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At least 19 recordsLinked to original sources
PubMed2006

Interoceptive hypersensitivity and interoceptive exposure in patients with panic disorder: specificity and effectiveness.

BACKGROUND: Interoceptive exposure has been validated as an effective component of cognitive behavioral therapy (CBT) for the treatment of panic disorder but has hitherto received little research attention. We examined the effectiveness of various interoceptive exposure exercises using the Body Sensations Questionnaire (BSQ) (Chambless et al., 1984). METHODS: We first performed an exploratory principal factor analysis of all the items contained in the BSQ to obtain meaningful dimensions of interoceptive fears. Next, we examined the correlations between each interoceptive exposure task's degree of similarity to panic attacks and each BSQ factor and then examined whether the BSQ factor scores decreased in comparison with the baseline values when the corresponding exposure tasks were successfully completed by the subjects. RESULTS: The factor analyses revealed four factors, which we named "pseudoneurological fears", "gastrointestinal fears", "cardiorespiratory fears" and "fears of dissociative feelings." Among the nine interoceptive exposure tasks, 'hyperventilation', 'shaking head', 'holding breath' and 'chest breathing' were considered to reproduce pseudoneurological symptoms, 'breathing through a straw' was considered to reproduce gastrointestinal symptoms, and 'spinning' was considered to reproduce both pseudoneurological and dissociative symptoms; none of the interoceptive exercises were found to reproduce cardiorespiratory symptoms. Among each group of patients for whom 'hyperventilation', 'holding breath', 'spinning' or 'chest breathing' was effective, a significant improvement in the BSQ pseudoneurological fears factor scores was observed. On the other hand, no significant difference between the baseline and endpoint values of the BSQ gastrointestinal fears or the BSQ fears of dissociative feelings factor scores were observed among the patients for whom 'spinning' or 'breathing through a straw' was effective. CONCLUSION: Several interoceptive exposure tasks were particularly effective in reducing pseudoneurological fears. New interoceptive tasks, especially tasks related to cardiorespiratory and dissociative feelings, are needed.

Adult↗
PubMed2000

Prefrontal dopamine is directly involved in the anxiogenic interoceptive cue of pentylenetetrazol but not in the interoceptive cue of chlordiazepoxide in the rat.

RATIONALE: The prefrontal cortical (PFC) dopamine (DA) system has been implicated in anxiety-related behavioral changes, but direct, unequivocal support for this idea is sparse. OBJECTIVES: The present aim was to study the functional significance of prefrontal DA using the pentylenetetrazol (PTZ) discrimination model of anxiety. A comparison was made with its role in the cue of the anxiolytic drug chlordiazepoxide (CDP). METHODS: Two groups of rats were trained to discriminate either PTZ (20 mg/kg, s.c.) or CDP (10 mg/kg, i.p.) from saline using an operant drug discrimination procedure. After prolonged training, half of each group was used to assess biochemical changes induced by both drugs in different sub areas of the PFC. For the remaining rats, discrimination training continued and generalization tests with PTZ and CDP were performed. Rats were then provided with bilateral guide cannulae aimed at the ventromedial (vm) PFC, and the effects of local infusions of DAergic drugs on discriminative performance were evaluated. RESULTS: CDP did not affect PFC DA activity, but PTZ increased the DOPAC/DA ratio in the vmPFC selectively. Generalization tests showed that the cues of PTZ and CDP were dose dependent. In PTZ-trained rats, infusions of the DA receptor antagonist cis-flupenthixol into the vmPFC blocked the PTZ cue dose dependently, whereas the agonist apomorphine partially generalized to this cue. In CDP-trained rats, neither drug antagonized or generalized to the CDP cue, showing that PFC DA is not critically involved in the CDP cue and that local pharmacological manipulations of PFC DA do not affect discriminative abilities per se. CONCLUSIONS: The DAergic innervation of the PFC is directly involved in the behavioral effects of PTZ suggesting a role for it in anxiety.

Animals↗
PubMed1977

The role of interoception in learned visceral control.

Research concerned with the psychology and physiology of interoceptive processes is reviewed with the purpose of evaluating theoretical formulations of learned visceral control. Basic animal research in interoception provides relevant information; however, much research dealing directly with interoception and learned control is inadequate due either to inappropriate measurement of interoceptive ability or to poor experimental design. The two primary theoretical orientations linking interoception and learned visceral control differ according to the role ascribed to external feedback; the first views feedback as an enhancement of interoceptive cues, the second as an enhancement of exteroceptive cues. These theories are discussed with regard to recent investigations of learned visceral control.

Afferent Pathways↗
PubMed2005

Interoceptive exposure therapy combined with trauma-related exposure therapy for post-traumatic stress disorder: a case report.

Trauma-related exposure therapy is a useful but not universally effective treatment for post-traumatic stress disorder. Anxiety sensitivity may play an important role in this disorder, as it does in panic disorder. Studies have shown that interoceptive exposure therapy reduces anxiety sensitivity in panic disorder. The present case study was a preliminary investigation of the merits of including interoceptive exposure therapy in the treatment of post-traumatic stress disorder, in order to improve treatment outcome for a patient who had no history of panic disorder or panic attacks. Interoceptive exposure therapy (4 sessions) was one component of treatment, combined with trauma-related exposure therapy (4 sessions of imaginal exposure followed by 4 sessions of in vivo exposure). Treatment outcome was assessed with the Clinician-Administered Post-traumatic Stress Disorder Scale, a self-report measure of post-traumatic stress disorder symptoms, and measures of symptoms and cognitions commonly associated with post-traumatic stress disorder. Scores on all outcome measures decreased over the course of treatment, with gains maintained at 1- and 3-month follow-up. Symptoms of anxiety sensitivity and post-traumatic stress disorder decreased during interoceptive exposure therapy. The results indicate that interoceptive exposure therapy is a promising adjunctive intervention for post-traumatic stress disorder. Further research is needed into the merits of combining interoceptive exposure therapy and trauma-related exposure therapy as a means of boosting treatment efficacy.

Accidents, Traffic↗
PubMed2005

Interoception in emotional experience.

PURPOSE OF REVIEW: Many theories of emotion have postulated a close relationship of the feedback of physiological changes and their perception with emotional experience. This paper reviews recent advances in theory and brain-imaging research on this topic of interoception and describes a hypothetical model of the potential mechanisms. RECENT FINDINGS: Research from patients with spinal-cord injuries and pure autonomic failure suggests that emotion-related peripheral autonomic changes are not necessary for emotional experience. However, in support of a role for centrally integrated feedback from the whole body, imaging studies found that activations in areas commonly associated with interoception and emotion (anterior insula and anterior cingulate) were correlated with individual differences in interoception (heartbeat detection) and trait measures of emotion. Because recent theory distinguishes between two levels of emotional experience (phenomenology and awareness), this paper proposes a hypothetical model of the effects of interoception on phenomenology and awareness. This model classifies interoception into the central representation of feedback from the whole body, the perception of actual physiological changes as well as the perception of illusory changes. SUMMARY: Consistent with recent theories of emotion, evidence from brain imaging supports the notion that centrally integrated feedback from the whole body plays a role in emotional experience. Because research on neural correlates of emotional experience is at an early stage, the hypothesized model of potential causal links between interoception and emotional experience might serve as a helpful guide to future research.

Autonomic Nervous System↗
PubMed2007

Neural systems connecting interoceptive awareness and feelings.

In many theories of emotions the representations of bodily responses play an important role for subjective feelings. We tested the hypothesis that the perception of bodily states is positively related to the experienced intensity of feelings as well as to the activity of first-order and second-order brain structures involved in the processing of feelings. Using a heartbeat perception task, subjects were separated into groups with either high or poor interoceptive awareness. During emotional picture presentation we measured high-density EEG and used spatiotemporal current density reconstruction to identify regions involved in both interoceptive awareness and emotion processing. We observed a positive relation between interoceptive awareness and the experienced intensity of emotions. Furthermore, the P300 amplitudes to pleasant and unpleasant pictures were enhanced for subjects with high interoceptive awareness. The source reconstruction revealed that interoceptive awareness is related to an enhanced activation in both first-order structures (insula, somatosensory cortices) and second-order structures (anterior cingulate, prefrontal cortices). We conclude that the perception of bodily states is a crucial determinant for the processing and the subjective experience of feelings.

Adolescent↗
PubMed2005

Mild interoceptive stressors affect learning and reactivity to contextual cues: toward understanding the development of unexplained illnesses.

Contextual learning is evident with repeated experiences with agents and treatments that induce frank illness and interoceptive stress. Here, we examined whether acute treatment with mild interoceptive stressors (low doses of pyridostigmine bromide (PB), neostigmine bromide (NB), and interleukin (IL)-1beta) may serve as unconditional stimuli supporting contextual learning. Rats were exposed to interoceptive and exteroceptive stressors in contexts distinguished by visual or olfactory cues. Acoustic startle responses (ASRs) were measured the day following exposure and 2 weeks thereafter, without delivery of the unconditional stimuli. The appearance, form, and duration of startle potentiation depended on the distinguishing features of the context and the nature of the interoceptive stressor. Rats given cholinesterase inhibitors (PB and NB), but not IL-1beta or exposed to an exteroceptive stressor, exhibited exaggerated ASRs in a novel context distinguished by visual cues. Treatment with either PB or IL-1beta led to potentiated ASRs in the presence of odors congruent with those experiences during exposure to the stressor. Startle potentiation by odor was still apparent 2 weeks after treatment. For contexts differentiated by visual stimuli, cholinomimetics transiently alter reactivity within novel contexts. In the case of contexts differentiated by odors, learning is apparent at least 2 weeks after acute treatment of cholinomimetics and IL-1beta. Contextual learning and changes in reactivity consequent to mild interoceptive stressors such as PB may play a role in the development of nonspecific symptoms typical of unexplained illnesses, such as Gulf War Illness.

Animals↗
PubMed1992

Emergent equivalence relations between interoceptive (drug) and exteroceptive (visual) stimuli.

Conditional "if-then" relations between drug (interoceptive) stimuli and visual (exteroceptive) stimuli were taught to 4 normal humans. Interoceptive stimuli were the effects produced by 0.32 mg/70 kg triazolam (a prototypical benzodiazepine) and placebo (lactose-filled capsules); exteroceptive stimuli were black symbols on white flash cards. Following the training of the prerequisite conditional relations, tests of emergent relations were conducted between exteroceptive stimuli and between interoceptive and exteroceptive stimuli. Equivalence relations emerged immediately without explicit training for all 4 subjects. Accuracy of responding during the interoceptive-exteroceptive equivalence tests and subjects' self-reports showed consistent discrimination between the drug effects of triazolam and placebo. Finally, a generalization test assessed whether a novel visual stimulus presented in the context of the placebo (i.e., no drug) would generalize to visual stimuli belonging to the placebo stimulus class. All 3 subjects who completed this test reliably chose the visual stimuli belonging to the placebo class and not the visual stimuli belonging to the triazolam stimulus class. The development of equivalence relations between interoceptive and exteroceptive stimuli demonstrates that private and public stimulus events can emerge as members of the same equivalence class. Theoretical and clinical implications are discussed.

Adult↗
PubMed1992

[Comparison of two different methods for measuring interoception of obstructions in asthma patients].

For measuring the interoception of airway resistance, bronchial obstructions are often simulated by flow-resistive loads applied externally (i.e. outside the body) into the respiratory flow. However, it is open to doubt whether interoception characteristics obtained in this manner are really related to the clinical pattern of complaints of asthmatic patients. Possibly such externally applied resistance simulates merely an aspect of the physics of apnoea but not a clinical and hence also psychological aspect of the same. To estimate the significance of these aspects for the perception of obstructions, this ability was measured in 25 asthmatic patients first by means of external added loads; this test was then repeated by noting the subjective assessment of bronchial obstructions caused during a routine histamine provocation test. Both interoception parameters correlated only slightly (rxy = 0.31) which is discussed as a pointer to the assumption that, among other parameters, psychological factors may considerably modify the perception of flow resistivity. No correlations were seen between the characteristic interoception value obtained by means of mesh resistivities and the different variables of the clinical pattern of symptoms. On the other hand, the interoception parameter measured on the basis of bronchial obstructions revealed significant connections with several clinical variables: the greatly increased incidence of respiratory distress at night or during certain external conditions, coping medication, physical exercise and style. It is concluded that only such parameters of perception of obstructions are clinically relevant for patients suffering from asthma, which consider not only the somaticophysical but also the psychic component of asthmatic respiratory distress.

Adolescent↗
PubMed1996

Interoceptive sensory signals produced by 24-hr food deprivation, pharmacological glucoprivation, and lipoprivation.

The energy antimetabolites 2-deoxy-D-glucose (2-DG) and Na-2-mercaptoacetate (MA) both reliably augment food intake in rats. The present research was designed to assess if they also give rise to interoceptive cues like 24-hr food deprivation. Rats were first trained to discriminate a mild shock based on interoceptive cues arising from 1- and 24-hr food deprivation. They were then tested for generalized control of conditioned responding to interoceptive cues produced by 2-DG, MA, and saline. Results suggest that 2-DG (350 mg/kg) produces interoceptive sensory cues like those following 24-hr food deprivation. Further, no evidence was found to suggest that MA, either alone or in combination with 2-DG (100 mg/kg), produces interoceptive cues like 2-DG or 24-hr food deprivation.

Animals↗
PubMedDate not supplied

Some neurophysiological mechanisms of the perception of interoceptive signals.

The principal objective of this study consisted in the identification of some basic mechanisms of the perception of the interoceptive signal. The EEG activation reaction through mechanoreceptive stimulation of the stomach served as the indicator. A positive relationship was found between the intensity of the activation reaction and the intensity of the stimulus employed; the extinguishability of the reaction in response to repeatedly acting interoceptive stimuli was also found. The characteristic features of the EEG activation reaction during an interoceptive effect and the characteristic on- and off-responses (the development of the reaction at the beginning and ending of the action of the stimulus) were identified. The data presented are aimed at the disclosure of the interaction of the elements of the dual function of the interoceptive analyzer: as a feedback signal for the central apparatus subserving the control of visceral functions and as an important element of the nonspecific activation of the brain.

Animals↗
PubMed1985

Heart beat interoception: a study of individual differences.

There were two principal aims of the study: to carry out preliminary evaluation of a novel heartbeat tracking technique for objectively measuring cardiac interoception; and to determine whether good and poor heartbeat perceivers could be differentiated with respect to other parameters reflecting individual differences in emotionality, including gender and 'emotional character'. Subjects first completed a battery of self-report questionnaires designed to measure characteristics of emotional experience, and then underwent a series of heartbeat tracking trials in which they used the index finger to tap in synchrony with their ongoing heartbeat activity (interoceptive tracking) and also with an audiotape of pre-recorded heartbeat sounds (exteroceptive tracking). The perceptual index was based on the variability of beat to tap latency. Concurrent validity findings suggested that the tracking index reflects a promising measure of cardiac interoceptive acuity. Good perceivers were found to have higher heart-rate measures than poor perceivers. With regard to 'emotional character' good perceivers had higher state anxiety, and were less emotionally expressive, although these differences were only marginally significant (P less than 0.08) with multivariate testing. Applications of the heartbeat tracking technique for further empirical evaluation of the role of interoception in emotion are discussed.

Adolescent↗
PubMed1996

Interoception.

During the last two decades, research on interoception has experienced a surprising renaissance. New experimental approaches and methods have revealed much about the processing of afferent signals from the inner organs of the body, and have allowed more accurate descriptions of these processes, as well as a more accurate determination of their functional significance in the experience and behavior of humans. Besides neuromuscular, respiratory, and gastrointestinal interoceptive processes, the cardiovascular afferent influences are now known to be very important. Invariably, the central questions concern sensitivity to signals from the body, factors which may influence judgement of perception, and the degree to which conventional hypotheses regarding the interoceptive capabilities of humans may require revision. Findings from general psychological and clinical studies have shown that humans may attain remarkable levels of interoceptive performance. On the other hand, they also show how deep the chasm is between visceral processes and perception, and between that which is perceived and the reports thereof. Only interdisciplinary approaches to these complex processes promise success.

Autonomic Nervous System↗