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Our judgements are often influenced by other people's views and opinions. Interoception also influences decision making, but little is known about its role in social influence and particularly, the extent to which other people may influence our decisions. Across two experiments, using different forms of social influence, participants judged the trustworthiness of faces presented either during the systolic phase of the cardiac cycle, when baroreceptors convey information from the heart to the brain, or during diastolic phase, when baroreceptors are quiescent. We quantified the extent to which participants changed their minds (as an index of social influence) following the social feedback, in order to compare two competing hypotheses. According to the Arousal-Confidence Hypothesis, cardiac signals create a context of heightened bodily arousal that increases confidence in perceptual judgements. People should, therefore, be less subject to social influence during systole. By contrast, according to the Uncertainty-Conformity Hypothesis, cardiac signals increase neural noise and sensory attenuation, such that people should display greater effects of social influence during systole, as they then underweight private interoceptive signals in favour of the external social information. Across two studies that used different kind of social interactions, we found that participants changed their minds more when faces were presented at systole. Our results, therefore, support the Uncertainly-Conformity hypothesis and highlight how cardiac afferent signals contribute to shape our social decision-making in different types of social interactions., Competing Interests: Declaration of Competing Interest The authors report no conflict of interests., (Copyright © 2023. Published by Elsevier B.V.)

Interoception, defined as the sense of the internal bodily state, plays a critical role in physical, cognitive, emotional and social well-being. Regarding physical well-being, contemporary models of exercise regulation incorporate interoceptive processes in the regulation of physical exertion. Top-down processes continuously monitor the physiological condition of the body to ensure allostasis is maintained, however, flagged perturbations also appear to influence these higher order processes in return. More specifically, enhancing one's physiological arousal by means of physical activity is a viable way of manipulating the afferent input entering the interoceptive system, appearing to optimise the integration of early sensory stimulation with later affective responses. Despite this, the relationship between physical activity and top-down regulation is underrepresented in interoceptive research. We here address this gap by integrating findings from different disciplines to support the overlapping mechanisms, with the hope of stimulating further research in this field. Developing our understanding of how interoceptive processes are shaped by physical activity could hold significant clinical implications considering the impact of interoceptive deficits to mental health and well-being., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

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., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The exact causes of Idiopathic Environmental Intolerance Attributed to Electromagnetic Fields (IEI-EMF, i.e., experience of somatic symptoms attributed to low-level electromagnetic fields) are still unknown. Psychological causation such as nocebo effects seem plausible. This study aimed to experimentally induce a nocebo effect for somatic symptom perception and examined whether it was reproducible after one week. We also examined whether these effects were associated with increased sympathetic activity and whether interoceptive accuracy (IAcc) moderated these relationships. Participants were recruited from the general population and instructed that electromagnetic exposure can enhance somatosensory perception. They participated twice in a cued exposure experiment with tactile stimulation and sham WiFi exposure in 50% of trials. The two sessions were scheduled one week apart (session 1: N = 65, session 2: N = 63). Before session 1, participants watched either a 6-min film on adverse health effects of EMF or a neutral film on trade of mobile phones. IAcc was assessed with the heartbeat detection paradigm. Electrodermal activity served as a measure of sympathetic activation. Evidence for a nocebo effect (i.e., increased self-reported intensity and aversiveness and electrodermal activity) during sham WiFi exposure was observed in both sessions. IAcc moderated the nocebo effect, depending on stimulus intensity. Contrary to previous findings, no difference emerged between the health-related EMF and the neutral films. Based on negative instructions, somatic perception and physiological responding can be altered. This is consistent with the assumption that IEI-EMF could be due to nocebo effects, suggesting an important role for psychological interventions., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The autonomic nervous system (ANS) plays a key role in maintaining physiological homeostasis, and research with neurotypical and autistic individuals has found relations between cardiac autonomic responses, as well as awareness of one's cardiac responses, and social and emotional processing. The current study examined relations between cardiac autonomic activity, heartbeat perception, emotion processing, and levels of autistic traits in a group of college students. Cardiac ANS at baseline and during an emotional picture task was measured, and a heartbeat perception task was used to assess interoceptive accuracy (IA). Questionnaires then assessed autistic traits, alexithymia (difficulties processing one's own emotions), and emotion recognition. Consistent with past work, greatest heart rate deceleration was seen in response to negative images. In the overall sample, no correlations were found between cardiac ANS, IA, autistic traits, and aspects of emotion processing, but when examining individuals high and low on autistic traits separately, distinct associations were found. Within the group of participants with elevated autistic traits, greater baseline respiratory sinus arrhythmia (RSA) was predictive of lower levels of alexithymia and autistic traits, as well as higher IA, but these associations were not seen in participants low on autistic traits. These findings suggest that variability in autistic traits in a non-autistic sample can lead to differential relations between cardiac autonomic responses, awareness of one's cardiac responses, and emotion processing., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background and Objectives: Deviations in interoception might contribute to the development and maintenance of mental disorders. The improvement of interoceptive accuracy (IA) is desirable but assessment and training methods remain controversial. For instance, it was assumed that performance increases in heartbeat counting paradigms after cardiac feedback were due to an improvement of knowledge with regard to heart rate rather than due to an actual improvement in IA., Methods: Here, we examined effects of contingent cardiac feedback training, non-contingent cardiac feedback, mindfulness practice, and a waiting period with external attentional focus on IA. 100 healthy participants underwent a mental tracking paradigm before and after 20 min of training or waiting., Results: Results revealed a significant increase of IA in the contingent feedback condition (d = 1.21, p ≤ .001) and no significant changes after non-contingent feedback, mindfulness practice or waiting (d ≤ 0.37; p ≥ .06). Furthermore, IA increase was significantly higher after the contingent feedback training compared to all other conditions, including non-contingent feedback., Limitations: Future studies need to replicate these findings in clinical samples and examine time dependent effects., Conclusions: The results provide evidence for the trainability of heartbeat perception. IA improvements may reduce the symptom burden in people suffering from mental disorders and psychophysiological conditions that have been linked to lower interoceptive accuracy such as depression, somatic symptom disorder, chronic pain, and functional somatic syndromes. Consequently, exploration of biofeedback training procedures shall be continued with the aim of identifying relevant mediators of beneficial effects and future implementation in clinical practice., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Interoception may contribute to substance use disorder as it relates to the body's experience of substance use or withdrawal. However, only a few studies have directly investigated associations between interoception and alcohol use. The objective of this study was to compare individuals with alcohol use disorder (AUD) and healthy controls on interoceptive sensibility and accuracy., Methods: The sample was comprised of two groups: individuals meeting criteria for AUD (N = 114) and healthy controls (N = 110) not meeting criteria for AUD. Interoceptive sensibility was assessed with a self-report measure (the Private Body Consciousness subscale) and interoceptive accuracy - with a behavioral measure (the Schandry test). In addition, associations between interoception and other well-recognized correlates of AUD (sleep problems, depressive and anxiety symptoms, impulsivity) were tested. Barratt's Impulsiveness Scale, Brief Symptom Inventory, and Athens Insomnia Scale were utilized to assess psychopathological symptoms as covariates., Results: When controlling for level of anxiety, sleep problems, age, sex and education, individuals with AUD scored significantly higher on self-reported interoceptive sensibility and lower on interoceptive accuracy in comparison to healthy controls. Higher interoceptive sensibility was associated with more severe sleep problems and anxiety symptoms., Conclusions: These results have to be treated as preliminary and need to be replicated; however, findings indicate that interoception may present a novel therapeutic target for treatment of AUD., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Little is known about the conscious experience of internal bodily sensations in preschool-aged children. Given that preschoolers are in the most rapid phase of brain development, and display profound emotional development, it was the aim of the present study to establish an adapted interoceptive accuracy paradigm and to investigate associations between sociodemographic (age, sex) and emotional variables with interoceptive accuracy. Forty-nine children (aged 4-6 years) completed the jumping jack paradigm (JJP), a heartbeat tracking paradigm, which includes a noninvasive physical perturbation via performing jumping jacks for 10 s. An interoceptive accuracy score was based on the comparison between self-reported and objectively recorded heart rate prior to and after completion of jumping jacks. Children also completed validated measures for emotion recognition and emotion regulation. Children's objectively recorded heart rate significantly increased after the JJP by 20 bpm on average. There was a positive relationship between reactivity on self-reported heart rate and objectively recorded heart rate increase. The derived scores for interoceptive accuracy increased with age, suggesting older children to report more self-reported heart rate change than objectively recorded, but were unrelated to children's sex or BMI. While emotion recognition and regulation significantly increased with age, the interoceptive accuracy score was unrelated to emotion recognition, but marginally associated to emotion regulation. Children with higher interoceptive accuracy score (i.e., self-reporting more heart rate change than objectively recorded) received lower emotion regulation score. The present study is the first to depict a novel behavioral paradigm to assess interoceptive accuracy in preschool-aged children., (Copyright © 2019. Published by Elsevier B.V.)

Integration of body-related signals within the peripersonal space (PPS) contributes to bodily self-awareness. Whereas several studies have shown how individual PPS extension is shaped by external factors, e.g. during interactions with people and objects, no studies have looked at interoceptive influences on PPS extension. We exposed participants to an audio-tactile interaction task, to measure their PPS boundary (Session 1), and to a heartbeat counting task and a time estimation task, to specifically assess their interoceptive accuracy (Session 2). Participants' traits of private self-consciousness and social anxiety were also evaluated, to account for their possible effect on the relation between interoception and PPS representation. We found that higher interoceptive accuracy specifically predicts narrower PPS boundary. Moreover, this relation is moderated by individual traits of private self-consciousness, but not social anxiety. Extending the concept of interoceptive influences on exteroceptive body representations to PPS, our results, first, support the idea that a dynamic balance between intero-exteroceptive processing might represent a general principle underlying bodily self-awareness; second, they shed light on how interoception may affect also the way we interface with the external world. Finally, showing that, in order for interoceptive accuracy to be effective on the intero-exteroceptive balance, it is important that individuals tend to focus on inner sensations and feelings, our results suggest that a comprehensive intero-exteroceptive model of bodily self-awareness should be (at least) a three-dimensional model that includes individual self-consciousness traits., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Interoception and exteroception for body signals are two different ways of perceiving the self: the first from within, the second from outside. We investigated the relationship between Interoceptive Accuracy (IAcc) and external perception of the body and we tested if seeing the body from an external perspective can affect IAcc. Fifty-two healthy female subjects performed a standard heartbeat perception task to assess the IAcc, before and after the Body Image Revealer (BIR), which is a body perception task designed to assess the different aspects of body-image. The performance of the lower IAcc group in the heartbeat perception task significantly improved after the exteroceptive task. These findings highlight the relations between interoceptive and exteroceptive body-representations, supporting the view that these two kinds of awareness are linked and interact with each other., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Interoceptive and exteroceptive information are both essential for the construction and update of self-awareness. Whereas several studies have shown how interoceptive accuracy or cardiac feedback influences body-awareness, no studies have looked at the reverse effect, namely how exteroceptively-driven changes in body-ownership and self-identification can influence individuals' ability to detect internal bodily signals. We exposed participants to the Rubber Hand Illusion (Experiment 1) and to the Enfacement Illusion (Experiment 2), and tested how this change in the sense of body-ownership and self-identification affected their interoceptive accuracy (IAcc). The heartbeat-counting task was used to measure IAcc before the bodily illusions, and then the same task was interleaved with periods of visuo-tactile stimulation, during which synchronous and asynchronous multisensory stimulation was applied. We found that a change in body-ownership significantly improved performance of participants with lower interoceptive accuracy. In contrast, a change in self-identification significantly decreased performance of participants with higher interoceptive accuracy. These results suggest that changes in different domains of self-awareness can differentially impact individuals' ability to accurately detect signals arising from within the body, highlighting the distinct role that interoceptive signals play for different facets of bodily self-consciousness., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Garfinkel and Critchley (2013) recently proposed a three level model of interoception. Only few studies, however, have empirically tested this theoretical model thus far. The present study aimed at investigating (1) the central assumptions of this model, i.e. that Accuracy, Sensibility and Awareness are distinguishable facets of interoception and that Interoceptive Accuracy is the basic level of interoception, and (2) whether cardiovascular activation (as indexed by heart rate) is differentially related to the three facets of interoception. Analyses were conducted on a total sample of N=159 healthy participants (118 female [74.2%]; mean age=23.9years, SD=3.3, range=19-45) who performed either the heartbeat tracking task, the heartbeat discrimination task or both. The results suggest that Accuracy, Sensibility and Awareness are empirically distinct facets of interoception, showing no correlation when based on heartbeat tracking, but moderate correlations when based on heartbeat discrimination. The assumption that Interoceptive Accuracy is the basic level of interoception could only be partially confirmed. Instead, we conclude that the level of objective physiological states should be considered as the most basic level of interoceptive signal processing., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background and Objectives: This study tested whether relatively low levels of interoceptive accuracy (IAcc) are associated with body dysmorphic disorder (BDD) symptoms. Additionally, given research indicating that power attunes individuals to their internal states, we sought to determine if state interoceptive accuracy could be improved through an experimental manipulation of power.., Method: Undergraduate women (N = 101) completed a baseline measure of interoceptive accuracy and then were randomized to a power or control condition. Participants were primed with power or a neutral control topic and then completed a post-manipulation measure of state IAcc. Trait BDD symptoms were assessed with a self-report measure., Results: Controlling for baseline IAcc, within the control condition, there was a significant inverse relationship between trait BDD symptoms and interoceptive accuracy. Continuing to control for baseline IAcc, within the power condition, there was not a significant relationship between trait BDD symptoms and IAcc, suggesting that power may have attenuated this relationship. At high levels of BDD symptomology, there was also a significant simple effect of experimental condition, such that participants in the power (vs. control) condition had better interoceptive accuracy. These results provide initial evidence that power may positively impact interoceptive accuracy among those with high levels of BDD symptoms.., Limitations: This cross-sectional study utilized a demographically homogenous sample of women that reflected a broad range of symptoms; thus, although there were a number of participants reporting elevated BDD symptoms, these findings might not generalize to other populations or clinical samples., Conclusions: This study provides the first direct test of the relationship between trait BDD symptoms and IAcc, and provides preliminary evidence that among those with severe BDD symptoms, power may help connect individuals with their internal states. Future research testing the mechanisms linking BDD symptoms with IAcc, as well as how individuals can better connect with their internal experiences is needed.., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The need for social affiliation is one of the most important and fundamental human needs. Unsurprisingly, humans display strong negative reactions to social exclusion. In the present study, we investigated the effect of social exclusion on interoceptive accuracy - accuracy in detecting signals arising inside the body - measured with a heartbeat perception task. We manipulated exclusion using Cyberball, a widely used paradigm of a virtual ball-tossing game, with half of the participants being included during the game and the other half of participants being ostracized during the game. Our results indicated that heartbeat perception accuracy decreased in the excluded, but not in the included, participants. We discuss these results in the context of social and physical pain overlap, as well as in relation to internally versus externally oriented attention., (Copyright © 2015 Elsevier B.V. All rights reserved.)