Interoceptive signaling in alcohol cognitive biases: Role of family history and alliesthetic components

Abstract

The role of interoceptive signals in the development of cognitive biases for drug‐related cues has been hypothesized in the past; however, experimental evidence is lacking. This report examined the relationship between physiological responses and memories for alcohol cues. Participants (n = 158) were categorized as having either a positive or negative family history of alcohol use disorder (AUD). They were assigned to an alcohol, placebo, or control beverage condition to which they were blinded. All participants were presented with alcohol, neutral, and emotional cues. Heart rate variability (HRV) at 0.1 Hz, as an index of viscero‐afferent reactivity, and in the high‐frequency range was measured during picture‐cue exposure. Participants then completed free recall and repetition priming tasks to assess memories for previously presented stimuli. Participants with a positive family history (FHP) for AUD who received an alcohol beverage displayed a positive relationship between 0.1 Hz HRV and free recall. This effect was specific to alcohol cues, highlighting the relevance of physiological signals in the development of alcohol cognitive biases. These results support the hypothesis of a coordinated brain‐body interaction in the development of drug‐related behaviors. FHP as an AUD risk factor may increase the mapping of physiological responses onto cognitive biases for alcohol cues. Increased ratings of subjective intoxication dampened this relationship, suggesting that perceived bodily states may modulate incentive salience processes. This report provides novel evidence for the involvement of interoceptive signals in addictive processes, setting a precedent for the exploration of brain‐body interactions in the study of alcohol cognitive biases.

Changes in interoception after alcohol administration correlate with expectancies and subjective effects

“…We propose that changes in the perception of bodily states construct an interoceptive experience of reinforcing alcohol effects, 21,35 which in turn informs future alcohol expectancies to mediate the development and prognosis of alcohol use behaviours. Together with our previous findings that alcohol bodily states shape alcohol cue reactivity, 11,12 this report provides novel experimental perspectives on interoception and drinking behaviour that were lacking. 9…”

“…We cannot therefore rule out that interoception mediates the generation of subjective craving, and this study does not seem suitable to characterize such phenomenon. In any case, an interoceptive basis for craving is not necessarily observable through subjective ratings, and our previous findings of increased cognitive cue reactivity associated with alcohol‐induced bodily states 11,12 would provide support for the role of interoception in alcohol urges. Further, here, we characterize the role of interoception in the reinforcing and incentive components of alcohol, fitting the predictions of Paulus et al 21 Conversely, Gray and Critchley 20 conceptualized the role of interoception in craving through the development of anxiety and tension, and our experiment does not address the negative reinforcement framework.…”

“…Given that physiological signals are integrated through interoceptive pathways to generate behavioural and emotional adaptations in healthy populations, 1 it is likely that interoceptive processes also can support cognitive‐affective processes in addictive behaviours 8–10 . Alcohol administration modulates interoceptive responses towards alcohol cues, giving rise to alcohol cognitive biases in persons at high risk for alcohol use disorder 11 . Alcohol administration can also affect participants' internal bodily states, changing the value of alcohol‐related cues and incentive salience processes as a function of cardiovascular reactivity to alcohol effects 12 .…”

“…[8][9][10] Alcohol administration modulates interoceptive responses towards alcohol cues, giving rise to alcohol cognitive biases in persons at high risk for alcohol use disorder. 11 Alcohol administration can also affect participants' internal bodily states, changing the value of alcohol-related cues and incentive salience processes as a function of cardiovascular reactivity to alcohol effects. 12 There is however limited research on the effects of alcohol on cardiac interoceptive abilities, the perception of one's own heartbeat.…”

Anterior insular cortex firing links initial and sustained encoding during aversion-resistant alcohol consumption

“…[14,26]), and other groups do find less sensitivity to cost with AUD [124][125][126], while greater drinking is associated with more alcohol problems [11][12][13][14]. Thus, some authors [20,121] have emphasized that, from a clinician's perspective, multiple factors can contribute to AUD expression [127][128][129][130][131][132][133], including compulsion-like drives. In addition, the intermittent access alcohol-drinking model we utilize exhibits several features which could be considered related to human AUD, including escalation of intake [25,57], sensitivity to compounds that reduce human drinking [57], withdrawal symptoms (although moderate) [134,135], and front loading (indicating motivation for alcohol [27,41,136,137]), in addition to compulsion-like responding.…”