Research, Department for Health, University of Bath, Bath, United Kingdom
| | - Christopher Eccleston
- Centre for Pain Research, Department for Health, University of Bath, Bath, United Kingdom
- Department of Clinical and Health Psychology, Ghent University, Ghent, Belgium
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48
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Abstract
Various aspects of physical and mental health have been linked to an individual’s ability to perceive the physical condition of their body (‘interoception’). In addition, numerous studies have demonstrated a role for interoception in higher-order cognitive abilities such as decision-making and emotion processing. The importance of interoception for health and typical cognitive functioning has prompted interest in how interoception varies over the lifespan. However, few studies have investigated interoception into older adulthood, and no studies account for the set of physiological changes that may influence task performance. The present study examined interoception from young to very late adulthood (until 90 years of age) utilising a self-report measure of interoception (Study One) and an objective measure of cardiac interoception (Study Two). Across both studies, interoception decreased with age, and changes in interoceptive accuracy were observed which were not explained by accompanying physiological changes. In addition to a direct effect of age on interoception, an indirect effect of ageing on cardiac interoceptive accuracy mediated by body mass index (BMI) was found, such that ageing was associated with increased BMI which was, in turn, associated with reduced interoceptive accuracy. Such findings support and extend previous research demonstrating interoceptive decline with advancing age, and highlight the importance of assessing whether decreasing interoceptive ability is responsible for some aspects of age-related ill-health and cognitive impairment.
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49
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Desmedt O, Luminet O, Corneille O. The heartbeat counting task largely involves non-interoceptive processes: Evidence from both the original and an adapted counting task. Biol Psychol 2018; 138:185-188. [DOI: 10.1016/j.biopsycho.2018.09.004] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/02/2018] [Accepted: 09/06/2018] [Indexed: 01/05/2023]
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50
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Zamariola G, Maurage P, Luminet O, Corneille O. Interoceptive accuracy scores from the heartbeat counting task are problematic: Evidence from simple bivariate correlations. Biol Psychol 2018; 137:12-17. [DOI: 10.1016/j.biopsycho.2018.06.006] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/13/2018] [Accepted: 06/18/2018] [Indexed: 01/25/2023]
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