Panic and comorbid depression and their associations with stress reactivity, interoceptive awareness and interoceptive accuracy of various bioparameters

Limmer, Jan; Kornhuber, Johannes; Martin, Alexandra

doi:10.1016/j.jad.2015.07.010

Cited by 28 publications

(22 citation statements)

References 46 publications

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“…This has strengthened the idea that interoceptive awareness can impact behaviors and processes traditionally considered to be purely cognitive or representational. Furthermore, altered perception of bodily signals has been associated with psychological disorders such as depression, panic disorder, and stress (Limmer, Kornhuber, & Martin, ; Schulz & Vögele, ; Terhaar et al, ). It is therefore relevant to understand attentional processes potentially underlying individual differences in interoception.…”

Section: Discussionmentioning

confidence: 99%

Attending to the heart is associated with posterior alpha band increase and a reduction in sensitivity to concurrent visual stimuli

et al. 2017

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Attentional mechanisms have been studied mostly in specific sensory domains, such as auditory, visuospatial, or tactile modalities. In contrast, attention to internal interoceptive visceral targets has only recently begun to be studied, despite its potential importance in emotion, empathy, and self-awareness. Here, we studied the effects of shifting attention to the heart using a cue-target detection paradigm during continuous EEG recordings. Subjects were instructed to count either a series of visual stimuli (visual condition) or their own heartbeats (heart condition). Visual checkerboard stimuli were used as attentional probes throughout the task. Consistent with previous findings, attention modulated the amplitude of the heartbeat-evoked potentials. Directing attention to the heart significantly reduced the visual P1/N1 amplitude evoked by the attentional probe. ERPs locked to the attention-directing cue revealed a novel frontal positivity around 300 ms postcue. Finally, spectral power in the alpha band over parieto-occipital regions was higher while attending to the heart-when compared to the visual task-and correlated with subject's performance in the interoceptive task. These results are consistent with a shared, resource-based attentional mechanism whereby allocating attention to bodily signals can affect early responses to visual stimuli.

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Section: Discussionmentioning

confidence: 99%

Attending to the heart is associated with posterior alpha band increase and a reduction in sensitivity to concurrent visual stimuli

et al. 2017

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“…Whether other modalities such as gastrointestinal system that is closer related to eating pathology is also affected in the same extent like the investigated cardiovascular system is not yet clear, suggesting that other experimental measures like the waterload paradigm (21) might be useful in combination to the heartbeat detection task. A complex interaction between different modalities of internal systems was described by a recent study in panic disorder patients (56). Limmer et al (56) reported an increased accuracy for cardiac signals alone, whereas IA for other internal signals like assessed skin conductance changes was perceived attenuated as compared to healthy controls.…”

Section: Discussionmentioning

confidence: 99%

“…A complex interaction between different modalities of internal systems was described by a recent study in panic disorder patients (56). Limmer et al (56) reported an increased accuracy for cardiac signals alone, whereas IA for other internal signals like assessed skin conductance changes was perceived attenuated as compared to healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Interoceptive Processes in Anorexia Nervosa in the Time Course of Cognitive-Behavioral Therapy: A Pilot Study

Fischer

Berberich²,

Zaudig³

et al. 2016

Front. Psychiatry

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ObjectivePrevious studies report reduced interoceptive abilities in anorexia nervosa (AN) using various methods. Recent research suggests that different levels of interoceptive processes aiming at different subdomains of interoceptive abilities must be further distinguished as these levels can be differentially affected. Two important levels refer to interoceptive accuracy (IA) derived from objective performance tasks such as the heartbeat detection task and interoceptive sensibility (IS) as assessed by self-report. There is a lack of studies investigating both IA and IS in AN and examining them in the time course of therapy. The aim of this pilot study was to evaluate the different interoceptive processes – especially IA and IS – in the time course of therapy.MethodsFifteen patients with AN (restricting type) from the Psychosomatic Clinic in Windach were investigated three times (T1, T2, T3) during a standardized cognitive-behavioral therapy and compared with 15 matched healthy controls assessed at Ulm University in a comparable design. All participants performed the heartbeat detection task examining IA and completed standard psychological assessments including an assessment of IS.ResultsPatients with AN showed a significantly decreased weight, higher levels of depression, and both reduced IA and IS compared to healthy controls at T1. Following therapy, patients recovered in terms of weight and depression symptomatology. A descriptive trend for recovering from IA and IS was observed.DiscussionOur findings suggest that interoceptive deficits are present in recovered patients. Therefore, further investigations are needed with more patients, differentiating between relapsed and recovered patients, and more specific training methods to improve interoceptive processes.

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“…According to Ehlers and Breuer (1996) , those inconsistencies are due to different instructions and sample characteristics used in subsequent research (e.g., including patients with medication that might has affected their cardiovascular systems). Previous research proved this only for the accuracy of cardiovascular signals, but they found no evidence for other interoceptive abilities ( Limmer et al, 2015 ). To conclude, there is evidence that interoceptive processes are disturbed in people with different mental problems.…”

Section: Introductionmentioning

confidence: 92%

Improvement of Interoceptive Processes after an 8-Week Body Scan Intervention

Fischer

Messner

Pollatos

2017

Front. Hum. Neurosci.

118

109

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Objective: Interoceptive processes are defined as ability to detect sensations arising within the body. There is a growing body of research investigating ways of improving interoceptive processes. One promising approach increasing the attention to bodily sensations is the body scan (BS), a method stemming from mindfulness-based stress reduction. Research so far revealed only heterogenous findings of meditational practice and mindfulness-based stress reduction on interoceptive processes. Even more importantly, there is no study considering the effect of an 8-week BS intervention on interoceptive processes and the distinguishable subdomains of interoception. Therefore, the main objective of this research is to examine the effects of a BS intervention on different interoceptive subdomains over 8 weeks of training in two different samples.Methods: In study 1, healthy participants executed a 20 min standardized audiotaped BS in the BS intervention group (n = 25) each day over 8 weeks. The control group (n = 24) listened to an audio book for the same amount of time. In study 2, the BS group (n = 18) was compared to an inactive control group (n = 18). In both studies, three measurement points were realized and interoceptive accuracy (IAc) – using a heartbeat perception task – as well as interoceptive sensibility (IS) – using confidence ratings for the heartbeat perception task and the subscale ‘interoceptive awareness’ of the Eating Disorder Inventory-2 (EDI-2) – were assessed.Results: In study 1, we found, as a descriptive trend, IAc and confidence ratings to be increased irrespective of the condition. However, post hoc analysis revealed a significant improvement of IAc between T1 and T3 in the BS intervention only. IS revealed to be unaffected by the interventions. In study 2, we observed a significant positive effect of the BS intervention on IAc and confidence ratings compared to the inactive controls. As in study 1, IS (EDI-2) was unaffected by the intervention.Discussion: The results highlight the fact that interoception can be improved by long-term interventions focusing on bodily signals. Further studies might focus on clinical samples showing deficits in interoceptive processes and could use other bodily systems for measurement (e.g., respiratory signals) as well methods manipulating body ownership.

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Panic and comorbid depression and their associations with stress reactivity, interoceptive awareness and interoceptive accuracy of various bioparameters

Abstract: The potentially conflicting findings coalesce, as panic was associated with an increase of the ability to perceive the fear-related parameter and a simultaneous decrease of the ability to perceive other parameters. The superordinate integration of afferent signals might be impaired.

Cited by 28 publications

References 46 publications

Attending to the heart is associated with posterior alpha band increase and a reduction in sensitivity to concurrent visual stimuli

Attending to the heart is associated with posterior alpha band increase and a reduction in sensitivity to concurrent visual stimuli

Interoceptive Processes in Anorexia Nervosa in the Time Course of Cognitive-Behavioral Therapy: A Pilot Study

Improvement of Interoceptive Processes after an 8-Week Body Scan Intervention

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