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Stoupi NA, Weijs ML, Imbach L, Lenggenhager B. Heartbeat-evoked potentials following voluntary hyperventilation in epilepsy patients: respiratory influences on cardiac interoception. Front Neurosci 2024; 18:1391437. [PMID: 39035777 PMCID: PMC11259972 DOI: 10.3389/fnins.2024.1391437] [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: 02/26/2024] [Accepted: 06/12/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Current evidence indicates a modulating role of respiratory processes in cardiac interoception, yet whether altered breathing patterns influence heartbeat-evoked potentials (HEP) remains inconclusive. Methods Here, we examined the effects of voluntary hyperventilation (VH) as part of a clinical routine examination on scalp-recorded HEPs in epilepsy patients (N = 80). Results Using cluster-based permutation analyses, HEP amplitudes were compared across pre-VH and post-VH conditions within young and elderly subgroups, as well as for the total sample. No differences in the HEP were detected for younger participants or across the full sample, while an increased late HEP during pre-VH compared to post-VH was fond in the senior group, denoting decreased cardiac interoceptive processing after hyperventilation. Discussion The present study, thus, provides initial evidence of breathing-related HEP modulations in elderly epilepsy patients, emphasizing the potential of HEP as an interoceptive neural marker that could partially extend to the representation of pulmonary signaling. We speculate that aberrant CO2-chemosensing, coupled with disturbances in autonomic regulation, might constitute the underlying pathophysiological mechanism behind the obtained effect. Available databases involving patient records of routine VH assessment may constitute a valuable asset in disentangling the interplay of cardiac and ventilatory interoceptive information in various patient groups, providing thorough clinical data to parse, as well as increased statistical power and estimates of effects with higher precision through large-scale studies.
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Affiliation(s)
- Niovi A Stoupi
- Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Marieke L Weijs
- Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Lukas Imbach
- Department of Neurology, University Hospital of Zurich, Zürich, Switzerland
- Swiss Epilepsy Center, Klinik Lengg, Zürich, Switzerland
- Zurich Neuroscience Center, University of Zurich and ETH Zurich, Zürich, Switzerland
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Verbakel I, Bou Kheir G, de Rijk M, Dhondt K, Bliwise D, Pauwaert K, Monaghan T, Hervé F, Vogelaers D, Mariman A, Everaert K. Is the insomnia phenotype the common denominator in LUTS during transition periods? An expert NOPIA research group review. Neurourol Urodyn 2024; 43:1134-1146. [PMID: 38289321 DOI: 10.1002/nau.25372] [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: 09/29/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024]
Abstract
AIMS As people age, sleep stages and characteristics transition over time, but sleep deficits can profoundly impact health and cognitive functioning. Chronic sleep deprivation is linked to impaired attention and productivity, weakened immunity, increased risk of cardiovascular disease, obesity, and mental health disorders. Insomnia, obstructive sleep apnea syndrome, hormonal changes, nocturia, neurological disorders, and life events interfere with sleep patterns and some are linked to lower urinary tract symptoms (LUTS). This NOPIA symposium on Lifelong LUTS aimed to analyze the literature on associations between sleep and LUTS, generate ideas for future research, and explore whether there is support for the concept of lifelong LUTS in relation to changes in sleep throughout the lifespan. METHODS An international panel of experts took part in an online meeting addressing the role of lifelong LUTS in relationship to sleep and the brain organized by the NOPIA research group. The manuscript summarizes existing literature, hypotheses, future research ideas, and clinical recommendations. RESULTS Insomnia, sleep fragmentation, hyperarousal, and sensory processing disorders emerged as potential factors in the relationship between sleep and LUTS. Insomnia is often a persistent factor and may have been the initial symptom; however, it is often unrecognized and/or unaddressed in healthcare settings. By recognizing insomnia as a primary driver of various health issues, including nocturia, transitional care aims to address root causes and underlying problems earlier to initiate appropriate treatment. CONCLUSIONS A multidisciplinary approach with collaboration between healthcare professionals from various disciplines, such as urology, sleep medicine, gynecology, pediatrics, and geriatrics, is needed and should include validated measurements such as the insomnia severity index and sleep and voiding diaries. Ensuring ongoing follow-up and monitoring through transitional care is crucial for individuals with persistent sleep problems and LUTS, allowing issues that arise or fluctuate over the lifespan to be addressed.
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Affiliation(s)
- Irina Verbakel
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - George Bou Kheir
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Mathijs de Rijk
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Karlien Dhondt
- Department of Child and Adolescent Psychiatry, Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium
| | - Don Bliwise
- Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kim Pauwaert
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Thomas Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - François Hervé
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Dirk Vogelaers
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
- Department of General Internal Medicine, AZ Delta, Roeselare, Belgium
| | - An Mariman
- Center for Integrative Medicine, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
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Haustein M, Thomas EBK, Scheer K, Denburg NL. Interoception, Affect, and Cognition in Older Adults. Exp Aging Res 2024; 50:279-295. [PMID: 36871576 PMCID: PMC10477322 DOI: 10.1080/0361073x.2023.2183704] [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: 08/26/2022] [Accepted: 02/20/2023] [Indexed: 03/07/2023]
Abstract
Interoception is the detection of signals that arise from within the body. Interoceptive sensitivity has been found to be associated with affect and cognition among younger adults, and examination of these relationships in older adult samples is beginning to emerge. Here, we take an exploratory approach to determine how demographic, affective, and cognitive variables relate to interoceptive sensitivity in neurologically normal older adults, aged 60-91 years old. Ninety-one participants completed a comprehensive neuropsychological battery, self-report questionnaires, and a heartbeat counting task to measure interoceptive sensitivity. Our findings revealed several relationships: 1) interoceptive sensitivity was inversely correlated with measures of positive emotionality: participants with higher interoceptive sensitivity tended to have lower levels of positive affect and trait extraversion; 2) interoceptive sensitivity was found to positively correlate with cognition: participants who performed better on the heartbeat-counting task also tended to perform better on a measure of delayed verbal memory; and 3) when examining the predictors of interoceptive sensitivity in a single hierarchical regression model, higher interoceptive sensitivity was related to: higher time estimation, lower positive affect, lower extraversion, and higher verbal memory. In total, the model accounted for 38% of the variability in interoceptive sensitivity (R2 = .38). These results suggest that, among older adults, interoceptive sensitivity is facilitative for aspects of cognition but perhaps disruptive for certain aspects of emotional experience.
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Affiliation(s)
- Marcus Haustein
- Department of Neurology, Division of Cognitive Neuroscience, University of Iowa Carver College of Medicine, Iowa, USA
- Department of Emergency Medicine, Great River Health System, West Burlington, Iowa, USA
| | - Emily B K Thomas
- Department of Psychological and Brain Sciences, University of Iowa College of Liberal Arts and Sciences, Iowa, USA
| | - Kodi Scheer
- Department of Neurology, Division of Cognitive Neuroscience, University of Iowa Carver College of Medicine, Iowa, USA
| | - Natalie L Denburg
- Department of Neurology, Division of Cognitive Neuroscience, University of Iowa Carver College of Medicine, Iowa, USA
- Department of Psychological and Brain Sciences, University of Iowa College of Liberal Arts and Sciences, Iowa, USA
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Charbonneau JA, Santistevan AC, Raven EP, Bennett JL, Russ BE, Bliss-Moreau E. Evolutionarily conserved neural responses to affective touch in monkeys transcend consciousness and change with age. Proc Natl Acad Sci U S A 2024; 121:e2322157121. [PMID: 38648473 PMCID: PMC11067024 DOI: 10.1073/pnas.2322157121] [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: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024] Open
Abstract
Affective touch-a slow, gentle, and pleasant form of touch-activates a different neural network than which is activated during discriminative touch in humans. Affective touch perception is enabled by specialized low-threshold mechanoreceptors in the skin with unmyelinated fibers called C tactile (CT) afferents. These CT afferents are conserved across mammalian species, including macaque monkeys. However, it is unknown whether the neural representation of affective touch is the same across species and whether affective touch's capacity to activate the hubs of the brain that compute socioaffective information requires conscious perception. Here, we used functional MRI to assess the preferential activation of neural hubs by slow (affective) vs. fast (discriminative) touch in anesthetized rhesus monkeys (Macaca mulatta). The insula, anterior cingulate cortex (ACC), amygdala, and secondary somatosensory cortex were all significantly more active during slow touch relative to fast touch, suggesting homologous activation of the interoceptive-allostatic network across primate species during affective touch. Further, we found that neural responses to affective vs. discriminative touch in the insula and ACC (the primary cortical hubs for interoceptive processing) changed significantly with age. Insula and ACC in younger animals differentiated between slow and fast touch, while activity was comparable between conditions for aged monkeys (equivalent to >70 y in humans). These results, together with prior studies establishing conserved peripheral nervous system mechanisms of affective touch transduction, suggest that neural responses to affective touch are evolutionarily conserved in monkeys, significantly impacted in old age, and do not necessitate conscious experience of touch.
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Affiliation(s)
- Joey A. Charbonneau
- Neuroscience Graduate Program, University of California, Davis, CA95616
- Neuroscience and Behavior Unit, California National Primate Research Center, University of California, Davis, CA95616
| | - Anthony C. Santistevan
- Neuroscience and Behavior Unit, California National Primate Research Center, University of California, Davis, CA95616
- Department of Psychology, University of California, Davis, CA95616
| | - Erika P. Raven
- Department of Radiology, Center for Biomedical Imaging, New York University Grossman School of Medicine, New York, NY10016
| | - Jeffrey L. Bennett
- Neuroscience and Behavior Unit, California National Primate Research Center, University of California, Davis, CA95616
- Department of Psychology, University of California, Davis, CA95616
- Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, Sacramento, CA95817
- The Medical Investigation of Neurodevelopmental Disorders Institute, University of California, Sacramento, CA95817
| | - Brian E. Russ
- Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute, Orangeburg, NY10962
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY10029
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY10029
- Department of Psychiatry, New York University Langone, New York, NY10016
| | - Eliza Bliss-Moreau
- Neuroscience and Behavior Unit, California National Primate Research Center, University of California, Davis, CA95616
- Department of Psychology, University of California, Davis, CA95616
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Bätz LR, Ye S, Lan X, Ziaei M. Increased functional integration of emotional control network in late adulthood. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.10.588823. [PMID: 38659752 PMCID: PMC11040603 DOI: 10.1101/2024.04.10.588823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Across the adult lifespan, there are changes in how emotions are perceived and regulated. As individuals age, there is an observed improvement in emotion regulation and overall quicker recovery from negative emotions. While previous studies have shown differences in emotion processing in late adulthood, the corresponding differences in large-scale brain networks remain largely underexplored. By utilizing large-scale datasets such as the Human Connectome Project (HCP-Aging, N = 621 ) and Cambridge Centre for Ageing and Neuroscience (Cam-CAN, N = 333 ), we were able to investigate how emotion regulation networks' functional topography differs across the entire adult lifespan. Based on previous meta-analytic work that identified four large-scale functional brain networks involved in emotion generation and regulation, we found an increase in the functional integration of the emotional control network among older adults. Additionally, confirming through the nonlinear model, individuals around the age of 70 showed a steadier decline in integration of a network mediating emotion generation and regulation via interoception. Furthermore, the analyses revealed a negative association between age and perceived stress and loneliness that could be attributed to differences in large-scale emotion regulation networks. Our study highlights the importance of identifying topological changes in the functional emotion network architecture across the lifespan, as it allows for a better understanding of emotional aging and psychological well-being in late adulthood.
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Affiliation(s)
- Leona Rahel Bätz
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Shuer Ye
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Xiaqing Lan
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Maryam Ziaei
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
- K.G. Jebsen Centre for Alzheimer’s disease, Norwegian University of Science and Technology, Trondheim, Norway
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Joshi V, Graziani P, Del-Monte J. Interoceptive sensibility, intuitive eating, binge, and disordered eating behavior among individuals with obesity: A comparative study with the general population. J Health Psychol 2024:13591053241237900. [PMID: 38532256 DOI: 10.1177/13591053241237900] [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: 03/28/2024] Open
Abstract
The present study assessed the links between interoceptive sensibility, binge, disordered (emotional, restrained, and external) and intuitive eating among individuals with obesity (n = 57) and normal weight (n = 29). Individuals with obesity presented lower "attention regulation," "body-listening," and "trusting" interoceptive dimensions. When age was controlled, group differences on "trusting" remained significant. Individuals with obesity showed lower intuitive eating, higher emotional, and binge eating compared to controls. Higher "body listening," "eating for physical rather than emotional reasons," and "reliance on hunger and satiety cues" predicted lower binge eating whereas "external eating" predicted higher binge eating among individuals with obesity. Eating for physical reasons and reliance on hunger and satiety had protective mediating roles in the relationship between external and binge eating in both groups. Interoceptive sensibility and intuitive eating should conjointly serve as psychotherapeutic targets for disordered eating, obesity, and weight management.
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Affiliation(s)
- Vrutti Joshi
- Université de Nîmes, France
- Aix-Marseille Université, France
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Lee SJ, Lee M, Kim HB, Huh HJ. The Relationship Between Interoceptive Awareness, Emotion Regulation and Clinical Symptoms Severity of Depression, Anxiety and Somatization. Psychiatry Investig 2024; 21:255-264. [PMID: 38569583 PMCID: PMC10990629 DOI: 10.30773/pi.2023.0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/27/2023] [Accepted: 12/03/2023] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE The primary objective of this study was to examine the associations among emotion regulation strategies, interoceptive awareness, and psychological distress measures-namely, depression, anxiety, and somatization. Additionally, we aimed to explore the predictive power of various facets of interoceptive awareness in determining the severity of symptoms for each mental disorder. METHODS A cohort of 130 outpatients diagnosed with depression/anxiety disorder were recruited, and 20 subjects exhibiting incomplete responses were excluded from the dataset, leading to a final sample size of 110 outpatients. The clinical symptoms were measured by Patient Health Questionnaire-9, State-Trait Anxiety Inventory Form Y, and Symptom Checklist-90-Revised, and the usage of emotion-regulation strategies and interoceptive awareness was assessed with Emotion Regulation Questionnaire and Multidimensional Assessment of Interoceptive Awareness (MAIA), respectively. A hierarchical regression analysis was performed to examine whether emotion-regulation strategies and interoceptive awareness explain the statistically significant variance in each of the symptoms. RESULTS In the depression model, cognitive reappraisal, accept, and attention regulation showed significant associations, while in the anxiety model, cognitive reappraisal, attention regulation, trust, and notice emerged as significant factors. Lastly, cognitive reappraisal and attention regulation were found to be significant contributors to the final model for somatization. CONCLUSION The inclusion of MAIA subscales improved the predictive ability of the regression model, highlighting the independent association between interoceptive awareness-particularly attention regulation-and clinical symptoms of anxiety and depression. Additionally, the study underscores the relevance of considering the specific pathological context when implementing interventions, as evidenced by the positive associations between the accept subscale and depression and between the notice subscale and anxiety, respectively.
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Affiliation(s)
- Su Jin Lee
- Department of Psychology, Ewha Womans University, Seoul, Republic of Korea
| | - Mimi Lee
- Department of Psychology, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeong Beom Kim
- Department of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | - Hyu Jung Huh
- Department of Psychiatry, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Republic of Korea
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Köteles F. Vague sensations. About the background and consequences of discordance between actual and perceived physiological changes. Clin Psychol Rev 2024; 108:102382. [PMID: 38218123 DOI: 10.1016/j.cpr.2024.102382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/28/2023] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Empirical evidence consistently shows that discordance, also called dissociation or discrepancy, between actual physiological (mainly visceral) events and their perceived counterparts is substantial. On the one hand, we typically do not perceive actual visceral events occurring in our bodies; on the other hand, sometimes we do perceive bodily changes that do not really take place. This narrative review presents the available empirical findings on the discordance, and summarizes possible explanations that approach the phenomenon from the viewpoint of evolution, cognitive development, and predictive processing. Also, the role of top-down factors, such as expectations and experiences is discussed. Finally, practically relevant consequences of the discordance are presented using the examples of mind-body practices, the placebo and nocebo phenomenon, and medically unexplained symptoms. It is concluded that the discordance between actual and perceived body changes can have a negative impact on health, mainly through issues with adherence and other behavioral factors. The existence of actual-perceived discordance should be taught and demonstrated in the elementary and high school, as well as in many areas of higher education.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary; Ádám György Psychophysiology Research Group, Budapest, Hungary.
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Grunewald W, Waitz-Kudla SN, Levinson CA, Brown TA, Smith AR. Development and Psychometric Validation of the Body Trust Scale. Assessment 2024:10731911231225200. [PMID: 38311906 DOI: 10.1177/10731911231225200] [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: 02/06/2024]
Abstract
Interoception (e.g., abilities to recognize/attend to internal sensations) is robustly associated with psychopathology. One form of interoception, body trust, is relevant for the development of disordered eating and suicidal thoughts/behaviors. However, measures of body trust are narrow, despite research suggesting body trust is multifaceted. The aim of this study was to develop a comprehensive measure of body trust: The Body Trust Scale (BTS). 479 U.S. adults completed self-report surveys containing the BTS and psychopathology measures. Exploratory and confirmatory factor analyses revealed a three-factor structure: Comfort with One's Body, Physical Attractiveness, and Comfort with Internal Sensations. Factors showed strong construct, convergent, and divergent validity, as well as moderate predictive validity for suicidal thoughts/non-suicidal self-injury. Furthermore, factors showed strong internal consistency, test-retest reliability, and were invariant across the gender binary. The BTS can be used in research and clinical settings to understand how specific facets of body trust relate to psychopathology.
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de Rijk MM, Peter S, Wolf-Johnston A, Heesakkers J, van Koeveringe GA, Birder LA. Quantification of Aging-Related Decreases in Sensory Innervation of the Bladder Trigone in Rats. Int Neurourol J 2024; 28:40-45. [PMID: 38461855 DOI: 10.5213/inj.2346220.110] [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: 09/26/2023] [Accepted: 11/13/2023] [Indexed: 03/12/2024] Open
Abstract
PURPOSE The prevalence of lower urinary tract symptoms (LUTS), characterized by problems regarding storage and/or voiding of urine, is known to significantly increase with age. Effective communication between the lower urinary tract and the central nervous system (CNS) is essential for the optimal function of this system, and heavily relies on the efficient interaction between the bladder urothelium and the afferent nerve fibers situated in close proximity to the urothelium within the lamina propria. METHODS We aimed to quantify aging-related differences in the expression of calcitonin gene-related peptide (CGRP, an established marker for sensory nerve fibers) in the trigonal mucosal layers of young (3-4 months) and aged (25-30 months) rats. We evaluated trigonal tissue from 3 animals per age group. Tissue was serially sectioned at 10 μm and stained for CGRP. Images were taken along the full length of the tissue. For each image we computed the total CGRP-positive area (μm2) and the median value for each animal was used for further analysis. RESULTS Upon statistical analysis the aged rats show a significantly lower CGRP-positive area compared to young rats (P=0.0049). These results indicate that aging has a negative effect on the area of CGRP-positive signal in the trigone. CONCLUSION The structural and functional integrity of the sensory web in the trigonum of rats is negatively affected by the aging process, potentially leading to impaired communication between the bladder urothelium the CNS. Consequently, these perturbations in the sensory system may contribute to the pathogenesis or exacerbation LUTS.
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Affiliation(s)
- Mathijs M de Rijk
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Saša Peter
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Amanda Wolf-Johnston
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - John Heesakkers
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Gommert A van Koeveringe
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Lori A Birder
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Blickle M, Klüpfel C, Homola GA, Gamer M, Herrmann MJ, Störk S, Gelbrich G, Heuschmann PU, Deckert J, Pham M, Menke A. Heart rate variability, interoceptive accuracy and functional connectivity in middle-aged and older patients with depression. J Psychiatr Res 2024; 170:122-129. [PMID: 38134721 DOI: 10.1016/j.jpsychires.2023.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND AND OBJECTIVE Major depressive disorder (MDD) is associated with increased cardiac morbidity. Reduced heart rate variability (HRV) as well as lower interoceptive accuracy (IAc) have been observed in MDD as possible sympathomimetic mechanisms related to insula activity. The salience network (SN) anchored by the insula has been posited as a crucial functional network for cardiac sensations and the default mode network (DMN) for MDD. This study aimed to investigate the relation between insula-centered and depression-related brain networks, IAc and HRV in patients with depression as a possible mechanism by which MDD increases cardiac morbidity. METHODS 30 depressed inpatients and 30 healthy subjects (derived from the population-based "Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression" cohort study, STAAB) all over 50 years were examined. HRV and IAc were assessed via electrocardiogram and a heartbeat perception task prior to a 3 T resting-state functional magnetic resonance imaging. Seed-to-voxel resting-state functional connectivity (FC) analysis was conducted with six seeds in the insula and two seeds in the DMN. RESULTS Depressed patients on the one hand showed decreased FC between insula cortex and frontal as well occipital cortical brain regions compared to controls. Depressed patients on the other hand exhibited higher FC between the medial prefrontal cortex and the insula cortex compared to controls. However, depressed patients did not differ in HRV nor in IAc compared to controls. CONCLUSION Thus, differences in insula-related brain networks in depression in our study were not mirrored by differences in HRV and IAc. Future research is needed to define the mechanism by which depression increases cardiac morbidity.
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Affiliation(s)
- Manuel Blickle
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Catherina Klüpfel
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - György A Homola
- Department of Neuroradiology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Matthias Gamer
- Department of Psychology, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Stefan Störk
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany; Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany
| | - Götz Gelbrich
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany; Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany
| | - Peter U Heuschmann
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany; Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany
| | - Jürgen Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Mirko Pham
- Department of Neuroradiology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Andreas Menke
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Medical Park Chiemseeblick, Rasthausstr. 25, 83233, Bernau am Chiemsee, Germany; Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
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Brennan A, Benton D, Gaylor C, Young HA. The role of interoception in age-related obesity: A structural equation modelling study. Appetite 2023; 191:107045. [PMID: 37741343 DOI: 10.1016/j.appet.2023.107045] [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: 06/01/2023] [Revised: 08/21/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
The obesity pandemic and its adverse effect on health and quality of life are well established. In younger populations, interoception and aberrant eating behaviour contribute to overconsumption and being overweight. Although the incidence of obesity is higher in older individuals, they remain under-researched in the obesity literature. Therefore, the present study considered the role of general (interoceptive sensibility) and appetite-specific (hunger drive and satiety responsiveness) interoception and obesogenic eating behaviour (food responsivity, emotional eating, enjoyment of eating) in the association between age and BMI. A total of 1006 female adults (aged 18 to 80) completed the Adult Eating Behaviour Questionnaire and the Interoceptive Attention and Accuracy scales. Structural Equation Modelling (SEM) in AMOS was used to explore the data for multiple serial mediation effects. Despite being more overweight, older adults reported lower interoceptive attention, hunger drive, emotional overeating, food responsivity, and enjoyment of food. In contrast, compared to younger adults, older adults reported a higher interoceptive accuracy, and a similar responsivity to satiety. Importantly, two indirect pathways positively mediated the link between age and BMI: (1) age ➤(-)➤ interoceptive attention ➤(+)➤ satiety responsivity ➤(-)➤ emotional eating ➤(+)➤ BMI and (2) age ➤(-)➤ interoceptive attention ➤(+)➤ satiety responsivity ➤(-)➤ food responsivity ➤(+)➤ BMI. However, a stronger antagonistic indirect pathway was also present: age ➤(-)➤ interoceptive attention ➤(+)➤ hunger drive ➤(+)➤ emotional eating ➤(+)➤ BMI. The present findings suggested that overall reduced interoceptive attention in older adults may protect against weight gain by lowering hunger and the propensity towards obesogenic eating behaviours. These findings have implications for the design of appetite interventions in older populations.
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13
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Naraindas AM, Cooney SM. Body image disturbance, interoceptive sensibility and the body schema across female adulthood: a pre-registered study. Front Psychol 2023; 14:1285216. [PMID: 38098520 PMCID: PMC10720753 DOI: 10.3389/fpsyg.2023.1285216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Body image disturbance (BID) typically involves explicit negative attitudes toward one's shape and weight and is associated with altered interoceptive sensibility (the subjective perception of internal bodily states). This association is a known risk factor for the development and maintenance of eating disorders. However, while research has centred on younger women with eating disorders, diverse facets of BID appear in women without eating disorders across adulthood. Research shows that in the general population, young women (ages 18-25) with high BID exhibit disturbances in the body schema: an implicit sensorimotor representation of the body in space which includes mental simulation of a movement such as motor imagery. Given that body image is subject to age-related influences, it is important to investigate how age-related variation in BID can influence the body schema beyond young adulthood alone. Here, we examine the relationship between BID, interoceptive sensibility and the body schema across female adulthood. Methods Cross-sectional data was collected online from 1,214 women across four age groups: Young adults (18-24), Adults (25-39), Middle-aged adults (40-59), and Older aged adults (60-75). BID was indexed by questionnaires measuring body objectification, state, and trait body dissatisfaction. Interoceptive sensibility (IS) was measured using the MAIA-2 questionnaire. The body schema was evaluated through the Own Body Transformation task: a mental rotation task which assesses the capacity to make an embodied mental transformation. Results Analyses revealed that while body objectification and trait body dissatisfaction decreased from young to older adulthood, state body dissatisfaction showed a marked increase. A negative relationship between IS and BID across all age groups was also evidenced. Finally, age, BID and orientation of the presented body were significant predictors of the time taken to make an embodied transformation. Discussion These findings highlight the consistent relationship of BID and IS across age groups beyond young adulthood and demonstrate the varying importance of different aspects of BID as individuals age. We also evidence for the first time that disruptions in body image have the potential to impact implicit sensorimotor representations of the body even in women without eating disorders across female adulthood.
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Affiliation(s)
| | - Sarah M. Cooney
- School of Psychology, University College Dublin, Dublin, Ireland
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14
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Fermin AS, Sasaoka T, Maekawa T, Chan HL, Machizawa MG, Okada G, Okamoto Y, Yamawaki S. Insula neuroanatomical networks predict interoceptive awareness. Heliyon 2023; 9:e18307. [PMID: 37520943 PMCID: PMC10374932 DOI: 10.1016/j.heliyon.2023.e18307] [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: 10/12/2022] [Revised: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
Interoceptive awareness (IA), the subjective and conscious perception of visceral and physiological signals from the body, has been associated with functions of cortical and subcortical neural systems involved in emotion control, mood and anxiety disorders. We recently hypothesized that IA and its contributions to mental health are realized by a brain interoception network (BIN) linking brain regions that receive ascending interoceptive information from the brainstem, such as the amygdala, insula and anterior cingulate cortex (ACC). However, little evidence exists to support this hypothesis. In order to test this hypothesis, we used a publicly available dataset that contained both anatomical neuroimaging data and an objective measure of IA assessed with a heartbeat detection task. Whole-brain Voxel-Based Morphometry (VBM) was used to investigate the association of IA with gray matter volume (GMV) and the structural covariance network (SCN) of the amygdala, insula and ACC. The relationship between IA and mental health was investigated with questionnaires that assessed depressive symptoms and anxiety. We found a positive correlation between IA and state anxiety, but not with depressive symptoms. In the VBM analysis, only the GMV of the left anterior insula showed a positive association with IA. A similar association was observed between the parcellated GMV of the left dorsal agranular insula, located in the anterior insula, and IA. The SCN linking the right dorsal agranular insula with the left dorsal agranular insula and left hyper-granular insula were positively correlated with IA. No association between GMV or SCN and depressive symptoms or anxiety were observed. These findings revealed a previously unknown association between IA, insula volume and intra-insula SCNs. These results may support development of non-invasive neuroimaging interventions, e.g., neurofeedback, seeking to improve IA and to prevent development of mental health problems, such anxiety disorders.
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Affiliation(s)
- Alan S.R. Fermin
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
| | - Takafumi Sasaoka
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
| | - Toru Maekawa
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
| | - Hui-Ling Chan
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
| | - Maro G. Machizawa
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
| | - Go Okada
- Department of Psychiatry and Neurosciences, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
| | - Shigeto Yamawaki
- Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, 734-8553, Hiroshima city, Hiroshima, Japan
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15
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Campos C, Rocha NB, Barbosa F. Dissociating cognitive and affective empathy across psychopathy dimensions: The role of interoception and alexithymia. Front Psychol 2023; 14:1082965. [PMID: 37457066 PMCID: PMC10345207 DOI: 10.3389/fpsyg.2023.1082965] [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: 10/28/2022] [Accepted: 03/15/2023] [Indexed: 07/18/2023] Open
Abstract
This study examined the associations between psychopathy dimensions (triarchic phenotypes and classical factors), empathy domains (cognitive and affective), and interoception (interoceptive attention and accuracy) while accounting for the putative role of alexithymia. A community sample (n = 515) completed an online survey encompassing: Triarchic Psychopathy Measure (boldness, meanness, disinhibition); Levenson Self-Report Psychopathy Scale (primary and secondary psychopathy); Body Perception Questionnaire (interoceptive attention); Interoceptive Accuracy Scale; Toronto Alexithymia Scale. Hierarchical linear regression models were implemented for hypothesis-driven analyses examining the associations between psychopathy, empathy, and interoception while controlling for sex, age, and alexithymia. Exploratory path models were employed to investigate alexithymia and/or cognitive empathy as mediators between interoception and psychopathy. Our results largely confirmed the postulated empathy profiles across psychopathy dimensions, as meanness and primary psychopathy displayed a broad empathy impairment, while disinhibition and secondary psychopathy were only associated with diminished cognitive empathy. Importantly, boldness displayed a unique pattern (enhanced cognitive empathy and reduced affective empathy), further reinforcing its importance within the constellation of psychopathy traits. Contrary to our hypotheses, self-perceived interoceptive attention and accuracy were not associated with either psychopathy dimension after controlling for alexithymia. However, interoceptive accuracy and alexithymia were associated with cognitive empathy, while alexithymia was also positively related to all psychopathy dimensions (as expected), despite the unexpected strong and negative association with boldness. Exploratory analyses suggested significant indirect effects (mediation) between interoceptive accuracy and psychopathy via alexithymia and/or cognitive empathy. These mediating effects must be interpreted with caution and future studies should be designed to formally test this model.
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Affiliation(s)
- Carlos Campos
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Neurocognition Group|LabRP, School of Health, Center for Rehabilitation Research, Polytechnic University of Porto, Porto, Portugal
| | - Nuno Barbosa Rocha
- School of Health, Center for Translational Health and Medical Biotechnology Research, Polytechnic University of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Locatelli G, Matus A, James R, Salmoirago-Blotcher E, Ausili D, Vellone E, Riegel B. What is the role of interoception in the symptom experience of people with a chronic condition? A systematic review. Neurosci Biobehav Rev 2023; 148:105142. [PMID: 36965864 DOI: 10.1016/j.neubiorev.2023.105142] [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: 08/02/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Interoception, the ability of the organism to sense, interpret, and regulate signals originating from within the body, plays an important role in how individuals perceive and respond to symptoms. However, there is scarce evidence on the role of interoception in the symptom experience of people with chronic conditions. AIM To synthesize the role of interoception in the symptom experience of adults with a chronic condition. METHODS Systematic review. We searched PubMed, Psychinfo, Embase, CINAHL, and Science Citation Index-Expanded. We included primary research (all study designs) addressing our study aim, published between 2013-2021, and measuring at least one dimension of interoception. Any chronic condition and any symptom were included. No language limits were applied. Only the adult population was included. RESULTS We included 18 quantitative studies investigating the relationship between three interoceptive dimensions (i.e., accuracy, sensibility, awareness) and condition-specific symptoms in 10 chronic conditions. People with chronic conditions had lower interoceptive accuracy than healthy controls. Higher interoceptive sensibility was associated with lower symptom severity/frequency. Higher interoceptive accuracy was associated with lower symptom severity/frequency in half of the studies, while the other half reported the opposite. Only one study explored interoceptive awareness. CONCLUSION Interoceptive abilities are lower in patients with chronic conditions. Higher interoceptive sensibility is associated with lower symptom severity/frequency, but this relationship is unclear when it comes to interoceptive accuracy and awareness.
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Affiliation(s)
- Giulia Locatelli
- Department of biomedicine and prevention, University of Rome Tor Vergata, Italy; Faculty of Health Sciences, Australian Catholic University, Australia.
| | - Austin Matus
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Richard James
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | | | - Davide Ausili
- School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Ercole Vellone
- Department of biomedicine and prevention, University of Rome Tor Vergata, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, USA
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17
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Interoception in Old Age. Brain Sci 2022; 12:brainsci12101398. [PMID: 36291331 PMCID: PMC9599927 DOI: 10.3390/brainsci12101398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
Emotion regulation in old age was found to be more efficient; seniors seem to focus less on the negative aspects of experiences. Here, we ask, do older individuals regulate their emotions more efficiently or are they numb to the physiological changes that modulate these emotions? Interoception, the perception of physical feelings, influences a person’s mood, emotions, and sense of well-being, and was hardly tested among older adults. We examined the awareness of physiological changes (physiological arousal—blood pressure and heart rate) of 47 older adults, compared to 18 young adults, and their subjective reports of emotional experiences while viewing emotional stimuli. Interoception was decreased in old age. Blood pressure medications had a partial role in this reduction. Moreover, interoception mediated emotional experience, such that low interoception led to lower experiences of changes in physiological arousal. These findings may account for the emotional changes in old age, suggesting a decline in sensitivity with age, which leads to a positive interpretation of information.
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18
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Elliott J, Pfeifer G. Relationship between interoceptive sensibility, age, and COVID-19 anxiety during the first national lockdown in the United Kingdom. Aging Ment Health 2022; 26:2112-2119. [PMID: 35045774 DOI: 10.1080/13607863.2022.2026878] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: Interoception refers to the multidimensional representation of the internal states of the body, including sensation, appraisal, integration, and regulation. COVID-19 targets internal respiratory, temperature and gastrointestinal systems, thus posing a threat to humans that causes anxiety. Here, we examined the relationship between interoceptive sensibility and COVID-19 anxiety during the first UK national lockdown, when uncertainties surrounding the virus were at their peak.Methods: Between April and July 2020, N = 232 individuals across four age-categories completed questionnaires measuring interoceptive sensibility (BPQ-SF and MAIA-2), an adapted State-Trait-Anxiety Inventory (STAI) to assess COVID-19 anxiety, and a Perceived Quality of Life (QoL) questionnaire.Results: Higher scores on the BPQ-SF were related to higher levels of COVID-19 anxiety, while the MAIA-2 subscales Not Worrying, Attention Regulation, and Trusting of bodily signals were related to lower levels of COVID-19 anxiety. Age was related to lower levels of COVID-19 anxiety yet showed no significant (Bonferroni-corrected) relationship with interoceptive dimensions. Trait anxiety, Not Worrying, perceived quality of work, and COVID-19-related media consumption emerged as significant predictors of COVID-19 anxiety.Conclusion: Findings suggest that interoceptive dimensions differentially relate to COVID-19 anxiety irrespective of age, with implications for managing health anxiety and adaptive behaviour during a pandemic across the lifespan.
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Affiliation(s)
- Jennifer Elliott
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - Gaby Pfeifer
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, United Kingdom
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19
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Magnon V, Vallet GT, Benson A, Mermillod M, Chausse P, Lacroix A, Bouillon-Minois JB, Dutheil F. Does heart rate variability predict better executive functioning? A systematic review and meta-analysis. Cortex 2022; 155:218-236. [DOI: 10.1016/j.cortex.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/09/2022] [Accepted: 07/19/2022] [Indexed: 12/20/2022]
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20
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Sun W, Ueno D, Narumoto J. Brain Neural Underpinnings of Interoception and Decision-Making in Alzheimer's Disease: A Narrative Review. Front Neurosci 2022; 16:946136. [PMID: 35898412 PMCID: PMC9309692 DOI: 10.3389/fnins.2022.946136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
This study reviews recent literature on interoception directing decision-making in Alzheimer's disease (AD). According to the somatic marker hypothesis, signals from the internal body direct decision-making and involve the ventromedial prefrontal cortex (vmPFC). After reviewing relevant studies, we summarize the brain areas related to interoception and decision-making (e.g., vmPFC, hippocampus, amygdala, hypothalamus, anterior cingulate cortex, and insular cortex) and their roles in and relationships with AD pathology. Moreover, we outline the relationship among interoception, the autonomic nervous system, endocrine system, and AD pathology. We discuss that impaired interoception leads to decreased decision-making ability in people with AD from the perspective of brain neural underpinning. Additionally, we emphasize that anosognosia or reduced self-awareness and metacognition in AD are remarkably congruent with the malfunction of the autonomic nervous system regulating the interoceptive network. Furthermore, we propose that impaired interoception may contribute to a loss in the decision-making ability of patients with AD. However, there still exist empirical challenges in confirming this proposal. First, there has been no standardization for measuring or improving interoception to enhance decision-making ability in patients with AD. Future studies are required to better understand how AD pathology induces impairments in interoception and decision-making.
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21
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Feldman MJ, Siegel E, Barrett LF, Quigley KS, Wormwood JB. Affect and Social Judgment: The Roles of Physiological Reactivity and Interoceptive Sensitivity. AFFECTIVE SCIENCE 2022; 3:464-479. [PMID: 36046009 PMCID: PMC9382998 DOI: 10.1007/s42761-022-00114-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/11/2022] [Indexed: 06/03/2023]
Abstract
Humans imbue the objects of their perception with affective meaning, a phenomenon called affective realism. The affective realism hypothesis proposes that a brain continually predicts the meaning of sensations (e.g., identifying a sound as a siren, or a visual array as a face) in part by representing the current state of the body and the immediate physiological impact that similar sensory events have entailed in the past. However, the precise contribution of physiological activity to experiences of affective realism remains unknown. In the present study, participants' peripheral physiological activity was recorded while they made social evaluative judgments of target faces displaying neutral expressions. Target faces were shown concurrent with affective images that were suppressed from reportable awareness using continuous flash suppression. Results revealed evidence of affective realism-participants judged target faces more positively when paired with suppressed positive stimuli than suppressed negative stimuli-but this effect was significantly less pronounced among individuals higher in cardiac interoceptive sensitivity. Moreover, while some modest differences in peripheral physiological activity were observed across suppressed affective stimulus conditions, physiological reactivity to affective stimuli did not directly predict social evaluative judgments. We explore the implications of these findings with respect to both theories of emotion and theories detailing a role for interoception in experiences of first-person subjectivity. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-022-00114-9.
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Affiliation(s)
- Mallory J. Feldman
- University of North Carolina at Chapel Hill, 231 E. Cameron Ave, Chapel Hill, NC 27514 USA
| | | | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA 02115 USA
- Department of Psychiatry and the Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Boston, MA USA
| | - Karen S. Quigley
- Department of Psychology, Northeastern University, Boston, MA 02115 USA
| | - Jolie B. Wormwood
- Department of Psychology, University of New Hampshire, Durham, NH 03824 USA
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22
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Abstract
SignificanceThe capacity to sense interoceptive signals is thought to be fundamental to broad functions including, but not limited to, homeostasis and the experience of the self. While neuroanatomical evidence suggests that nonhuman animals-namely, nonhuman primates-may possess features necessary for interoceptive processing in a way that is similar to humans, behavioral evidence of this capacity is slim. We presented macaques with audiovisual stimuli that were either synchronous or asynchronous with their heartbeat and demonstrated that they view asynchronous stimuli, whether faster or slower, for a significantly longer period than they do synchronous stimuli.
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23
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Pearson A, Pfeifer G. Two Measures of Interoceptive Sensibility and the Relationship With Introversion and Neuroticism in an Adult Population. Psychol Rep 2022; 125:565-587. [PMID: 33112205 PMCID: PMC8793296 DOI: 10.1177/0033294120965461] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Interoception, the ability to detect internal bodily signals, is vital for an individual's well-being and is increasingly connected to mental health disorders. Research investigating relationships between individual differences in interoception and personality types is limited, and mixed results are reported across a variety of interoceptive tasks, measures, and conceptualisations. Guided by biological theories, this study contributed further to the understanding of the relationship between interoception and personality by utilising two interoceptive measures. A sample of adults (N = 114) completed three questionnaires online questionnaire, two assessing interoceptive sensibility (Body Perception Questionnaire, BPQ; and the Multidimensional Assessment of Interoceptive Awareness, MAIA) and one that assessed personality (Eysenck Personality Inventory, EPI). Multiple regression and correlational analyses showed no significant relationship between interoceptive sensibility and introversion, whereas a predictive relationship was demonstrated between interoceptive sensibility and neuroticism. Furthermore, the BPQ and subscales of the MAIA predicted neuroticism in different directions suggesting the two measures assess different constructs and thus strengthened support for a multidimensional consideration of interoception. The results have clinical implications, including the targeting of contemplative training approaches for individuals demonstrating high interoceptive sensibility and neurotic traits to improve the mental well-being of healthy individuals and clinical populations.
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Affiliation(s)
- Alison Pearson
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Gaby Pfeifer
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK
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24
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Torregrossa LJ, Amedy A, Roig J, Prada A, Park S. Interoceptive functioning in schizophrenia and schizotypy. Schizophr Res 2022; 239:151-159. [PMID: 34891079 DOI: 10.1016/j.schres.2021.11.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/06/2021] [Accepted: 11/27/2021] [Indexed: 12/31/2022]
Abstract
Though bodily self-disturbances are well documented in schizophrenia, interoceptive functioning (i.e., the perception of the internal state of the body) remains poorly understood in this population. In fact, only two studies to date have empirically measured interoceptive ability in schizophrenia. Both studies documented a deficit in interoceptive accuracy (i.e., the objective performance on a heartbeat detection task), and one noted differences in interoceptive sensibility (i.e., the subjective experience of interoception) in this population. To our knowledge, interoceptive awareness (i.e., the metacognitive awareness of one's interoceptive ability) has never been measured in schizophrenia and the link between interoceptive functioning and schizotypy remains unexplored. The present study addresses this gap by investigating the three dimensions of interoception in individuals with schizophrenia and matched controls (Experiment 1, N = 58) and in relation to schizotypal traits (Experiment 2, N = 109). Consistent with the literature, Experiment 1 documented a deficit in interoceptive accuracy and differences in interoceptive sensibility in individuals with schizophrenia. For the first time, our study revealed intact interoceptive awareness in individuals with schizophrenia. Against our expectations, we found no link between schizotypy and interoceptive functioning in Experiment 2. Our novel findings bear important clinical implications as insight into one's interoceptive limitations (i.e., intact interoceptive awareness) might promote treatment seeking behavior in schizophrenia. The lack of association between interoceptive ability and schizotypy in non-help-seeking youths suggests that changes in interoception may only arise with the onset of psychosis.
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Affiliation(s)
| | - Amad Amedy
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Jacqueline Roig
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Andrea Prada
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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25
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McIntosh RC, Lobo JD, Yang A, Schneiderman N. Brainstem network connectivity with mid-anterior insula predicts lower systolic blood pressure at rest in older adults with hypertension. J Hum Hypertens 2021; 35:1098-1108. [PMID: 33462388 PMCID: PMC8919345 DOI: 10.1038/s41371-020-00476-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 11/13/2020] [Accepted: 12/10/2020] [Indexed: 11/09/2022]
Abstract
Central regulation of heart rate and blood pressure provides the bases for a neurogenic mechanism of hypertension (HTN). Post menopause (PM) age coincides with changes in resting state functional brain connectivity (rsFC) as well as increased risk for HTN. Whether the neural networks underpinning cardioautonomic control differ between PM women with and without HTN is unclear. Phenotypic and functional neuroimaging data from the Nathan Kline Institute was first evaluated for group differences in intrinsic network connectivity between 22 HTN post menopausal women and 22 normotensive controls. Intrinsic rsFC of the midbrain-brainstem-cerebellar network with bilateral mid-anterior insula was lower in women with HTN (FWE-corrected, p < 0.05). Z-scores indicating rsFC of these regions were extracted from the 44 PM women and a cohort of 111 adults, not presenting with metabolic or neurodegenerative disease, and compared to in-office systolic and diastolic blood pressure. Lower rsFC of the left (r = -0.17, p = 0.019) and right (r = -0.14, p = 0.048) mid-anterior insula with brainstem nuclei was associated with higher systolic blood pressure in the combined sample. The magnitude of this effect in men and women of post menopausal age supports a neurogenic mechanism for blood pressure regulation in older adults with HTN.
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Affiliation(s)
- Roger C McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | - Judith D Lobo
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Anting Yang
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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26
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Prentice F, Murphy J. Sex differences in interoceptive accuracy: A meta-analysis. Neurosci Biobehav Rev 2021; 132:497-518. [PMID: 34838927 DOI: 10.1016/j.neubiorev.2021.11.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/19/2022]
Abstract
Interoceptive accuracy, the ability to correctly perceive internal signals arising from the body, is thought to be disrupted in numerous mental and physical health conditions. Whilst evidence suggests poorer interoceptive accuracy in females compared to males, raising the possibility that interoceptive differences may relate to sex differences in mental and physical health, results concerning sex differences in interoceptive accuracy are mixed. Given such ambiguity, this meta-analysis aimed to establish the presence or absence of sex differences in interoceptive accuracy across cardiac, respiratory, and gastric domains. A review of 7956 abstracts resulted in 93 eligible studies. Results demonstrated superior accuracy in males across cardiac, but not gastric, tasks, while findings on respiratory tasks were mixed. Effect sizes were consistent across cardiac tasks, but instability and/or moderate heterogeneity was observed across other domains, likely due to the small number of eligible studies. Despite such limitations, results indicate the possibility of sex differences across interoception tasks and domains. Methodological limitations concerning the influence of physiological factors, and directions for future research are discussed.
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Affiliation(s)
- Freya Prentice
- Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, United Kingdom.
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom
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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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Schulz A, Back SN, Schaan VK, Bertsch K, Vögele C. On the construct validity of interoceptive accuracy based on heartbeat counting: Cardiovascular determinants of absolute and tilt-induced change scores. Biol Psychol 2021; 164:108168. [PMID: 34411619 DOI: 10.1016/j.biopsycho.2021.108168] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022]
Abstract
Interoceptive accuracy (IAcc) as assessed with the heartbeat counting task (IAccHBCT) may be affected by a range of factors including (1.) the ability to adequately detect cardiac signals, indicated by IAcc in a heartbeat discrimination task (IAccHBDT), (2.) cardiac signal properties, affected by sympathetic and parasympathetic tone, and (3.) non-interoceptive processes, including time estimation accuracy (TEAcc). In the current study we investigated the contribution of these factors to absolute and Δ IAccHBCT scores, induced by passive head-up and head-down tilt in 49 healthy individuals. A set of hierarchical regression models showed IAccHBDT scores as the strongest and, across different orthostatic (tilt) conditions, most stable (positive) predictor of absolute and Δ IAccHBCT scores. Neither indicators of cardiac signal properties (except for HR in head-down-tilt), nor TEAcc predicted absolute or Δ IAccHBCT scores. These findings support the convergent and discriminant validity of absolute and Δ IAccHBCT scores.
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Affiliation(s)
- André Schulz
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Sarah N Back
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Violetta K Schaan
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Katja Bertsch
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Claus Vögele
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Chen WG, Schloesser D, Arensdorf AM, Simmons JM, Cui C, Valentino R, Gnadt JW, Nielsen L, Hillaire-Clarke CS, Spruance V, Horowitz TS, Vallejo YF, Langevin HM. The Emerging Science of Interoception: Sensing, Integrating, Interpreting, and Regulating Signals within the Self. Trends Neurosci 2021; 44:3-16. [PMID: 33378655 DOI: 10.1016/j.tins.2020.10.007] [Citation(s) in RCA: 244] [Impact Index Per Article: 81.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/21/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023]
Abstract
Interoception refers to the representation of the internal states of an organism, and includes the processes by which it senses, interprets, integrates, and regulates signals from within itself. This review presents a unified research framework and attempts to offer definitions for key terms to describe the processes involved in interoception. We elaborate on these definitions through illustrative research findings, and provide brief overviews of central aspects of interoception, including the anatomy and function of neural and non-neural pathways, diseases and disorders, manipulations and interventions, and predictive modeling. We conclude with discussions about major research gaps and challenges.
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Affiliation(s)
- Wen G Chen
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, MD 20892, USA.
| | - Dana Schloesser
- Office of Behavioral and Social Sciences Research (OBSSR), NIH, Bethesda, MD 20892, USA
| | - Angela M Arensdorf
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Janine M Simmons
- National Institute of Mental Health (NIMH), NIH, Bethesda, MD 20892, USA
| | - Changhai Cui
- National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, MD 20892, USA
| | - Rita Valentino
- National Institute on Drug Abuse (NIDA), NIH, Bethesda, MD 20892, USA
| | - James W Gnadt
- National Institute of Neurological Disorders and Stroke (NINDS), NIH, Bethesda, MD 20892, USA
| | - Lisbeth Nielsen
- National Institute on Aging (NIA), NIH, Bethesda, MD 20892, USA
| | | | - Victoria Spruance
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, MD 20892, USA
| | - Todd S Horowitz
- National Cancer Institute (NCI), NIH, Bethesda, MD 20892, USA
| | - Yolanda F Vallejo
- National Institute of Dental and Craniofacial Research (NIDCR), NIH, Bethesda, MD 20892, USA
| | - Helene M Langevin
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, MD 20892, USA
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Bonaz B, Lane RD, Oshinsky ML, Kenny PJ, Sinha R, Mayer EA, Critchley HD. Diseases, Disorders, and Comorbidities of Interoception. Trends Neurosci 2021; 44:39-51. [PMID: 33378656 DOI: 10.1016/j.tins.2020.09.009] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022]
Abstract
Interoception, the sense of the body's internal physiological state, underpins homeostatic reflexes, motivational states, and sensations contributing to emotional experiences. The continuous nature of interoceptive processing, coupled to behavior, is implicated in the neurobiological construction of the sense of self. Aberrant integration and control of interoceptive signals, originating in the brain and/or the periphery, can perturb the whole system. Interoceptive abnormalities are implicated in the pathophysiology of psychiatric disorders and in the symptomatic expression of developmental, neurodegenerative, and neurological disorders. Moreover, interoceptive mechanisms appear central to somatic disorders of brain-body interactions, including functional digestive disorders, chronic pain, and comorbid conditions. The present article provides an overview of disorders of interoception and suggests future directions for better understanding, diagnosis, and management of these disorders.
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Affiliation(s)
- Bruno Bonaz
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institute Neurosciences and Division of Hepato-Gastroenterology, CHU Grenoble Alpes, 38000 Grenoble, France.
| | - Richard D Lane
- Department of Psychiatry, University of Arizona, Tucson, AZ 85724-5002, USA; Department of Psychology, University of Arizona, Tucson, AZ 85724-5002, USA; Department of Neuroscience, University of Arizona, Tucson, AZ 85724-5002, USA
| | - Michael L Oshinsky
- National Institute of Neurological Disorders and Stroke/National Institutes of Health, Bethesda, MD 20894, USA
| | - Paul J Kenny
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rajita Sinha
- Yale Stress Center, Yale School of Medicine, New Haven, CT, 06519, USA
| | - Emeran A Mayer
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, UK
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Individuals with Autistic Traits Exhibit Heightened Alexithymia But Intact Interoceptive-Exteroceptive Sensory Integration. J Autism Dev Disord 2021; 52:3142-3152. [PMID: 34286394 DOI: 10.1007/s10803-021-05199-y] [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] [Accepted: 07/13/2021] [Indexed: 12/14/2022]
Abstract
Interoceptive accuracy has been widely measured using the Heartbeat Tracking Test (HTT). We devised the novel paradigm of Interoception-Exteroception Synchronicity Judgement (IESJ) task to assess participants' interoceptive accuracy, exteroceptive accuracy, and the balancing score which reflected the ability to allocate attentions between interoceptive and exteroceptive signals. This study administered the behavioural paradigms of the HTT and the IESJ as well as other self-report scales to 119 typically-developing youths. Individuals with lower autistic traits (n = 30) showed comparable interoceptive accuracy, exteroceptive accuracy, and balancing scores as their higher autistic traits counterparts (n = 33). Taken together, the high autistic traits subgroup exhibited higher levels of alexithymia but not empathy or interoception than the low autistic traits subgroup.
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Multidimensional Interoception and Autistic Traits Across life Stages: Evidence From a Novel Eye-tracking Task. J Autism Dev Disord 2021; 52:2644-2655. [PMID: 34264487 DOI: 10.1007/s10803-021-05155-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 12/18/2022]
Abstract
Interoception is believed to underlie socio-cognitive functions which are often impaired in individuals with autism spectrum disorders (ASD). In this study, Experiment 1 examined in a sample of 114 neurotypical college students the associations among autistic traits, alexithymia, and interoceptive accuracy (IA), which was assessed by a novel paradigm "Eye-tracking Interoceptive Accuracy Task (EIAT). In Experiment 2, EIAT and the Autism Spectrum Quotient were administered to 52 preschool children, 50 adolescents, and 50 adults. Experiment 1 supported the association between autistic traits and alexithymia, but failed to support their association with multidimensional interoception. Experiment 2 strongly supported the association between age and IA. We conclude that cardiac IA differs between neurotypical age groups, but shows limited relationship with autistic traits.
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Lin CY, Hammash M, Mudd-Martin G, Biddle MJ, Dignan M, Moser DK. Older and younger patients' perceptions, evaluations, and responses to worsening heart failure symptoms. Heart Lung 2021; 50:640-647. [PMID: 34091110 DOI: 10.1016/j.hrtlng.2021.05.005] [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: 09/18/2020] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Whether recognition and prompt response to worsening symptoms are worse in older compared with younger patients with heart failure (HF) is unclear. OBJECTIVES The aims of this study were to compare older and younger patients (1) perceptions, evaluations, and responses to worsening HF symptoms, and (2) responses once worsening symptoms were perceived. METHODS A mixed-methods study was conducted and to compare data between older (≥ 65) and younger (< 65) in 185 patients hospitalized with HF. RESULTS There were few differences attributed to age. In response to higher perceived symptom distress, patients in both groups did nothing and hoped their symptoms would go away (p = 0.004), ignored symptoms and continued doing what they were doing (p = 0.002), or laid down to relax (p < 0.001). CONCLUSIONS The majority of patients, regardless of age, did not recognize, interpret, and respond appropriately to HF symptoms. Interventions should be tested that target better symptom appraisal and promote appropriate symptom responses in patients with HF across all ages.
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Affiliation(s)
- Chin-Yen Lin
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, United States.
| | - Muna Hammash
- School of Nursing, University of Louisville, 555 S Floyd Street, Louisville, KY, United States.
| | - Gia Mudd-Martin
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, United States.
| | - Martha J Biddle
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, United States.
| | - Mark Dignan
- Department of Internal Medicine, University of Kentucky, 800 Rose Street, Room CC44, Lexington, KY, United States.
| | - Debra K Moser
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, United States.
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Cross-cultural adaptation and psychometric properties of the Italian version of the Body Perception Questionnaire. PLoS One 2021; 16:e0251838. [PMID: 34043660 PMCID: PMC8158925 DOI: 10.1371/journal.pone.0251838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/OBJECTIVE The purpose of this study was to cross-culturally adapt the Body Perception Questionnaire Short Form (BPQ-SF) into Italian and to assess its psychometric properties in a sample of Italian subjects. METHODS A forward-backward method was used for translation. 493 adults were recruited for psychometric analysis. Structural validity was assessed with confirmatory factor analysis and a hypothesis testing approach. Internal consistency was assessed by Cronbach's alpha and McDonald's omega. Measurement invariance analysis was applied with an age-matched American sample. RESULTS The single-factor structure fit the awareness subscale (RMSEA = .036, CFI = .983, TLI = .982). Autonomic reactivity (ANSR) was well-described by supra- and sub-diaphragmatic subscales (RMSEA = .041, CFI = .984, TLI = .982). All subscales were positively correlated (r range: .50-.56) and had good internal consistency (McDonald's Omega range: .86-.92, Cronbach's alpha range: .88-.91). Measurement invariance analysis for the Awareness model showed significant results (p<0.001) in each step (weak, strong and strict) whereas the ANSR showed significant results (p<0.001) only for the strong and strict steps. CONCLUSIONS Our results support the Italian version of the BPQ as having consistent psychometric properties in comparison with other languages.
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Poli A, Maremmani AGI, Chiorri C, Mazzoni GP, Orrù G, Kolacz J, Porges SW, Conversano C, Gemignani A, Miccoli M. Item Reduction, Psychometric and Biometric Properties of the Italian Version of the Body Perception Questionnaire-Short Form (BPQ-SF): The BPQ-22. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3835. [PMID: 33917552 PMCID: PMC8038843 DOI: 10.3390/ijerph18073835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022]
Abstract
Body awareness disorders and reactivity are mentioned across a range of clinical problems. Constitutional differences in the control of the bodily state are thought to generate a vulnerability to psychological symptoms. Autonomic nervous system dysfunctions have been associated with anxiety, depression, and post-traumatic stress. Though interoception may be a transdiagnostic mechanism promoting the improvement of clinical symptomatology, few psychometrically sound, symptom-independent, self-report measures, informed by brain-body circuits, are available for research and clinical use. We validated the Italian version of the body perception questionnaire (BPQ)-short form and found that response categories could be collapsed from five to three and that the questionnaire retained a three-factor structure with items reduced from 46 to 22 (BPQ-22). The first factor was loaded by body awareness items; the second factor comprised some items from the body awareness scale and some from the subdiaphragmatic reactivity scale (but all related to bloating and digestive issues), and the third factor by supradiaphragmatic reactivity items. The BPQ-22 had sound psychometric properties, good convergent and discriminant validity and test-retest reliability and could be used in clinical and research settings in which the body perception assessment is of interest. Psychometric findings in light of the polyvagal theory are discussed.
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Affiliation(s)
- Andrea Poli
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
- Verdi Clinical Center, 59100 Prato, Italy
- Florence Cognitive School, 50144 Florence, Italy;
| | - Angelo Giovanni Icro Maremmani
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Versilia Zone, 55049 Viareggio, Italy;
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), 55045 Pietrasanta, Italy
- G. De Lisio Institute of Behavioral Sciences, 56100 Pisa, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genova, 16121 Genova, Italy;
| | | | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
| | - Jacek Kolacz
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (J.K.); (S.W.P.)
| | - Stephen W. Porges
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (J.K.); (S.W.P.)
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
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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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The Relationship Between Body Awareness and Self-care in Patients With Heart Failure: Moderating Effect of Age. J Cardiovasc Nurs 2021; 37:266-273. [PMID: 33764942 DOI: 10.1097/jcn.0000000000000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recognizing changing symptoms is challenging for patients with heart failure (HF), especially older patients. Body awareness involves an attentional focus on and awareness of internal bodily changes. Patients with poor body awareness are unlikely to recognize subtle bodily changes, which may result in improper self-care. Despite the potential benefits of body awareness, its contribution to HF management has not been examined. AIMS The aims of this study were to examine the relationship between body awareness and self-care in patients with HF and explore whether this relationship varies by age. METHODS Patients (N = 136) completed the Body Awareness Questionnaire and 2 scales of the Self-care of HF Index (maintenance and management). Linear regression models were constructed to explore the relationship between body awareness and self-care after controlling for covariates. The moderation effect of age on the relationship between body awareness and self-care was examined using the PROCESS macro. RESULTS Body awareness was associated with self-care maintenance (unstandardized coefficient = 0.19; 95% confidence interval, 0.05-0.34) but not management. When the interaction effect of body awareness and age was entered in the regression model, neither self-care maintenance nor management was related to this interaction term. CONCLUSION We found that body awareness is conducive to self-care maintenance but not self-care management in patients with HF, and the relationship between body awareness and self-care did not vary by age. Our findings suggest that relying on internal body sensations may be insufficient to facilitate self-care management. Thus, other strategies along with the strategies to enhance body awareness are necessary to improve the full process of self-care in HF patients.
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MacCormack JK, Henry TR, Davis BM, Oosterwijk S, Lindquist KA. Aging bodies, aging emotions: Interoceptive differences in emotion representations and self-reports across adulthood. Emotion 2021; 21:227-246. [PMID: 31750705 PMCID: PMC7239717 DOI: 10.1037/emo0000699] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bodily sensations are closely linked to emotional experiences. However, most research assessing the body-emotion link focuses on young adult samples. Inspired by prior work showing age-related declines in autonomic reactivity and interoception, we present 2 studies investigating age-related differences in the extent to which adults (18-75 years) associate interoceptive or internal bodily sensations with emotions. Study 1 (N = 150) used a property association task to assess age effects on adults' tendencies to associate interoceptive sensations, relative to behaviors or situations, with negative emotion categories (e.g., anger, sadness). Study 2 (N = 200) used the Day Reconstruction experience sampling method to assess the effect of age on adults' tendencies to report interoceptive sensations and emotional experiences in daily life. Consistent with prior literature suggesting that older adults have more muted physiological responses and interoceptive abilities than younger adults, we found that older adults' mental representations (Study 1) and self-reported experiences (Study 2) of emotion are less associated with interoceptive sensations than are those of younger adults. Across both studies, age effects were most prominent for high arousal emotions (e.g., anger, fear) and sensations (e.g., racing heart) that are often associated with peripheral psychophysiological concomitants in young adults. These findings are consistent with psychological constructionist models and a "maturational dualism" account of emotional aging, suggesting additional pathways by which emotions may differ across adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Williams IA, Reuber M, Levita L. Interoception and stress in patients with Functional Neurological Symptom Disorder. Cogn Neuropsychiatry 2021; 26:75-94. [PMID: 33372576 DOI: 10.1080/13546805.2020.1865895] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Research suggests that patients with Functional Neurological Symptom Disorder (pwFND) struggle to identify their own emotions and associated physiological cues (interoceptive sensitivity, IS). However, it is not known how this deficit interacts with stress. This study aimed to assess IS in pwFND at baseline and following stress induction, and relate the findings to self-reported emotion processing difficulties. METHODS Twenty-six pwFND and 27 healthy controls performed the Heart Beat Detection Task pre- and post-stress induction with the Cold Pressor Test. Participants also completed questionnaires assessing anxiety (GAD-7) and depressive symptomology (PHQ-9), as well as emotion processing (EPS-25). RESULTS Patients reported deficits in emotion processing (p < . 001) and had lower IS (p = .032) than healthy controls. IS improved following stress induction across both groups (p = .003) but patients' IS was lower than that of healthy controls' pre-and post-stress induction. Exploratory analyses revealed that patients reporting sensory symptoms had lower IS at baseline than patients who did not. CONCLUSION Our findings suggest that pwFND are relatively impaired in the identification of their emotions at baseline and following stress induction. This may be related to the experience of functional sensory symptoms and has implications for the psychological treatment of emotion dysregulation in this population.
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Affiliation(s)
| | - Markus Reuber
- Academic Neurology, The University of Sheffield, Sheffield, UK
| | - Liat Levita
- Department of Psychology, The University of Sheffield, Sheffield, UK
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Raimo S, Boccia M, Di Vita A, Cropano M, Guariglia C, Grossi D, Palermo L. The Body Across Adulthood: On the Relation Between Interoception and Body Representations. Front Neurosci 2021; 15:586684. [PMID: 33716641 PMCID: PMC7943607 DOI: 10.3389/fnins.2021.586684] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 01/27/2021] [Indexed: 12/31/2022] Open
Abstract
Interoceptive information plays a pivotal role in building body representations (BR), but the association between interoception and the different types of BR in healthy individuals has never been systematically investigated. Thus, this study aimed to explore the association between BR and interoceptive sensibility (IS) throughout adulthood. One hundred thirty-seven healthy participants (50 aged from 18 to 40 years old; 50 aged from 41 to 60 years old; and 37 over 60 years old) were given a self-report tool for assessing IS (the Self-Awareness Questionnaire; SAQ), and a specific battery including tasks evaluating three different BR (i.e., the body schema, using the Hand Laterality Task; the body structural representation, using the Frontal Body Evocation task, FBE; and body semantics, using the Object-Body Part Association Task) as well as control tasks (i.e., tasks with non-body stimuli). The older age group (aged over 60 years old) showed lower performances on the tasks probing the body schema and body structural representation than younger groups (aged 18 to 40 and 41 to 60 years old). More interestingly, worse performances on a task assessing the body schema were significantly associated with higher IS with older age, suggesting that higher awareness of one's inner body sensations would decrease the plasticity of this BR. These findings are interpreted according to the neuropsychological model of BR development and the effects of aging on the brain.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Maddalena Boccia
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - Antonella Di Vita
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - Maria Cropano
- Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Cecilia Guariglia
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - Dario Grossi
- Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Liana Palermo
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
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41
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Vieillard S, Msika C. Les modifications du fonctionnement cognitif et émotionnel avec l’avancée en âge au prisme d’une approche incarnée. ANNEE PSYCHOLOGIQUE 2021. [DOI: 10.3917/anpsy1.211.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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42
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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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43
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Noradrenergic activation induced by yohimbine decreases interoceptive accuracy in healthy individuals with childhood adversity. Dev Psychopathol 2021; 34:1013-1024. [PMID: 33446284 DOI: 10.1017/s0954579420001613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Acute stress affects interoception, but it remains unclear if this is due to activation of the sympatho-adreno-medullary (SAM) or hypothalamic-pituitary-adrenocortical axis. This study aimed to investigate the effect of SAM axis activation on interoceptive accuracy (IAcc). Central alpha2-adrenergic receptors represent a negative feedback mechanism of the SAM axis. Major depressive disorder and adverse childhood experiences (ACE) are associated with alterations in the biological stress systems, including central alpha2-adrenergic receptors. Here, healthy individuals with and without ACE as well as depressive patients with and without ACE (n = 114; all without antidepressant medication) were tested after yohimbine (alpha2-adrenergic antagonist) and placebo. We assessed IAcc and sensibility in a heartbeat counting task. Increases in systolic and diastolic blood pressure after yohimbine confirmed successful SAM axis activation. IAcc decreased after yohimbine only in the healthy group with ACE, but remained unchanged in all other groups (Group × Drug interaction). This effect may be due to selective upregulation of alpha2-adrenergic receptors after childhood trauma, which reduces capacity for attention focus on heartbeats. The sympathetic neural pathway including alpha2-adrenergic circuitries may be essential for mediating interoceptive signal transmission. Suppressed processing of physical sensations in stressful situations may represent an adaptive response in healthy individuals who experienced ACE.
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Kamp SM, Schulz A, Forester G, Domes G. Older adults show a higher heartbeat-evoked potential than young adults and a negative association with everyday metacognition. Brain Res 2021; 1752:147238. [PMID: 33406407 DOI: 10.1016/j.brainres.2020.147238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/11/2020] [Indexed: 11/16/2022]
Abstract
The ability to monitor internal bodily and cognitive processes is essential for everyday functioning and independence in older adults, because it allows for adjustments when lapses in performance are imminent. In the present study, age-related morphological changes to the heartbeat evoked potential (HEP), an electrophysiological cortical representation of cardiac signals, and its association with self-reported everyday cognition were examined. A community sample of older adults showed an increased HEP amplitude, which could reflect a stronger representation of early stages of cardiac interoception, and a more anterior scalp distribution of the HEP, suggesting a more widespread configuration of the underlying neural generators, compared to a group of young adults. Furthermore, in older adults, HEP amplitude was negatively correlated with self-estimated everyday cognitive functioning. Older adults with pronounced cortical representations of peripheral signals may thus be more likely to take note of lapses in their own bodily and cognitive function, leading to lower estimates of their cognitive abilities. These results provide novel insights into age-related changes in interoceptive processing and their association with metacognitive judgments, with potentially far-reaching implications for cognitive aging and age-related cognitive decline.
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Affiliation(s)
- Siri-Maria Kamp
- Neurocognitive Psychology Unit, University of Trier, Germany.
| | | | - Glen Forester
- Neurocognitive Psychology Unit, University of Trier, Germany
| | - Gregor Domes
- Biological and Clinical Psychology Unit, University of Trier, Germany
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45
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Bekrater-Bodmann R, Azevedo RT, Ainley V, Tsakiris M. Interoceptive Awareness Is Negatively Related to the Exteroceptive Manipulation of Bodily Self-Location. Front Psychol 2020; 11:562016. [PMID: 33343444 PMCID: PMC7746809 DOI: 10.3389/fpsyg.2020.562016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/06/2020] [Indexed: 12/21/2022] Open
Abstract
The perception of being located within one's body (i.e., bodily self-location) is an essential feature of everyday self-experience. However, by manipulating exteroceptive input, healthy participants can easily be induced to perceive themselves as being spatially dislocated from their physical bodies. It has previously been suggested that interoception, i.e., the processing of inner physiological signals, contributes to the stability of body representations; however, this relationship has not previously been tested for different dimensions of interoception and bodily self-location. In the present study, using an advanced automatized setup, we systematically manipulated participants' perspective of their own body (first- vs third-person perspective) as well as the synchrony of visuotactile stimulation (synchronous vs asynchronous). The malleability of bodily self-location was assessed using a questionnaire targeting in-body and out-of-body experiences. Participants also performed a heartbeat discrimination task to assess their interoceptive accuracy (behavioral performance), interoceptive sensibility (confidence in their interoceptive abilities), and interoceptive awareness (meta-cognitive representation of interoceptive signals). Bodily self-location was significantly influenced by perspective, with third-person perspective being associated with stronger out-of-body experiences compared to first-person perspective. Furthermore, there was a significant perspective × stimulation interaction, with subsequent analyses showing that participants reported out-of-body experiences particularly under third-person perspective combined with synchronous visuotactile stimulation. Correlation and regression analyses revealed that meta-cognitive interoceptive awareness was specifically and negatively related to the exteroceptively mediated malleability of body experiences. These results indicate that the perception of the self being located within one's body relies on the interaction of exteroceptive input and higher-order interoceptive abilities. This has implications for theoretical considerations about the bodily self in health as well as for the understanding of disturbed bodily self-processing in clinical contexts.
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Affiliation(s)
- Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
| | - Ruben T Azevedo
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom.,Department of Psychology, University of Kent, Canterbury, United Kingdom
| | - Vivien Ainley
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
| | - Manos Tsakiris
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom.,Warburg Institute, School of Advanced Study, University of London, Bloomsbury, United Kingdom.,Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Luxembourg
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Ueno D, Matsuoka T, Kato Y, Ayani N, Maeda S, Takeda M, Narumoto J. Individual Differences in Interoceptive Accuracy Are Correlated With Salience Network Connectivity in Older Adults. Front Aging Neurosci 2020; 12:592002. [PMID: 33335482 PMCID: PMC7736179 DOI: 10.3389/fnagi.2020.592002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/21/2020] [Indexed: 12/18/2022] Open
Abstract
Interoceptive accuracy refers to the ability to consciously perceive the physical condition of the inner body, including one’s heartbeat. In younger adults, interoceptive accuracy is correlated with insular and orbitofrontal cortical connectivity within the salience network (SN). As interoceptive accuracy and insular cortex volume are known to decrease with aging, we aimed to evaluate the correlation between SN connectivity and interoceptive accuracy in older adults. 27 older adults (mean age, 77.29 years, SD = 6.24; 19 female) underwent resting-state functional magnetic resonance imaging, followed by a heartbeat counting task and neuropsychological test. We evaluated the correlation between interoceptive accuracy and SN connectivity with age, sex, cognitive function, and total gray matter volume as covariates. Region of interest-to-region of interest analyses showed that interoceptive accuracy was positively correlated with the functional connectivity (FC) of the left rostral prefrontal cortex with the right insular, right orbitofrontal, and anterior cingulate cortices [F(6,16) = 4.52, false discovery rate (FDR)-corrected p < 0.05]. Moreover, interoceptive accuracy was negatively correlated to the FC of the left anterior insular cortex with right intra-calcarine and visual medial cortices (F(6,16) = 2.04, FDR-corrected p < 0.10). These findings suggest that coordination between systems, with a positive correlation between left rostral prefrontal cortex and the SN and a negative correlation between left insular cortex and vision-related exteroceptive brain regions, is important for maintaining interoceptive accuracy in older adults.
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Affiliation(s)
- Daisuke Ueno
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuka Kato
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nobutaka Ayani
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Saaya Maeda
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Minato Takeda
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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47
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McPhillips MV, Li J, Hodgson NA, Cacchione PZ, Dickson VV, Gooneratne NS, Riegel B. Daytime sleepiness and napping in nursing-home eligible community dwelling older adults: A mixed methods study. Gerontol Geriatr Med 2020; 6:2333721420970730. [PMID: 35059470 PMCID: PMC8764400 DOI: 10.1177/2333721420970730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 01/18/2023] Open
Abstract
Objectives To describe perceptions and beliefs about daytime sleepiness and napping along with subjective and objective daytime sleep characteristics in nursing-home eligible community dwelling older adults. Methods A mixed methods study; we conducted semi-structured interviews and measured sleep variables via Actigraphy, sleep diary, and Epworth Sleepiness Scale (ESS). Napping was defined as >10 minutes; anything less was considered dozing. Results Final sample (n = 40) was primarily female (85%), Black (100%), with a mean age of 72 ± 9.5 years. Few (25%) reported daytime sleepiness (ESS >10). However, average duration of napping per day was 33.1 ± 11.5 minutes with a nap frequency of 2.5 ± 1.5 naps. Conclusion Our sample napped frequently throughout the day, yet the majority reported no daytime sleepiness. These older adults did not always recognize napping or how much they napped.
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Affiliation(s)
| | - Junxin Li
- Johns Hopkins University, Baltimore, MD, USA
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48
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Jones A, Silas J, Todd J, Stewart A, Acree M, Coulson M, Mehling WE. Exploring the Multidimensional Assessment of Interoceptive Awareness in youth aged 7-17 years. J Clin Psychol 2020; 77:661-682. [PMID: 33035384 DOI: 10.1002/jclp.23067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/09/2020] [Accepted: 09/19/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to adapt the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire for younger respondents. METHOD The language of the MAIA was revised and children aged 7-10 years (n = 212) and adolescents aged 11-17 years (n = 217) completed the questionnaire. RESULTS The original eight-factor model was tested for fit using confirmatory factor analysis. The model had an acceptable fit in the total sample and younger subsample and overall fit in the older subsample was adequate following modification. Internal consistency was good, except for the Noticing, Not-Distracting and Not-Worrying scales. Results also demonstrated a negative linear relationship between the trusting scale and age, suggesting that youths may lose trust in their body as they age. CONCLUSION The adapted MAIA can be used with a younger population and, depending on the research question, individual MAIA scales may be selected. The survey is available at https://osher.ucsf.edu/maia.
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Affiliation(s)
- Alexander Jones
- Department of Psychology, School of Science and Technology, Middlesex University, London, UK
| | - Jonathan Silas
- Department of Psychology, School of Science and Technology, Middlesex University, London, UK
| | - Jennifer Todd
- School of Psychology and Sport Science, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Anita Stewart
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, California, USA
| | - Michael Acree
- Osher Center for Integrative Medicine, University of California, San Francisco, California, USA
| | - Mark Coulson
- School of Psychology, Faculty of Social Sciences, University of East Anglia, UK
| | - Wolf E Mehling
- Osher Center for Integrative Medicine, University of California, San Francisco, California, USA.,Department of Family and Community Medicine, University of California, San Francisco, California, USA
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49
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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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50
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MacCormack JK, Stein AG, Kang J, Giovanello KS, Satpute AB, Lindquist KA. Affect in the Aging Brain: A Neuroimaging Meta-Analysis of Older Vs. Younger Adult Affective Experience and Perception. AFFECTIVE SCIENCE 2020; 1:128-154. [PMID: 36043210 PMCID: PMC9382982 DOI: 10.1007/s42761-020-00016-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/20/2020] [Indexed: 05/15/2023]
Abstract
We report the first functional neuroimaging meta-analysis on age-related differences in adult neural activity during affect. We identified and coded experimental contrasts from 27 studies (published 1997-2018) with 490 older adults (55-87 years, M age = 69 years) and 470 younger adults (18-39 years, M age = 24 years). Using multilevel kernel density analysis, we assessed functional brain activation contrasts for older vs. younger adult affect across in-scanner tasks (i.e., affect induction and perception). Relative to older adults, younger adults showed more reliable activation in subcortical structures (e.g., amygdala, thalamus, caudate) and in relatively more posterior aspects of specific brain structures (e.g., posterior insula, mid- and posterior cingulate). In contrast, older adults exhibited more reliable activation in the prefrontal cortex and more anterior aspects of specific brain structures (e.g., anterior insula, anterior cingulate). Meta-analytic coactivation network analyses further revealed that in younger adults, the amygdala and mid-cingulate were more central, locally efficient network nodes, whereas in older adults, regions in the superior and medial prefrontal cortex were more central, locally efficient network nodes. Collectively, these findings help characterize age differences in the brain basis of affect and provide insights for future investigations into the neural mechanisms underlying affective aging.
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Affiliation(s)
- Jennifer K. MacCormack
- Department of Psychiatry, University of Pittsburgh, 506 Old Engineering Hall, 3943 O’Hara St, Pittsburgh, PA 15213 USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Andrea G. Stein
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI USA
| | - Kelly S. Giovanello
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Ajay B. Satpute
- Department of Psychology, Northeastern University, Boston, MA USA
| | - Kristen A. Lindquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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