Search

Acne vulgaris (AV) is a chronic inflammatory skin condition predominantly observed during adolescence. Interoception accuracy (IAc) refers to the ability to perceive internal bodily states such as hunger and thirst. Since the brain and skin originate from the same embryological layer, the ectoderm, it is hypothesized that skin changes and disorders might affect individual perceptions. The purpose of this study is to evaluate the relationship between IAc and AV. This study included 94 AV patients and 94 sex- and age-matched healthy controls. The participants completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Dermatology Life Quality Index (DLQI), and heartbeat perception task to assess IAc. The severity of acne was assessed using the Global Acne Grading System (GAGS). Acne patients had lower IAc scores than controls did (P = 0.026). Severe depression or anxiety symptoms were associated with lower IAc scores (P = 0.027, P = 0.046). Acne severity did not significantly affect IAc scores. There was a weak negative connection between the DLQI score and IAc (r = -0.208, P = 0.022), suggesting that lower quality of life is correlated with reduced IAc. Gender significantly influenced IAc. As a result, individuals with acne may have a reduced capacity to accurately perceive internal bodily states, potentially impacting overall well-being. Enhancing interoception might positively contribute to AV treatment and management. [ABSTRACT FROM AUTHOR]

Background: Interoception, the processing and integration of bodily signals, is crucial for emotional experiences and overall well-being. The interoceptive network, including the somatosensory cortices, has been recognized for its role in interoceptive and emotional processing. High-definition transcranial, direct-current stimulation (HD-tDCS) has been demonstrated to modulate brain activity in the primary somatosensory cortex (S1). Based on those findings, we hypothesized that anodal HD-tDCS over the right S1 would enhance interoceptive abilities and heighten emotional perception. Methods: Thirty-six healthy adults participated in two sessions separated by at least one week. A 20-min HD-tDCS stimulation (2 mA), and a sham stimulation, were applied in randomized order. Both conditions involved pre-tDCS physical activation by ergometer cycling. Interoceptive abilities were assessed before and after both sessions using a heartbeat-perception and respiratory-load task. Emotional perception was measured using four matched international affective picture system (IAPS) picture sets presented randomly. Results: Active HD-tDCS did not significantly improve interoceptive accuracy, interoceptive emotion evaluation, or interoceptive sensibility. However, a notable increase in cardiac interoceptive awareness was observed after active HD-tDCS. The expected enhancement of emotional processing was not observed. Conclusions: This study represents the first attempt to modulate interoceptive and emotional processing using HD-tDCS over S1. Although consistent enhancement was not observed, our findings provide insights into the modulation of interoceptive and emotional processes with HD-tDCS, suggesting avenues for further research. Further studies should consider the nuanced effects of stimulation techniques and the complex interplay between interoception and emotion. [ABSTRACT FROM AUTHOR]

Blind individuals have superior abilities to perform perceptual tasks that rely on exteroceptive information, since visual deprivation is associated with heightened cross-modal plasticity. However, it is unknown whether neuroplasticity after visual loss also affects interoception, that is, the sensations arising from one's inner organs that convey information about the physiological state of the body. Herein, we examine the influence of blindness on cardiac interoception, which is an interoceptive submodality that has important links to emotional processing and bodily self-awareness. We tested 36 blind and 36 age- and sex-matched sighted volunteers and examined their cardiac interoceptive ability using the heartbeat counting task. The results showed that blind individuals had significantly higher accuracy in perceiving their heartbeat than did individuals in a matched sighted control group. In contrast, there were no significant differences between the groups in the metacognitive dimensions of cardiac interoception or the purely physiological measurement of heart rate, thereby underscoring that the improved accuracy likely reflects a superior perceptual sensitivity to cardiac interoceptive signals in blind individuals. We conclude that visual deprivation leads to an enhanced ability to count one's own heartbeats, which has important implications for the study of the extent of cross-modal plasticity after visual loss, understanding emotional processing in blind individuals, and learning how bodily self-awareness can develop and be sustained in the absence of visual experience. [ABSTRACT FROM AUTHOR]

Background: Interoception, the processing and integration of bodily signals, is crucial for emotional experiences and overall well-being. The interoceptive network, including the somatosensory cortices, has been recognized for its role in interoceptive and emotional processing. High-definition transcranial, direct-current stimulation (HD-tDCS) has been demonstrated to modulate brain activity in the primary somatosensory cortex (S1). Based on those findings, we hypothesized that anodal HD-tDCS over the right S1 would enhance interoceptive abilities and heighten emotional perception. Methods: Thirty-six healthy adults participated in two sessions separated by at least one week. A 20-min HD-tDCS stimulation (2 mA), and a sham stimulation, were applied in randomized order. Both conditions involved pre-tDCS physical activation by ergometer cycling. Interoceptive abilities were assessed before and after both sessions using a heartbeat-perception and respiratory-load task. Emotional perception was measured using four matched international affective picture system (IAPS) picture sets presented randomly. Results: Active HD-tDCS did not significantly improve interoceptive accuracy, interoceptive emotion evaluation, or interoceptive sensibility. However, a notable increase in cardiac interoceptive awareness was observed after active HD-tDCS. The expected enhancement of emotional processing was not observed. Conclusions: This study represents the first attempt to modulate interoceptive and emotional processing using HD-tDCS over S1. Although consistent enhancement was not observed, our findings provide insights into the modulation of interoceptive and emotional processes with HD-tDCS, suggesting avenues for further research. Further studies should consider the nuanced effects of stimulation techniques and the complex interplay between interoception and emotion.

Peripheral emotion theories suggest a crucial role of interoception for emotion perception, which in turn facilitates emotion regulation. Laboratory studies found positive relations between interoceptive accuracy and perceived emotion intensity and arousal. Studies in natural settings are largely missing, but seem important by virtue of emotional experience and regulation diversity.

Schandry's mental heartbeat tracking task is a widely used measure of interoception, assessing heartbeat perception. We classify the factors that contribute to performance on the task as (i) trait-like characteristics, (ii) expectation-related factors, and (iii) factors showing participants' task set. We recommend conducting further research to better understand what exactly the task measures. [ABSTRACT FROM AUTHOR]

Acne vulgaris (AV) is a chronic inflammatory skin condition predominantly observed during adolescence. Interoception accuracy (IAc) refers to the ability to perceive internal bodily states such as hunger and thirst. Since the brain and skin originate from the same embryological layer, the ectoderm, it is hypothesized that skin changes and disorders might affect individual perceptions. The purpose of this study is to evaluate the relationship between IAc and AV. This study included 94 AV patients and 94 sex- and age-matched healthy controls. The participants completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Dermatology Life Quality Index (DLQI), and heartbeat perception task to assess IAc. The severity of acne was assessed using the Global Acne Grading System (GAGS). Acne patients had lower IAc scores than controls did (P = 0.026). Severe depression or anxiety symptoms were associated with lower IAc scores (P = 0.027, P = 0.046). Acne severity did not significantly affect IAc scores. There was a weak negative connection between the DLQI score and IAc (r = -0.208, P = 0.022), suggesting that lower quality of life is correlated with reduced IAc. Gender significantly influenced IAc. As a result, individuals with acne may have a reduced capacity to accurately perceive internal bodily states, potentially impacting overall well-being. Enhancing interoception might positively contribute to AV treatment and management., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Although attentional focusing in sports has been broadly investigated, the findings vary when it comes to endurance sports. This study provides a comparison between relevant foci in the literature of running economy. These include two internal foci-one addressing automated processes (running movement) and the other nonautomated processes (internal body signals and perceived exertion), an external focus (video) and a control condition. Furthermore, we investigated the influence of interoceptive sensitivity on oxygen consumption within the different attention conditions. Thirty recreational runners performed a four 6-min run at moderate intensity consisting of the four counterbalanced conditions. Running economy was assessed by spiroergometry, and interoception was measured using a heartbeat tracking task. Results revealed a significantly better running economy for the external focus of attention compared with all other conditions. No significant correlations were observed between the heartbeat perception score and oxygen consumption in any condition. [ABSTRACT FROM AUTHOR]

In some early classical emotional theories, psychologist JAMES has proposed that emotions are the perception of physiological changes in the body, i. e., physiological changes (such as rapid heartbeat) occur before emotions such as fear and tension. Later, researchers defined the human body's ability to perceive internal physiological signals (such as heartbeat, breathing and gastrointestinal peristalsis) as interoception, in which behavioral evaluation of heartbeat perception has received extensive attention. At present, it is generally accepted that interoception can be measured in three dimensions, i. e., accuracy, sensitivity and awareness. Several studies have shown that interoception is highly correlated with the intensity of emotional experience, and the changes in interoception can also be observed in the clinical groups suffering from anxiety disorder, depression disorder, schizophrenia and other mental disorders. Using functional magnetic resonance imaging and other techniques, the researchers has found that the insula may be the center of interoception, which overlaps with the active brain regions of emotional experience, providing the neuroanatomical evidence for the emotional theory. Recently, more and more studies focus on the field of interoception, but the published domestic reviews mostly concentrated on psychology without connection with clinical practice. Therefore, this paper comprehensively reviews the interoceptive dimensions, measurement methods, research techniques and clinical researches based on heartbeat perception, and prospects the research directions of interoception. [ABSTRACT FROM AUTHOR]

Background: Behavioral models suggest that strong tension-reduction alcohol-outcome expectancies (TREs) among drinkers should be associated with greater tension reduction after drinking. Yet, the few studies investigating this have found either no relationship or the opposite relationship. Objectives: We sought to explore this relationship by building upon the limitations of past studies and employing a placebo-controlled, within-subject experimental design. Methods: Sixty social drinkers (26 M, 34 F) visited the lab on two occasions spaced one week apart. Each participant was randomly assigned to receive alcoholic drinks targeting a BAC of 0.05% on one testing day and placebo drinks on the other, with the order counter-balanced. On both testing days, participants completed measures of state anxiety and fear both before drinking and following a drinking/absorption period. While completing the self-report measures, participants were anticipating an impending, mildly stressful heartbeat perception task. Results: Multilevel modeling revealed that the more strongly individuals believed that alcohol reduces tension, the less the pharmacologic properties of alcohol did so (p =.02 for the state anxiety outcome measure; p =.001 for the fear outcome measure). This was the case even with anxiety sensitivity – a known predictor of stress-response dampening – controlled for. Conclusions: These results provide further evidence for the paradoxical association of TREs and the dampening of anxiety. Additionally, the findings are consistent with the basis of expectancy challenges that aim to reframe inaccurate TREs among drinkers. [ABSTRACT FROM AUTHOR]

Decision-making deficits in individuals with alcohol use disorder (AUD) may be partly related to their decreased interoceptive awareness (IA), which is associated with some aspects of mindfulness. 52 abstinent male inpatients with AUD (current severity: moderate or severe) and 52 healthy male volunteers performed the heart rate tracking task and a computerised version of the Iowa gambling task (IGT). Trait mindfulness was evaluated with the mindful attention awareness scale (MAAS). Heartbeat perception (HBP), MAAS, and IGT scores of patients with AUD were significantly lower than those of healthy controls. The difference between groups with respect to IGT scores did not remain significant after controlling for the covariates, and HBP scores were linked significantly to the subjects' IGT performance. HBP scores significantly predicted IGT scores of both the overall sample and patients. MAAS scores did not correlate significantly with HBP and IGT scores in either the patient or control group. It is possible that IA plays a role in decision-making and decreased interoceptive accuracy is a predictor of impaired decision-making in individuals with AUD. More empirical data are needed to develop a better insight into the relationship between IA and multi-dimensional nature of mindfulness. [ABSTRACT FROM AUTHOR]

Blindness is associated with heightened sensory abilities, such as improved hearing and tactile acuity. Moreover, recent evidence suggests that blind individuals are better than sighted individuals at perceiving their own heartbeat, suggesting enhanced interoceptive accuracy. Structural changes in the occipital cortex have been hypothesized as the basis of these behavioral enhancements. Indeed, several studies have shown that congenitally blind individuals have increased cortical thickness within occipital areas compared to sighted individuals, but how these structural differences relate to behavioral enhancements is unclear. This study investigated the relationship between cardiac interoceptive accuracy and cortical thickness in 23 congenitally blind individuals and 23 matched sighted controls. Our results show a significant positive correlation between performance in a heartbeat counting task and cortical thickness only in the blind group, indicating a connection between structural changes in occipital areas and blind individuals' enhanced ability to perceive heartbeats., (© The Author(s) 2024. Published by Oxford University Press.)

Interoception is essential for the maintenance of physical and mental health. Paradigms assessing cardioceptive accuracy do not separate sensitivity from bias or are very demanding. We present the piloting (study 1; N = 60) and psychometric evaluation and validation (study 2; N = 84) of a novel task for the assessment of cardiac interoceptive perception following the principles of signal detection theory. By disentangling sensitivity and response bias, we demonstrate that the previously used interoceptive accuracy score of the heartbeat mental tracking task represents an amalgam of sensitivity and response bias. The new task demonstrated adequate test–retest reliabilities for sensitivity (d′) and response bias (c). Sensitivity was inversely related (β = −.36) to somatic symptom distress after statistically controlling for response bias. The novel cardiovascular signal detection task is easy to implement, feasible, and promising in terms of unraveling the role of (cardiac) interoceptive perception in psychopathology. Public Significance Statement: The ability to perceive one's own bodily signals appears crucial for our emotional and physical well-being. Changes in this ability are assumed to contribute to mental disorders and chronic somatic symptoms (e.g., chronic pain). In two studies, we present a novel task for an improved assessment of body perception as a starting point for a better understanding of mental disorders and their effective treatment in the future. [ABSTRACT FROM AUTHOR]

Previous studies have shown that the human capacity to gauge one's own physiological state is notoriously flawed. The cause for the mismatch between perceived and physiological stress has not yet been properly identified. In this study, we assumed that cardioceptive accuracy (CAc) is positively associated with cardiovascular reactivity, and CAc and expectation about stress might account for the discrepancy between perceived and physiological stress. In a crossover experiment, we assessed cardioceptive accuracy in two ways (mental heartbeat tracking task and perception of heart rate), and induced physiological (handgrip exercise) and mental (N-back task) stress in 64 university students (51 % male, mean age 22.2). We assessed cardiac and electrodermal activity, and expected and perceived stress. We found that indicators of cardioceptive accuracy were not associated with cardiovascular reactivity. However, heart rate perception moderated the association between the change in heart rate and perceived stress in the physical but not in the mental task. Whereas heartbeat tracking accuracy was not associated with perceived stress. Moreover, perceived stress was predicted by the expected stress but not by the change in heart rate and electrodermal activity in the mental stress task. In conclusion, heart rate perception and expectation of stress may shape perceived stress more than actual physiological changes in moderate acute stress. • In physical stress, HR perception moderated HR change and perceived stress relation • In mental stress, perceived stress was predicted by expected stress • Heartbeat tracking accuracy was not associated with perceived stress • Cardioceptive accuracy measures were not associated with cardiovascular reactivity [ABSTRACT FROM AUTHOR]

It has been suggested that our perception of the internal milieu, or the body's internal state, is shaped by our beliefs and previous knowledge about the body's expected state, rather than being solely based on actual interoceptive experiences. This study investigated whether heartbeat perception could be illusorily distorted towards prior subjective beliefs, such that threat expectations suffice to induce a misperception of heartbeat frequency. Participants were instructed to focus on their cardiac activity and report their heartbeat, either tapping along to it (Experiment 1) or silently counting (Experiment 2) while ECG was recorded. While completing this task, different cues provided valid predictive information about the intensity of an upcoming cutaneous stimulation (high- vs. low- pain). Results showed that participants expected a heart rate increase over the anticipation of high- vs. low-pain stimuli and that this belief was perceptually instantiated, as suggested by their interoceptive reports. Importantly, the perceived increase was not mirrored by the real heart rate. Perceptual modulations were absent when participants executed the same task but with an exteroceptive stimulus (Experiment 3). The findings reveal, for the first time, an interoceptive illusion of increased heartbeats elicited by threat expectancy and shed new light on interoceptive processes through the lenses of Bayesian predictive processes, providing tantalizing insights into how such illusory phenomena may intersect with the recognition and regulation of people's internal states. • Anticipation of pain elicits an illusory increase in perceived heartbeats. • Threat expectancy does not influence actual heart rate. • Anticipated threat shapes interoceptive perception, not exteroceptive perception. • Threat-induced interoceptive illusions align with Bayesian predictive processes. • Interoceptive illusions contribute to our understanding of psychological conditions. [ABSTRACT FROM AUTHOR]

Abstract Background Interoceptive deficits have been found to be associated with suicidal ideation and behavior. However, an objective measure of interoceptive accuracy has not been investigated in participants with suicide ideation, by now. This study aimed at investigating interoceptive accuracy and sensibility in persons with and without suicide ideation (SI) while controlling for severity of depressive symptoms. Method Ninety-five participants (age: M = 34.8, SD = 11.6, n = 56 female [58.9%]; n = 51 patients with a Major Depressive Disorder and n = 44 healthy participants) were assessed for interoceptive accuracy and sensibility, depression and SI. Results Twenty-five participants (26%) reported SI. They showed interoceptive accuracy comparable to persons without SI (t = −.81, p = .422), but significantly lower interoceptive sensibility. After controlling for severity of depressive symptoms in a hierarchical linear regression analysis, most associations between interoceptive sensibility and SI disappeared. Conclusion Results suggest that suicide ideators do not lack the ability to perceive their own bodily signals but they feel less able to use them in a way that is advantageous for them. Differences between suicide ideators and non-ideators appear to be largely driven by depressive symptoms (depression bias).

The present study was prepared on the assumption that interoceptive awareness (IA) and decision-making processes are implicated in addiction, and that somatic feedback plays an important role in decision-making. The study participants included 80 abstinent male inpatients with alcohol use disorder (n = 40) or opioid use disorder (n = 40) according to DSM-5 criteria (current severity: moderate or severe), along with 40 healthy male volunteers. All participants performed the heart rate tracking task as an objective physiological performance measure of IA and a computerized version of the Iowa gambling task (IGT) as a validated measure of decision-making. Impulsiveness was assessed using the Barratt Impulsiveness Scale 11 (BIS-11). Craving was evaluated with the Penn Alcohol Craving Scale (PACS) or Substance Craving Scale (SCS). (1) Heartbeat perception (HBP) and IGT scores were similar between the patients with alcohol or opioid addiction, being significantly lower than those in the control group, and the difference remained significant even when controlling for the factors that were significant in bivariate analyses; (2) HBP scores of patients correlated significantly with IGT scores, even when controlling the effect of the related variables; (3) BIS-11 scores of patients negatively correlated significantly with HBP scores and did not correlate significantly with IGT scores; and (4) PACS/SCS scores did not correlate significantly with HBP and IGT scores. Our findings support the hypothesis that IA and decision-making processes are implicated in addiction and that decreased IA is associated with impaired decision-making. [ABSTRACT FROM AUTHOR]

ObjectivePrevious research has shown reduced interoceptive accuracy (IAcc) in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of IAcc on depression and attention.MethodsThirty-six depressed patients from the Psychosomatic Clinic in Windach were matched with 36 healthy controls according to age and sex and were assessed at Ulm University. All participants completed the Beck Depression Inventory-II, the heartbeat perception task to examine IAcc, and the d2 test assessing selective attention.ResultsDepressed patients showed attention deficits—both for general visual attention and IAcc—compared to healthy controls. The mediation analyses revealed that the relationship between depression and attention is not mediated via IAcc. Furthermore, depression predicts IAcc and attention, but these effects are direct and largely unaffected by the respective other variable.DiscussionThe results of the present study highlight both interoceptive as well as attention deficits in depressed patients. No clear mediation between these variables could be shown in this study. More elaborative research is needed to clarify whether different approaches to improve IAcc are effective for these deficits in depressed patients and could therefore be of importance as an additional aspect of therapy in depression.

Objective: Previous research has shown reduced interoceptive accuracy (IAcc) in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of IAcc on depression and attention. Methods: Thirty-six depressed patients from the Psychosomatic Clinic in Windach were matched with 36 healthy controls according to age and sex and were assessed at Ulm University. All participants completed the Beck Depression Inventory-II, the heartbeat perception task to examine IAcc, and the d2 test assessing selective attention. Results: Depressed patients showed attention deficits—both for general visual attention and IAcc—compared to healthy controls. The mediation analyses revealed that the relationship between depression and attention is not mediated via IAcc. Furthermore, depression predicts IAcc and attention, but these effects are direct and largely unaffected by the respective other variable. Discussion: The results of the present study highlight both interoceptive as well as attention deficits in depressed patients. No clear mediation between these variables could be shown in this study. More elaborative research is needed to clarify whether different approaches to improve IAcc are effective for these deficits in depressed patients and could therefore be of importance as an additional aspect of therapy in depression. [ABSTRACT FROM AUTHOR]

[Background] A biased perception of physiological hyperreactivity to social-evaluative situations is crucial for the maintenance of social anxiety disorder (SAD). Alterations in interoceptive accuracy (IAc) when confronted with social stressors may play a role for SAD in children. We expected a biased perception of hyperarousal in children with SAD before treatment and, consequently, a reduced bias after successful cognitive behavioral therapy (CBT). [Method] In two centers, 64 children with the diagnosis of SAD and 55 healthy control (HC) children (both 9 to 13 years) participated in the Trier Social Stress Test for Children (TSST-C), which was repeated after children with SAD were assigned to either a 12-week group CBT (n = 31) or a waitlist condition (n = 33). Perception of and worry about physiological arousal and autonomic variables (heart rate, skin conductance) were assessed. After each TSST-C, all children further completed a heartbeat perception task to assess IAc. [Results] Before treatment, children with SAD reported both a stronger perception of and more worry about their heart rate and skin conductance than HC children, while the objective reactivity of heart rate did not differ. Additionally, children with SAD reported heightened perception of and increased worry about trembling throughout the TSST-C compared to HC children, but reported increased worry about blushing only after the stress phase of the TSST-C compared to HC children. Children with and without SAD did not differ in IAc. Contrary to our hypothesis, after treatment, children in the CBT group reported heightened perception of physiological arousal and increased worry on some parameters after the baseline phase of the TSST-C, whereas actual IAc remained unaffected. IAc before and after treatment were significantly related. [Conclusions] Increased self-reported perception of physiological arousal may play a role in childhood SAD and could be an important target in CBT. However, further studies should examine if this is an epiphenomenon, a temporarily occurring and necessary condition for change, or indeed an unwanted adverse intervention effect.

Classic and modern emotion theories suggest that the perception of bodily sensations, or interoception, is foundational to emotion processing. The present research examined whether interoception is enhanced among people high in ruminative tendencies, especially under stress. To test this notion, the present research examined the effects of a mild stressor on subjective and objective measures of interoception among people varying in ruminative tendencies. Under conditions of mild stress, rumination was positively associated with self-reported private body consciousness -a marker of interoceptive sensibility- in Study 1 (N = 312) and with heartbeat detection accuracy (especially in the presence of auditory interference) in Study 2 (N = 180). In both studies, rumination was not significantly associated with interoceptive sensibility or accuracy in the absence of stress. These findings suggest that stress-induced amplification of bodily sensations may be important in explaining emotional dysregulation among chronic ruminators. [ABSTRACT FROM AUTHOR]

Under resting conditions, cardioceptive accuracy—the acuity of the perception of heartbeats—is associated with the self‐reported intensity of affective states but not with reported valence. Physical exertion elicits positive affect below the anaerobic threshold and negative affect above the threshold while arousal gradually increases. The current research aimed to study the associations between cardioceptive accuracy and characteristics of the affective response (arousal and valence) during physical activity. About 67 undergraduate students completed the Schandry task and rated their perceived exertion (Borg‐scale) and affective experience (arousal and valence) under three physical loads (running on a treadmill below, around, and above the anaerobic threshold). Cardioceptive accuracy was associated with the arousal component of the affective states during physical activity but not with valence and perceived exertion. The accuracy of perception of heartbeats is generally positively related to self‐reported arousal but not to valence of the affective state in a number of studies on emotions. Physical activity evokes intensity‐dependent affective changes; however, the transferability of the above pattern to exercise settings has not been shown to date. The present study demonstrates that accuracy of cardiac perception is positively associated with arousal but not related to valence in affective states evoked by physical activity. [ABSTRACT FROM AUTHOR]

Over the last years, the neurobiological mechanisms of empathy have been extensively investigated. Recent investigations suggest that interoceptive processes, in particular, those that are related to the experience and perception of cardiac changes, are relevant for affect sharing, mentalizing and self-other distinction. To further investigate the association between interoception and affect-sharing, we measured emotional contagion and interoceptive accuracy in a sample of healthy participants (n = 84). Emotional contagion was assessed with an established self-report questionnaire and interoceptive accuracy was assessed with a validated heartbeat detection task. Across a series of complementary analyses, we found a sex- and valence-dependent association between interoception and affection sharing: Among female but not male participants, interoceptive accuracy was positively associated with emotional contagion for negative but not positive states of others. We provide an evolutionary-based explanation for these findings, which are consistent with previous findings showing positive associations between interoceptive accuracy, mentalizing and self-other distinction. [ABSTRACT FROM AUTHOR]

Background: Interoceptive deficits have been found to be associated with suicidal ideation and behavior. However, an objective measure of interoceptive accuracy has not been investigated in participants with suicide ideation, by now. This study aimed at investigating interoceptive accuracy and sensibility in persons with and without suicide ideation (SI) while controlling for severity of depressive symptoms. Method: Ninety-five participants (age: M = 34.8, SD = 11.6, n = 56 female [58.9%]; n = 51 patients with a Major Depressive Disorder and n = 44 healthy participants) were assessed for interoceptive accuracy and sensibility, depression and SI. Results: Twenty-five participants (26%) reported SI. They showed interoceptive accuracy comparable to persons without SI (t = −.81, p =.422), but significantly lower interoceptive sensibility. After controlling for severity of depressive symptoms in a hierarchical linear regression analysis, most associations between interoceptive sensibility and SI disappeared. Conclusion: Results suggest that suicide ideators do not lack the ability to perceive their own bodily signals but they feel less able to use them in a way that is advantageous for them. Differences between suicide ideators and non-ideators appear to be largely driven by depressive symptoms (depression bias). [ABSTRACT FROM AUTHOR]

• Heartbeat evoked potentials were heightened in anorexia nervosa. • There was a trend toward higher interoceptive accuracy in anorexia nervosa. • Cardiac autonomic activation and interoceptive sensibility were unaltered. To assess cardiac interoception in anorexia nervosa (AN) using a multidimensional approach. We assessed the physiological dimensions of cardioception, i.e. the peripheral signal itself (heart rate, HR, and heart rate variability, HRV) and its cortical representation (heartbeat evoked potentials, HEPs), and the psychological dimensions of interoceptive accuracy (heartbeat perception) and interoceptive sensibility (confidence ratings). Electroencephalogram (EEG) and electrocardiogram (ECG) were recorded concurrently during rest and while performing a heartbeat perception task in a sample of 19 female in-patients with AN (DSM-5) and 19 healthy control women (HC). HEPs, defined as mean EEG amplitude in a time window of 455–595 ms after the R-peak of the ECG, were significantly larger in the AN than in the HC group across conditions (p =.002, d = 1.06). There was a trend toward better heartbeat perception in AN, but no group differences in HR, HRV, and confidence ratings. Individuals with AN showed an interoceptive profile of heightened cortical processing, a trend toward heightened interoceptive accuracy, and unaltered cardiac autonomic activation and interoceptive sensibility. In terms of neurobiological models of AN, enhanced cortical representations of interoceptive signals might reflect a mechanism, which promotes fasting by alleviating negative body states. [ABSTRACT FROM AUTHOR]

Reduced perception of bodily signals and low levels of intuitive eating have been reported in patients with anorexia nervosa (AN) compared with normal‐weight individuals. However, findings have been inconsistent and treatment progress might account for some of these inconsistencies. Thirty‐seven inpatients with AN and 39 normal‐weight controls completed a heartbeat perception task and the Intuitive Eating Scale–2. Patients with AN reported lower intuitive eating than controls, whereas interoceptive sensitivity did not differ between groups. Higher interoceptive sensitivity was related to higher intuitive eating across both groups. In patients with AN, both higher interoceptive sensitivity and intuitive eating correlated with the number of days in the hospital and with higher body mass index (BMI), when controlling for BMI at admission. These relationships suggest that interoceptive sensitivity and intuitive eating improve during treatment. Future research should determine whether these improvements promote weight gain or follow it. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine the effect of an acute increase in cortisol in response to a psychosocial stressor on heartbeat perception, in a laboratory environment. Thirty-six participants (20 women, 16 men, mean age = 21.7 years, standard deviation = 1.7 years) completed a heartbeat counting task (Schandry paradigm) before and after exposure to an acute psychosocial stressor (Trier Social Stress Test; TSST). Heartbeat counting performance was compared between participants who exhibited strong cortisol responses (>15.5% increase in cortisol from baseline; responders) and those who did not (non-responders). Responders showed increased heartbeat counting accuracy following the TSST, which was not observed in non-responders. The two groups did not differ in their responsivity to subjective anxiety ratings or heart rate. These results indicated that acutely elevated cortisol in response to a psychosocial stressor is associated with increased interoceptive accuracy. The results provide a possible explanation for inconsistent findings on the effect of stress exposure on interoception. • There are two-way associations between stress and perception of the heartbeat. • We tested the role of cortisol in the effects of stress on heartbeat perception. • Participants with strong cortisol responses showed improved heartbeat perception. • The results suggest that cortisol mediates the effects of stress on perception. [ABSTRACT FROM AUTHOR]

Objective: The term interoception refers to the perception of bodily cues. In empirical studies, it is assessed using heartbeat detection or tracking tasks, often with the implicit assumption that cardioception reflects general interoceptive ability. Studies that applied a multichannel approach measured only a limited number of modalities. In the current study, six modalities were assessed to gain a deeper understanding of the relationship between the different sensory channels of interoception.Methods: For 118 university students (53% male) gastric perception (water load test), heartbeat perception (Schandry task), proprioception (elbow joint), ischemic pain (tourniquet technique), balancing ability (one leg stand), and perception of bitter taste were measured. Pair-wise correlation analysis and exploratory factor analyses (principal component analysis (PCA) and maximum likelihood (ML) extraction with oblimin rotation) were then carried out with a three-factor solution to investigate the underlying associations.Results: Correlation analysis only revealed significant associations between variables belonging to the same sensory modality (gastric perception, pain, bitter taste). Similarly, the three factors that consistently emerged in the factor analyses represented the three aforementioned modalities.Discussion: Interoceptive sensitivity assessed by using one channel only cannot be generalized. Interoceptive modalities carrying crucial information for survival are not integrated with other channels.

Narratív összefoglalónkban megkíséreljük felvázolni az interocepcióval kapcsolatos kutatások jelenlegi helyzetét. A definíciós nehézségek, modalitások és dimenziók áttekintése után sorra vesszük a méréssel kapcsolatos elméleti és gyakorlati problémákat, majd részletesebben is bemutatjuk az interocepció idegrendszeri hátterét. Az alapok áttekintése után a szívdobogás-percepciós kutatást alapul véve három fő témakörre fókuszálunk: 1) az interocepció és az érzelmek kapcsolatára, 2) az interocepció szerepére a self felépülésében és fennmaradásában, valamint 3) az interocepció stabilitására/változtathatóságára. Végül megkíséreljük integrálni az interocepció káros és hasznos vonatkozásait hangsúlyozó elméleteket, majd megemlítünk néhány olyan átfogó modellt, amelyek valószínűleg meg fogják határozni az interocepció kutatásának következő éveit. The aim of this narrative review is to provide an overview of current research on interoception. An introduction to the challenges of defining interoception, as well as interoceptive modalities and dimensions, is followed by a description of theoretical and practical problems concerning its assessment. After presenting the neurological foundations of interoception, three main topics are discussed, based on the empirical findings of heartbeat perception research: (1) interoception and emotions, (2) interoception and continuity and development of the self, (3) the stability and malleability of interoceptive sensitivity. We attempt to integrate the theoretical accounts of adaptive and maladaptive aspects of interoception. Finally, we present some contemporary models that could influence the future of interoception research. [ABSTRACT FROM AUTHOR]

Aberrant interoceptive accuracy could contribute to the co-occurrence of anxiety and premonitory urge in chronic tic disorders (CTD). If it can be manipulated through intervention, it would offer a transdiagnostic treatment target for tics and anxiety. Interoceptive accuracy was first assessed consistent with previous protocols and then re-assessed following an instruction attempting to experimentally enhance awareness. The CTD group demonstrated lower interoceptive accuracy than controls but, importantly, this group difference was no longer significant following instruction. In the CTD group, better interoceptive accuracy was associated with higher anxiety and lower quality of life, but not with premonitory urge. Aberrant interoceptive accuracy may represent an underlying trait in CTD that can be manipulated, and relates to anxiety and quality of life. [ABSTRACT FROM AUTHOR]

Abstract: Interoceptive accuracy (IAc), that is, the ability to accurately perceive one's own bodily signals, is widely assumed to be a trait, although experimental manipulations such as stress may affect IAc. We used structural equation modeling to estimate the reliability of IAc, and the proportions of individual differences in IAc, explained by a trait and occasion‐specific effects of situation and person‐situation interactions. We assessed IAc in 59 healthy participants (40 women, MAge = 23.4 years) on three consecutive measurement occasions, approximately 1 week apart, in a rest and poststress condition, using a heartbeat counting and a heartbeat discrimination task. The results showed fair temporal stability (intraclass correlation coefficients ≥ 0.38) and good reliability (Mdn = .63; range .49–.83) for both methods. While around 40% of the variance of a single IAc measurement could be explained by a trait, approximately 27% was accounted for by occasion‐specific effects of situation and person‐situation interaction. These results suggest that IAc measures are relatively consistent and that situations and person‐situation interactions impact IAc as measured at a certain point in time. An aggregation across at least two measurements is recommended when using IAc as a trait variable. [ABSTRACT FROM AUTHOR]

Abstract: Interoception is the process of perceiving afferent signals arising from within the body including heart rate (HR), gastric signals, etc., and has been described as a mechanism crucially involved in the creation of self‐awareness and selfhood. The heartbeat perception task is a tool to measure individuals' interoceptive accuracy (IAcc). IAcc correlates positively with measures of self‐awareness and with attributes including emotional sensitivity, empathy, prosocial behavior, and efficient decision making. IAcc is only moderate in the general population, and attempts to identify groups of people who might have higher IAcc due to their specific training (e.g., yoga, meditation) have not been successful. However, a recent study with musicians suggests that those trained in the arts might exhibit high IAcc. Here, we tested IAcc in 20 professional dancers and 20 female control participants on a heartbeat perception task. Dancers had a higher IAcc, and this effect was independent of their lower heart rates (a proxy measure of physical fitness), counting ability, and knowledge about HR. An additional between‐groups analysis after a median split in the dancer group (based on years of dance experience) showed that junior dancers' IAcc differed from controls, and senior dancers' IAcc was higher than both junior dancers and controls. General art experience correlated positively with IAcc. No correlations were found between IAcc and questionnaire measures of empathy, emotional experience, and alexithymia. These findings are discussed in the context of current theories of interoception and emotion—highlighting the features of arts training that might be related to IAcc. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated interoception in fibromyalgia (FM), a disorder characterized by chronic pain accompanied by mood deregulation. Based on observations on the relationship between somatosensory processing and pain in FM and considering the affective symptoms of this disorder, we tested in FM three dimensions of interoception: interoceptive accuracy (IA), interoceptive awareness (IAW) and interoceptive sensibility (IS). Materials and methods: Twenty-one female FM patients (Mage = 50.3) and 21 female matched controls (Mage = 46.3) completed a heartbeat tracking task as an assessment of IA, rated confidence in their responses as a measure of IAW and completed the Multidimensional Assessment of Interoceptive Awareness as a measure of IS. Furthermore, they completed self-report scales that, according to a principal component analysis, targeted anxiety, emotional consciousness and pain-related affect and reactions. Results: Multiple regression analyses showed that increased pain-related affect and reactions decrease IA in FM. When the results of each group were examined separately, such effect was found only in FM patients. On its turn, IS was predicted by emotional consciousness and painrelated affect and reactions, but these effects did not differ between FM and controls. Finally, none of the variables we used predicted IAW. Discussion: Pain-related affect and reactions in FM patients can reduce their interoceptive ability. Our results help to better understand the integration between bodily signals and emotional processing in chronic pain. [ABSTRACT FROM AUTHOR]

Objective: Fear of hypoglycemia (FoH) is a limiting factor for diabetes self-management and can have detrimental effects on quality of life. However, relatively little is known about its underlying mechanisms. In line with findings on patients with anxiety disorders, we hypothesized that interoceptive accuracy (IA) might be positively linked to FoH in patients with type 2 diabetes (T2DM).Methods: 133 patients with T2DM were screened according to the extreme quartiles of the Hypoglycemia Fear Survey worry subscale (HFS-W). Overall, 66 participants (HFS-W<4; HFS-W>17) were included in the present study. Participants completed questionnaires on sociodemographic and diabetes-related measures. Accuracy of heartbeat perception was assessed using the mental tracking task.Results: Contrary to expectations, IA did not differ significantly between patients with low and high FoH. A linear regression analysis demonstrated that the experience of mild hypoglycemia (β=0.32, p≤0.01) and its interaction with IA (β=-0.26, p=0.040) were significant predictors of FoH, indicating that low IA and a history of experiencing mild hypoglycemia are positively associated with FoH.Conclusion: Our findings suggest a positive association of low IA in combination with prior episodes of hypoglycemia and FoH in patients with T2DM. The results are in line with recent findings on IA in patients with chronic somatic symptom distress more generally and contribute to our understanding of the relations between interoception, body related fears, and physical symptom perception. [ABSTRACT FROM AUTHOR]

Interoception is the sense of the physiological condition of the entire body. Impaired interoception has been associated with aberrant activity of the insula in major depressive disorder (MDD) during heartbeat perception tasks. Despite clinical relevance, studies investigating interoceptive impairments in MDD have never been reviewed systematically according to the guidelines of the PRISMA protocol, and therefore we collated studies that assessed accuracy in detecting heartbeat sensations (interoceptive accuracy, IAc) in MDD (databases: PubMed/Medline, PsycINFO, and PsycARTICLES). Out of 389 records, six studies met the inclusion criteria. The main findings suggest that (i) moderately depressed samples exhibit the largest interoceptive deficits as compared with healthy adults. (ii) difficulties in decision making and low affect intensity are correlated with low IAc, and (iii) IAc seems to normalize in severely depressed subjects. These associations may be confounded by sex, anxiety or panic disorder, and intake of selective serotonin reuptake inhibitors. Our findings have implications for the development of interoceptive treatments that might relieve MDD-related symptoms or prevent relapse in recurrent depression by targeting the interoceptive nervous system.

Sensitivity to signals arising within the body (interoceptive awareness) has been implicated in emotion processing; interindividual differences in interoceptive awareness modulate both subjective and physiological indicators of emotional experience and the regulation of emotion-related behaviors. This study investigated interoceptive awareness in patients with fibromyalgia syndrome (FMS), a chronic pain condition accompanied by various affective symptoms. Interoceptive awareness was assessed in 45 FMS patients and 31 healthy individuals using a heartbeat perception task. Cognitive performance, comorbid psychiatric disorders and medication use were assessed as possible confounding variables. Concerning the primary outcome, patients exhibited markedly reduced heartbeat perception compared to healthy individuals. Moreover, there was an inverse relationship between interoceptive awareness and FMS symptom severity. Reduced interoceptive awareness may be involved in the affective aspects of FMS pathology. Poor access to bodily signals may restrict patients´ ability to integrate these signals during emotional processing, which, by extension, may preclude optimal emotional self-regulation. [ABSTRACT FROM AUTHOR]

Introduction: The current study was prepared based on the assumption that awareness of the interoceptive processes may be disturbed in addicted individuals. Methods: The participants in the study included 84 abstinent male inpatients who were addicted to alcohol (n = 33), heroin (n = 29), or synthetic cannabinoids (n = 22) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), and 35 healthy male volunteers. Interoceptive awareness (IA) was measured using the heartbeat perception (HBP) task. Addiction severity was assessed using the addiction profile index (API). Alexithymia was assessed using the Toronto alexithymia scale (TAS-20). Results: Patients addicted to alcohol, heroin, or synthetic cannabinoids had similar IA, and their HBP scores were significantly lower than those of healthy control subjects. There was a significant negative correlation between HBP scores and TAS-20 subscores, thus indicating difficulties in identifying feelings. HBP scores were not significantly correlated with API scores. API scores were significantly correlated with total alexithymia scores and subscores, thus indicating difficulties in identifying and describing feelings. Discussion: As our main finding, a decrease in IA in addicted patients in comparison to healthy controls may provide support for the hypothesis that awareness of the interoceptive processes may be disturbed in addiction. [ABSTRACT FROM AUTHOR]

Objective: Previous studies report reduced interoceptive abilities in anorexia nervosa (AN) using various methods. Recent research suggests that different levels of interoceptive processes aiming at different subdomains of interoceptive abilities must be further distinguished as these levels can be differentially affected. Two important levels refer to interoceptive accuracy (IA) derived from objective performance tasks such as the heartbeat detection task, and interoceptive sensibility (IS) as assessed by self-report. There is a lack of studies investigating both IA and IS in AN, and examining them in the time course of therapy. Aim of the pilot study was to evaluate the different interoceptive processes – especially IA and IS – in the time course of therapy.Methods: Fifteen patients with AN (restricting type) from the Psychosomatic Clinic in Windach were investigated three times (T1, T2, T3) during a standardized cognitive-behavioral therapy and compared to fifteen matched healthy controls assessed at Ulm University in a comparable design. All participants performed the heartbeat detection task examining IA and completed standard psychological assessments including an assessment of IS. Results: Patients with AN showed a significantly decreased weight, higher levels of depression and both reduced IA and IS compared to healthy controls at T1. Following therapy, patients recovered in terms of weight and depression symptomatology. A descriptive trend for recovering from IA and IS was observed. Discussion: Our findings suggest that interoceptive deficits are present in recovered patients. Therefore, further investigations are needed with more patients, differentiating between relapsed and recovered patients, and more specific training methods to improve interoceptive processes.

Interoception is defined as the perceptual activity involved in the processing of internal bodily signals. While the ability of internal perception is considered a relatively stable trait, recent data suggest that learning to integrate multisensory information can modulate it. Making music is a uniquely rich multisensory experience that has shown to alter motor, sensory, and multimodal representations in the brain of musicians. We hypothesize that musical training also heightens interoceptive accuracy comparable to other perceptual modalities. Thirteen professional singers, twelve string players, and thirteen matched non-musicians were examined using a well-established heartbeat discrimination paradigm complemented by self-reported dispositional traits. Results revealed that both groups of musicians displayed higher interoceptive accuracy than non-musicians, whereas no differences were found between singers and string-players. Regression analyses showed that accumulated musical practice explained about 49% variation in heartbeat perception accuracy in singers but not in string-players. Psychometric data yielded a number of psychologically plausible inter-correlations in musicians related to performance anxiety. However, dispositional traits were not a confounding factor on heartbeat discrimination accuracy. Together, these data provide first evidence indicating that professional musicians show enhanced interoceptive accuracy compared to non-musicians. We argue that musical training largely accounted for this effect.

Interoception, defined as afferent information arising from within the body, is the basis of all emotional experience and underpins the ‘self’. However, people vary in the extent to which interoceptive signals reach awareness. This trait modulates both their experience of emotion and their ability to distinguish ‘self’ from ‘other’ in multisensory contexts. The experience of emotion and the degree of self/other distinction or overlap are similarly fundamental to empathy, which is an umbrella term comprising affect sharing, empathic concern and perspective-taking. A link has therefore often been assumed between interoceptive awareness and empathy despite a lack of clear evidence. To test the hypothesis that individual differences in both traits should correlate, we measured interoceptive awareness in four experiments, using a well-validated heartbeat perception task, and compared this with scores on several tests that relate to various aspects of empathy. We firstly measured scores on the Index of Interpersonal Reactivity and secondly on the Questionnaire of Cognitive and Affective Empathy. Thirdly, because the ‘simulationist’ account assumes that affect sharing is involved in recognising emotion, we employed the ‘Reading the Mind in the Eyes Task’ for the recognition of facial expressions. Contrary to expectation, we found no significant relationships between interoceptive awareness and any aspect of these measures. This striking lack of direct links has important consequences for hypotheses about the extent to which empathy is necessarily embodied. Finally, to assess cognitive perspective-taking ability, which specifically requires self/other distinction, we used the ‘Director Task’ but found no relationship. We conclude that the abilities that make up empathy are potentially related to interoceptive awareness in a variety of conflicting ways, such that a direct association between interoceptive awareness and various components of empathy has yet to be established.

Objective: Previous studies report reduced interoceptive abilities in anorexia nervosa (AN) using various methods. Recent research suggests that different levels of interoceptive processes aiming at different subdomains of interoceptive abilities must be further distinguished as these levels can be differentially affected. Two important levels refer to interoceptive accuracy (IA) derived from objective performance tasks such as the heartbeat detection task and interoceptive sensibility (IS) as assessed by self-report. There is a lack of studies investigating both IA and IS in AN and examining them in the time course of therapy. The aim of this pilot study was to evaluate the different interoceptive processes - especially IA and IS - in the time course of therapy. Methods: Fifteen patients with AN (restricting type) from the Psychosomatic Clinic in Windach were investigated three times (T1, T2, T3) during a standardized cognitive-behavioral therapy and compared with 15 matched healthy controls assessed at Ulm University in a comparable design. All participants performed the heartbeat detection task examining IA and completed standard psychological assessments including an assessment of IS. Results: Patients with AN showed a significantly decreased weight, higher levels of depression, and both reduced IA and IS compared to healthy controls at T1. Following therapy, patients recovered in terms of weight and depression symptomatology. A descriptive trend for recovering from IA and IS was observed. Discussion: Our findings suggest that interoceptive deficits are present in recovered patients. Therefore, further investigations are needed with more patients, differentiating between relapsed and recovered patients, and more specific training methods to improve interoceptive processes. [ABSTRACT FROM AUTHOR]

Individuals differ in their awareness of afferent information from within their bodies, which is typically assessed by a heartbeat perception measure of 'interoceptive accuracy' (IAcc). Neural and behavioural correlates of this trait have been investigated, but a theoretical explanation has yet to be presented. Building on recent models that describe interoception within the free energy/predictive coding framework, this paper applies similar principles to IAcc, proposing that individual differences in IAcc depend on 'precision' in interoceptive systems, i.e. the relative weight accorded to 'prior' representations and 'prediction errors' (that part of incoming interoceptive sensation not accounted for by priors), at various levels within the cortical hierarchy and between modalities. Attention has the effect of optimizing precision both within and between sensory modalities. Our central assumption is that people with high IAcc are able, with attention, to prioritize interoception over other sensory modalities and can thus adjust the relative precision of their interoceptive priors and prediction errors, where appropriate, given their personal history. This characterization explains key findings within the interoception literature; links results previously seen as unrelated or contradictory; and may have important implications for understanding cognitive, behavioural and psychopathological consequences of both high and low interoceptive awareness. This article is part of the themed issue 'Interoception beyond homeostasis: affect, cognition and mental health'. [ABSTRACT FROM AUTHOR]

Background: Interoceptive abilities are known to be affected in anorexia nervosa (AN). Previous studies could show that private self-focus can enhance interoceptive accuracy (IAcc) in healthy participants. As body dissatisfaction is high in AN, confrontation with bodily features such as the own face might have a directly opposed effect in AN. Whether patients with AN can benefit from self-focus in their IAcc and whether this pattern changes over the time-course of cognitive behavioral therapy was investigated in this study. Methods: Fifteen patients with AN from the Psychosomatic Clinic in Windach were assessed three times in the time course of a standardized cognitive-behavioral therapy. They were compared to 15 controls, recruited from Ulm University and tested in a comparable setting. Both groups performed the heartbeat perception task assessing IAcc under two conditions either enhancing ("Self") or decreasing ("Other") self-focused attention. Furthermore, body dissatisfaction was assessed by a subscale of the Eating Disorder (ED) Inventory 2. Results: Patients with AN scored higher in IAcc when watching others' faces as compared to one's own face while performing the heartbeat perception task. The opposite pattern was observed in controls. IAcc remained reduced in AN as compared to controls in the time-course of cognitive-behavioral therapy, while body-dissatisfaction improved in AN. High body dissatisfaction was related to poorer IAcc in the "Self" condition. Conclusions: Our findings suggest that using self-focused attention reduces IAcc in AN while the opposite pattern was observed in controls. Confronting anorexic patients with bodily features might increase body-related avoidance and therefore decrease IAcc. The current study introduces a new perspective concerning the role of interoceptive processes in AN and generates further questions regarding the therapeutic utility of methods targeting self-focus in the treatment of AN. [ABSTRACT FROM AUTHOR]

Error awareness has been argued to depend on sensory feedback and interoceptive awareness (IA) ( Ullsperger, Harsay, Wessel, & Ridderinkhof, 2010 ). We recorded EEG while participants performed a speeded Go/No-Go task in which they signaled error commission. Visibility of the effector was manipulated, while IA was measured with a heartbeat perception task. The late Pe was larger for aware than unaware errors. The ERN was also found to be modulated by error awareness, but only when the hand was visible, suggesting that its sensitivity to error awareness depends on the availability of visual sensory feedback. Only when the response hand was visible, the late Pe amplitude to aware errors correlated with IA, suggesting that sensory feedback and IA synergistically contribute to the emergence of error awareness. These findings underscore the idea that several sources of information accumulate in time following action execution in order to enable errors to break through and reach awareness. [ABSTRACT FROM AUTHOR]