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      Interoception and psychopathology: A developmental neuroscience perspective

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          Highlights

          • Reviews literature on the development of interoception.

          • Atypical interoception may cause onset of psychopathology in adolescence.

          • Atypical interoception may also cause risky behaviour in adolescence.

          • Interoceptive changes may underlie socio-emotional changes in late adulthood.

          Abstract

          Interoception refers to the perception of the physiological condition of the body, including hunger, temperature, and heart rate. There is a growing appreciation that interoception is integral to higher-order cognition. Indeed, existing research indicates an association between low interoceptive sensitivity and alexithymia (a difficulty identifying one’s own emotion), underscoring the link between bodily and emotional awareness. Despite this appreciation, the developmental trajectory of interoception across the lifespan remains under-researched, with clear gaps in our understanding. This qualitative review and opinion paper provides a brief overview of interoception, discussing its relevance for developmental psychopathology, and highlighting measurement issues, before surveying the available work on interoception across four stages of development: infancy, childhood, adolescence and late adulthood. Where gaps in the literature addressing the development of interoception exist, we draw upon the association between alexithymia and interoception, using alexithymia as a possible marker of atypical interoception. Evidence indicates that interoceptive ability varies across development, and that this variance correlates with established age-related changes in cognition and with risk periods for the development of psychopathology. We suggest a theory within which atypical interoception underlies the onset of psychopathology and risky behaviour in adolescence, and the decreased socio-emotional competence observed in late adulthood.

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          Most cited references163

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          Interoceptive inference, emotion, and the embodied self.

          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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            An insular view of anxiety.

            We propose a general hypothesis that integrates affective and cognitive processing with neuroanatomy to explain anxiety pronenes. The premise is that individuals who are prone to anxiety show an altered interoceptive prediction signal, i.e., manifest augmented detection of the difference between the observed and expected body state. As a consequence, the increased prediction signal of a prospective aversive body state triggers an increase in anxious affect, worrisome thoughts and other avoidance behaviors. The anterior insula is proposed to play a key role in this process. Further testing of this model--which should include investigation of genetic and environmental influences--may lead to the development of novel treatments that attenuate this altered interoceptive prediction signal in patients with anxiety disorders.
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              Cognitive, social, and physiological determinants of emotional state.

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                Author and article information

                Contributors
                Journal
                Dev Cogn Neurosci
                Dev Cogn Neurosci
                Developmental Cognitive Neuroscience
                Elsevier
                1878-9293
                1878-9307
                23 December 2016
                February 2017
                23 December 2016
                : 23
                : 45-56
                Affiliations
                [a ]MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
                [b ]School of Psychology, The University of East London, London, UK
                [c ]Institute of Cognitive Neuroscience, UCL, London, UK
                [d ]Dept of Experimental Psychology, University of Oxford, Oxford, UK
                Author notes
                [* ]Corresponding author at: Social, Genetic and Developmental Psychiatry Centre (MRC) Institute of Psychiatry, Psychology and Neuroscience – PO80 De Crespigny Park, Denmark Hill, London SE5 8AF, UK. Jennifer.Murphy@ 123456kcl.ac.uk
                Article
                S1878-9293(16)30127-X
                10.1016/j.dcn.2016.12.006
                6987654
                28081519
                cdadd879-9f10-4f62-9989-83187d0f3c83
                © 2017 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 July 2016
                : 19 December 2016
                : 19 December 2016
                Categories
                Review

                Neurosciences
                interoception,development,psychopathology,emotion,insula,alexithymia
                Neurosciences
                interoception, development, psychopathology, emotion, insula, alexithymia

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