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      Impact of intranasal oxytocin on interoceptive accuracy in alcohol users: an attentional mechanism?

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          Abstract

          Interoception, i.e. the perception and appraisal of internal bodily signals, is related to the phenomenon of craving, and is reportedly disrupted in alcohol use disorders. The hormone oxytocin influences afferent transmission of bodily signals and, through its potential modulation of craving, is proposed as a possible treatment for alcohol use disorders. However, oxytocin’s impact on interoception in alcohol users remains unknown. Healthy alcohol users ( n = 32) attended two laboratory sessions to perform tests of interoceptive ability (heartbeat tracking: attending to internal signals and, heartbeat discrimination: integrating internal and external signals) after intranasal administration of oxytocin or placebo. Effects of interoceptive accuracy, oxytocin administration and alcohol intake, were tested using mixed-effects models. On the tracking task, oxytocin reduced interoceptive accuracy, but did not interact with alcohol consumption. On the discrimination task, we found an interaction between oxytocin administration and alcohol intake: Oxytocin, compared with placebo, increased interoceptive accuracy in heavy drinkers, but not in light social drinkers. Our study does not suggest a pure interoceptive impairment in alcohol users but instead potentially highlights reduced flexibility of internal and external attentional resource allocation. Importantly, this impairment seems to be mitigated by oxytocin. This attentional hypothesis needs to be explicitly tested in future research.

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          Interoception in anxiety and depression

          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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            Alcohol myopia. Its prized and dangerous effects.

            This article explains how alcohol makes social responses more extreme, enhances important self-evaluations, and relieves anxiety and depression, effects that underlie both the social destructiveness of alcohol and the reinforcing effects that make it an addictive substance. The theories are based on alcohol's impairment of perception and thought--the myopia it causes--rather than on the ability of alcohol's pharmacology to directly cause specific reactions or on expectations associated with alcohol's use. Three conclusions are offered (a) Alcohol makes social behaviors more extreme by blocking a form of response conflict. (b) The same process can inflate self-evaluations. (c) Alcohol myopia, in combination with distracting activity, can reliably reduce anxiety and depression in all drinkers by making it difficult to allocate attention to the thoughts that provoke these states. These theories are discussed in terms of their significance for the prevention and treatment of alcohol abuse.
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              Oxytocin attenuates amygdala responses to emotional faces regardless of valence.

              Oxytocin is known to reduce anxiety and stress in social interactions as well as to modulate approach behavior. Recent studies suggest that the amygdala might be the primary neuronal basis for these effects. In a functional magnetic resonance imaging study using a double-blind, placebo-controlled within-subject design, we measured neural responses to fearful, angry, and happy facial expressions after intranasal application of 24 IU oxytocin compared with placebo. Oxytocin reduced right-sided amygdala responses to all three face categories even when the emotional content of the presented face was not evaluated explicitly. Exploratory whole brain analysis revealed modulatory effects in prefrontal and temporal areas as well as in the brainstem. Results suggest a modulatory role of oxytocin on amygdala responses to facial expressions irrespective of their valence. Reduction of amygdala activity to positive and negative stimuli might reflect reduced uncertainty about the predictive value of a social stimulus and thereby facilitates social approach behavior.
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                Author and article information

                Journal
                Soc Cogn Affect Neurosci
                Soc Cogn Affect Neurosci
                scan
                Social Cognitive and Affective Neuroscience
                Oxford University Press
                1749-5016
                1749-5024
                April 2018
                28 March 2018
                28 March 2018
                : 13
                : 4
                : 440-448
                Affiliations
                [1 ]Clinical Imaging Science Centre, Brighton and Sussex Medical School, Brighton BN1 9RY, UK
                [2 ]Psychology Department, University of Sussex, Brighton BN1 9RR, UK
                [3 ]SCALab, CNRS UMR 9193, University of Lille, Lille 59045, France
                [4 ]Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
                [5 ]Sussex Addiction Research and Intervention Centre (SARIC), University of Sussex, BN1 9RR, UK
                [6 ]Sackler Centre for Consciousness Science, University of Sussex, BN1 9QJ, UK
                Author notes
                Correspondence should be addressed to Sophie Betka, Neuroscience Department, Trafford Centre, Clinical Imaging Science Centre, Brighton and Sussex Medical School, Brighton BN1 9RY, UK. E-mail: s.betka@ 123456bsms.ac.uk .
                Author information
                http://orcid.org/0000-0001-9548-4391
                http://orcid.org/0000-0002-4029-3720
                Article
                nsy027
                10.1093/scan/nsy027
                5928407
                29618101
                942b5e59-6a71-4827-b490-32ce2955c6d1
                © The Author(s) (2018). Published by Oxford University Press.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 07 December 2017
                : 16 February 2018
                : 19 March 2018
                Page count
                Pages: 9
                Funding
                Funded by: Rotary Foundation 10.13039/100004460
                Funded by: European Research Council 10.13039/100010663
                Award ID: CCFIB AG 234150
                Categories
                Original Articles

                Neurosciences
                alcohol,addiction,alcohol use,oxytocin,interoception,attention
                Neurosciences
                alcohol, addiction, alcohol use, oxytocin, interoception, attention

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