Interoception and Mental Health: A Roadmap.

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Abstract

Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. However, a number of conceptual and methodological challenges have made it difficult for interoceptive constructs to be broadly applied in mental health research and treatment settings. In November 2016, the Laureate Institute for Brain Research organized the first Interoception Summit, a gathering of interoception experts from around the world, with the goal of accelerating progress in understanding the role of interoception in mental health. The discussions at the meeting were organized around four themes: interoceptive assessment, interoceptive integration, interoceptive psychopathology, and the generation of a roadmap that could serve as a guide for future endeavors. This review article presents an overview of the emerging consensus generated by the meeting.

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Interoceptive inference, emotion, and the embodied self.

Anil K. Seth (2013)

The concept of the brain as a prediction machine has enjoyed a resurgence in the context of the Bayesian brain and predictive coding approaches within cognitive science. To date, this perspective has been applied primarily to exteroceptive perception (e.g., vision, audition), and action. Here, I describe a predictive, inferential perspective on interoception: 'interoceptive inference' conceives of subjective feeling states (emotions) as arising from actively-inferred generative (predictive) models of the causes of interoceptive afferents. The model generalizes 'appraisal' theories that view emotions as emerging from cognitive evaluations of physiological changes, and it sheds new light on the neurocognitive mechanisms that underlie the experience of body ownership and conscious selfhood in health and in neuropsychiatric illness. Copyright © 2013 Elsevier Ltd. All rights reserved.

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Interoceptive predictions in the brain.

Lisa Feldman Barrett, W Simmons (2015)

Intuition suggests that perception follows sensation and therefore bodily feelings originate in the body. However, recent evidence goes against this logic: interoceptive experience may largely reflect limbic predictions about the expected state of the body that are constrained by ascending visceral sensations. In this Opinion article, we introduce the Embodied Predictive Interoception Coding model, which integrates an anatomical model of corticocortical connections with Bayesian active inference principles, to propose that agranular visceromotor cortices contribute to interoception by issuing interoceptive predictions. We then discuss how disruptions in interoceptive predictions could function as a common vulnerability for mental and physical illness.

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Interoception in anxiety and depression

Martin Paulus, Murray Stein (2010)

We review the literature on interoception as it relates to depression and anxiety, with a focus on belief, and alliesthesia. The connection between increased but noisy afferent interoceptive input, self-referential and belief-based states, and top-down modulation of poorly predictive signals is integrated into a neuroanatomical and processing model for depression and anxiety. The advantage of this conceptualization is the ability to specifically examine the interface between basic interoception, self-referential belief-based states, and enhanced top-down modulation to attenuate poor predictability. We conclude that depression and anxiety are not simply interoceptive disorders but are altered interoceptive states as a consequence of noisily amplified self-referential interoceptive predictive belief states.

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Author and article information

Journal

Journal ID (iso-abbrev): Biol Psychiatry Cogn Neurosci Neuroimaging

Title: Biological psychiatry. Cognitive neuroscience and neuroimaging

Publisher: Elsevier BV

ISSN (Electronic): 2451-9030

ISSN (Print): 2451-9022

Publication date (Electronic): June 2018

Volume: 3

Issue: 6

Affiliations

[1 ] Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma. Electronic address: skhalsa@laureateinstitute.org.

[2 ] California Institute of Technology, Pasadena, California.

[3 ] Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.

[4 ] Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom.

[5 ] Department of Physiology, University of Florida, Gainesville, Florida.

[6 ] Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.

[7 ] Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California.

[8 ] Department of Psychiatry, University of Arizona, Tucson, Arizona.

[9 ] Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.

[10 ] Department of Psychology, Southern Methodist University, Dallas, Texas.

[11 ] Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, Florida.

[12 ] Department of Neurology, Johns Hopkins University, Baltimore, Maryland.

[13 ] Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland.

[14 ] Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.

[15 ] Department of Psychology, University of Tulsa, Tulsa, Oklahoma.

[16 ] Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland; Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland.

[17 ] Department of Psychiatry, University of California, San Diego, San Diego, California.

[18 ] Department of Health Psychology, University of Leuven, Leuven, Belgium.

[19 ] Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma.

Article

Publisher Item ID: S2451-9022(17)30234-3 Mid ID: NIHMS973241

DOI: 10.1016/j.bpsc.2017.12.004

PMC ID: 6054486

PubMed ID: 29884281

SO-VID: b3a835d4-971b-40f8-afc3-bf440548b2df

History

Keywords: Biomarker,Computational psychiatry,Interoception,Mental health,Research Domain Criteria,Treatment

Data availability:

Keywords: Biomarker, Computational psychiatry, Interoception, Mental health, Research Domain Criteria, Treatment

Interoception and Mental Health: A Roadmap.

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Special series on COVID-19 and Mental Health

Most cited references 119

Interoceptive inference, emotion, and the embodied self.

Interoceptive predictions in the brain.

Interoception in anxiety and depression

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