Interoception in mental disorders: from self-awareness to interventions

Submitted: April 17, 2024
Accepted: May 24, 2024
Published: June 18, 2024
Abstract Views: 1164
PDF: 200
Supplementary: 84
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Authors

  • Han-xue Yang School of Psychology, Beijing Language and Culture University, Beijing, China.
  • Han-yu Zhou Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
  • Simon S.Y. Lui Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
  • Raymond C.K. Chan rckchan@psych.ac.cn Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences; CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.

Interoception, the sense of the physiological condition of our body, has been proposed as a common vulnerability factor for psychopathology. Despite evidence confirming the relationship between interoception and a wide variety of clinical conditions, and multiple attempts to improve interoception in the cardiac domain, it remains debatable whether interoception can be altered through behavioural or meditative interventions. The present paper intends to review this issue and propose a theoretical framework encompassing self-awareness, interoceptive awareness, neuroplasticity, and biofeedback. We propose that a four-domain interoceptive intervention approach (cardiac, respiratory, thermal and muscular interoception) may be efficient and effective for training interoceptive abilities, which might in turn alleviate psychopathologies.

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Citations

Ardizzi M, Ambrosecchia M, Buratta L, et al. (2016). Interoception and positive symptoms in schizophrenia. Front Human Neurosci 10:379.
Baumeister R (1999). The nature and structure of the self: An overview. In: R. Baumeister, editor. The self in social psychology. Philadelphia: Psychology Press; p. 1–21.
Berner LA, Simmons AN, Wierenga CE, et al. (2019). Altered anticipation and processing of aversive interoceptive experience among women remitted from bulimia nervosa. Neuropsychopharmacology 44:1265–73.
Borhani K, Làdavas E, Fotopoulou A, Haggard P (2017). “Lacking warmth”: alexithymia trait is related to warm-specific thermal somatosensory processing. Biol Psychol 128:132–40.
Brewer R, Murphy J, Bird G (2021). Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 130:470-508.
Caspi A, Houts RM, Belsky DW, et al. (2014). The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clin Psychol Sci 2:119-37.
Ceunen E, Vlaeyen JWS, Van Diest I (2016). On the origin of interoception. Front Psychol 7:743.
Craig AD (2002). How do you feel? Interoception: The sense of the physiological condition of the body. Nat Rev Neurosci 3:655-66.
Craig AD (2009). How do you feel - now? The anterior insula and human awareness. Nat Rev Neurosci 10:59-70.
Critchley HD, Harrison NA (2013). Visceral influences on brain and behavior. Neuron 77:624-38.
Critchley H, Eccles J, van Praag CG, et al. (2018). Interoceptive gating of anxiety and fear, a novel target for anxiety treatment. Biol Psychiat 83:S13.
D'Antoni F, Feruglio S, Matiz A, et al. (2022). Mindfulness meditation leads to increased dispositional mindfulness and interoceptive awareness linked to a reduced dissociative tendency. J Trauma Dissociation 23:8-23.
Farb NAS, Segal ZV, Anderson AK (2013). Mindfulness meditation training alters cortical representations of interoceptive attention. Soc Cogn Affect Neurosci 8:15-26.
Garfinkel SN, Tiley C, O'Keeffe S, et al. (2016). Discrepancies between dimensions of interoception in autism: Implications for emotion and anxiety. Biol Psychol 114:117-26.
Godde B, Erhardt J, Braun C (2003). Behavioral significance of input-dependent plasticity of human somatosensory cortex. Neuroreport 14:543-6.
Gottfried JA, O’Doherty J, Dolan RJ (2002). Appetitive and aversive olfactory learning in humans studied using event-related functional magnetic resonance imaging. J Neurosci 22:10829-37.
Harshaw C (2015). Interoceptive dysfunction: toward an integrated framework for understanding somatic and affective disturbance in depression. Psychol Bull 141:311-63.
Harver A, Katkin ES, Bloch E (1993). Signal-detection outcomes on heartbeat and respiratory resistance detection tasks in male and female subjects. Psychophysiology 30:223-30.
Herbert BM, Herbert C, Pollatos O (2011). On the relationship between interoceptive awareness and alexithymia: Is interoceptive awareness related to emotional awareness? J Pers 79:1149-75.
Hogeveen J, Bird G, Chau A, et al. (2016). Acquired alexithymia following damage to the anterior insula. Neuropsychologia 82:142-8.
Jancke L, Gaab N, Wustenberg T, et al. (2001). Short-term functional plasticity in the human auditory cortex: an fMRI study. Brain Res Cogn Brain Res 12:479-85.
Katkin ES, Reed SD, Deroo C (1983). A methodological analysis of 3techniques for the assessment of individual differences in heartbeat detection. Psychophysiology 20:452.
Khalsa SS, Rudrauf D, Sandesara C, et al. (2009). Bolus isoproterenol infusions provide a reliable method for assessing interoceptive awareness. Int J Psychophysiol 72:34–45.
Khalsa SS, Hassanpour MS, Strober M, et al. (2018). Interoceptive anxiety and body representation in anorexia nervosa. Front Psychiatry 9:444.
Krautwurst S, Gerlach AL, Gomille L, et al. (2014). Health anxiety - an indicator of higher interoceptive sensitivity? J Behav Ther Exp Psychiatry 45:303-9.
Krieghoff V, Waszak F, Prinz W, Brass M (2011). Neural and behavioral correlates of intentional actions. Neuropsychologia 49:767–76.
Meyerholz L, Irzinger J, Witthoeft M, et al. (2019). Contingent biofeedback outperforms other methods to enhance the accuracy of cardiac interoception: A comparison of short interventions. J Behav Ther Exp Psychiatry 63:12-20.
Murphy J, Catmur C, Bird G (2018). Alexithymia is associated with a multidomain, multidimensional failure of interoception: evidence from novel tests. J Exp Psychol Gen 147:398-408.
Musculus L, Tünte MR, Raab M, Kayhan E (2021). An embodied cognition perspective on the role of interoception in the development of the minimal self. Front Psychol 12:716950.
Palmer CE, Tsakiris M (2018). Going at the heart of social cognition: Is there a role for interoception in self-other distinction? Curr Opin Psychol 24:21-6.
Palser ER, Fotopoulou A, Pellicano E, Kilner JM (2018). The link between interoceptive processing and anxiety in children diagnosed with autism spectrum disorder: Extending adult findings into a developmental sample. Biol Psychol 136:13-21.
Park H-D, Bernasconi F, Bello-Ruiz J, et al. (2016). Transient modulations of neural responses to heartbeats covary with bodily self-consciousness. J Neurosci 36:8453-60.
Plans D, Ponzo S, Morelli D, et al. (2021). Measuring interoception: The phase adjustment task. Biol Psychol 165:108171.
Quadt L, Garfinkel SN, Mulcahy JS, et al. (2021). Interoceptive training to target anxiety in autistic adults (ADIE) A single-center, superiority randomized controlled trial. EClinicalMedicine 39:101042.
Quattrocki E, Friston K (2014). Autism, oxytocin and interoception. Neurosci Biobehav Rev 47:410-30.
Schandry R (1981). Heart beat perception and emotional experience. Psychophysiology 18:483-8.
Schandry R, Weitkunat R (1990). Enhancement of heartbeat-related brain potentials through cardiac awareness training. Int J Neurosci 53:243-53.
Schauder KB, Mash LE, Bryant LK, Cascio C J (2015). Interoceptive ability and body awareness in autism spectrum disorder. J Exp Child Psychol 131:193–200.
Schillings C, Karanassios G, Schulte N, et al. (2022). The effects of a 3-week heartbeat perception training on interoceptive abilities. Front Neurosci 16:838055.
Seth AK (2013). Interoceptive inference, emotion, and the embodied self. Trends Cogn Sci 17:565-73.
Seth AK, Tsakiris M (2018). Being a beast machine: the somatic basis of selfhood. Trends Cogn Sci 22:969-81.
Smith AR, Kinkel-Ram S, Grunwald W, et al.(2022). A pilot feasibility study of reconnecting to internal sensations and experiences (RISE), a mindfulness-informed intervention to reduce interoceptive dysfunction and suicidal ideation, among university students in India. Brain Sci 12:237.
Tsakiris M (2017). The multisensory basis of the self: From body to identity to others. Q J Exp Psychol (Hove) 70:597-609.
Van Dyck Z, Vögele C, Blechert J, et al. (2016). The water load test as a measure of gastric interoception: development of a two-stage protocol and application to a healthy female population. PLoS One 11:e0163574.
Yang HX, Zhou HY, Zheng H, et al. (2022). individuals with autistic traits exhibit heightened alexithymia but intact interoceptive-exteroceptive sensory integration. J Autism Dev Disorde 52:3142-52.
Zaman J, Weltens N, Ly HG, et al. (2016). Influence of interoceptive fear learning on visceral perception. Psychosom Med 78:248-58.

How to Cite

Yang, H.- xue, Zhou, H.- yu, Lui, S. S., & Chan, R. C. (2024). Interoception in mental disorders: from self-awareness to interventions. Proceedings of the European Academy of Sciences and Arts, 3. https://doi.org/10.4081/peasa.32