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      Interoception in anxiety and depression

      review-article
      1 , 2 , 3 , , 1 , 2 , 3
      Brain Structure & Function
      Springer-Verlag
      Anxiety, Depression, Interoception, Insula, Belief, Alliesthesia

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          Abstract

          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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          Most cited references134

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          Does rejection hurt? An FMRI study of social exclusion.

          A neuroimaging study examined the neural correlates of social exclusion and tested the hypothesis that the brain bases of social pain are similar to those of physical pain. Participants were scanned while playing a virtual ball-tossing game in which they were ultimately excluded. Paralleling results from physical pain studies, the anterior cingulate cortex (ACC) was more active during exclusion than during inclusion and correlated positively with self-reported distress. Right ventral prefrontal cortex (RVPFC) was active during exclusion and correlated negatively with self-reported distress. ACC changes mediated the RVPFC-distress correlation, suggesting that RVPFC regulates the distress of social exclusion by disrupting ACC activity.
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            Searching for a baseline: functional imaging and the resting human brain.

            Functional brain imaging in humans has revealed task-specific increases in brain activity that are associated with various mental activities. In the same studies, mysterious, task-independent decreases have also frequently been encountered, especially when the tasks of interest have been compared with a passive state, such as simple fixation or eyes closed. These decreases have raised the possibility that there might be a baseline or resting state of brain function involving a specific set of mental operations. We explore this possibility, including the manner in which we might define a baseline and the implications of such a baseline for our understanding of brain function.
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              Interoception: the sense of the physiological condition of the body.

              Converging evidence indicates that primates have a distinct cortical image of homeostatic afferent activity that reflects all aspects of the physiological condition of all tissues of the body. This interoceptive system, associated with autonomic motor control, is distinct from the exteroceptive system (cutaneous mechanoreception and proprioception) that guides somatic motor activity. The primary interoceptive representation in the dorsal posterior insula engenders distinct highly resolved feelings from the body that include pain, temperature, itch, sensual touch, muscular and visceral sensations, vasomotor activity, hunger, thirst, and 'air hunger'. In humans, a meta-representation of the primary interoceptive activity is engendered in the right anterior insula, which seems to provide the basis for the subjective image of the material self as a feeling (sentient) entity, that is, emotional awareness.
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                Author and article information

                Contributors
                +1-858-5349442 , +1-858-5349450 , mpaulus@ucsd.edu
                Journal
                Brain Struct Funct
                Brain Structure & Function
                Springer-Verlag (Berlin/Heidelberg )
                1863-2653
                1863-2661
                21 May 2010
                21 May 2010
                June 2010
                : 214
                : 5-6
                : 451-463
                Affiliations
                [1 ]Department of Psychiatry, University of California, San Diego (UCSD), 8939 Villa La Jolla Drive, La Jolla, CA 92037 USA
                [2 ]Department of Family and Preventive Medicine, University of California, San Diego (UCSD), La Jolla, CA USA
                [3 ]Psychiatry Service, Veterans Affairs San Diego Health Care System, San Diego, USA
                Article
                258
                10.1007/s00429-010-0258-9
                2886901
                20490545
                cce3d7b1-1d89-4dbd-99a4-1f02db0e4636
                © The Author(s) 2010
                History
                : 8 December 2009
                : 21 April 2010
                Categories
                Review
                Custom metadata
                © Springer-Verlag 2010

                Neurology
                depression,belief,interoception,alliesthesia,anxiety,insula
                Neurology
                depression, belief, interoception, alliesthesia, anxiety, insula

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