An active inference theory of allostasis and interoception in depression

Shifting boundaries, extended minds: ambient technology and extended allostatic control

This article applies the thesis of the extended mind to ambient smart environments. These systems are characterised by an environment, such as a home or classroom, infused with multiple, highly networked streams of smart technology working in the background, learning about the user and operating without an explicit interface or any intentional sensorimotor engagement from the user. We analyse these systems in the context of work on the "classical" extended mind, characterised by conditions such as "trust and glue" and phenomenal transparency, and find that these conditions are ill-suited to describing our engagement with ambient smart environments. We then draw from the active inference framework, a theory of brain function which casts cognition as a process of embodied uncertainty minimisation, to develop a version of the extended mind grounded in a process ontology, where the boundaries of mind are understood to be multiple and always shifting. Given this more fluid account of the extended mind, we argue that ambient smart environments should be thought of as extended allostatic control systems, operating more or less invisibly to support an agent's biological capacity for minimising uncertainty over multiple, interlocking timescales. Thus, we account for the functionality of ambient smart environments as extended systems, and in so doing, utilise a markedly different version of the classical thesis of extended mind.

Exploring the impact of maternal early life adversity on interoceptive sensibility in pregnancy: implications for prenatal depression

PURPOSE

Pregnancy is a sensitive period of development in adult life characterized by massive changes in physical, emotional, and cognitive function. Such changes may be adaptive, e.g., facilitating adjustment to physical demands, but they may also reflect or contribute to risks inherent to this stage of life, e.g., prenatal depression. One cognitive ability that may undergo change during pregnancy and contribute to mental wellness is interoception - the ability to perceive, integrate, and model sensory information originating from the body. Strong interoceptive abilities are associated with lower rates of depression in non-pregnant adult populations, and interoception is generally weaker in individuals at higher risk for depression, for example, exposure to early life adversity (ELA). In the present online, cross-sectional study, we investigated whether interoception in pregnant women differed based on histories of ELA, in ways that increased their relative risk for prenatal depression symptoms.

METHODS

The pregnant individuals were in the second trimester of their first pregnancy and were compared to a group of nulliparous, non-parenting women.

RESULTS

Previous exposure to ELA significantly moderated pregnancy-related differences in self-reported interoception (interoceptive sensibility). A further moderated-mediation analysis revealed that the extent to which interoceptive sensibility buffered against depressive symptoms was conditional on ELA exposure, suggesting more ELA is associated with lower interoceptive sensibility during pregnancy, which increased prenatal depression risk.

CONCLUSIONS

Together this work suggests that levels of interoception during pregnancy are sensitive to previous adversity exposure. It also suggests that interoceptive-focused interventions for preventing/treating prenatal depressive symptoms in high-risk women may be worth exploring.

Common threads: Altered interoceptive processes across affective and anxiety disorders

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

Prevalence of Depression in Older Adults and the Potential Protective Role of Volunteering: Findings From the LongROAD Study

BACKGROUND

As the US population continues to age, depression and other mental health issues have become a significant challenge for healthy aging. Few studies, however, have examined the prevalence of depression in community-dwelling older adults in the United States.

METHODS

Baseline data from the Longitudinal Research on Aging Drivers study were analyzed to examine the prevalence and correlates of depression in a multisite sample of community-dwelling adults aged 65-79 years who were enrolled and assessed between July 2015 and March 2017. The Patient-Reported Outcomes Measurement Information System (PROMIS) depression scale was used to determine the depression status.

RESULTS

Of the 2990 study participants, 186 (6.2%) had depression at the time of assessment. Elevated prevalence of depression was found in those who were 65-69 years of age (7.9%); were women (7.2%); were not married (8.1%); had attained an education of high school or less (8.3%); or had annual household incomes less than $50,000 (10.7%). Older adults with a positive history of depression or chronic medical conditions (e.g., diabetes mellitus and anxiety) had a significantly higher prevalence of depression whereas those engaged in volunteering activities had a significantly lower prevalence of depression. With adjustment for demographic characteristics and comorbidities, volunteering was associated with a 43% reduction in the odds of depression (adjusted odds ratio: 0.57, 95% confidence interval 0.40-0.81).

CONCLUSIONS

The point prevalence of depression in this multisite sample of community-dwelling older adults in the United States was 6.2%, which varied significantly with demographic characteristics and comorbid conditions. Engagement in volunteering activities might help older adults to reduce their risk of depression.

"It's safer to believe that others don't like me" - A qualitative study on the paradoxical value of negative core beliefs in depression

Depression is related to difficulty revising established negative self-beliefs in response to novel positive experiences. This propensity is in some way paradoxical because negative beliefs usually have many obvious negative consequences for the individual (e.g., feeling upset). Using a qualitative approach, the present study sought to explore what makes such negative self-beliefs valuable from the patients' perspectives. In 14 patients with major depression, we conducted semi-structured interviews that explored the perceived benefits of retaining an individually specified negative core belief as well as the perceived costs of changing it. In a deductive-inductive approach based on a recent theoretical model of the value of beliefs, we found eight themes that may explain why people with depression uphold negative beliefs (intercoder agreement: κ = .81): expectation management, certainty and control, avoiding cognitive dissonance, adaptivity in the past, protection of higher values, attachment and belonging, saving resources, short-term counterevidence. The two most frequently mentioned themes were that retaining negative beliefs helps patients sustain certainty and keep expectations low to prevent future disappointments. While previous research has advanced the understanding of how (i.e., through which mechanisms) people with depression maintain negative self-beliefs, the present study provides novel insights into why they do so.

Allostatic Interoceptive Overload Across Psychiatric and Neurological Conditions

Emerging theories emphasize the crucial role of allostasis (anticipatory and adaptive regulation of the body's biological processes) and interoception (integration, anticipation, and regulation of internal bodily states) in adjusting physiological responses to environmental and bodily demands. In this review, we explore the disruptions in integrated allostatic interoceptive mechanisms in psychiatric and neurological disorders, including anxiety, depression, Alzheimer's disease, and frontotemporal dementia. We assess the biological mechanisms associated with allostatic interoception, including whole-body cascades, brain structure and function of the allostatic interoceptive network, heart-brain interactions, respiratory-brain interactions, the gut-brain-microbiota axis, peripheral biological processes (inflammatory, immune), and epigenetic pathways. These processes span psychiatric and neurological conditions and call for developing dimensional and transnosological frameworks. We synthesize new pathways to understand how allostatic interoceptive processes modulate interactions between environmental demands and biological functions in brain disorders. We discuss current limitations of the framework and future transdisciplinary developments. This review opens a new research agenda for understanding how allostatic interoception involves brain predictive coding in psychiatry and neurology, allowing for better clinical application and the development of new therapeutic interventions.

Interoceptive Mechanisms and Emotional Processing

Interoception, the sensing of internal bodily signals, is intricately linked with the experience of emotions. Various theoretical models of emotion incorporate aspects of interoception as a fundamental component alongside higher-order processes such as the appraisal of internal signals guided by external context. Interoception can be delineated into different dimensions, which include the nature of afferent signals, the accuracy with which they can be sensed, their neural processing, and the higher-order interpretation of these signals. This review methodically evaluates these interoceptive dimensions through empirical research to illustrate their role in shaping emotions. Clinical and neurodevelopmental conditions characterized by altered emotional profiles, such as anxiety, depression, schizophrenia, posttraumatic stress disorder, emotionally unstable personality disorder, and autism, exhibit distinct changes in interoception. Various therapeutic approaches, including behavioral, pharmacological, and psychological strategies, may be efficacious for treating conditions associated with emotional alterations by targeting interoceptive mechanisms.

Survival in a world of complex dangers

How did our nomadic ancestors continually adapt to the seemingly limitless and unpredictable number of dangers in the natural world? We argue that human defensive behaviors are dynamically constructed to facilitate survival in capricious and itinerant environments. We first hypothesize that internal and external states result in state constructions that combine to form a meta-representation. When a threat is detected, it triggers the action construction. Action constructions are formed through two contiguous survival strategies: generalization strategies, which are used when encountering new threats and ecologies. Generalization strategies are associated with cognitive representations that have high dimensionality and which furnish flexible psychological constructs, including relations between threats, and imagination, and which converge through the construction of defensive states. We posit that generalization strategies drive 'explorative' behaviors including information seeking, where the goal is to increase knowledge that can be used to mitigate current and future threats. Conversely, specialization strategies entail lower dimensional representations, which underpin specialized, sometimes reflexive, or habitual survival behaviors that are 'exploitative'. Together, these strategies capture a central adaptive feature of human survival systems: self-preservation in response to a myriad of threats.

Nature heals: An informational entropy account of self-organization and change in field psychotherapy

This paper reviews biophysical models of psychotherapeutic change based on synergetics and the free energy principle. These models suggest that introducing sensory surprise into the patient-therapist system can lead to self-organization and the formation of new attractor states, disrupting entrenched patterns of thoughts, emotions, and behaviours. We propose that the therapist can facilitate this process by cultivating epistemic trust and modulating embodied attention to allow surprising affective states to enter shared awareness. Transient increases in free energy enable the update of generative models, expanding the range of experiences available within the patient-therapist phenomenal field. We hypothesize that patterns of disorganization at behavioural and physiological levels, indexed by increased entropy, complexity, and lower determinism, are key markers and predictors of psychotherapeutic gains. Future research should investigate how the therapist's openness to novelty shapes therapeutic outcomes.

Integrating brainstem and cortical functional architectures

The brainstem is a fundamental component of the central nervous system, yet it is typically excluded from in vivo human brain mapping efforts, precluding a complete understanding of how the brainstem influences cortical function. In this study, we used high-resolution 7-Tesla functional magnetic resonance imaging to derive a functional connectome encompassing cortex and 58 brainstem nuclei spanning the midbrain, pons and medulla. We identified a compact set of integrative hubs in the brainstem with widespread connectivity with cerebral cortex. Patterns of connectivity between brainstem and cerebral cortex manifest as neurophysiological oscillatory rhythms, patterns of cognitive functional specialization and the unimodal-transmodal functional hierarchy. This persistent alignment between cortical functional topographies and brainstem nuclei is shaped by the spatial arrangement of multiple neurotransmitter receptors and transporters. We replicated all findings using 3-Tesla data from the same participants. Collectively, this work demonstrates that multiple organizational features of cortical activity can be traced back to the brainstem.

What can the psychoneuroimmunology of yoga teach us about depression's psychopathology?

Depression, the most prevailing mental health condition, remains untreated in over 30% of patients. This cluster presents with sub-clinical inflammation. Investigations trialling anti-inflammatory medications had mixed results. The lack of results may result from inflammation's complexity and targeting only a few of depression's abnormal pathways. Mind-body therapies' biological and neuro-imaging studies offer valuable insights into depression psychopathology. Interestingly, mind-body therapies, like yoga, reverse the aberrant pathways in depression. These aberrant pathways include decreased cognitive function, interoception, neuroplasticity, salience and default mode networks connectivity, parasympathetic tone, increased hypothalamic-pituitary-adrenal (HPA) axis activity, and metabolic hyper/hypofunction. Abundant evidence found yogic techniques improving self-reported depressive symptoms across various populations. Yoga may be more effective in treating depression in conjunction with pharmacological and cognitive therapies. Yoga's psychoneuroimmunology teaches us that reducing allostatic load is crucial in improving depressive symptoms. Mind-body therapies promote parasympathetic tone, downregulate the HPA axis, reduce inflammation and boost immunity. The reduced inflammation promotes neuroplasticity and, subsequently, neurogenesis. Improving interoception resolves the metabolic needs prediction error and restores homeostasis. Additionally, by improving functional connectivity within the salience network, they restore the dynamic switching between the default mode and central executive networks, reducing rumination and mind-wandering. Future investigations should engineer therapies targeting the mechanisms mentioned above. The creation of multi-disciplinary health teams offering a combination of pharmacological, gene, neurofeedback, behavioural, mind-body and psychological therapies may treat treatment-resistant depression.

Neural Interoceptive Processing Is Modulated by Deep Brain Stimulation to Subcallosal Cingulate Cortex for Treatment-Resistant Depression

BACKGROUND

Symptoms of depression are associated with impaired interoceptive processing of bodily sensation. The antidepressant effects of subcallosal cingulate deep brain stimulation (SCC DBS) include acute change in bodily sensation, and the SCC target is connected to cortical regions critically involved in interoception. This study tested whether cortical interoceptive processing is modulated by SCC DBS for treatment-resistant depression.

METHODS

In 8 patients receiving SCC DBS for treatment-resistant depression, we used electroencephalography to measure the heartbeat-evoked potential (HEP), a putative readout of neural interoception, before surgery and over 6 months of treatment with DBS. We also examined the immediate effect of DBS on the HEP and correlated HEP change over time with outcomes of treatment for depression.

RESULTS

HEP amplitude increased from baseline to 6 months of DBS treatment, and this increase was associated with faster antidepressant response. Recording with stimulation on (vs. off) had an immediate effect on HEP in the laboratory. Overall, modulation of the HEP was most pronounced in sensors over the left parietal cortex.

CONCLUSIONS

Brain-based evidence implies an interoceptive element in the mechanism of treatment efficacy with DBS for treatment-resistant depression and substantiates a theorized connection between interoception and depression.

Hemispheric divergence of interoceptive processing across psychiatric disorders

Interactions between top-down attention and bottom-up visceral inputs are assumed to produce conscious perceptions of interoceptive states, and while each process has been independently associated with aberrant interoceptive symptomatology in psychiatric disorders, the neural substrates of this interface are unknown. We conducted a preregistered functional neuroimaging study of 46 individuals with anxiety, depression, and/or eating disorders (ADE) and 46 propensity-matched healthy comparisons (HC), comparing their neural activity across two interoceptive tasks differentially recruiting top-down or bottom-up processing within the same scan session. During an interoceptive attention task, top-down attention was voluntarily directed towards cardiorespiratory or visual signals. In contrast, during an interoceptive perturbation task, intravenous infusions of isoproterenol (a peripherally-acting beta-adrenergic receptor agonist) were administered in a double-blinded and placebo-controlled fashion to drive bottom-up cardiorespiratory sensations. Across both tasks, neural activation converged upon the insular cortex, localizing within the granular and ventral dysgranular subregions bilaterally. However, contrasting hemispheric differences emerged, with the ADE group exhibiting (relative to HCs) an asymmetric pattern of overlap in the left insula, with increased or decreased proportions of co-activated voxels within the left or right dysgranular insula, respectively. The ADE group also showed less agranular anterior insula activation during periods of bodily uncertainty (i.e. when anticipating possible isoproterenol-induced changes that never arrived). Finally, post-task changes in insula functional connectivity were associated with anxiety and depression severity. These findings confirm the dysgranular mid-insula as a key cortical interface where attention and prediction meet real-time bodily inputs, especially during heightened awareness of interoceptive states. Furthermore, the dysgranular mid-insula may indeed be a 'locus of disruption' for psychiatric disorders.

A systematic review and meta-analysis of the relationship between subjective interoception and alexithymia: Implications for construct definitions and measurement

Although research indicates that self-reported interoception is associated with deficits in identifying and describing emotional experience, and externally oriented thinking styles (alexithymia), this relationship appears moderated by how interoception is measured. A systematic review and meta-analyses examined the association between self-reported interoception and alexithymia, investigating how different interoceptive questionnaires relate to alexithymia at global and facet levels. PsychINFO, PubMed, Scopus, and Web of Science databases were searched with predefined terms related to self-reported interoception and alexithymia. Three reviewers independently assessed articles, extracted data, and undertook risk of bias assessment. Thirty-two cross-sectional studies published between 1996 and 2023 were included. Random-effects meta-analyses and narrative synthesis indicated that global alexithymia was positively associated with measures of interoceptive confusion, autonomic nervous system reactivity, and heightened interoceptive attention, and inversely associated with interoceptive accuracy and adaptive interoception, indexed by composite Multidimensional Assessment of Interoceptive Awareness scores, but particularly interoceptive trusting, self-regulation, and attention regulation. These patterns were observed for alexithymic facets and stronger in magnitude for difficulty identifying feelings and difficulty describing feelings, relative to externally oriented thinking. Overall, results suggested that the association between self-reported interoception and alexithymia differs as a function of the interoceptive self-report. The review highlighted issues with construct definition and operationalisation and determined that existing interoceptive self-reports broadly capture maladaptive and adaptive sensing, attention, interpretation, and memory. The findings underscore the importance of specifying interoceptive constructs and using appropriate assessments to improve convergence between constructs and measurements, further suggesting potential clinical utility in using existing self-reports to measure interoception and alexithymia, facilitating interventions targeting mind-body connections.

The Algorithmic Agent Perspective and Computational Neuropsychiatry: From Etiology to Advanced Therapy in Major Depressive Disorder

Major Depressive Disorder (MDD) is a complex, heterogeneous condition affecting millions worldwide. Computational neuropsychiatry offers potential breakthroughs through the mechanistic modeling of this disorder. Using the Kolmogorov theory (KT) of consciousness, we developed a foundational model where algorithmic agents interact with the world to maximize an Objective Function evaluating affective valence. Depression, defined in this context by a state of persistently low valence, may arise from various factors-including inaccurate world models (cognitive biases), a dysfunctional Objective Function (anhedonia, anxiety), deficient planning (executive deficits), or unfavorable environments. Integrating algorithmic, dynamical systems, and neurobiological concepts, we map the agent model to brain circuits and functional networks, framing potential etiological routes and linking with depression biotypes. Finally, we explore how brain stimulation, psychotherapy, and plasticity-enhancing compounds such as psychedelics can synergistically repair neural circuits and optimize therapies using personalized computational models.

WACARDIA: Graphical MATLAB software for Wireless Assessment of CARDiac Interoceptive Accuracy

Many theories of psychological function emphasize the importance of bodily sensations and the ability to accurately detect them, known as interoceptive accuracy. The most common measure of interoceptive accuracy uses heartbeat detection tasks such as the Whitehead Task, yet to our knowledge there are no freely accessible programs to conduct this task. In this paper, we present novel software called WACARDIA (Wireless Assessment of CARDiac Interoceptive Accuracy), which is free, open-source software that conducts the heartbeat detection task using Matlab and Psychtoolbox. WACARDIA contains several key features supporting participant engagement, operator convenience, and measurement accuracy. First, the program includes an optional practice trial of unlimited duration, a participant-facing graphical interface, and the ability to perform heartbeat detection training. Second, the operator is provided with a graphical user interface, live trial feedback, an accurate wireless electrocardiogram device, and a separate program to conduct the related Heartbeat Tracking task. Finally, the program ensures the accuracy of collected data by scheduling the delivery of tones with high precision and implementing fail-safes to automatically reset erroneous measurements. This paper includes flowcharts that help create transparency by describing our algorithm. We also outline customizable aspects of the program with the intent to have WACARDIA's algorithm expanded to accommodate more situations and applications. With this paper, we hope to encourage the practice of publicizing research software to contribute to the transparency, rigor, and reproducibility of scientific studies. WACARDIA and video tutorials are available at www.github.com/iankleckner/wacardia and http://wacardia.iankleckner.com.

He Who Seeks Finds (Bodily Signals): German Validation of the Interoceptive Attention Scale (IATS) and its Relationship with Subclinical Psychopathology

Alterations in interoception have been linked to psychopathology. Recent findings suggest that both the attention to and the accuracy of, interoceptive perceptions may be oppositely related to subclinical symptomatology. Thus, providing well-validated tools that tap into these interoceptive processes is crucial for understanding the relation between interoceptive processing and subclinical psychopathology. In the current study (N = 642), we aimed to (1) validate the German version of the Interoceptive Attention Scale (IATS; Gabriele et al., 2022), and (2) test the differential association of self-reported interoceptive attention and accuracy with subclinical symptomatology, including alexithymia, depressive, and anxious symptomatology. We observed that a one-factor solution is a well-fitting model for the IATS. Further, the IATS showed good internal consistency, convergent, and divergent validity, but poor test-retest reliability. Self-reported interoceptive attention and accuracy were unrelated to each other. However, IATS scores were positively related to all measures of psychopathology (except depressive symptomatology), whereas self-reported interoceptive accuracy scores showed negative or nonsignificant relations with these. Our data suggest that the IATS is a good instrument to measure self-report interoceptive attention in the German population. Further, we highlight the need to distinguish between constructs of interoception to better understand the relation between interoception and psychopathology.

Emotion topology: extracting fundamental components of emotions from text using word embeddings

This exploratory study examined the potential of word embeddings, an automated numerical representation of written text, as a novel method for emotion decomposition analysis. Drawing from a substantial dataset scraped from a Social Media site, we constructed emotion vectors to extract the dimensions of emotions, as annotated by the readers of the texts, directly from human language. Our findings demonstrated that word embeddings yield emotional components akin to those found in previous literature, offering an alternative perspective not bounded by theoretical presuppositions, as well as showing that the dimensional structure of emotions is reflected in the semantic structure of their text-based expressions. Our study highlights word embeddings as a promising tool for uncovering the nuances of human emotions and comments on the potential of this approach for other psychological domains, providing a basis for future studies. The exploratory nature of this research paves the way for further development and refinement of this method, promising to enrich our understanding of emotional constructs and psychological phenomena in a more ecologically valid and data-driven manner.

Active inference goes to school: the importance of active learning in the age of large language models

Human learning essentially involves embodied interactions with the material world. But our worlds now include increasing numbers of powerful and (apparently) disembodied generative artificial intelligence (AI). In what follows we ask how best to understand these new (somewhat 'alien', because of their disembodied nature) resources and how to incorporate them in our educational practices. We focus on methodologies that encourage exploration and embodied interactions with 'prepared' material environments, such as the carefully organized settings of Montessori education. Using the active inference framework, we approach our questions by thinking about human learning as epistemic foraging and prediction error minimization. We end by arguing that generative AI should figure naturally as new elements in prepared learning environments by facilitating sequences of precise prediction error enabling trajectories of self-correction. In these ways, we anticipate new synergies between (apparently) disembodied and (essentially) embodied forms of intelligence. This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.

The fear-avoidance model as an embodied prediction of threat

The fear-avoidance model is a well-established framework in the understanding of persistent pain. It proposes a dichotomous path: either the context is interpreted as safe; there is no fear reaction and, therefore, the individual engages in active (positive) coping; or the context is interpreted as threatening, leading to a self-reinforcing vicious circle of fear and (negative) avoidance. We propose an embodied interpretation of this phenomenon employing the joint framework of predictive coding and active inference. The key idea is that multisensory integration of exteroceptive, proprioceptive, and interoceptive sensory inputs can lead to dysfunctional experiences of threat in nonthreatening situations. Threat inference can promote fear responses, maladaptive strategies (i.e., avoidance) and self-provides evidence for threat in associated or future contexts, or both. Under this treatment, the prediction of nonrealized threat becomes self-evidencing and context-invariant, and hence self-perpetuating. Safety cues are unable to attenuate the interpretation of the negative context as the dominant inference of the context is threatful and gains more precision and becomes resistant over time. Our model provides an explanation for the emergence of a dysfunctional fear response in the clinical setting despite apparent safety based on modern concepts from theoretical (computational) neuroscience.

Heartbeat-related spectral perturbation of electroencephalogram reflects dynamic interoceptive attention states in the trial-by-trial classification analysis

Attending to heartbeats for interoceptive awareness initiates distinct electrophysiological responses synchronized with the R-peaks of an electrocardiogram (ECG), such as the heartbeat-evoked potential (HEP). Beyond HEP, this study proposes heartbeat-related spectral perturbation (HRSP), a time-frequency map of the R-peak locked electroencephalogram (EEG), and explores its characteristics in identifying interoceptive attention states using a classification approach. HRSPs of EEG brain components specified by independent component analysis (ICA) were used for the offline and online classification of interoceptive states. A convolutional neural network (CNN) designed specifically for HRSP was applied to publicly available data from a binary-state experiment (attending to self-heartbeats and white noise) and data from our four-state classification experiment (attending to self-heartbeats, white noise, time passage, and toe) with diverse input feature conditions of HRSP. From the dynamic state perspective, we evaluated the primary frequency bands of HRSP and the minimal number of averaging epochs required to reflect changing interoceptive attention states without compromising accuracy. We also assessed the utility of group ICA and models for classifying HRSP in new participants. The CNN for trial-by-trial HRSP with actual R-peaks demonstrated significantly higher classification accuracy than HRSP with sham, i.e., randomly positioned, R-peaks. Gradient-weighted class activation mapping highlighted the prominent role of theta and alpha bands between 200-600 ms post-R-peak-features absent in classifications using sham HRSPs. Online classification benefits from employing a group ICA and classification model, ensuring reliable accuracy without individual EEG precollection. These results suggest HRSP's potential to reflect interoceptive attention states, proposing transformative implications for clinical applications.

Active Inference in Psychology and Psychiatry: Progress to Date?

The free energy principle is a formal theory of adaptive self-organising systems that emerged from statistical thermodynamics, machine learning and theoretical neuroscience and has since been translated into biologically plausible 'process theories' of cognition and behaviour, which fall under the banner of 'active inference'. Despite the promise this theory holds for theorising, research and practical applications in psychology and psychiatry, its impact on these disciplines has only now begun to bear fruit. The aim of this treatment is to consider the extent to which active inference has informed theoretical progress in psychology, before exploring its contributions to our understanding and treatment of psychopathology. Despite facing persistent translational obstacles, progress suggests that active inference has the potential to become a new paradigm that promises to unite psychology's subdisciplines, while readily incorporating the traditionally competing paradigms of evolutionary and developmental psychology. To date, however, progress towards this end has been slow. Meanwhile, the main outstanding question is whether this theory will make a positive difference through applications in clinical psychology, and its sister discipline of psychiatry.

Sympathetic arousal among depressed college students: Examining the interplay between psychopathology and social activity

Depressed individuals exhibit altered sensitivity to both positive and negative social contact, and may not reap the same psychological and emotional benefits to socializing as non-depressed individuals. Although depressive symptoms and loneliness predict social withdrawal and decreased pleasure, little is currently understood about immediate affective arousal dynamics during real-time socializing. Using a novel ambulatory protocol that tracked both objective features of affective arousal (electrodermal activity) and subjective valence (self-reported) during college students' social interactions, we evaluated the moderating role of depression and loneliness symptoms on the associations between socializing with others (specifically, with a romantic partner, a close friend, or a group of friends) and the arousal and valence dimensions of affect. Among a racially and ethnically diverse sample of 118 college students (64% African American/Black/Continental African, 20% Latinx, 8% Asian, and 8% White) recruited from a large, predominantly White Midwestern university, those lower in depression and loneliness symptomatology evinced decreased average arousal (Β = -0.10, SE = 0.04, p < .01) when in relaxed and intimate socializing contexts (e.g., with a romantic partner and a close friend), consistent with the idea that these contexts facilitate important opportunities for psychological rest and recovery. Those lower in depression and loneliness symptoms also showed higher average arousal when socializing in the energizing context of being with a group of friends. Overall, the results suggest psychopathology is reflected in patterns of sympathetic arousal when socializing, with more depressed and lonely individuals generally feeling worse while receiving fewer psychophysiological rewards in multiple socializing contexts.

Disembodiment and Affective Resonances in Esketamine Treatment of Depersonalized Depression Subtype: Two Case Studies

INTRODUCTION

Dissociative experiences are considered undesirable ketamine's adverse events. However, they might be crucial for ketamine's antidepressant effects, at least in some depression subtypes. Current understandings of ketamine's therapeutic potentials converge on the so-called "relaxed prior hypothesis," suggesting that glutamatergic blockage up-weights bottom-up surprising somatosensory/affective states. As a result, ketamine improves short-term plasticity in depression by enhancing sensitivity to interoceptive signals.

METHODS

We selected 2 case studies for their paradigmatic description of "depersonalized depression" (Entfremdungsdepression) symptoms. Patients were included in a 6-month-long esketamine program for treatment resistant depression, during which we collected their spontaneous experience with esketamine. According to a neurophenomenological approach, we combined subjective reports from unstructured clinical interviews and the review of previous objective neuroimaging results and neurocomputational models to unveil the relation between esketamine antidepressant effects and interoceptive sensitivity.

RESULTS

According to our clinical observations, esketamine-induced dissociation might be particularly effective in the depersonalized depression subtype, in which interoceptive awareness and interaffectivity are particularly compromised. Ketamine and esketamine's dissociative effects and particularly disembodiment might suspend previously acquired patterns of feeling, sensing, and behaving.

CONCLUSIONS

Coherently with previous research, we suggest that esketamine-induced disembodiment allows for a transient window of psychological plasticity and enhanced sensitivity, where the body recovers its permeability to affective affordances.

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

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

Emotional concepts shape the perceptual representation of body expressions

Emotion perception interacts with how we think and speak, including our concept of emotions. Body expression is an important way of emotion communication, but it is unknown whether and how its perception is modulated by conceptual knowledge. In this study, we employed representational similarity analysis and conducted three experiments combining semantic similarity, mouse-tracking task, and one-back behavioral task with electroencephalography and functional magnetic resonance imaging techniques, the results of which show that conceptual knowledge predicted the perceptual representation of body expressions. Further, this prediction effect occurred at approximately 170 ms post-stimulus. The neural encoding of body expressions in the fusiform gyrus and lingual gyrus was impacted by emotion concept knowledge. Taken together, our results indicate that conceptual knowledge of emotion categories shapes the configural representation of body expressions in the ventral visual cortex, which offers compelling evidence for the constructed emotion theory.

Scale for time and space experience in anxiety (STEA): Phenomenology and its clinical relevance

Anxiety is a pervasive emotional state where, phenomenologically, subjects often report changes in their experience of time and space. However, a systematic and quantified examination of time and space experience in terms of a self-report scale is still missing which eventually could also be used for clinical differential diagnosis. Based on historical phenomenological literature and patients' subjective reports, we here introduce, in a first step, the Scale for Time and Space Experience of Anxiety (STEA) in a smaller sample of 19 subjects with anxiety disorders and, in a second step, validate its shorter clinical version (cSTEA) in a larger sample of 48 anxiety subjects. The main findings are (i) high convergent and divergent validity of STEA with both Beck Anxiety Inventory (BAI) (r = 0.7325; p < 0.001) and Beck Depression Inventory (BDI) (r = 0.7749; p < 0.0001), as well as with spontaneous mind wandering (MWS) (r = 0.7343; p < 0.001) and deliberate mind wandering (MWD) (r = 0.1152; p > 0.05), (ii) statistical feature selection shows 8 key items for future clinical usage (cSTEA) focusing on the experience of temporal and spatial constriction, (iii) the effects of time and space experience (i.e., for both STEA and cSTEA scores) on the level of anxiety (BAI) are mediated by the degree of spontaneous mind wandering (MWS), (iv) cSTEA allows for differentiating high levels of anxiety from the severity of comorbid depressive symptoms, and (v) significant reduction in the cSTEA scores after a therapeutic intervention (breathing therapy). Together, our study introduces a novel fully quantified and highly valid self-report instrument, the STEA, for measuring time-space experiences in anxiety. Further we develop a shorter clinical version (cSTEA) which allows assessing time space experience in a valid, quick, and simple way for diagnosis, differential diagnosis, and therapeutic monitoring of anxiety.

A Hypothalamic Perspective of Human Socioemotional Behavior

Historical evidence from stimulation and lesion studies in animals and humans demonstrated a close association between the hypothalamus and typical and atypical socioemotional behavior. A central hypothalamic contribution to regulation of socioemotional responses was also provided indirectly by studies on oxytocin and arginine vasopressin. However, a limited number of studies have so far directly investigated the contribution of the hypothalamus in human socioemotional behavior. To reconsider the functional role of the evolutionarily conserved hypothalamic region in regulating human social behavior, here I provide a synthesis of neuroimaging investigations showing that the hypothalamus is involved in multiple and diverse facets of human socioemotional behavior through widespread functional interactions with other cortical and subcortical regions. These neuroimaging findings are then integrated with recent optogenetics studies in animals demonstrating that the hypothalamus plays a more active role in eliciting socioemotional responses and is not simply a downstream effector of higher-level brain systems. Building on the aforementioned evidence, the hypothalamus is argued to substantially contribute to a continuum of human socioemotional behaviors promoting survival and preservation of the species that extends from exploratory and approaching responses facilitating social bonding to aggressive and avoidance responses aimed to protect and defend formed relationships.

The Mediating Role of Interoceptive Sensitivity in the Relationship between Physical Activity and Depression Symptoms in College Students

A substantial body of evidence indicates that neurological, psychological, and behavioral health issues are profoundly linked to interoceptive sensitivity. The present study aimed to identify the effects of interoceptive sensitivity on the relationship between physical activity and symptoms of depression in Chinese college students. This study employed a cross-sectional design using convenience sampling. An online self-reported survey was distributed to college students in China. The participants' interoceptive sensitivity, physical activity levels, and depressive symptoms were measured using the MAIA-2, IPAQ-SF, and PHQ-9, respectively. The mediating effect was tested via regression analysis and a parallel mediation model, with bootstrap confidence intervals for indirect effects. The results showed a significant negative correlation between physical activity and depression. A significant positive correlation was observed between physical activity and seven dimensions of interoceptive sensitivity. Conversely, interoceptive sensitivity exhibited a negative correlation with depression. The bootstrap mediation analysis showed that the "not distracting" and "trusting" dimensions of interoceptive sensitivity had significant indirect effects on the relationship between physical activity and depression, suggesting that physical activity might reduce depressive symptoms via these two interoceptive sensitivity dimensions. The findings suggest that interoceptive sensitivity should be integrated into therapeutic interventions, such as physical activity interventions, in the treatment of mental illnesses, particularly depression. Increasing physical activity levels, with a specific focus on enhancing interoceptive modulation, appears to be a promising approach for addressing depression in college students.

Placebo treatment affects brain systems related to affective and cognitive processes, but not nociceptive pain

Drug treatments for pain often do not outperform placebo, and a better understanding of placebo mechanisms is needed to improve treatment development and clinical practice. In a large-scale fMRI study (N = 392) with pre-registered analyses, we tested whether placebo analgesic treatment modulates nociceptive processes, and whether its effects generalize from conditioned to unconditioned pain modalities. Placebo treatment caused robust analgesia in conditioned thermal pain that generalized to unconditioned mechanical pain. However, placebo did not decrease pain-related fMRI activity in brain measures linked to nociceptive pain, including the Neurologic Pain Signature (NPS) and spinothalamic pathway regions, with strong support for null effects in Bayes Factor analyses. In addition, surprisingly, placebo increased activity in some spinothalamic regions for unconditioned mechanical pain. In contrast, placebo reduced activity in a neuromarker associated with higher-level contributions to pain, the Stimulus Intensity Independent Pain Signature (SIIPS), and affected activity in brain regions related to motivation and value, in both pain modalities. Individual differences in behavioral analgesia were correlated with neural changes in both modalities. Our results indicate that cognitive and affective processes primarily drive placebo analgesia, and show the potential of neuromarkers for separating treatment influences on nociception from influences on evaluative processes.

Is depression a global brain disorder with topographic dynamic reorganization?

Major depressive disorder (MDD) is characterized by a multitude of psychopathological symptoms including affective, cognitive, perceptual, sensorimotor, and social. The neuronal mechanisms underlying such co-occurrence of psychopathological symptoms remain yet unclear. Rather than linking and localizing single psychopathological symptoms to specific regions or networks, this perspective proposes a more global and dynamic topographic approach. We first review recent findings on global brain activity changes during both rest and task states in MDD showing topographic reorganization with a shift from unimodal to transmodal regions. Next, we single out two candidate mechanisms that may underlie and mediate such abnormal uni-/transmodal topography, namely dynamic shifts from shorter to longer timescales and abnormalities in the excitation-inhibition balance. Finally, we show how such topographic shift from unimodal to transmodal regions relates to the various psychopathological symptoms in MDD including their co-occurrence. This amounts to what we describe as 'Topographic dynamic reorganization' which extends our earlier 'Resting state hypothesis of depression' and complements other models of MDD.

Ghrelin is associated with an elevated mood after an overnight fast in depression

BACKGROUND

Major depressive disorder (MDD) comprises subtypes with distinct symptom profiles. For example, patients with melancholic and atypical MDD differ in the direction of appetite and body weight changes as well as mood reactivity. Despite reported links to altered energy metabolism, the role of circulating neuropeptides from the gut in modulating such symptoms remains largely elusive.

METHODS

We collected data from 103 participants, including 52 patients with MDD and 51 healthy control participants (HCP). After an overnight fast, we measured plasma levels of (acyl and des-acyl) ghrelin and participants reported their current metabolic and mood states using visual analog scales (VAS). Furthermore, they completed symptom-related questionnaires (i.e., STAI-T).

RESULTS

Patients with atypical versus melancholic MDD reported less negative affect (p = 0.025). Higher levels of acyl ghrelin (corrected for BMI) were associated with improved mood (p = 0.012), specifically in patients with MDD. These associations of ghrelin were not mood-item specific and exceeded correlations with trait markers of negative affectivity. In contrast to associations with mood state, higher levels of ghrelin were not associated with increased hunger per se or changes in appetite in patients with MDD.

LIMITATIONS

The study is limited by the cross-sectional design without an intervention.

CONCLUSIONS

Our results reveal potentially mood-enhancing effects of ghrelin in fasting individuals that exceed associations with metabolic state ratings. These associations with circulating neuropeptides might help explain anti-depressive effects of fasting interventions and could complement conventional treatments in patients with melancholic MDD.

Interoception in anxiety, depression, and psychosis: a review

Research has examined the relationship between interoception and anxiety, depression, and psychosis; however, it is unclear which aspects of interoception have been systematically examined, what the combined findings are, and which areas require further research. To answer these questions, we systematically searched and narratively synthesised relevant reviews, meta-analyses, and theory papers (total n = 34). Existing systematic reviews and meta-analyses (anxiety n = 2; depression n = 2; psychosis n = 0), focus on cardiac interoceptive accuracy (heartbeat perception), and indicate that heartbeat perception is not systematically impaired in anxiety or depression. Heartbeat perception might be poorer in people with psychosis, but further evidence is needed. Other aspects of interoception, such as different body systems and processing levels, have been studied but not systematically reviewed. We highlight studies examining these alternative bodily domains and levels, review the efficacy of interoception-based psychological interventions, and make suggestions for future research.

Funding

Wellcome Trust UK.

Non-invasive vagus nerve stimulation conditions increased invigoration and wanting in depression

BACKGROUND

Major depressive disorder (MDD) is often marked by impaired motivation and reward processing, known as anhedonia. Many patients do not respond to first-line treatments, and improvements in motivation can be slow, creating an urgent need for rapid interventions. Recently, we demonstrated that transcutaneous auricular vagus nerve stimulation (taVNS) acutely boosts effort invigoration in healthy participants, but its effects on depression remain unclear.

OBJECTIVE

To assess the impact of taVNS on effort invigoration and maintenance in a sample that includes patients with MDD, evaluating the generalizability of our findings.

METHODS

We used a single-blind, randomized crossover design in 30 patients with MDD and 29 matched (age, sex, and BMI) healthy control participants (HCP).

RESULTS

Consistent with prior findings, taVNS increased effort invigoration for rewards in both groups during Session 1 (p = .040), particularly for less wanted rewards in HCP (pboot < 0.001). However, invigoration remained elevated in all participants, and no acute changes were observed in Session 2 (Δinvigoration = 3.3, p = .12). Crucially, throughout Session 1, we found taVNS-induced increases in effort invigoration (pboot = 0.008) and wanting (pboot = 0.010) in patients with MDD, with gains in wanting maintained across sessions (Δwanting = 0.06, p = .97).

CONCLUSIONS

Our study replicates the invigorating effects of taVNS in Session 1 and reveals its generalizability to depression. Furthermore, we expand upon previous research by showing taVNS-induced conditioning effects on invigoration and wanting within Session 1 in patients that were largely sustained. While enduring motivational improvements present challenges for crossover designs, they are highly desirable in interventions and warrant further follow-up research.

Interoceptive awareness in a clinical setting: the need to bring interoceptive perspectives into clinical evaluation

Interoceptive awareness (IA) is crucial to understanding mental health. The Multidimensional Assessment of Interoceptive Awareness (MAIA) scale, available in approximately 30 languages, has gained global recognition for its research applicability. This review highlights the critical importance of integrating IA evaluation in clinical settings, advocating for the MAIA scale's potential as a screening tool. Through an examination of academic databases, including Scopus, PubMed, Google Scholar, and J-STOR, our analysis spans seven mental health domains: eating disorders (ED), depression, stress, anxiety, autism spectrum disorder (ASD), chronic pain, and suicide ideation (SI). Thirty-eight studies showed links between several dimensions of IA with different disorders. That is, ED was related to Body Trust and Self-Regulation; anxiety to Body Listening, Emotional Awareness, and Self-Regulation; depression to Noticing and Emotional Awareness; ASD to Trusting, Emotional Awareness, and Noticing; chronic pain to Not-Worrying and Self-Regulation; and SI with Trusting. These insights hold profound implications for both clinical practice and mental health research. Integrating IA assessments into standard clinical protocols has the potential to improve our understanding of pathology, enrich patient care, and enhance therapeutic strategies.

Hemispheric divergence of interoceptive processing across psychiatric disorders

Interactions between top-down attention and bottom-up visceral inputs are assumed to produce conscious perceptions of interoceptive states, and while each process has been independently associated with aberrant interoceptive symptomatology in psychiatric disorders, the neural substrates of this interface are unknown. We conducted a preregistered functional neuroimaging study of 46 individuals with anxiety, depression, and/or eating disorders (ADE) and 46 propensity-matched healthy comparisons (HC), comparing their neural activity across two interoceptive tasks differentially recruiting top-down or bottom-up processing within the same scan session. During an interoceptive attention task, top-down attention was voluntarily directed towards cardiorespiratory or visual signals, whereas during an interoceptive perturbation task, intravenous infusions of isoproterenol (a peripherally-acting beta-adrenergic receptor agonist) were administered in a double-blinded and placebo-controlled fashion to drive bottom-up cardiorespiratory sensations. Across both tasks, neural activation converged upon the insular cortex, localizing within the granular and ventral dysgranular subregions bilaterally. However, contrasting hemispheric differences emerged, with the ADE group exhibiting (relative to HCs) an asymmetric pattern of overlap in the left insula, with increased or decreased proportions of co-activated voxels within the left or right dysgranular insula, respectively. The ADE group also showed less agranular anterior insula activation during periods of bodily uncertainty (i.e., when anticipating possible isoproterenol-induced changes that never arrived). Finally, post-task changes in insula functional connectivity were associated with anxiety and depression severity. These findings confirm the dysgranular mid-insula as a key cortical interface where attention and prediction meet real-time bodily inputs, especially during heightened awareness of interoceptive states. Further, the dysgranular mid-insula may indeed be a "locus of disruption" for psychiatric disorders.

Exploring the role of neuronal-enriched extracellular vesicle miR-93 and interoception in major depressive disorder

Major depressive disorder (MDD) is associated with interoceptive processing dysfunctions, but the molecular mechanisms underlying this dysfunction are poorly understood. This study combined brain neuronal-enriched extracellular vesicle (NEEV) technology and serum markers of inflammation and metabolism with Functional Magnetic Resonance Imaging (fMRI) to identify the contribution of gene regulatory pathways, in particular micro-RNA (miR) 93, to interoceptive dysfunction in MDD. Individuals with MDD (n = 41) and healthy comparisons (HC; n = 35) provided blood samples and completed an interoceptive attention task during fMRI. EVs were separated from plasma using a precipitation method. NEEVs were enriched by magnetic streptavidin bead immunocapture utilizing a neural adhesion marker (L1CAM/CD171) biotinylated antibody. The origin of NEEVs was validated with two other neuronal markers - neuronal cell adhesion molecule (NCAM) and ATPase Na+/K+ transporting subunit alpha 3 (ATP1A3). NEEV specificities were confirmed by flow cytometry, western blot, particle size analyzer, and transmission electron microscopy. NEEV small RNAs were purified and sequenced. Results showed that: (1) MDD exhibited lower NEEV miR-93 expression than HC; (2) within MDD but not HC, those individuals with the lowest NEEV miR-93 expression had the highest serum concentrations of interleukin (IL)-1 receptor antagonist, IL-6, tumor necrosis factor, and leptin; and (3) within HC but not MDD, those participants with the highest miR-93 expression showed the strongest bilateral dorsal mid-insula activation during interoceptive versus exteroceptive attention. Since miR-93 is regulated by stress and affects epigenetic modulation by chromatin re-organization, these results suggest that healthy individuals but not MDD participants show an adaptive epigenetic regulation of insular function during interoceptive processing. Future investigations will need to delineate how specific internal and external environmental conditions contribute to miR-93 expression in MDD and what molecular mechanisms alter brain responsivity to body-relevant signals.

The Cerebellum as an Embodying Machine

Whereas emotion theorists often keep their distance from the embodied approach, theorists of embodiment tend to treat emotion as a mainly physiologic process. However, intimate links between emotions and the body suggest that emotions are privileged phenomena to attempt to reintegrate mind and body and that the body helps the mind in shaping emotional responses. To date, research has favored the cerebrum over other parts of the brain as a substrate of embodied emotions. However, given the widely demonstrated contribution of the cerebellum to emotional processing, research in affective neuroscience should consider embodiment theory as a useful approach for evaluating the cerebellar role in emotion and affect. The aim of this review is to insert the cerebellum among the structures needed to embody emotions, providing illustrative examples of cerebellar involvement in embodied emotions (as occurring in empathic abilities) and in impaired identification and expression of embodied emotions (as occurring in alexithymia).

A synergetic turn in cognitive neuroscience of brain diseases

Despite significant improvements in our understanding of brain diseases, many barriers remain. Cognitive neuroscience faces four major challenges: complex structure-function associations; disease phenotype heterogeneity; the lack of transdiagnostic models; and oversimplified cognitive approaches restricted to the laboratory. Here, we propose a synergetics framework that can help to perform the necessary dimensionality reduction of complex interactions between the brain, body, and environment. The key solutions include low-dimensional spatiotemporal hierarchies for brain-structure associations, whole-brain modeling to handle phenotype diversity, model integration of shared transdiagnostic pathophysiological pathways, and naturalistic frameworks balancing experimental control and ecological validity. Creating whole-brain models with reduced manifolds combined with ecological measures can improve our understanding of brain disease and help identify novel interventions. Synergetics provides an integrated framework for future progress in clinical and cognitive neuroscience, pushing the boundaries of brain health and disease toward more mature, naturalistic approaches.

Neural representation in active inference: Using generative models to interact with-and understand-the lived world

This paper considers neural representation through the lens of active inference, a normative framework for understanding brain function. It delves into how living organisms employ generative models to minimize the discrepancy between predictions and observations (as scored with variational free energy). The ensuing analysis suggests that the brain learns generative models to navigate the world adaptively, not (or not solely) to understand it. Different living organisms may possess an array of generative models, spanning from those that support action-perception cycles to those that underwrite planning and imagination; namely, from explicit models that entail variables for predicting concurrent sensations, like objects, faces, or people-to action-oriented models that predict action outcomes. It then elucidates how generative models and belief dynamics might link to neural representation and the implications of different types of generative models for understanding an agent's cognitive capabilities in relation to its ecological niche. The paper concludes with open questions regarding the evolution of generative models and the development of advanced cognitive abilities-and the gradual transition from pragmatic to detached neural representations. The analysis on offer foregrounds the diverse roles that generative models play in cognitive processes and the evolution of neural representation.

Active Inference and Social Actors: Towards a Neuro-Bio-Social Theory of Brains and Bodies in Their Worlds

Although research including biological concepts and variables has gained more prominence in sociology, progress assimilating the organ of experience, the brain, has been theoretically and technically challenging. Formal uptake and assimilation have thus been slow. Within psychology and neuroscience, the traditional brain, which has made brief appearances in sociological research, is a "bottom-up" processor in which sensory signals are passed up the neural hierarchy where they are eventually cognitively and emotionally processed, after which actions and responses are generated. In this paper, we introduce the Active Inference Framework (AIF), which casts the brain as a Bayesian "inference engine" that tests its "top-down" predictive models against "bottom-up" sensory error streams in its attempts to resolve uncertainty and make the world more predictable. After assembling and presenting key concepts in the AIF, we describe an integrated neuro-bio-social model that prioritizes the microsociological assertion that the scene of action is the situation, wherein brains enculturate. Through such social dynamics, enculturated brains share models of the world with one another, enabling collective realities that disclose the actions afforded in those times and places. We conclude by discussing this neuro-bio-social model within the context of exemplar sociological research areas, including the sociology of stress and health, the sociology of emotions, and cognitive cultural sociology, all areas where the brain has received some degree of recognition and incorporation. In each case, sociological insights that do not fit naturally with the traditional brain model emerge intuitively from the predictive AIF model, further underscoring the interconnections and interdependencies between these areas, while also providing a foundation for a probabilistic sociology.

Digital Being: social media and the predictive mind

Social media is implicated today in an array of mental health concerns. While concerns around social media have become mainstream, little is known about the specific cognitive mechanisms underlying the correlations seen in these studies or why we find it so hard to stop engaging with these platforms when things obviously begin to deteriorate for us. New advances in computational neuroscience, however, are now poised to shed light on this matter. In this paper, we approach the phenomenon of social media addiction through the lens of the active inference framework. According to this framework, predictive agents like us use a 'generative model' of the world to predict our own incoming sense data and act to minimize any discrepancy between the prediction and incoming signal (prediction error). In order to live well and be able to act effectively to minimize prediction error, it is vital that agents like us have a generative model, which not only accurately reflects the regularities of our complex environment but is also flexible and dynamic and able to stay accurate in volatile and turbulent circumstances. In this paper, we propose that some social media platforms are a spectacularly effective way of warping an agent's generative model and of arresting the model's ability to flexibly track and adapt to changes in the environment. We go on to investigate cases of digital tech, which do not have these adverse effects and suggest-based on the active inference framework-some ways to understand why some forms of digital technology pose these risks, while others do not.

The police hunch: the Bayesian brain, active inference, and the free energy principle in action

In the realm of law enforcement, the "police hunch" has long been a mysterious but crucial aspect of decision-making. Drawing on the developing framework of Active Inference from cognitive science, this theoretical article examines the genesis, mechanics, and implications of the police hunch. It argues that hunches - often vital in high-stakes situations - should not be described as mere intuitions, but as intricate products of our mind's generative models. These models, shaped by observations of the social world and assimilated and enacted through active inference, seek to reduce surprise and make hunches an indispensable tool for officers, in exactly the same way that hypotheses are indispensable for scientists. However, the predictive validity of hunches is influenced by a range of factors, including experience and bias, thus warranting critical examination of their reliability. This article not only explores the formation of police hunches but also provides practical insights for officers and researchers on how to harness the power of active inference to fully understand policing decisions and subsequently explore new avenues for future research.

Are depressive symptoms linked to a reduced pupillary response to novel positive information?-An eye tracking proof-of-concept study

Introduction

Depressive symptoms have been linked to difficulties in revising established negative beliefs in response to novel positive information. Recent predictive processing accounts have suggested that this bias in belief updating may be related to a blunted processing of positive prediction errors at the neural level. In this proof-of-concept study, pupil dilation in response to unexpected positive emotional information was examined as a psychophysiological marker of an attenuated processing of positive prediction errors associated with depressive symptoms.

Methods

Participants (N = 34) completed a modified version of the emotional Bias Against Disconfirmatory Evidence (BADE) task in which scenarios initially suggest negative interpretations that are later either confirmed or disconfirmed by additional information. Pupil dilation in response to the confirmatory and disconfirmatory information was recorded.

Results

Behavioral results showed that depressive symptoms were related to difficulties in revising negative interpretations despite disconfirmatory positive information. The eye tracking results pointed to a reduced pupil response to unexpected positive information among people with elevated depressive symptoms.

Discussion

Altogether, the present study demonstrates that the adapted emotional BADE task can be appropriate for examining psychophysiological aspects such as changes in pupil size along with behavioral responses. Furthermore, the results suggest that depression may be characterized by deviations in both behavioral (i.e., reduced updating of negative beliefs) and psychophysiological (i.e., decreased pupil dilation) responses to unexpected positive information. Future work should focus on a larger sample including clinically depressed patients to further explore these findings.

Pain suffering and the self. An active allostatic inference explanation

Distributed processing that gives rise to pain experience is anchored by a multidimensional self-model. I show how the phenomenon of pain asymbolia and other atypical pain-related conditions (Insensitivity to Pain, Chronic Pain, 'Social' Pain, Insensitivity to Pain, Chronic Pain, 'Social' Pain, empathy for pain and suffering) can be explained by this idea. It also explains the patterns of association and dissociation among neural correlates without importing strong modular assumptions. It treats pain processing as a species of allostatic active inference in which the mind co-ordinates its processing resources to optimize basic bodily functioning at different time scales. The self is inferred to be source and target of regulation in this process. The self-modelling account reconciles conflicting deaffectualization and depersonalization accounts of pain asymbolia by showing how depersonalization and pain asymbolia arise at different levels of hierarchical self modelling.

Synthetic surprise as the foundation of the psychedelic experience

Psychedelic agents, such as LSD and psilocybin, induce marked alterations in consciousness via activation of the 5-HT2A receptor (5-HT2ARs). We hypothesize that psychedelics enforce a state of synthetic surprise through the biased activation of the 5-HTRs system. This idea is informed by recent insights into the role of 5-HT in signaling surprise. The effects on consciousness, explained by the cognitive penetrability of perception, can be described within the predictive coding framework where surprise corresponds to prediction error, the mismatch between predictions and actual sensory input. Crucially, the precision afforded to the prediction error determines its effect on priors, enabling a dynamic interaction between top-down expectations and incoming sensory data. By integrating recent findings on predictive coding circuitry and 5-HT2ARs transcriptomic data, we propose a biological implementation with emphasis on the role of inhibitory interneurons. Implications arise for the clinical use of psychedelics, which may rely primarily on their inherent capacity to induce surprise in order to disrupt maladaptive patterns.

Active inference as a theory of sentient behavior

This review paper offers an overview of the history and future of active inference-a unifying perspective on action and perception. Active inference is based upon the idea that sentient behavior depends upon our brains' implicit use of internal models to predict, infer, and direct action. Our focus is upon the conceptual roots and development of this theory of (basic) sentience and does not follow a rigid chronological narrative. We trace the evolution from Helmholtzian ideas on unconscious inference, through to a contemporary understanding of action and perception. In doing so, we touch upon related perspectives, the neural underpinnings of active inference, and the opportunities for future development. Key steps in this development include the formulation of predictive coding models and related theories of neuronal message passing, the use of sequential models for planning and policy optimization, and the importance of hierarchical (temporally) deep internal (i.e., generative or world) models. Active inference has been used to account for aspects of anatomy and neurophysiology, to offer theories of psychopathology in terms of aberrant precision control, and to unify extant psychological theories. We anticipate further development in all these areas and note the exciting early work applying active inference beyond neuroscience. This suggests a future not just in biology, but in robotics, machine learning, and artificial intelligence.

Migraine as an allostatic reset triggered by unresolved interoceptive prediction errors

Until now, a satisfying account of the cause and purpose of migraine has remained elusive. We explain migraine within the frameworks of allostasis (the situationally-flexible, forward-looking equivalent of homeostasis) and active inference (interacting with the environment via internally-generated predictions). Due to its multimodality, and long timescales between cause and effect, allostasis is inherently prone to catastrophic error, which might be impossible to correct once fully manifest, an early indicator which is elevated prediction error (discrepancy between prediction and sensory input) associated with internal sensations (interoception). Errors can usually be resolved in a targeted manner by action (correcting the physiological state) or perception (updating predictions in light of sensory input); persistent errors are amplified broadly and multimodally, to prioritise their resolution (the migraine premonitory phase); finally, if still unresolved, progressive amplification renders further changes to internal or external sensory inputs intolerably intense, enforcing physiological stability, and facilitating accurate allostatic prediction updating. As such, migraine is an effective 'failsafe' for allostasis, however it has potential to become excessively triggered, therefore maladaptive.

Respiratory sinus arrhythmia (RSA), vagal tone and biobehavioral integration: Beyond parasympathetic function

Linchpin to the entire area of psychophysiological research and discussion of the vagus is the respiratory and cardiovascular phenomenon known as respiratory sinus arrhythmia (RSA; often synonymous with high-frequency heart-rate variability when it is specifically linked to respiratory frequency), i.e. rhythmic fluctuations in heart rate synchronized to inspiration and expiration. This article aims 1) to clarify concepts, terms and measures commonly employed during the last half century in the scientific literature, which relate vagal function to psychological processes and general aspects of health; and 2) to expand upon an earlier theoretical model, emphasizing the importance of RSA well beyond the current focus upon parasympathetic mechanisms. A close examination of RSA and its relations to the vagus may 1) dispel certain commonly held beliefs about associations between psychological functioning, RSA and the parasympathetic nervous system (for which the vagus nerve plays a major role), and 2) offer fresh perspectives about the likely functions and adaptive significance of RSA, as well as RSA's relationship to vagal control. RSA is neither an invariably reliable index of cardiac vagal tone nor of central vagal outflow to the heart. The model here presented posits that RSA represents an evolutionarily entrenched, cardiovascular and respiratory phenomenon that significantly contributes to meeting continuously changing metabolic, energy and behavioral demands.