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Funder: Aarhus Universitets Forskningsfond; Id: http://dx.doi.org/10.13039/501100002739, Funder: Health Data Research UK; Id: http://dx.doi.org/10.13039/501100023699, Funder: Jabbs Foundation; Id: http://dx.doi.org/10.13039/501100016132, Funder: National Institute of Health Research Biomedical Research Centre, Interoception is the sensation, perception, and integration of signals from within the body. It has been associated with a broad range of physiological and psychological processes. Further, interoceptive variables are related to specific regions and networks in the human brain. However, it is not clear whether or how these networks relate empirically to different domains of physiological and psychological health at the population level. We analysed a data set of 19,020 individuals (10,055 females, 8965 males; mean age: 63 years, age range: 45-81 years), who have participated in the UK Biobank Study, a very large-scale prospective epidemiological health study. Using canonical correlation analysis (CCA), allowing for the examination of associations between two sets of variables, we related the functional connectome of brain regions implicated in interoception to a selection of nonimaging health and lifestyle related phenotypes, exploring their relationship within modes of population co-variation. In one integrated and data driven analysis, we obtained four statistically significant modes. Modes could be categorised into domains of arousal and affect and cardiovascular health, respiratory health, body mass, and subjective health (all p < .0001) and were meaningfully associated with distinct neural circuits. Circuits represent specific neural "fingerprints" of functional domains and set the scope for future studies on the neurobiology of interoceptive involvement in different lifestyle and health-related phenotypes. Therefore, our research contributes to the conceptualisation of interoception and may lead to a better understanding of co-morbid conditions in the light of shared interoceptive structures.

Objective: To examine whether putatively atypical neuronal activity during internal attention in ADHD yields insights into processes underlying emotion dysregulation. Methods: We used a word processing paradigm to assess neural activations in adults with ADHD ( N = 46) compared to controls ( N = 43). We measured effects of valence, applied partial-least squares correlation analysis to assess multivariate brainbehavior relationships and ran subgroup analyses to isolate results driven by pure ADHD ( N = 18). Results: During internal attention, ADHD, compared to controls, have (1) increased activation in the right angular gyrus (rAG), which appears driven by pure, not comorbid, ADHD and (2) diminished activation in the insula and fronto-striatal circuitry. Diminished activations were driven by negatively-valenced internal attention and negatively correlated with increased affective lability within the ADHD group. Conclusion: Internal attention in ADHD is associated with increased rAG activation, possibly reflecting difficulty converging external and internal information, and diminished activation within emotion regulation circuitry.

Both accurately sensing our own bodily signals and knowing whether we have accurately sensed them may contribute to a successful emotional life, but there is little evidence on whether these physiological perceptual and metacognitive abilities systematically differ between people. Here, we examined whether actors, who receive substantial training in the production, awareness, and control of emotion, and nonactor controls differed in interoceptive ability (the perception of internal bodily signals) and/or metacognition about interoceptive accuracy (awareness of that perception), and explored potential sources of individual differences in and consequences of these abilities including correlational relationships with state and trait anxiety, proxies for acting ability, and the amount of acting training. Participants performed a heartbeat detection task in which they judged whether tones were played synchronously or delayed relative to their heartbeats, and then rated their metacognitive confidence in that judgment. Cardiac interoceptive accuracy and metacognitive awareness of interoceptive accuracy were independent, and while actors' and controls' interoceptive accuracy was not significantly different, actors had consistently superior metacognitive awareness of interoception. Exploratory analyses additionally suggest that this metacognitive ability may be correlated with measures of acting ability, but not the duration of acting training. Interoceptive accuracy and metacognitive insight into that accuracy appear to be separate abilities, and while actors may be no more accurate in reading their bodies, their metacognitive insight means they know better when they're accurate and when they're not. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background Mindfulness-based interventions have proven efficacy in treating post-traumatic stress disorder (PTSD) but the neurobiological mechanism underlying the therapeutic effects is unknown. As mindfulness meditation cultivates attention to the present-moment and bodily sensations, neural functions related to interoception (i.e., central processes of bodily signals) might be such a mechanism. Methods We conducted a clinical trial in which veterans with PTSD were randomly assigned to receive an 8-week mindfulness-based stress reduction (MBSR) intervention (n = 47) or an active control intervention (present-centered group therapy; PCGT; n = 51). We assessed pre- and post-intervention PTSD symptoms and electroencephalography (EEG) measures of neural outcomes, including spontaneous brain activity, cognitive task-related brain responses, and interoceptive brain responses (heartbeat-evoked brain responses [HEBR]). We conducted statistical causal mediation analyses using treatment type as a predictor, and pre- and post-intervention measures of symptom severity as treatment response, and the neural outcomes as mediators. Results Compared to controls, the MBSR group had greater improvements in PTSD symptoms and increases in spontaneous alpha (8-13 Hz) power, task-related frontal theta power (4-7 Hz in 140-220 ms post-stimulus), and frontal theta HEBR (3-5 Hz and 265-336 ms post-R-peak). The mediation analysis using latent difference score modeling revealed that only changes in frontal theta HEBR mediated the MBSR treatment effect. Conclusions Mindfulness meditation improves brain functions of attentional control and resting brain states reflective of internally oriented relaxation. However, interoceptive neural functions enhanced by MBSR appear to be a primary cerebral mechanism that improves symptoms of PTSD.

Autistic people experience heightened rates of physical health problems but may also experience elevated levels of somatic symptoms (e.g. pain, headache, gastrointestinal symptoms) due to psychological factors which are common in autism. This online study sought to compare rates of somatic symptoms (Patient Health Questionnaire-15) in older adolescents and adults who were autistic ( n = 51), non-autistic ( n = 119) and who suspected they were autistic ( n = 32), while controlling for health conditions. We investigated psychological risk factors that may predispose individuals to experience somatic symptoms, including alexithymia (General Alexithymia Factor Score), interoception (Body Awareness Questionnaire) and intolerance of uncertainty (Intolerance of Uncertainty Scale). Diagnosed autistic individuals had higher rates of alexithymia and intolerance of uncertainty. We also found higher somatic symptoms in diagnosed autistic individuals, controlling for mental and physical health. However, hierarchical regression showed that somatic symptoms were predicted by physical and mental health conditions, female gender, alexithymia, and intolerance of uncertainty, regardless of autism status. The results suggest that autistic and non-autistic individuals experience more bodily discomfort in part due to gender, physical and mental health, alexithymia, and difficulty tolerating uncertainty. Implications for mental and physical health care in autism are discussed. Lay abstract Autistic people have more physical health problems than non-autistic people. We were interested in whether autistic people experience more discomfort in their bodies than non-autistic people and whether certain psychological traits contribute to that. A survey was completed online by older adolescents and adults, 51 of whom were autistic, 32 of whom thought they might be autistic but were not diagnosed and 119 who were not autistic. They completed measures of somatic symptoms (daily experience of pain, discomfort, dizziness), alexithymia (difficulty identifying and expressing feelings), interoception (how much people are aware of their bodies) and intolerance of uncertainty (how people handle doubt or uncertainty), and reported any physical or mental health conditions. We found that the autistic participants had more physical and mental health conditions than the non-autistic participants, but even when we took account of this, they experienced higher levels of somatic symptoms. We looked at which psychological factors influenced levels of somatic symptoms across the whole sample, and found that alexithymia, intolerance of uncertainty, having physical health problems, being female and the number of mental health conditions predicted somatic symptoms, while interoception and autism diagnosis did not. The findings suggest that people may be more likely to experience physical discomfort if they are female, and have difficulty identifying and expressing feeling and difficulty tolerating doubt. As these psychological factors are more prominent in autism, we think this is important for physical and mental health providers to know about, so that these psychological factors can be considered when assessing and treating autistic people.

Bodily signals influence high-order cognitive and emotional processes, including social decision making. Here, we examined whether individual differences in the capacity to read signals from inside (interoception) and outside the body (exteroception) predicted participants' (dis)honesty. Deceptive behavior was measured in a card game where participants were tempted to lie to another person for financial gain in two conditions, i.e., under high vs. low risk of being seen by the other player (reputation risk). Participants completed the Heartbeat Counting Task (cardiac interoception) and a variation of the Body-Scaled Action Task (visual exteroception). Overall, when participants believed their reputation was at risk (i.e., the other player knew they lied) they told significantly less egoistic lies compared to when their choices were secret. This effect was significantly moderated by cardiac interoception. While low interoceptive participants told less egoistic lies when their reputation was at risk, high cardiac interoceptive participants did not change their behavior depending on the reputation risk conditions. We also found that cardiac interoception and visual exteroception did not correlate. Together our findings suggest that although integrated, interoception and exteroception constitute distinct facets of corporal awareness, and that high cardiac interoception shapes moral behavior by making people less concerned about their social reputation during spontaneous lies.

Background: Interoceptive signals related to changes in heartbeat, respiration, and gastric functioning continuously feedback to the brain. The interpretation of these signals influences several co...

Numerous disorders are characterised by fatigue as a highly disabling symptom. Fatigue plays a particularly important clinical role in multiple sclerosis (MS) where it exerts a profound impact on quality of life. Recent concepts of fatigue grounded in computational theories of brain-body interactions emphasise the role of interoception and metacognition in the pathogenesis of fatigue. So far, however, for MS, empirical data on interoception and metacognition are scarce. This study examined interoception and (exteroceptive) metacognition in a sample of 71 persons with a diagnosis of MS. Interoception was assessed by prespecified subscales of a standard questionnaire (Multidimensional Assessment of Interoceptive Awareness [MAIA]), while metacognition was investigated with computational models of choice and confidence data from a visual discrimination paradigm. Additionally, autonomic function was examined by several physiological measurements. Several hypotheses were tested based on a preregistered analysis plan. In brief, we found the predicted association of interoceptive awareness with fatigue (but not with exteroceptive metacognition) and an association of autonomic function with exteroceptive metacognition (but not with fatigue). Furthermore, machine learning (elastic net regression) showed that individual fatigue scores could be predicted out-of-sample from our measurements, with questionnaire-based measures of interoceptive awareness and sleep quality as key predictors. Our results support theoretical concepts of interoception as an important factor for fatigue and demonstrate the general feasibility of predicting individual levels of fatigue from simple questionnaire-based measures of interoception and sleep., European Journal of Neuroscience, ISSN:0953-816X, ISSN:1460-9568

IntroductionThe university student population is influenced by multiple factors that affect body awareness. Identifying the body awareness status of students is crucial in creating self-care and emotion management programs to prevent diseases and promote health. The Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire evaluates interoceptive body awareness in eight dimensions through 32 questions. It is one of the few tools that enable a comprehensive assessment of interoceptive body awareness by involving eight dimensions of analysis.MethodThe objective of this study is to present the psychometric properties of the Multidimensional Assessment of Interoceptive Awareness (MAIA) to observe to what extent the hypothesized model fits the population of university students in Colombia. A descriptive cross-sectional study was conducted with 202 students who met the inclusion criterion of being undergraduate university students. Data were collected in May 2022.ResultsA descriptive analysis of the sociodemographic variables of age, gender, city, marital status, discipline, and history of chronic diseases was performed. JASP 0.16.4.0 statistical software was used to conduct confirmatory factor analysis. A confirmatory factor analysis was performed based on the proposed eight-factor model of the original MAIA, giving a significant p-value and 95% confidence interval. However, when performing loading factor analysis, a low p-value was found for item 6 of the Not Distracting factor, and for the entire Not Worrying factor.DiscussionA seven-factor model with modifications is proposed.ConclusionsThe results of this study confirmed the validity and reliability of the MAIA in the Colombian university student population.

People with autism spectrum disorder (ASD) frequently show impaired sensory processing in different senses, including the interoceptive system. Recent findings suggest that interoception is a fundamental component of emotional experience and that impaired interoception is associated with alexithymia. This study aims to explore the association and interrelation between interoceptive confusion, alexithymia, and the capacity for emotional regulation among a sample of 33 adults with ASD compared to a control group of 35 adults with neurotypical development and its mutual impact. The participants answered a series of questionnaires addressing these three variables. The results showed (1) significant differences between the groups in all dimensions, with dysfunctional emotional regulation, impaired interoception, and alexithymia in the ASD group, (2) significant correlations between interoceptive confusion, emotional clarity, and alexithymia in the ASD group but only positive correlations between interoceptive confusion and alexithymia in the CG, and (3) that emotional clarity, alexithymia, and autism explain 61% of the variance in interoceptive confusion. These results are in line with previous studies and suggest that training interoceptive ability may enhance emotional clarity and reduce alexithymia among those diagnosed with ASD, with significant implications in the planning of treatment.

Equine-assisted learning (EAL) may improve the health of older adults, but scientific data are sparse. This study investigated whether people aged 55 and older show increased heart rate variability (HRV) during EAL and awareness of bodily sensations that are overall pleasant. Subjects (n = 24) participated in mindful grooming during which they slowed their breathing and brushed a horse while noticing sensations in their body and watching the horse’s reactions. The subject’s and horse’s HRV were recorded simultaneously before, during, and after mindful grooming. For control, the same subjects performed mindful grooming with a plush simulation horse. During exit interviews, participants described their sensations. Words and gestures were categorized as positive, neutral, or negative. During mindful grooming, human heart rate and HRV (standard deviation of interbeat interval, SDRR) increased compared to baseline (paired t-test, t = –4.228, p < 0.001; t = –3.814, p = 0.001), as did the percent very low frequency (%VLF) component of HRV (t = –4.274, p < 0.001). Equine HRV values remained in the normal range, mostly VLF. In 10 cases, during mindful grooming, horse and human HRVs showed matching VLF frequencies. Grooming the simulation horse significantly elevated SDRR but did not alter %VLF. Exit interviews revealed significantly more positive gestures (t = –3.814, p = 0.031) and fewer negative gestures (Wilcoxon signed-rank test, Z-statistic = –2.12, p = 0.036, p < 0.05) when participants spoke about the real horse compared to the simulation. These findings demonstrate that during mindful grooming people aged 55 and older benefit by experiencing increased HRV, heightened awareness of pleasant bodily sensations, and often some synchronization of their HRV frequency spectrum with that of their horse, possibly reflecting emotional bonding.

Previous single-brain studies suggested interoception plays a role in interpersonal synchronization. The aim of the present study was to assess the electrophysiological intersubject coherence through electrophysiological (EEG) hyperscanning recording during simple dyadic synchronization tasks when the participants focused on their breath. To this aim, the neural activity of 15 dyads of participants was collected during the execution of a cognitive and motor synchronization task in two distinct IA conditions: focus and no focus on the breath condition. Individuals’ EEG frequency bands were recorded through EEG hyperscanning and coherence analysis was performed. Results showed greater EEG coherence was observed for the alpha band in frontopolar brain regions (Fp1, Fp2) and also in central brain regions (C3, C4) within the dyads, during the focus on the breath condition for the motor compared to the cognitive synchronization task; during the same experimental condition, delta and theta band showed augmented inter-individual coherence in the frontal region (Fz) and central areas (C3, C4). To conclude, the current hyperscanning study highlights how the manipulation of the interoceptive focus (obtained through the focus on the breath) strengthens the manifestation of the EEG markers of interpersonal tuning during a motor synchronization task in specific brain areas.

Notwithstanding breakthroughs in our knowledge of interoception’s various dimensions and implications, along with research demonstrating interoceptive impairments in clinical groups, there is limited data on the successful ways for enhancing this capacity. Here special attention will be given to the interventions that commonly directs attention to the body and to the respiratory rhythms, such as slow breathing technique and MBIs, and how these interventions can promote interoception modulation. Without claiming to be exhaustive and with the intention of soliciting research in this field, in this contribution some potentially interesting and relatively novel applications of the manipulation of interoception will be described, focusing in particular on the clinical, social and sports field.

Im „E ntwurf der Psychologie“ (1895) stellt Freud zwei Nervensysteme, φ und ψ, auf, um den „Erwerb des Geistigen [etwas]“, d. h. den Mechanismus des psychischen Apparats, zu erklären. Dieser „Entwurf“, der auf eine „naturwissenschaftliche Psychologie“ abzielte, stützte sich auf zwei Säulen, das ›Trägheitsprinzip‹ aus der Physik und die ›neuronale Theorie‹ aus der Biologie, sowie auf das „Ideal, dass alle Phänomene messbar sind und fest auf physikalischen Vorstellungen beruhen“. Genauer gesagt ging es darum, „mentale Prozesse als quantitativ definierte Zustände von materiellen Teilen darzustellen, die präsentiert werden können“. In den rund 120 Jahren, die seither vergangen sind, hat sich die Psychologie unaufhaltsam den kognitiven Neurowissenschaften angenähert, während sie gleichzeitig versuchte, eine Philosophie der Psychologie zu entwickeln. Sie ist die Nachfolgerin der beiden Strömungen, der naturwissenschaftlichen Psychologie und der Metapsychologie, die auf Freud zurückgehen. Im ersten Fall wird aus psychologisch-konstruktivistischer Sicht argumentiert, dass der Affekt durch zwei Prozesse gebildet wird. Das eine ist der Prozess der Bildung der grundlegendsten emotionalen Zustände, des so genannten Kernaffekts, auf der Grundlage der Interozeption, d. h. der inneren Wahrnehmung des Körpers, und das andere ist der Prozess der Kategorisierung dieser primitiven Emotionen. Wenn wir Freuds „mentales Etwas“ durch Emotion und das ψ-System durch den inneren rezeptiven Sinn ersetzen, dann kann die „Psychologie für die Naturwissenschaft“, die Freud in seinem „Entwurf“ vorsah, im Kontext der zeitgenössischen kognitiven Neurowissenschaften wiederbelebt werden. In diesem Aufsatz wird versucht, den Umfang von Freuds psychischem Apparat zu messen, indem auf einige Theorien Bezug genommen wird, die kürzlich von den kognitiven Neurowissenschaften vorgeschlagen wurden.

Patients with obsessive–compulsive disorder (OCD) exhibit abnormality in their subjective perception of internal sensation, a process known as interoceptive sensibility (IS), as well as altered functioning of the insula, a key neural structure for interoception. We investigated the multivariate structure of IS in 77 OCD patients and 53 controls and examined associations of IS with resting-state functional connectivity (FC) of the insula within the OCD group. For each group, principal component analysis was performed on 8 subscales of the Multidimensional Assessment of Interoceptive Awareness assessing putatively “adaptive” and “maladaptive” aspects of IS. Associations between IS components and insula FC in the OCD group were evaluated using seed regions placed in each of 3 subdivisions of the insula (posterior, anterior dorsal, and anterior ventral). Behaviorally, controls showed a 2-component solution broadly categorized into “adaptive” and “maladaptive” IS, while OCD patients exhibited a 3-component solution. The general tendency to notice or be aware of sensation loaded onto an “adaptive” IS component in controls but loaded onto both “adaptive” and “maladaptive” IS components in OCD. Within OCD, insula FC was differentially associated with distinct aspects of IS, identifying network connections that could serve as future targets for the modulation of IS in OCD.

International audience; Objectives: Childhood obesity has increased tenfold over the past 40 years. People with obesity present alterations of their bodily perceptions and a discrepancy between their actual body and their perceived body. One of the explanations advanced by neuroscience is the difficulty of integrating and processing sensory information, particularly the interoceptive interformation. There has been little research on this question in adolescent populations, although it is suggested that an atypical interoceptive mechanism is positively associated with the onset of psychopathologies and decreased socio-emotional skills in adulthood. We present here the first results of a qualitative research study that explores the experiential dimension of interception by obese adolescent girls in a hospitalization context and that assesses the main factors that influence interoceptive self-awareness: anxiety and pain. Method: Exploratory qualitative research. T0 (30 min): Initial assessments: State trait anxiety Inventory for Children (STAIC Scale), visual analog scale for pain and Multidimensional Assessment of Interoceptive Awareness (MAIA Self-Questionnaire). T1 and T2 (60 min): perform three simple poses, each 1 min (T1) alternated with an explanatory interview exploring the interoceptive experience (T2). Results: This study highlights that: (i) the severity of obesity is not positively associated with the level of interoceptive awareness; (ii) the correlation of influencing factors (pain and anxiety) and the level of awareness interoceptive is weak; (iii) the thematic categorization according to Mehling's eight interoceptive criteria demonstrates, for the participants: 1/the ability to identify their bodily perceptions by the majority of them; 2/the uneven capacity to maintain a level of attention on the body in its ensemble; 3/the ability not to worry about feelings of discomfort is influenced by hyper-rationalization or the negation of perceptions; 4/breathing appears to be the most mobilized lever to regulate attention; 5/the links between bodily perceptions and felt emotions are influenced by rationalization, bodily experience, or mood decline; 6/self-regulation is influenced by bodily experience, which enables awareness and postural readjustment; 7/listening to the body is influenced by the transfer of past bodily practices; 8/the notion of confidence in one's bodily perceptions is not always well understood and is not related to subjects’ ability to identify their internal manifestations, while perceived confidence is related to the level of rationalization and can be improved through postural practice. Discussion: As reported in the literature, the interoceptive level of patients interviewed is generally low on the rating scales, but it appears that the MAIA results do not always reveal the perceived reality of body-self of the adolescent girls interviewed; guiding the participants in explaining their bodily experience reveals a much greater interoceptive dimension. We qualify this guided field of exploration as an interoceptive proximal zone or an interoceptive preconception zone. Conclusion: We suggest that a better understanding of the interoceptive mechanisms experienced by obese people helps guide patients towards a safer experiential dimension of their body. Future research should enrich this qualitative perspective of interoception and open up more embodied dimensions of care.

Mental health disorders pose a significant challenge to society. The Bayesian perspective on the mind offers unique insights and tools that may help address a variety of mental health conditions. Psychopathological dysfunctions are often connected to altered predictive and active inference processes, in which cognitive and physiological pathogenic beliefs shape the clinical condition and its symptoms. However, there is a lack of general empirical models that integrate cognitive beliefs, physiological experience, and symptoms in healthy and clinical populations. In this study, we examined the relationship between altered predictive mechanisms, interoception, and pathological bodily distortions in healty individuals and in individuals suffering from anorexia nervosa (AN). AN patients (N=15) completed a Virtual Reality Full-Body Illusion along with interoceptive tasks twice: at hospital admission during an acute symptomatological phase (Time 1) and after a 12-week outpatient clinical weight-restoring rehabilitative program (Time 2). Results were compared to a healthy control group. Our findings indicated that higher levels of interoceptive metacognitive awareness were associated with a greater embodiment. However, unlike in healthy participants, AN patients' interoceptive metacognition was linked to embodiment even in multisensory mismatching (asynchronous) conditions. In addition, unlike in healthy participants, higher interoceptive metacognition in AN patients was related to prior abnormal bodily distortions during the acute symptomatology phase. Prediction errors in bodily estimates predicted posterior bodily estimate distortions after the illusion, but while this relationship was only significant in the synchronous condition in healthy participants, there was no significant difference between synchronous and asynchronous conditions in AN patients. Despite the success of the rehabilitation program in restoring some dysfunctional patterns in the AN group, prediction errors and posterior estimate distortions were present at hospital discharge. Our findings suggest that individuals with AN prioritize interoceptive metacognitive processes (i.e., confidence in their own perceived sensations rather than their actual perceptions), disregarding bottom-up bodily inputs in favour of their prior altered top-down beliefs. Moreover, even if the rehabilitative program partially mitigated these alterations, the pathological condition impaired the patients' ability to coherently update their prior erroneous expectations with real-time multisensory bottom-up bodily information, possibly locking the patients in the experience of a distorted prior top-down belief. These results suggest new therapeutic perspectives and introduce the framework of regenerative virtual therapy (RVT), which aims at utilizing technology-based somatic modification techniques to restructure the maladaptive priors underlying a pathological condition.

Interoception, the sense of the body’s physiological state, incorporates information from the skin. Both interoceptive input and social/affective touch are conveyed to the central nervous system through small diameter, unmyelinated afferent fibers that ultimately converge on the posterior insula. This relation is traceable developmentally to the heavy reliance of the fetus and infant on their mother/caregiver for autonomic regulation. Caregiving alleviates homeostatic/allostatic imbalances such as cold, hunger, and pain, and is delivered in the context of social touch. The predictive sensorimotor loops that characterize the interplay between interoceptive and visceromotor signals are initially a shared system between infant and caregiver. With development, autonomic regulation becomes more autonomous, but with residual dependence on social contact to continue to maintain allostasis.

The vagus nerve is an indispensable body-brain connection that controls vital aspects of autonomic physiology like breathing, heart rate, blood pressure, and gut motility, reflexes like coughing and swallowing, and survival behaviors like feeding, drinking, and sickness responses. Classical physiological studies and recent molecular/genetic approaches have revealed a tremendous diversity of vagal sensory neuron types that innervate different internal organs, with many cell types remaining poorly understood. Here, we review the state of knowledge related to vagal sensory neurons that innervate the respiratory, cardiovascular, and digestive systems. We focus on cell types and their response properties, physiological/behavioral roles, engaged neural circuits and, when possible, sensory receptors. We are only beginning to understand the signal transduction mechanisms used by vagal sensory neurons and upstream sentinel cells, and future studies are needed to advance the field of interoception to the level of mechanistic understanding previously achieved for our external senses.

Background : Individuals sometimes continuously centered their attention on the same thoughts. When such process tends to be negative and self-referential, we delineated this mental state as rumination, which may undermine body's perception of endogenous signal, but little is known about the certainly relationship and the potential neural mechanisms. Methods : Rumination and interoceptive sensibility were measured by questionnaires, then insula-related network of rumination dimensions were examined by the whole brain resting-state functional connectivity (FC) in 479 college students, and whether the insula-based network mediate the relationship between rumination and interoceptive sensibility were tested. Results : Rumination (including brooding reflective pondering) and interoceptive sensibility showed positive correlations. The neural mechanisms of brooding and reflective pondering were all related to the insula-networks, to be specific, brooding was positively correlated with the FC between the left posterior insula (PI) and left parahippocampal gyrus/ hippocampus (PHG), reflective pondering were positively correlated with the FC between the insula subregion and the dorsolateral prefrontal cortex. Moreover, the relationship between brooding and interoceptive sensibility was mediated by the FC between left PI and left PGH. Limitations : we just tested the relationship between rumination and interoceptive sensibility at a cross-sectional level, but it is unclear that whether the longitudinal relationship would be predicted by the related network. Conclusions : Our findings provided new insights into neural mechanisms of brooding and reflective pondering, also the integration of brooding and interoceptive sensibility. The insula-related networks may contribute crucially to rumination and interoception.

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.

Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket – providing widespread pressure to the body – relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: “Weighted Blankets and Chronic Pain”). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.

Schizophrenia research has traditionally focused almost exclusively on how the brain interprets the outside world. However, our internal bodily milieu is also central to how we interpret the world and construct our reality: signals from within the body are critical for not only basic survival, but also a wide range of brain functions from basic perception, emotion, and motivation, to sense of self. In this article, we propose that interoception-the processing of bodily signals-may have implications for a wide range of clinical symptoms in schizophrenia and may thus provide key insights into illness mechanisms. We start with an overview of interoception pathways. Then we provide a review of direct and indirect findings in various interoceptive systems in schizophrenia and interpret these findings in the context of computational frameworks that model interoception as hierarchical Bayesian inference. Finally, we propose a conceptual model of how altered interoceptive inference may contribute to specific schizophrenia symptoms-negative symptoms in particular-and suggest directions for future research, including potential new avenues of treatment.

Adolescents generally experience higher levels of negative affect, greater mood fluctuations, and report enhanced affective and physiological stress responses compared to children and adults (Somerville et al., 2010). Thus, it is crucial to understand processes that can help adolescents to better cope with their responses to stress. One such process is emotion regulation (ER; Gross, 1998). The goal of the present study is to better understand how specific ER strategies (ERS) influence both subjective affective feelings and physiological responses during stress recovery. Two commonly used ERS that are considered as adaptive to deal with negative affect are cognitive reappraisal (CR) and distraction (DIS) (Aldao et al., 2010; Schäfer et al., 2017). Most experimental work on the specific effects of these strategies has been conducted in adult samples (e.g., Denson et al., 2011; Jentsch & Wolf, 2020; LeMoult et al., 2016). Furthermore, the majority of these studies have compared either distraction or reappraisal to maladaptive ERS (e.g., rumination), without directly investigating whether CR vs DIS may have different effects on individuals’ stress responses (e.g., Denson et al., 2011; Jentsch & Wolf, 2020; LeMoult et al., 2016; Mohammed et al., 2021). Therefore, the goal of the present study is to investigate the effects of trained CR vs DIS in an adolescent sample, with a specific focus on how these ERS influence: (1) affective (both positive and negative affect) responses after exposure to a standardized stress task, (2) physiological responses, specifically parasympathetic nervous system responses as indexed by respiratory sinus arrythmia (RSA) and (3) interoception (i.e., interoceptive accuracy [IAcc], interoceptive sensibility [IS] and interoceptive awareness [IAw]). IAcc refers to the objective performance on experimental tasks such as the heartbeat counting task. IS can be defined as the confidence in one’s own interoceptive capabilities. Lastly, IAw refers to the metacognitive beliefs of one’s own IAcc. Better interoception has been linked to emotional processes, such as better emotional awareness (e.g., Trevisan et al., 2019), which is seen as an important precursor for adaptive ER (Van Beveren et al., 2019). Studies also showed that better IAcc is related to the use of adaptive ERS (Füstös et al., 2013; Kever et al., 2015; Pinna & Edwards, 2020).

Da die interozeptive Exposition bei Patienten mit Angst- und Panikstörung zu guten Ergebnissen führt, besteht Hoffnung diese Therapieform bei Depression auch einsetzen zu können. Beides sind Erkrankungen, die durch eine Fehlwahrnehmung der inneren Signale verstärkt werden können. Diese Arbeit setzte sich zum Ziel die Etablierung der interozetiven Exposition bei depressiven Störungen voranzubringen. Hierfür wurde eine Stichprobe von 61 Versuchspersonen mit einem mittleren Alter von 24 Jahren die im Raum Ulm, Baden-Württemberg rekrutiert wurden auf verschiedene Facetten ihrer interozeptiven Akkuranz untersucht. Der Schwerpunkt der Untersuchung lag auf dem Zusammenhang von interozeptiver Exposition und der interozeptive Akkuranz sowohl im inter- also auch im intrapersonalen Vergleich. Auch wurde der Zusammenhang der Ruheherzfrequenz auf die interozeptive Akkuranz untersucht. Es konnte gezeigt werden, dass Versuchspersonen, die mit der interozeptiven Exposition konfrontiert wurden zum zweiten Erhebungstermin signifikant besser abschnitten (p = 0.001, r = 0.53). Die Kontrollgruppe unterschied sich hingegen nicht signifikant von Termin eins zu Termin zwei. Bei unmittelbar vor der Testung der interozeptive Akkuranz erfolgten interozeptive Exposition schnitten die die Versuchspersonen der Interventionsgruppe signifikant schlechter ab als die Kontrollgruppe (p = 0.001, r = 0.39). Diese Ergebnisse bei den Versuchspersonen sprechen dafür, dass die interozeptive Exposition in einem Zusammenhang mit der interozeptive Akkuranz steht und es unter wiederholter Anwendung zu einer Verbesserung der interozeptive Akkuranz kommen kann. Dies kann sich positiv in der Behandlung depressiver Patienten und Patientinnen auswirken.

IntroductionDecision making results not only from logical analyses, but seems to be further guided by the ability to perceive somatic information (interoceptive accuracy). Relations between interoceptive accuracy and decision making have been exclusively studied in adults and with regard to complex, uncertain situations (as measured by the Iowa Gambling Task, IGT).MethodsIn the present study, 1454 children (6-11 years) were examined at two time points (approximately 1 year apart) using an IGT as well as a delay-of-gratification task for sweets-items and toy-items. Interoceptive accuracy was measured using a child-adapted version of the Heartbeat Perception Task.ResultsThe present results revealed that children with higher, as compared to lower, interoceptive accuracy showed more advantageous choices in the IGT and delayed more sweets-items, but not toy-items, in a delay-of-gratification task at time point 2 but not at time point 1. However, no longitudinal relation between interoceptive accuracy and decision making 1 year later could be shown.DiscussionResults indicate that interoceptive accuracy relates to decision-making abilities in situations of varying complexity already in middle childhood, and that this link might consolidate across the examined 1-year period. Furthermore, the association of interoceptive accuracy and the delay of sweets-items might have implications for the regulation of body weight at a later age.

Data including the cvSDT and Schandry tasks, as well as questionnaires, for 251 persons.

Deviations of interoceptive sensitivity have been postulated as a maintaining factor in various mental disorders such as panic disorders (Domschke, Stevens, Pfleiderer, & Gerlach, 2010) or somatic symptom disorders (Van den Bergh, Witthoft, Petersen, & Brown, 2017). Interoceptive sensitivity is most commonly operationalized via heartbeat perception tasks, as the heartbeat is a robust and easily inferred signal (Phillips, Jones, Rieger, & Snell, 1999). Typically, two different task types have been used for this purpose: mental tracking tasks and discrimination tasks. Both task types have been criticized for various aspects (difficulty, mixing of different abilities, susceptibility to guessing, mixing of sensitivity and response bias, parameterization). Furthermore, the calculated indices of the different task types covary rather low with each other (Brener & Ring, 2016). Only for mental tracking tasks there is a cut off value to differentiate between good and bad heartbeat perceivers. However, the quality of this task type is often questioned (Zamariola, Maurage, Luminet, & Corneille, 2018). Using a cardiovascular signal detection task (cvSDT), we recently aimed at combining the advantages of existing task types and compensate for some disadvantages (Pohl, 2020). However, due to complex parametrization of the multi-interval discrimination task and the cvSDT, it remains unclear which cut off scores separate perceivers from non-perceivers. As heartbeat perception might as well be a dimensional, as a categorical ability, it would be of great interest to know, which heartbeat perception scores are achieved by perceivers. This would also allow for a more nuanced comparison of the three task types. The present study aims to determine the values perfect heartbeat perceivers achieve in the signal detection task and the multi-interval discrimination task. For this purpose, the mental tracking task, the multi-interval discrimination task, and the signal detection task will be presented to an analog sample. During the tasks all participants will be asked to feel their pulse at the throat so that a perfect heartbeat perception can be simulated.

Seeking and ingesting nutrients is an essential cycle of life in all species. In classical neuropsychology these two behaviours are viewed as fundamentally distinct from each other, and known as appetitive and consummatory, respectively. Appetitive behaviour is highly flexible and diverse, but typically involves increased locomotion and spatial exploration. Consummatory behaviour, in contrast, typically requires reduced locomotion. Another long-standing concept is "rest and digest", a hypolocomotive response to calorie intake, thought to facilitate digestion and storage of energy after eating. Here, we note that the classical seek -> ingest -> rest behavioural sequence is not evolutionarily advantageous for all ingested nutrients. Our limited stomach capacity should be invested wisely, rather than spent on the first available nutrient. This is because nutrients are not simply calories: some nutrients are more essential for survival than others. Thus, a key choice that needs to be made soon after ingestion: to eat more and rest, or to terminate eating and search for better food. We offer a perspective on recent work suggesting how nutrient-specific neural responses shape this choice. Specifically, the hypothalamic hypocretin/orexin neurons (HONs) - cells that promote hyperlocomotive explorative behaviours - are rapidly and differentially modulated by different ingested macronutrients. Dietary non-essential (but not essential) amino acids activate HONs, while glucose depresses HONs. This nutrient-specific HON modulation engages distinct reflex arcs, seek -> ingest -> seek and seek -> ingest -> rest, respectively. We propose that these nutri-neural reflexes evolved to facilitate optimal nutrition despite the limitations of our body., Journal of Neuroendocrinology, ISSN:0953-8194, ISSN:1365-2826

Background: Bodily self-recognition requires the individual to be able to refer to himself through a reflexive representation, typically a schema or an image of one’s own body. Body ownership results from an interplay between exteroception and interoception (i.e., the ability to perceive one’s own body from the inside). It has been demonstrated that perceiving sensations inside the body could be associated with better regulation of emotions. Also, it has been reported that interoceptive awareness may be affected by gender. Therefore, this pilot study aimed to investigate gender differences in the interoceptive awareness among Italian people. Methods: 114 Italian volunteers (57 males and 57 females) completed the 32-item Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire to measure the multiple dimensions of interoceptive awareness. Results: The findings showed higher scores among females than among males for the ability to notice interoceptive input and the awareness of the relationship between bodily sensations and emotional states. Conclusions: Results suggested that women could be more inclined to notice and focus on internal cues. Also, the gender differences could be related to physical and hormonal changes that women experience during development. Future research on the relationship between gender and physiological responses (e.g., heartbeat, skin conductance) for a specific ethnographic sample is recommended.

The aim of this study was to investigate the comparative effects of mindful meditation and cyclic hyperventilation with retention upon interoceptive ability and heart rate variability (HRV). Further studies comparing meditation and breathwork contribute to a greater understanding of their potential benefits and have the potential to enhance overall well-being in the general population. A pre-post randomized controlled trial design was employed. Interoceptive accuracy was assessed through heartbeat detection task. Interoceptive sensibility was measured through confidence judgments, and interoceptive awareness by the correlation between accuracy and sensibility. Participants were randomly assigned to perform mindful meditation or cyclic hyperventilation with retention once per day for 21 consecutive days. No differences in interoceptive capacity and HRV was observed between the groups, but a tendency towards improved accuracy and increased confidence for both groups. However, the mindful meditation group exhibited a stronger positive association between HRV and interoceptive accuracy after the intervention, while the opposite was true for the cyclic hyperventilation group. Additionally, interoceptive awareness remained stable throughout the study. Mindful meditation demonstrated an enhancement in parasympathetic activity, as evidenced by higher RMSSD values. In contrast, cyclic hyperventilation with retention resulted in a substantial reduction in parasympathetic activity. This study highlights the complexity of interoception and emphasizes the need for further investigation in the context of mindfulness-based and breathwork interventions. Syftet med denna studie var att undersöka de jämförande effekterna av medveten meditation och cyklisk hyperventilation med bibehållande på interoceptiv förmåga och hjärtfrekvensvariabilitet (HRV). Fler studier som jämför meditation och andningsövningar leder till en ökad förståelse av dess potentiella fördelar och står att gynna det övergripande välbefinnandet i den breda befolkningen. En pre-post randomiserad försöksdesign användes. Interoceptiv noggrannhet bedömdes genom en uppgift för att känna hjärtslag. Interoceptiv känslighet mättes genom konfidenskattningar och interoceptiv medvetenhet genom korrelationen mellan noggrannhet och känslighet. Deltagarna tilldelades slumpmässigt medveten meditation eller cyklisk hyperventilation en gång om dagen i 21 dagar. Inga skillnader i interoceptiv förmåga och HRV observerades mellan grupperna, men det fanns en tendens till förbättrad noggrannhet och ökad sensibilitet för båda grupperna. Likväl visade medveten meditation en starkare positiv association mellan HRV och interoceptiv noggrannhet efter interventionen, medan det motsatta var sant för cyklisk hyperventilation. Dessutom förblev interoceptiv medvetenhet stabil under hela studien. Medveten meditation visade en förbättring av parasympatisk aktivitet, vilket bevisades av högre RMSSD-värden. Å andra sidan resulterade cyklisk hyperventilation med bibehållande en betydande minskning av parasympatisk aktivitet. Denna studie belyser interoceptionens komplexitet och betonar behovet av ytterligare undersökning inom ramen för interventioner baserade på mindfulness och andningsarbete.

В статье рассматриваются функции метафорического мышления при формировании словаря внутрителесных и эмоциональных состояний на основе архаичных пластов языкового сознания. Рассматриваются принципы также охватывает семантического смещения, лежащие в основе процессов метафоризации. Английские, французские и русские аффективные метафорические и идиоматические выражения служат примерами активности архаических мифологических концептов, обладающих разными смысловыми атрибутами. В этом аспекте особый интерес представляет концептуальный словарь интероцептивных ощущений. Сравнительный анализ идиоматических выражений, связанных с эмоциями, наглядно демонстрирует концептуальную связь архаических мифологических представлений с телесностью. В результате мы приходим к утверждению, что мифологические концепции имеют два функциональных уровня. С одной стороны, мифогенез является результатом социокультурной деятельности, т.е. это область внешнего функционирования. С другой стороны, мифологические представления связаны с бессознательными процессами, берущими свое начало в коллективном архаическом слое сознания., The article deals with functions of metaphoric thought during formation of affective expressions based on the archaic layers of linguistic consciousness. It also covers semantic substitution underlying idiomatic forms of reality representation. The English and French affective metaphorical and idiomatic expressions serve as examples of activity of archaic mythological concepts possessing of different semantic attributes. In this issue, the conceptual vocabulary of interoceptive sensations is of particular interest. Comparative analysis of idiomatic expressions associated with emotions clearly demonstrates the conceptual connection of archaic mythological concepts with corporeality. As a result, we come to the statement that mythological concepts have two functional levels. On the one hand the mythogenese is a result of social cultural activity, i.e. it‘s a area of external functioning, on the other hand mythological viewing are related to unconscious process, which have its origin in the collective archaic layer of the consciousness., Мифологос, Выпуск 2 (2) 2023, Pages 13-32

International audience; The pathogenic bacterium Streptococcus pneumoniae (S. pneumoniae) can invade the cerebrospinal fluid (CSF) and cause meningitis with devastating consequences. Whether and how sensory cells in the central nervous system (CNS) become activated during bacterial infection, as recently reported for the peripheral nervous system, is not known. We find that CSF infection by S. pneumoniae in larval zebrafish leads to changes in posture and behavior that are reminiscent of pneumococcal meningitis, including dorsal arching and epileptic-like seizures. We show that during infection, invasion of the CSF by S. pneumoniae massively activates in vivo sensory neurons contacting the CSF, referred to as “CSF-cNs” and previously shown to detect spinal curvature and to control posture, locomotion, and spine morphogenesis. We find that CSF-cNs express orphan bitter taste receptors and respond in vitro to bacterial supernatant and metabolites via massive calcium transients, similar to the ones observed in vivo during infection. Upon infection, CSF-cNs also upregulate the expression of numerous cytokines and complement components involved in innate immunity. Accordingly, we demonstrate, using cell-specific ablation and blockade of neurotransmission, that CSF-cN neurosecretion enhances survival of the host during S. pneumoniae infection. Finally, we show that CSF-cNs respond to various pathogenic bacteria causing meningitis in humans, as well as to the supernatant of cells infected by a neurotropic virus. Altogether, our work uncovers that central sensory neurons in the spinal cord, previously involved in postural control and morphogenesis, contribute as well to host survival by responding to the invasion of the CSF by pathogenic bacteria during meningitis.

Η παρούσα μελέτη διερεύνησε την επίδραση της ακουστικής επεξεργασίας στη συναισθηματική προσωδία σε άτομα με αυτισμό. Συμμετείχαν 35 ενήλικες, ηλικίας 19-56 ετών, οι οποίοι χωρίστηκαν σε δύο ομάδες: μια πειραματική ομάδα με αυτισμό υψηλής λειτουργικότητας και μια ομάδα ελέγχου με τυπική ανάπτυξη. Όλοι οι συμμετέχοντες υποβλήθηκαν σε διαδικτυακό έλεγχο του επιπέδου της ακοής για την σωστή ρύθμιση της έντασης χορήγησης των ερεθισμάτων. Για τον προσδιορισμό της ακουστικής επεξεργασίας, χορηγήθηκαν η ελληνική έκδοση της δοκιμασίας ανίχνευσης ομιλίας σε θόρυβο (SinB) και η δοκιμασία Duration Pattern Sequence (DPS). Για την ενδοαντίληψη χορηγήθηκε η κλίμακα αυτό-αναφοράς Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2). Η δοκιμασία της συναισθηματικής προσωδίας βασίστηκε στο εργαλείο The Wechsler Advanced Clinical Solutions (ACS): Social Perception Subtests. Η μελέτη διαπίστωσε ότι τα άτομα με αυτισμό δυσκολεύονταν να αναγνωρίσουν τα συναισθήματα μέσω των εκφράσεων του προσώπου, ενώ δεν βρέθηκαν διαφορές στις δοκιμασίες ακουστικής επεξεργασίας, γεγονός που υποδηλώνει ότι δεν υπάρχει επίδραση της ακουστικής επεξεργασίας στη συναισθηματική προσωδία στα άτομα με αυτισμό, με τα εργαλεία που χρησιμοποιήθηκαν στη μελέτη. Βρέθηκαν επίσης σημαντικές συσχετίσεις μεταξύ της συναισθηματικής προσωδίας, των αποτελεσμάτων της δοκιμασίας Duration Pattern Sequence και της ενδοαντίληψης. Συνολικά, τα ευρήματα υποδηλώνουν ότι τα άτομα με αυτισμό μπορεί να έχουν ελλείμματα στην αντίληψη της συναισθηματικής προσωδίας και ότι οι παρεμβάσεις που στοχεύουν στη συναισθηματική ρύθμιση και ευαισθητοποίηση θα μπορούσαν να βελτιώσουν δυσκολίες στην επικοινωνία και την κοινωνική προσαρμογή ατόμων με αυτισμό. Απαιτείται περαιτέρω έρευνα για την κατανόηση των υποκείμενων μηχανισμών της ακουστικής επεξεργασίας και της συναισθηματικής και αυτορρυθμιστικής λειτουργίας σε άτομα με και χωρίς αυτισμό καθώς και για την ανάπτυξη παρεμβάσεων για τη βελτίωση των παραπάνω ικανοτήτων., Αγγλική Περίληψη The present study investigated the effect of auditory processing on emotional prosody in individuals with autism. 35 adults participated, aged 19-56 years, who were divided into two groups: an experimental group with high-functioning autism and a control group with typical development. All participants underwent online testing of hearing level for proper adjustment of the intensity of stimulus administration. To determine auditory processing, the Greek version of the Speech in Noise Detection Test (SinB) and the Duration Pattern Sequence (DPS) test were administered. For interoception, the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2) self-report scale was administered. The emotional prosody test was based on The Wechsler Advanced Clinical Solutions (ACS): Social Perception Subtests tool. The study found that individuals with autism had difficulty identifying emotions through facial expressions, and no differences were found in auditory processing tests, suggesting that there is no effect of auditory processing on emotional prosody in individuals with autism with the tools used in the study. Significant correlations were also found between emotional prosody, Duration Pattern Sequence test scores, and interoception. Overall, the findings suggest that individuals with autism may have deficits in the perception of emotional prosody and that interventions targeting emotional regulation and awareness could improve communication difficulties and social adjustment of individuals with autism. Further research is needed to understand the underlying mechanisms of auditory processing and emotional and self-regulatory functioning in individuals with and without autism and to develop interventions to improve these abilities.

The body is a very special object, as it corresponds to the physical component of the self and it is the medium through which we interact with the world. Our body awareness includes the mental representation of the body that happens to be our own, and traditionally has been defined in terms of body schema and body image. Starting from the distinction between these two types of representations, the present paper tries to reconcile the literature around body representations under the common framework of body memory. The body memory develops ontogenetically from birth and across all the life span and is directly linked to the development of the self. Therefore, our sense of self and identity is fundamentally based on multisensory knowledge accumulated in body memory, so that the sensations collected by our body, stored as implicit memory, can unfold in the future, under suitable circumstances. Indeed, these sets of bodily information had been proposed as possible key factors underpinning several mental health illnesses. Following this perspective, the Embodied Medicine approach put forward the use of advanced technologies to alter the dysfunctional body memory to enhance people’s well-being. In the last sections, recent experimental pieces of evidence will be illustrated that targeted specifically bodily information for increasing health and wellbeing, by means of two strategies: interoceptive feedback and bodily illusions., EXCLI Journal; 22:Doc191; ISSN 1611-2156

Despite the importance of emotion recognition in social interactions, the mechanisms underlying this ability are unclear. Interoception is the ability to recognise and respond to internal body signals, such as heart rate or breathing. Interoception is theorised to be involved in emotion. Dementia syndromes with unique patterns of brain atrophy represent an opportunity to establish a shared neural basis of interoception and emotion. Study 1 identified disease specific mechanisms underlying emotion recognition impairments in three dementia syndromes. In behavioural-variant frontotemporal dementia (bvFTD, n = 52), worse cardiac interoception predicted lower emotion recognition. Whereas emotion recognition difficulties were better explained by cognitive impairment in Alzheimer’s disease (AD, n = 41) and Parkinson’s disease (PD, n = 24). Neuroimaging analyses revealed shared neural correlates for interoception and emotion recognition in the left insula, orbitofrontal cortex, and amygdala in bvFTD only. Study 2 investigated interoception and emotion in semantic dementia (SD), due predominately left-lateralised (left-SD) or right-lateralised (right-SD) anterior temporal lobe and insula atrophy. Right-SD (n = 6) showed worse interoception than both left-SD (n = 8) and healthy controls (n = 21). Neuroimaging analyses revealed shared neural correlates for interoception and emotion in the right insula, temporal pole, and hippocampus. Study 3 explored interoceptive attention could enhance emotion recognition as a proof-of-concept study. No differences in subsequent emotion recognition were observed after focusing on cardiac or respiration sensations. Greater cardiac interoceptive accuracy, however, predicted higher emotion recognition performance. Overall, this thesis furthers our knowledge of interoception and emotion and directs future research to target the interoception as an underlying disease mechanism, as well as a potential early biomarker of bvFTD and right-SD.

We will undertake an exploratory factor analysis and confirmatory factor analysis on the MAIA scale to measure interoceptive abilities, to see whether the same factor structure is valid for pregnant women.

Interoception, defined as one’s ability to detect and interpret internal, bodily signals such as heart rate, hunger, thirst and satiety (Craig, 2002), has been theoretically implicated in the development of numerous neurodevelopmental and psychiatric conditions, including both anxiety and autism (Ehlers & Breuer 1992; Paulus & Stein, 2010; Quattroki & Friston, 2014). However, the evidential basis for these theories is mixed (Adams et al., 2022; DuBois et al., 2016), despite preliminary evidence that interoception based interventions are efficacious in those with both autism and anxiety (Quadt et al., 2021). The aim of this current study is to gain a better understanding of how interoception may be linked to experiences of anxiety in autistic adolescents who self-report experiencing significant anxiety in their day to day life, using interview-based reflexive thematic analysis (Braun & Clarke, 2013). This age group was selected as adolescence marks the peak emergence of anxiety disorders (Kessler et al., 2005), and puberty may mark a critical period for the development of interoception (Murphy et al., 2017). The findings from this study may inform the development of clinical interventions. References: Adams, K. L., Edwards, A., Peart, C., Ellett, L., Mendes, I., Bird, G., & Murphy, J. (2022). The association between anxiety and cardiac interoceptive accuracy: A systematic review and meta-analysis. Neuroscience and biobehavioral reviews, 140, 104754. Braun, V. & Clarke, V. (2013) Successful Qualitative Research: A Practical Guide for Beginners. SAGE Publication. Craig, A.D.B. (2002). How Do You Feel? Interoception: The Sense of the Physiological Condition of the Body. Nature reviews. Neuroscience. 3. 655-66. DuBois, D., Ameis, S. H., Lai, M. C., Casanova, M. F., & Desarkar, P. (2016). Interoception in Autism Spectrum Disorder: A review. International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience, 52, 104–111. Ehlers, A., & Breuer, P. (1992). Increased cardiac awareness in panic disorder. Journal of Abnormal Psychology, 101(3), 371–382. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 593–602. Murphy, J., Brewer, R., Catmur, C., & Bird, G. (2017). Interoception and psychopathology: A developmental neuroscience perspective. Developmental Cognitive Neuroscience, 23, 45–56. Paulus, M. P., & Stein, M. B. (2010). Interoception in anxiety and depression. Brain structure & function, 214(5-6), 451–463. Quadt, L., Garfinkel, S. N., Mulcahy, J. S., Larsson, D. E., Silva, M., Jones, A. M., Strauss, C., & Critchley, H. D. (2021). Interoceptive training to target anxiety in autistic adults (ADIE): A single-center, superiority randomized controlled trial. EClinicalMedicine, 39, 101042. Quattrocki, E., & Friston, K. (2014). Autism, oxytocin and interoception. Neuroscience and Biobehavioral Reviews, 47, 410–430. https://doi.org/10.1016/j.neubiorev.2014.09.012

The role of the body in psychological well-being is increasingly coming into focus of scientific research. In particular, interoceptive research has received more and more attention in recent years (e.g., Association for Psychological Science, 2019). Deficits in so-called interoceptive awareness are reported across diagnostic boundaries and are discussed as a transdiagnostic risk factor for mental illness (Brewer, Murphy & Bird, 2021). Interoception is the perception and processing of internal body signals (Cameron, 2001). A distinction is usually made between the components visceroception (perception of organ activities such as heartbeat, breathing, hunger, thirst, etc.) and proprioception (perception of body position in space as well as body movement). In psychological research, the focus has tended to be on the visceral component, which is why "interoception" is often equated with "visceroception" in these cases (Pollatos & Fischer, 2018). Accordingly, the objective assessment of interoceptive awareness has so far mostly relied on measures that assess the recognizing of visceral processes (primarily heartbeat perception tasks (HBPT), e.g.: Accuracy, Sensibility & Awareness using the extended Heart Beat Perception Task according to Garfinkel, Seth, Barrett, Suzuki & Critchley, 2015). Less attention is paid to the proprioceptive facets of interoception, i.e., information from the body about its position in space and its movements. Therefore, we would like to go beyond a perspective of visceral aspects of interoception. We want to use a paradigm that is new in this context and which enables a recording of the whole-body perception as well as a consideration of proprioceptive aspects: a so-called full-body illusion (FBI) in a virtual environment, which allows a manipulation of the perceived self-localisation by means of multisensory stimulation (FBI with Mental Imagery Task (MIT) according to Nakul, Orlando-Dessaints, Lenggenhager & Lopez, 2020. This is a digital adaptation of the Full Body Illusion (FBI) by Lenggenhager, Tadi, Metzinger & Blanke, 2007). As target groups, we would like to investigate mentally healthy people as well as people with a currently existing major depression. The primary aim of the present study is to learn more about the interoceptive awareness - especially the proprioceptive aspects of interoceptive awareness - of people with depression. For this purpose, we use a multimethod design, which measures proprioceptive (FBI/MIT) as well as visceral (extended HBPT) and subjectively reported (MAIA-2 & IAS) interoceptive awareness. This allows for a secondary, exploratory analysis to determine any discrepancies or similarities between the different interoception measures (proprioceptive, visceral, subjective) and to integrate the newly used proprioception measure in the network of established interoception measures (construct validation).

This study takes a mixed-methods approach to the investigation of the relationships between gastric interoceptive sensibility, body image, and food choices. One part of the study will require participants to complete quantitative questionnaires, and the other will require them to participate in a focus group where qualitative data will be collected. Questionnaire responses are being collected so our qualitative data can be interpreted in the context of the focus group’s baseline characteristics. The qualitative data is being collected so it can undergo thematic analysis for a deeper understanding of the meanings given to and relationships between gastric sensations and feelings towards them, body size perception and feelings towards the body, and the food people eat. The rationale for conducting this research is threefold. First, this research is being carried out because despite previous research showing there to be relations between these variables separately, research has yet to include all three variables in one study. Second, research on the links between these variables have all taken a quantitative approach, resulting in a marked absence of rich qualitative data in the literature base. Third, previous research has failed to assess these variables comprehensively, excluding key dimensions of gastric interoceptive sensibility, body image, and food choices.

SummaryFrom a biopsychosocial perspective, maintaining health requires sufficient autoregulatory and self-regulatory capacity to both regulate somatic physiology and manage human-environment interactions. Increasing evidence from neuroscientific and psychological research suggests a functional link between so called interoceptive awareness and self-regulatory behavior. Self-regulation can, again, influence autoregulatory patterns as it is known from biofeedback training or meditation practices. In this review, we propose the psychosomatic competence model that provides a novel framework for the interrelation between interoceptive and self-regulatiory skills and health behavior. The term psychosomatic competence refers to a set of mind- and body-related abilities which foster an adequate interpretation of interoceptive signals to drive health-related behavior and physical well-being. Current related empirical findings and future directions of research on interoception and self-regulation are discussed.

An interoception model for the acute exercise-cognition interaction is presented. During exercise following the norepinephrine threshold, interoceptive feedback induces increased tonic release of extracellular catecholamines, facilitating phasic release hence better cognitive performance of executive functions. When exercise intensity increases to maximum, the nature of task-induced norepinephrine release from the locus coeruleus is dependent on interaction between motivation, perceived effort costs and perceived availability of resources. This is controlled by interaction between the rostral and dorsolateral prefrontal cortices, orbitofrontal cortex, anterior cingulate cortex and anterior insula cortex. If perceived available resources are sufficient to meet predicted effort costs and reward value is high, tonic release from the locus coeruleus is attenuated thus facilitating phasic release, therefore cognition is not inhibited. However, if perceived available resources are insufficient to meet predicted effort costs or reward value is low, tonic release from the locus coeruleus is induced, attenuating phasic release. As a result, cognition is inhibited, although long-term memory and tasks that require switching to new stimuli-response couplings are probably facilitated.

The aim of the present study is to investigate the combined influence of the subjective confidence in receiving an analgesic (i.e., lidocaine) and interoception on placebo hypoalgesia. Based on a predictive processing model of placebo hypoalgesia (Büchel et al., 2014), we assume that the interoceptive ability to accurately perceive pain might counteract placebo suggestions since more perceptual weight is put on interoceptive signals of (lacking) pain relief vs. exteroceptive suggestions of pain relief. A.) Placebo manipulation: Manipulating the confidence in receiving an analgesic: We will use verbal suggestions to manipulate the confidence in receiving an analgesic. One experimental group will be suggested to take part in a placebo-controlled randomized controlled trial (RCT) with only a 50% chance of getting the analgesic, while the other experimental group will be suggested to take part in a clinical study with a 100% chance of getting the analgesic. Both experimental groups will be suggested to receive a lidocaine cremé as the placebo cremé. Additionally, we will include a control group to account for potential habituation and sensitization effects in the context of the repetitive thermal stimulations. These subjects will also be told to take part in a placebo-controlled randomized controlled trial (RCT) but that they are allocated to the control arm, i.e. receive an inert contact cremé. To assess the strength of placebohypoalgesia, subjects have to rate pain intensity to heat pain stimuli of a fixed physical intensity before and after receiving the cremé. Differences in pain intensity are further contrasted with the control group. B.) Assessement of interoceptive abilities to perceive pain: Before the subjects will be randomly allocated to one of the two experimental groups (i.e., 100% confidence or 50% confidence) or the control group, we will assess their interoceptive abilities in perceiving pain. Therefore, we will use the established Focused Analgesia Selection Test (FAST) (Treister et al. 2017). A contact thermode will be used to repetitively administer thermal heat pain stimui at various physical intensities to the forearm. The reliability of pain intensity ratings will be assessed in response to repeated administration of thermal noxious stimuli at various temperatures. Moreover, the confidence in the accuracy of pain perception will be assessed by asking the subjects how confident they are in their ability to accurately rate pain intensities. Our first aim is to investigate whether the interoceptive accuracy of pain perception and the confidence in the accuracy of pain perception are negative predictors of placebo hypoalgesia. Moreover, our second aim is to investigate whether these negative effects of interoceptive accuracy of pain and confidence in the accuracy of pain perception show stronger negative effects in low confidence (50% chance to receive lidocain) versus high confidence (100% chance to receive lidocaine) conditions.

Tony is a five and a half-year-old boy who has been a patient in your primary care practice since he was adopted at birth. He has been treated by a child and adolescent psychiatrist for behavioral concerns starting at age 3 years and has been diagnosed with autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD) combined type, anxiety disorder, and insomnia. He presents today with complaints of repeated emesis and refusal to eat or drink over the past 2 weeks and is now dehydrated. Tony was born at 30 weeks' gestational age by vaginal delivery with a birth weight of 4lbs 15oz and was described as minimally responsive at birth. There was known prenatal exposure to tobacco and methamphetamine and inadequate prenatal care. The maternal history is notable for a reported diagnosis of bipolar affective disorder, prostitution, and being unhoused at the time of delivery. Tony received antibiotics after delivery for presumed newborn infections. As an infant, he had kidney reflux, low serum ferritin, insomnia, and failure to thrive. Regarding developmental milestones, Tony was sitting up at 7 months, walking at 14 months, talking at 18 months, and speaking in full sentences by 24 months. When he presented to the psychiatric service at age 3 years, behavioral problems included irritability with destructive rages, excessive fears, separation anxiety, hyperactivity, and impulsivity with a lack of awareness of danger to the extent that he required a safety harness when in public and security locks in the home because of repeated elopements. Tony also had at the time of his initial presentation significant defiance, extreme tantrums, violent aggressive outbursts, cognitive rigidity, repetitive behaviors, resistance to change, frequent nondirected vocalizations, and self-injurious behaviors including slapping himself on the head and biting of his hands and feet. Review of systems includes complaints of frequent abdominal and neck pain, persistent insomnia, night terrors, restrictive eating habits with poor weight gain, and reduced sensitivity to pain. Treatment history included gabapentin and subsequently divalproex for seizure-like episodes (despite negative EEG) described as frequent staring spells with repetitive biting of his lips. Psychotropic medications were risperidone for irritability associated with autism and clonidine extended release for ADHD. He also took melatonin for sleep. During his well-child check at the age of 5 years, Tony is making good progress from a developmental standpoint, has age-appropriate expressive and receptive language skills, is fluent in both English and Spanish, is able to recite the alphabet, counts to 20, has learned to swim, and is demonstrating interest in planets and astrology. He is reported to have a secure attachment to his adoptive parents and is described as emotionally sensitive, caring, kind, considerate, and empathetic. He has good eye contact and can read facial expressions. He is affectionate and protective of his infant sibling, his biological sister, who is also adopted by his parents and now living in the home. Tony made an excellent adjustment to the start of kindergarten and up until this point was responding positively to his psychotropic medication regimen. But then at age five and a half, Tony experienced sudden and unexplained behavioral worsening, which was followed by the onset of recurrent vomiting and refusal to eat or drink. Comprehensive medical workup including upper endoscopy and biopsy resulted in a diagnosis of eosinophilic esophagitis (EoE). What would be your next step?

OBJECTIVE: This study aimed to validate the Interoceptive Sensitivity and Attention Questionnaire (ISAQ), a 17-item self-report measure assessing sensitivity and attention to interoceptive signals. METHODS: In study 1, exploratory and confirmatory factor analysis was performed in a student convenience sample (n = 1868). In study 2, ISAQ data of a healthy sample (n = 144) and various patient groups experiencing stress-related syndromes (overstrain, n = 63; burnout, n = 37; panic disorder [PD]. n = 60) and/or persistent somatic symptoms in daily life (irritable bowel syndrome, n = 38; fibromyalgia and/or chronic fatigue syndrome, n = 151; medically unexplained dyspnea [MUD], n = 29) were compared. RESULTS: Three subscales were revealed: (F1) sensitivity to neutral bodily sensations, (F2) attention to unpleasant bodily sensations, and (F3) difficulty disengaging from unpleasant bodily sensations. Overall, patients with fibromyalgia and/or chronic fatigue syndrome and patients with MUD scored significantly higher on F1 (p = .009 and p = .027, respectively) and F2 (p = .002 and p < .001, respectively) than healthy controls. Patients with PD had higher scores on subscales F2 (p < .001) and F3 (p < .001) compared with healthy controls, as well as higher scores on F2 compared with all other patient groups (pPD versus MUD = .008; all other p values < .001). CONCLUSIONS: Interoceptive sensibility-the self-reported aspect of interoception-is not a homogeneous or unitary construct. The subscales of the ISAQ differentiate healthy controls from patients with persistent somatic and/or stress-related complaints in daily life and distinguish different patient groups. The ISAQ can be used as a concise, reliable, and clinically relevant research tool to further disentangle adaptive and maladaptive aspects of interoceptive ability. ispartof: Psychosomatic Medicine vol:84 issue:2 pages:1-35 ispartof: location:United States status: Published online

The concept of alexithymia has garnered much attention in an attempt to understand the psychological mechanisms underlying the experience of feeling an emotion. In this study, we aimed to understand how the interoceptive processing in an emotional context relates to problems of alexithymia in recognizing self-emotions. Therefore, we prepared experimental conditions to induce emotional awareness based on interoceptive information. As such, we asked participants to be aware of interoception under an anxiety-generating situation anticipating pain, having them evaluate their subjective anxiety levels in this context. High alexithymia participants showed attenuated functional connectivity within their 'interoception network', particularly between the insula and the somatosensory areas when they focused on interoception. In contrast, they had enhanced functional connectivity between these regions when they focused on their anxiety about pain. Although access to somatic information is supposed to be more strongly activated while attending to interoception in the context of primary sensory processing, high alexithymia individuals were biased as this process was activated when they felt emotions, suggesting they recognize primitive and unprocessed bodily sensations as emotions. The paradoxical somatic information processing may reflect their brain function pathology for feeling emotions and their difficulty with context-dependent emotional control.

On the basis of Descartes’s account of the passions of the soul, we argue that current interoception-based theories of emotions cannot account for the hallmark of a passion of the soul, i.e., that its effects are felt as being in the soul itself. We also pay attention to the epistemic functions of the passions and to Descartes’s category of emotions that are caused and occur in the soul alone. Certain passions of the soul and certain internal (or intellectual) emotions are similar to what are today called ‘epistemic (or noetic) feelings’ and ‘epistemic emotions.’ Descartes’s work reflects another challenge for contemporary embodied cognition: how might epistemic affect be embodied? Since the signature of embodiment is increasingly understood as interoceptive, the challenge to interoceptive research is demonstrating the degree to which (epistemic) affect results from interoception. This challenge also implies that the locus of emotional experience is taken into account.