Enhanced cortical processing of cardio-afferent signals in anorexia nervosa

Lutz, Annika; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Dyck, Zoé Van; Vögele, Claus

doi:10.1016/j.clinph.2019.06.009

Cited by 48 publications

(59 citation statements)

References 70 publications

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“…Therefore, the findings of this study could reflect a generalised lack of confidence in ability, rather than a lack of confidence specific to interoceptive performance. It should be noted that the current results contrast with the findings of Lutz et al (13) who found no difference between groups in task confidence ratings (13).…”

Section: Discussioncontrasting

confidence: 99%

“…Contrary to the hypothesis that people with AN would exhibit lowered cardiac interoceptive accuracy compared to HC, the study found no significant differences between groups in heartbeat tracking performance. This is in line with a number of recent studies, including two that were published after the hypotheses for the current study were generated (12)(13)(14). The findings of the present study, and more recent research, contrast with previous research using the heartbeat tracking task in AN which found lowered accuracy in this population (10,11).…”

Section: Discussionsupporting

confidence: 90%

“…In the context of previous criticism of the EDI interoceptive subscale (13,15,18), interoceptive sensibility was assessed using total scores on the awareness subscale of the Porges Body Perception Questionnaire [BPQ (48)]. The subscale uses 45 questions to assess self-reported awareness of bodily symptoms, with participants answering on a Likert Scale from "never" to "always."…”

Section: Interoceptive Sensibilitymentioning

confidence: 99%

“…Using the heartbeat tracking task, two initial studies found that people with AN had lower interoceptive accuracy (10,11). By contrast, three more recent studies using the same measure found no significant differences between people with AN and healthy controls (HC) (12)(13)(14). One previous study has used a heartbeat discrimination task, finding no differences between people with AN and HC (15).…”

Section: Introductionmentioning

confidence: 99%

“…This subscale has been criticized for potentially measuring emotional, rather than somatic awareness (15), for not distinguishing between a lack of acceptance of emotional arousal, and a lack of clarity surrounding internal stimuli (18). The subscale also primarily focuses on the sensations of hunger and satiety, rather than including a range of different body sensations (13).…”

Section: Introductionmentioning

confidence: 99%

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Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

2020

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Background: Previous research on whether interoception is altered in anorexia nervosa (AN) using the heartbeat tracking task has yielded inconsistent results. However, no previous research has examined whether interoception is associated with alexithymia and autistic traits in AN, conditions which are more prevalent in this population and thought to be related to performance in this task. The aim of this study was to explore whether altered interoception in AN is associated with alexithymia and autistic traits. Methods: We assessed interoceptive accuracy using the heartbeat tracking task in n = 37 people with AN, and n = 37 age and gender matched healthy controls (HC), and explored within the AN group if interoceptive accuracy was related to self-rated alexithymia or autistic traits. We also assessed self-reported interoceptive ability, and the relationship between subjective and actual performance. Results: Heartbeat tracking task performance was not found to be altered in the AN group compared to the HC group. However, confidence ratings in task performance in the AN group were lower compared to the HC group. Unlike the HC group, confidence ratings in the AN group did not correlate with task performance. Within the AN group there was no relationship between interoceptive accuracy, alexithymia, and autistic traits, after controlling for the potential confounders of anxiety and depression. There was a relationship between confidence ratings and illness severity in the AN group. Conclusion: The results found no differences between heartbeat tracking task performance in people with AN compared to HC. There was no association between task performance, alexithymia and autistic traits in AN. Results do suggest that people with AN exhibit lowered confidence in their task performance, and that they may lack insight into this performance compared to HC. The findings are discussed in the context of potential significant limitations of the heartbeat tracking task, with recommendations for future research into interoception in AN.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 90%

Section: Interoceptive Sensibilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

2020

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Gastric interoception and gastric myoelectrical activity in bulimia nervosa and binge‐eating disorder

Dyck

Schulz

Blechert

et al. 2020

Intl J Eating Disorders

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Objective Identifying factors that control food intake is crucial to the understanding and treatment of eating disorders characterized by binge eating. In healthy individuals, stomach distension plays an important role in the development of satiation, but gastric sensations might be overridden in binge eating. The present study investigated the perception of gastric signals (i.e., gastric interoception) and gastric motility in patients experiencing binge‐eating episodes, that is, bulimia nervosa (BN) and binge‐eating disorder (BED). Method Twenty‐nine patients with BN or BED (ED group) and 32 age‐, sex‐, and BMI‐matched healthy controls (HC group) participated in the study. The onset of satiation and stomach fullness were assessed using a novel 2‐step water load test (WLT‐II). Gastric myoelectrical activity (GMA) was measured by electrogastrography (EGG) before and after ingestion of noncaloric water. Results Individuals in the ED group drank significantly more water until reporting satiation during the WLT‐II. The percentage of normal gastric myoelectrical power was significantly smaller in the ED group compared to HC, and negatively related to the number of objective binge‐eating episodes per week in patients with BN or BED. Power in the bradygastria range was greater in ED than in HC participants. Discussion Patients with EDs have a delayed response to satiation compared to HC participants, together with abnormal GMA. Repeated binge‐eating episodes may induce disturbances to gastric motor function.

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Sensor technology in eating disorders research: A systematic review

Presseller

Patarinski

Fan

et al. 2022

Intl J Eating Disorders

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Objective Sensor technologies offer exciting potential to objectively measure psychopathological correlates of eating pathology and eating disorder (ED) research utilizing sensors has rapidly proliferated in the past several years. The aims of the present review are: (1) characterize the types of sensors that have been utilized in ED research, (2) identify the psychopathological factors relevant to EDs that have been assessed using sensors, (3) describe the data supporting the validity and reliability of these sensors, (4) discuss limitations associated with these sensors, and (5) identify gaps that persist within the ED literature with regard to use of sensor technologies. Method A systematic search was conducted of PubMed, PsycINFO, Web of Science, ProQuest, and “gray” literature sources. Eligible publications were empirical studies that utilized sensors to measure at least one psychological variable among clinical ED populations. Results Sensors have been utilized with ED samples to measure eating behaviors, physical activity, sleep, autonomic nervous system activity, eyeblink startle response, visual attention, and visual‐haptic object integration. The reliability and validity of these sensors varies widely and there are a number of significant gaps that remain in the literature with regard to the types of sensors utilized, context in which sensors have been used, and populations studied. Discussion The existing literature utilizing sensors within ED research largely support the feasibility and acceptability of these tools. Sensors should continue to be utilized within the field, with a specific focus on examining the reliability and validity of these tools within ED samples and increasing the diversity of samples studied. Public Significance Statement Sensor technologies, such as those included in modern smartwatches, offer new opportunities to measure factors that may maintain or contribute to symptoms of eating disorders. This article describes the types of sensors that have been used in eating disorders research, challenges that may arise in using these sensors, and discusses new applications of these sensors that may be pursued in future research.

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Enhanced cortical processing of cardio-afferent signals in anorexia nervosa

Cited by 48 publications

References 70 publications

Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

Gastric interoception and gastric myoelectrical activity in bulimia nervosa and binge‐eating disorder

Sensor technology in eating disorders research: A systematic review

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