Effects of anxiety sensitivity and expectations on the modulation of the startle eyeblink response during a caffeine challenge

Benke, Christoph; Blumenthal, Terry D.; Modeß, Christiane; Hamm, Alfons O.; Pané-Farré, Christiane A.

doi:10.1007/s00213-015-3996-9

Cited by 16 publications

(12 citation statements)

References 61 publications

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“…This discrepancy may be explained by the view that under resting homeostatic conditions, interoceptive signals do not have as much biological salience as during nonhomeostatic perturbations that can signal threats to survival-be they physical, emotional or social. Individuals with panic disorder show increased autonomic arousal, heightened anxiety, and escape behaviors during exposure to experimental paradigms involving nonpharmacological approaches (e.g., being trapped in a small dark chamber) (Richter et al 2012) as well as pharmacological ones (e.g., oral caffeine ingestion) (Benke et al 2015). Interoceptive dysfunction in panic disorder can be conceptualized as a problem of hyperprecise priors and a lack of corrective adjustment following the sensory evidence.…”

Section: Panic Disordermentioning

confidence: 99%

An Active Inference Approach to Interoceptive Psychopathology

Paulus

Feinstein

Khalsa

2019

Annu. Rev. Clin. Psychol.

247

212

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Interoception refers to the process by which the nervous system senses and integrates signals originating from within the body, providing a momentary mapping of the body's internal landscape and its relationship to the outside world. Active inference is based on the premise that afferent sensory input to the brain is constantly shaped and modified by prior expectations. In this review we propose that interoceptive psychopathology results from two primary interoceptive dysfunctions: First, individuals have abnormally strong expectations of the situations that elicit bodily change (i.e., hyperprecise priors), and second, they have great difficulty adjusting these expectations when the environment changes (i.e., context rigidity). Here we discuss how these dysfunctions potentially manifest in mental illness and how interventions aimed at altering interoceptive processing can help the brain create a more realistic model of its internal state.

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Section: Panic Disordermentioning

confidence: 99%

An Active Inference Approach to Interoceptive Psychopathology

Paulus

Feinstein

Khalsa

2019

Annu. Rev. Clin. Psychol.

247

212

View full text Add to dashboard Cite

show abstract

“…It also begs the question of whether utilizing more potent cues during interoceptive exposure could boost the efficacy of this intervention. For example, panic disorder patients show increased autonomic arousal and heightened anxiety during exposure to experimental paradigms involving non-pharmacological approaches (being trapped in a small dark chamber) ( 138 ) as well as pharmacological ones (oral caffeine ingestion) ( 139 ). There is experimental evidence that pharmacological interoceptive exposure therapy can reduce anxiety disorder symptom severity either as a monotherapy ( 84 , 140 – 142 ) or as an augmentative approach ( 143 ).…”

Section: Panic Disorder: the Prototypical Interoceptive Disordermentioning

confidence: 99%

Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry?

2016

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Disrupted interoception is a prominent feature of the diagnostic classification of several psychiatric disorders. However, progress in understanding the interoceptive basis of these disorders has been incremental, and the application of interoception in clinical treatment is currently limited to panic disorder. To examine the degree to which the scientific community has recognized interoception as a construct of interest, we identified and individually screened all articles published in the English language on interoception and associated root terms in Pubmed, Psychinfo, and ISI Web of Knowledge. This search revealed that interoception is a multifaceted process that is being increasingly studied within the fields of psychiatry, psychology, neuroscience, and biomedical science. To illustrate the multifaceted nature of interoception, we provide a focused review of one of the most commonly studied interoceptive channels, the cardiovascular system, and give a detailed comparison of the most popular methods used to study cardiac interoception. We subsequently review evidence of interoceptive dysfunction in panic disorder, depression, somatic symptom disorders, anorexia nervosa, and bulimia nervosa. For each disorder, we suggest how interoceptive predictions constructed by the brain may erroneously bias individuals to express key symptoms and behaviors, and outline questions that are suitable for the development of neuroscience-based mental health interventions. We conclude that interoception represents a viable avenue for clinical and translational research in psychiatry, with a well-established conceptual framework, a neural basis, measurable biomarkers, interdisciplinary appeal, and transdiagnostic targets for understanding and improving mental health outcomes.

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“…These findings demonstrate that brainstem activities mediating defensive reflexes can receive a top-down modulation to select adequately the external potential threats. Moreover, factors such as expectation [ 57 ] and hypnotizability can affect both pain sensation and startle responses [ 58 – 62 ]. Although research has demonstrated that fear-evoking stimuli consistently potentiate the magnitude of the blink reflex [ 36 , 63 – 66 ], studies investigating the pain potentiation of the startle response has produced only inconclusive results.…”

Section: Introductionmentioning

confidence: 99%

Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study

Pascalis

Scacchia

2016

PLoS ONE

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We evaluated the influence of hypnotizability, pain expectation, placebo analgesia in waking and hypnosis on tonic pain relief. We also investigated how placebo analgesia affects somatic responses (eye blink) and N100 and P200 waves of event-related potentials (ERPs) elicited by auditory startle probes. Although expectation plays an important role in placebo and hypnotic analgesia, the neural mechanisms underlying these treatments are still poorly understood. We used the cold cup test (CCT) to induce tonic pain in 53 healthy women. Placebo analgesia was initially produced by manipulation, in which the intensity of pain induced by the CCT was surreptitiously reduced after the administration of a sham analgesic cream. Participants were then tested in waking and hypnosis under three treatments: (1) resting (Baseline); (2) CCT-alone (Pain); and (3) CCT plus placebo cream for pain relief (Placebo). For each painful treatment, we assessed pain and distress ratings, eye blink responses, N100 and P200 amplitudes. We used LORETA analysis of N100 and P200 waves, as elicited by auditory startle, to identify cortical regions sensitive to pain reduction through placebo and hypnotic analgesia. Higher pain expectation was associated with higher pain reductions. In highly hypnotizable participants placebo treatment produced significant reductions of pain and distress perception in both waking and hypnosis condition. P200 wave, during placebo analgesia, was larger in the frontal left hemisphere while placebo analgesia, during hypnosis, involved the activity of the left hemisphere including the occipital region. These findings demonstrate that hypnosis and placebo analgesia are different processes of top-down regulation. Pain reduction was associated with larger EMG startle amplitudes, N100 and P200 responses, and enhanced activity within the frontal, parietal, and anterior and posterior cingulate gyres. LORETA results showed that placebo analgesia modulated pain-responsive areas known to reflect the ongoing pain experience.

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Effects of anxiety sensitivity and expectations on the modulation of the startle eyeblink response during a caffeine challenge

Abstract: Unexpected symptom provocation leads to increased attention allocation toward feared arousal sensations in high anxiety sensitive persons. This finding broadens our understanding of modulatory mechanisms in defensive responding to bodily symptoms.

Cited by 16 publications

References 61 publications

An Active Inference Approach to Interoceptive Psychopathology

An Active Inference Approach to Interoceptive Psychopathology

Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry?

Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study

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