Interoception and psychopathology: A developmental neuroscience perspective

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.

Do body‐related sensations make feel us better? Subjective well‐being is associated only with the subjective aspect of interoception

“…One of the limitations of the current study is that its conclusions are valid for healthy individuals only; atypical interoception may lead to issues in psychological development and represent a general susceptibility to psychopathology (Murphy, Brewer, Catmur, & Bird, ). Extremely low and high levels of interoceptive accuracy with respect to one single modality might also have modality‐specific pathological consequences.…”

Does atypical interoception following physical change contribute to sex differences in mental illness?

“…Although this associative learning process has been proposed to be integral for development in infancy, any period in which substantial physical change occurs may require (re)learning and contextualisation of new or altered interoceptive sensations (Murphy et al, 2017).…”

Effects of mindfulness-based interventions on alexithymia: a systematic review

“…Taken together, these studies may indicate that increased awareness of present experience, particularly awareness of bodily sensations, may be one mechanism by which alexithymia is reduced. Alexithymia (awareness of emotional experience) has been found to be strongly related to interoception (awareness of bodily experience)40 and improvement in alexithymia symptoms has been associated with increased heartbeat perception accuracy 35. Furthermore, Santarnecchi et al 37 reported a significant correlation between the decrease in alexithymia and an increase in right insula thickness, an area of the brain, which is involved in both emotional and bodily awareness 41.…”