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OBJECTIVE: Recent research suggests that early signs of schizophrenia can be detected several years before its onset. Evidence suggests that the identification of at-risk individuals before the psychotic onset can significantly improve the course of the disorder. However, instruments employed for the detection of prodromal symptoms are far from being accurate in the prediction of a future transition to psychosis. The aim of the present review is to summarize literature on the early signs of schizophrenia and to identify physiological markers that may aid the identification of the disorder before psychotic transition. METHOD: This critical review includes studies published between 1979 and 2018 that were indexed in major databases with the following keywords: schizophrenia, prodromal phase, basic symptoms, autonomic nervous system, heart rate variability. RESULTS: The examination of the relevant literature showed that, despite recent progress in the identification of at-risk states, the currently employed instruments do not allow an effective prediction of a future psychotic onset. Also, evidence suggests a significant association between alterations in the autonomic nervous system (ANS) functioning and psychotic disorders. However, literature on the association between ANS functioning and at-risk states for psychosis is still scarce. The addition of physiological risk indicators may represent a step forward in the detection of at-risk individuals. CONCLUSIONS: Overall, the present literature review highlights that a future schizophrenic onset cannot be strongly predicted with current available measures. Given the established correlation between schizophrenia and autonomic dysregulation, an investigation of the ANS functioning in individuals who are at increased risk of developing schizophrenia may be particularly useful to improve the quality of the assessment, to identify at an early stage the dysregulated physiological patterns that have been linked with schizophrenia, and therefore to develop tailored interventions. Accordingly, it is crucial that future research investigates the presence of autonomic deficits in individuals at risk for psychosis.

Purpose Anorexia nervosa-restrictive subtype (AN-R) is a life-threatening disorder relying on behavioural abnormalities, such as excessive food restriction or exercise. Such abnormalities may be secondary to an “objectified” attitude toward body image and self. This is the first study exploring the impact of anomalous self-experience (ASEs) on abnormal body image attitude and eating disorder (ED) symptomatology in individuals with AN-R at onset. Methods We recruited Italian female participants, 40 with AN-R (mean age 18.3 ± 2.3) and 45 age and educational level-matched healthy controls (HCs) (mean age 18.2 ± 2.6). ASEs, body image attitude, and ED symptom severity were assessed through the examination of anomalous self-experience (EASE), the body uneasiness test (BUT), and the eating disorder examination questionnaire (EDE-Q), respectively. We conducted multivariate analysis of variance to investigate distribution patterns of variables of interest, and mediation analysis to test the effect of ASEs and body image on ED symptomatology. Results Individuals with AN-R scored higher than HCs on the EASE (p p = 0.009; bootstrapped LLCI = 0.067, ULCI = 0.240) was found in AN-R. After modelling the effect of abnormal body image attitude, the relationship between EASE total score and ED symptomatology was significantly mediated by BUT (p = 0.002; bootstrapped LLCI = 0.001, ULCI = 0.172). Conclusion Although the exact pathways linking AN-R to self-disorder remain to be identified, a broader exploration of transdiagnostic features in AN, including explorations of different dimensions of self-experience and intersubjectivity, may shed further light on the clinical phenomenology of the disorder. Level of evidence Level III, case–control analytic study.

The aim of this study is to investigate the bodily-self in Restrictive Anorexia, focusing on two basic aspects related to the bodily self: autonomic strategies in social behavior, in which others' social desirability features, and social cues (e.g., gaze) are modulated, and interoception (i.e., the sensitivity to stimuli originating inside the body). Furthermore, since previous studies carried out on healthy individuals found that interoception seems to contribute to the autonomic regulation of social behavior, as measured by Respiratory Sinus Arrhythmia (RSA), we aimed to explore this link in anorexia patients, whose ability to perceive their bodily signal seems to be impaired. To this purpose, we compared a group of anorexia patients (ANg; restrictive type) with a group of Healthy Controls (HCg) for RSA responses during both a resting state and a social proxemics task, for their explicit judgments of comfort in social distances during a behavioral proxemics task, and for their Interoceptive Accuracy (IA). The results showed that ANg displayed significantly lower social disposition and a flattened autonomic reactivity during the proxemics task, irrespective of the presence of others' socially desirable features or social cues. Moreover, unlike HCg, the autonomic arousal of ANg did not guide behavioral judgments of social distances. Finally, IA was strictly related to social disposition in both groups, but with opposite trends in ANg. We conclude that autonomic imbalance and its altered relationship with interoception might have a crucial role in anorexia disturbances.

Stimulus position is coded even if it is task-irrelevant, leading to faster response times when the stimulus and the response locations are compatible (spatial Stimulus–Response Compatibility–spatial SRC). Faster responses are also found when the handle of a visual object and the response hand are located on the same side; this is known as affordance effect (AE). Two contrasting accounts for AE have been classically proposed. One is focused on the recruitment of appropriate grasping actions on the object handle, and the other on the asymmetry in the object shape, which in turn would cause a handle-hand correspondence effect (CE). In order to disentangle these two accounts, we investigated the possible transfer of practice in a spatial SRC task executed with a S–R incompatible mapping to a subsequent affordance task in which objects with either their intact handle or a broken one were used. The idea was that using objects with broken handles should prevent the recruitment of motor information relative to object grasping, whereas practice transfer should prevent object asymmetry in driving handle-hand CE. A total of three experiments were carried out. In Experiment 1 participants underwent an affordance task in which common graspable objects with their intact or broken handle were used. In Experiments 2 and 3, the affordance task was preceded by a spatial SRC task in which an incompatible S–R mapping was used. Inter-task delays of 5 or 30 min were employed to assess the duration of transfer effect. In Experiment 2 objects with their intact handle were presented, whereas in Experiment 3 the same objects had their handle broken. Although objects with intact and broken handles elicited a handle-hand CE in Experiment 1, practice transfer from an incompatible spatial SRC to the affordance task was found in Experiment 3 (broken-handle objects), but not in Experiment 2 (intact-handle objects). Overall, this pattern of results indicate that both object asymmetry and the activation of motor information contribute to the generation of the handle-hand CE effect, and that the handle AE cannot be reduced to a SRC effect.

Humans' ability to represent their body state from within through interoception has been proposed to predict different aspects of human cognition and behaviour. We focused on the possible contribution of interoceptive sensitivity to social behaviour as mediated by adaptive modulation of autonomic response. We, thus, investigated whether interoceptive sensitivity to one's heartbeat predicts participants' autonomic response at different social distances. We measured respiratory sinus arrhythmia (RSA) during either a Social or a Non-social task. In the Social task each participant viewed an experimenter performing a caress-like movement at different distances from their hand. In the Non-social task a metal stick was moved at the same distances from the participant's hand. We found a positive association between interoceptive sensitivity and autonomic response only for the social setting. Moreover, only good heartbeat perceivers showed higher autonomic response 1) in the social compared to the non-social setting, 2) specifically, when the experimenter's hand was moving at boundary of their peripersonal space (20 cm from the participant's hand). Our findings suggest that interoceptive sensitivity might contribute to interindividual differences concerning social attitudes and interpersonal space representation via recruitment of different adaptive autonomic response strategies.

Introduction The awareness of one's body constitutes a basic experience of Self which modulates the individual engagement in social interactions. Indeed, Interoception Sensitivity (IS), an index of individual ability to represent one’s own internal body states, is implicated in the autonomic regulation in interpersonal context. Schizophrenia deficits in Self-experience and awareness, which frequently entail anomalies in self-other relationship, capture the ever-growing attention of researchers. Nevertheless, IS and autonomic regulation of schizophrenic patients in social context are completely new and not yet investigated aspects of Schizophrenia. Aim To investigate whether Schizophrenia could be associated with lower IS and with a dysfunctional autonomic regulation during social interaction. Methods 24 chronic schizophrenia patients, and a matched group of healthy controls, performed a Social and a Non-social task while respiratory sinus arrhythmia (an index of autonomic regulation) was measured. In the Social task participants viewed an experimenter performing a caress-like movement at different distances from their hand. In the Non-social task a metal stick was moved at the same distances from the participants’ hand. As measure of IS, a cardiac Mental Tacking Task was performed. Results Comparing to controls, Schizophrenia patients presented lower IS, absence of relation between IS and autonomic regulation, and an anomalous autonomic regulation in social and non-social contexts. Conclusions Deficits in Self-experience, associated with Schizophrenia, could be extended to patients’ sensitivity to internal bodily signals. Moreover, the observed altered autonomic regulation will be part of interpersonal interaction deficit frequently associated to Schizophrenia.

The involvement of the sensorimotor system in language understanding has been widely demonstrated. However, the role of context in these studies has only recently started to be addressed. Though words are bearers of a semantic potential, meaning is the product of a pragmatic process. It needs to be situated in a context to be disambiguated. The aim of this study was to test the hypothesis that embodied simulation occurring during linguistic processing is contextually modulated to the extent that the same sentence, depending on the context of utterance, leads to the activation of different effector-specific brain motor areas. In order to test this hypothesis, we asked subjects to give a motor response with the hand or the foot to the presentation of ambiguous idioms containing action-related words when these are preceded by context sentences. The results directly support our hypothesis only in relation to the comprehension of hand-related action sentences.