Clarifying the relationship between alexithymia and subjective interoception

The long-standing hypothesis that emotions rely on bodily states is back in the spotlight. This has led some researchers to suggest that alexithymia, a personality construct characterized by altered emotional awareness, reflects a general deficit in interoception. However, tests of this hypothesis have relied on heterogeneous assessment methods, leading to inconsistent results. To shed some light on this issue, we administered a battery of self-report questionnaires of interoception and alexithymia to three samples from Italy, the U.S., and Singapore (N = 814). Correlation and machine learning analyses showed that alexithymia was associated with deficits in both subjective interoceptive accuracy and attention. Alexithymics’ interoceptive deficits were primarily related to difficulty identifying and describing feelings. Interoception showed a weaker association with externally-oriented thinking as operationalized by the Toronto Alexithymia Scale (TAS-20) and no association with the affective dimension of alexithymia later introduced by the Bermond-Vorst Alexithymia Questionnaire (BVAQ). We discuss our results with reference to the theoretical and psychometric differences between these two measures of alexithymia and their shortcomings. Overall, our results support the view that interoceptive deficits are a core component of alexithymia, although the latter cannot be reduced to the former.

Disrupted interoception by auditory distractor: Difficulty inferring the internal bodily states?

Perception of internal bodily sensations or interoception has recently been studied under a predictive coding framework. In this framework, the brain utilizes both top-down prediction and bottom-up prediction error signals to determine the content of the perception through inferences regarding the cause of the ongoing sensation. Particularly, interoception and other exteroceptive sensory modalities are considered to share an integrated, intertwined process of inference. Thus, it is possible that exteroceptive stimuli interfere with the inference of interoception. Hence, we investigated whether auditory stimuli disrupted interoceptive inference that resulted in diminished awareness of interoception. Thirty healthy volunteers performed the heartbeat counting task with and without distractor sounds. The psychophysiological traits that would reflect the individual differences in prior prediction signals of interoception were measured as the high-frequency component of the heart rate variability (HF-HRV) at rest and trait interoceptive sensibility. The results showed that the auditory distractor diminished objective interoceptive accuracy, subjective confidence in interoception, and the intensity of the heartbeat, suggesting disrupted interoceptive inference under external stimuli. Importantly, individual differences in the distractor effect were modulated by both the HF-HRV and tendency to worry about bodily states. These findings support and extend the predictive coding account of interoception by suggesting that interoceptive inference could be disrupted by external stimuli and that such disruption may be modulated by a difference in prior predictions and its precision regarding interoception.

From pre-processing to advanced dynamic modeling of pupil data

The pupil of the eye provides a rich source of information for cognitive scientists, as it can index a variety of bodily states (e.g., arousal, fatigue) and cognitive processes (e.g., attention, decision-making). As pupillometry becomes a more accessible and popular methodology, researchers have proposed a variety of techniques for analyzing pupil data. Here, we provide recommendations and offer an up-to-date account of how pupil data can be analyzed in hypothesis-testing experiments. We first introduce pupillometry, its neural underpinnings, and the relation between pupil measurements, visual features (e.g., luminance), and other oculomotor behaviors (e.g., blinks, saccades), to stress the importance of understanding what is being measured and what can be inferred from changes in pupillary activity. We discuss pre-processing steps and contend that the insights gained from pupillometry are constrained by the analysis techniques available. Then, in addition to the traditional approach of analyzing mean pupil size within some epoch of interest, we focus on time series-based analyses, which enable one to relate dynamic changes in pupil size over time with dynamic changes in a stimulus series, task of interest, behavioral outcome measures, or other participants' pupil traces. Analytic techniques considered include: correlation (auto-, and cross-, reverse-, and inter/intra-subject-), regression (including temporal response functions), classification, dynamic time warping, phase clustering, magnitude squared coherence, detrended fluctuation analysis, and recurrence quantification analysis. Assumptions of these techniques, and examples of the scientific questions each can address, are outlined, with references to key papers and software packages.

Term or Phrase Usage and Contextual Meaning: A Reexamination of Semantic Issues in Translation

It has been observed that “words do not have meanings but rather meanings have words.” But even more, words and phrases, usually thought of as the basic units of meaning, actually should be seen as having only usages within contexts. These contexts themselves are the elements of communication that activate mental and bodily states and processes, and can be properly thought of as the construal of meaning. Sometimes these contexts of usage are shaped by phonological or grammatical patterns (see B. Bergen), sometimes by sociological factors such as reciprocity (see E. Goffman), and of course most commonly by lexical (usually radial) patterns and categories (traditionally presented as “semantic domains”). Cognitive linguists (e.g., Lakoff, Turner) have been hinting at something like this for a long time, but a clear restatement of what constitutes semantics is overdue.

Enhanced Expectation of External Sensations of the Chest Regulates the Emotional Perception of Fearful Faces

Emotional perception can be shaped by inferences about bodily states. Here, we investigated whether exteroceptive inferences about bodily sensations in the chest area influence the perception of fearful faces. Twenty-two participants received pseudo-electrical acupuncture stimulation at three different acupoints: CV17 (chest), CV23 (chin), and PC6 (left forearm). All stimuli were delivered with corresponding visual cues, and the control condition included visual cues that did not match the stimulated body sites. After the stimulation, the participants were shown images with one of five morphed facial expressions, ranging from 100% fear to 100% disgust, and asked to classify them as fearful or disgusted. Brain activity was measured using functional magnetic resonance imaging during the facial expression classification task. When the participants expected that they would receive stimulation of the chest (CV17), the ratio of fearful to non-fearful classifications decreased compared to the control condition, and brain activities within the periaqueductal gray and the default mode network decreased when they viewed fearful faces. Our findings suggest that bodily sensations around the chest, but not the other tested body parts, were selectively associated with fear perception and that altering external inferences inhibited the perception of fearful faces.

#3083 Fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): an interoceptive predictive coding model of pain and fatigue expression

IntroductionThe aetiology and pathophysiology of fibromyalgia and ME/CFS are poorly characterised but altered inflammatory, autonomic and interoceptive processes have been implicated. Interoception has been conceptualised as a predictive coding process; where top-down prediction signals compare to bottom-up afferents, resulting in prediction error signals indicating mismatch between expected and actual bodily states. Chronic dyshomeostasis and elevated interoceptive prediction error signals have been theorised to contribute to the expression of pain and fatigue in fibromyalgia and ME/CFS.Objectives/AimsTo investigate how altered interoception and prediction error relates to baseline expression of pain and fatigue in fibromyalgia and ME/CFS and in response to an inflammatory challenge.MethodsSixty-five patients with fibromyalgia and/or ME/CFS diagnosis and 26 matched controls underwent baseline assessment: self-report questionnaires assessing subjective pain and fatigue and objective measurements of pressure-pain thresholds. Participants received injections of typhoid (inflammatory challenge) or saline (placebo) in a randomised, double-blind, crossover design, then completed heartbeat tracking task (assessing interoceptive accuracy). Porges Body Questionnaire assessed interoceptive sensibility. Interoceptive prediction error (IPE) was calculated as discrepancy between objective accuracy and subjective sensibility.ResultsPatients with fibromyalgia and ME/CFS had significantly higher IPE (suggesting tendency to over-estimate interoceptive ability) and interoceptive sensibility, despite no differences in interoceptive accuracy. IPE and sensibility correlated positively with all self-report fatigue and pain measures, and negatively with pain thresholds. Following inflammatory challenge, IPE correlated negatively with the mismatch between subjective and objective measures of pain induced by inflammation.ConclusionsThis is the first study to reveal altered interoception processes in patients with fibromyalgia and ME/CFS, who are known to have dysregulated autonomic function. Notably, we found elevated IPE in patients, correlating with their subjective experiences of pain and fatigue. We hypothesise a predictive coding model, where mismatch between expected and actual internal bodily states (linked to autonomic dysregulation) results in prediction error signalling which could be metacognitively interpreted as chronic pain and fatigue. Our results demonstrate potential for further exploration of interoceptive processing in patients with fibromyalgia and ME/CFS, aiding understanding of these poorly defined conditions and providing potential new targets for diagnostic and therapeutic intervention.

Pre-stimulus fluctuations in heart-synchronised neural activity predict subsequent self-association with affective stimuli

We frequently associate ourselves with certain affective attributes (e.g., I am joyful, I am lazy, etc.) and not others. However, little is understood about how such self-associations come about. Interoceptive predictive theories propose that a sense of self, especially in an affective context, results from the brain making inferences about internal bodily states. A key prediction of these theories is that for an affective attribute to be self-associated, it would depend not only on the stimulus, but also non-stimulus-specific fluctuations in one’s bodily state; a hypothesis not yet tested. We measured EEG response synchronised to the cardiac cycle – a common way to measure interoceptive neural processing – prior to the presentation of pleasant and unpleasant adjectives to participants. Participants responded if the adjectives were self-descriptive or not. We found that cardiac-pulse-synchronised neural activity prior to the presentation of unpleasant adjectives predicted whether participants subsequently associated that adjective to themselves. This effect was observed over midfrontal scalp locations, commonly observed in interoceptive neural processing. No such effect was observed for pleasant adjectives, or by randomly shuffling the cardiac peak times to account for non-interoceptive neural differences. Our results confirm a key prediction of interoceptive predictive coding theories – that bodily signals are not just modulated in response to self-related and affective arousal, but that a subjective sense of affective self arises due to neural processing of bodily signals. Our results have important implications for many neuropsychiatric disorders that involve altered self-referential processing of unpleasant stimuli.

The role of exteroceptive and interoceptive awareness in executing socially relevant bodily actions: A naturalistic investigation of greeting behaviour in the UK and Spain

Body awareness is tightly linked to motor action. Non-verbal greetings constitute a behaviour through which an awareness of both, socio-cultural habits (exteroceptive awareness) and internal bodily states (interoceptive awareness) play out to influence the structure of action. To establish the effect of culture on non-verbal greeting behaviours, naturalistic observations were carried out in two countries (Britain and Spain) that are purported to exhibit differences in greeting types. Interoceptive awareness (IA) was subsequently measured in a proportion of observed participants (N = 33) who filled in the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). As expected, a significant difference in greeting type was observed between British (N = 252) and Spanish (N = 244) greeters. Scores of greeting intimacy and competency did not differ significantly between Britain and Spain. However, independent of culture, several significant relationships emerged between selective dimensions of the MAIA-2 and scores of intimacy and competency. Specifically, intimacy and competency scores were positively correlated with the ‘Awareness of Mind-Body Integration’ dimension. Greeting intimacy yielded additional positive relationships with the Not Distracting and Trusting subscales, and a negative relationship with the Not Worrying subscale. These relationships suggest that IA facilitates healthy social approach behaviour as expressed through greetings, irrespective of cultural greeting differences. We discuss interoceptive awareness and greeting behaviour in the context of attachment and consider the clinical implications for social anxiety.