The Feeling of Me Feeling for You: Interoception, Alexithymia and Empathy in Autism

Mul, Cari-lène; Stagg, Steven D.; Herbelin, Bruno; Aspell, Jane E.

doi:10.1007/s10803-018-3564-3

Cited by 145 publications

(163 citation statements)

References 83 publications

(122 reference statements)

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“…A recent study revealed that impaired interoceptive awareness, but not interoceptive sensitivity, is linked to autistic traits, alexithymia, and empathy. 126 Other studies in nonautistic populations have demonstrated a link between high alexithymia and impairments in interoceptive accuracy. 127 Together, these results suggest that interoceptive accuracy may be impaired in autistic individuals, and that this may be particularly coupled with emotion-processing deficits.…”

Section: Autism Spectrum Conditionsmentioning

confidence: 97%

The neurobiology of interoception in health and disease

Quadt

Critchley

Garfinkel

2018

Annals of the New York Academy of Sciences

315

231

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Interoception is the sensing of internal bodily sensations. Interoception is an umbrella term that encompasses (1) the afferent (body-to-brain) signaling through distinct neural and humoral (including immune and endocrine) channels; (2) the neural encoding, representation, and integration of this information concerning internal bodily state; (3) the influence of such information on other perceptions, cognitions, and behaviors; (4) and the psychological expression of these representations as consciously accessible physical sensations and feelings. Interoceptive mechanisms ensure physiological health through the cerebral coordination of homeostatic reflexes and allostatic responses that include motivational behaviors and associated affective and emotional feelings. Furthermore, the conscious, unitary sense of self in time and space may be grounded in the primacy and lifelong continuity of interoception. Body-to-brain interactions influence physical and mental well-being. Consequently, we show that systematic investigation of how individual differences, and within-individual changes, in interoceptive processing can contribute to the mechanistic understanding of physical and psychological disorders. We present a neurobiological overview of interoception and describe how interoceptive impairments at different levels relate to specific physical and mental health conditions, including sickness behaviors and fatigue, depression, eating disorders, autism, and anxiety. We frame these findings in an interoceptive predictive processing framework and highlight potential new avenues for treatments.

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Section: Autism Spectrum Conditionsmentioning

confidence: 97%

The neurobiology of interoception in health and disease

Quadt

Critchley

Garfinkel

2018

Annals of the New York Academy of Sciences

315

231

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“…Interoceptive dysregulation has been found in ASC (see DuBois et al 2016) with some intriguing links to oxytocin (Quattrocki and Friston 2014). However, since interoceptive dysregulation increases alexithymia-difficulty identifying one's own feelings and emotions-it has been argued that this underlies many of the social-emotional difficulties present in ASC (Mul et al 2018;Shah et al 2016). Specifically, it appears that lower interoception reduces emotional fidelity and thus could contribute to ASC through alexithymia.…”

Section: Influences Of Alexithymia and Interoceptionmentioning

confidence: 99%

The Mimicry Among Us: Intra- and Inter-Personal Mechanisms of Spontaneous Mimicry

Arnold

Winkielman

2019

J Nonverbal Behav

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This review explores spontaneous mimicry in the context of three questions. The first question concerns the role of spontaneous mimicry in processing conceptual information. The second question concerns the debate whether spontaneous mimicry is driven by simple associative processes or reflects higher-order processes such as goals, intentions, and social context. The third question addresses the implications of these debates for understanding atypical individuals and states. We review relevant literature and argue for a dynamic, context-sensitive role of spontaneous mimicry in social cognition and behavior. We highlight how the modulation of mimicry is often adaptive but also point out some cases of maladaptive modulations that impair an individuals' engagement in social life.

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“…Such impairment in the affective representation system would lead to an inability to form a consciously accessible representation of one’s own affective state, which is consistent with the diagnostic criterion of alexithymia as being aware of having an emotion, yet being unsure as to what emotion one experiences. In line with this, recent findings indicate that alexithymia is linked to a lack of interoceptive awareness (Mul et al, 2018), an important aspect of empathy, and that alexithymia may even be characterized by a general failure of interoception (Brewer et al, 2016; Murphy et al, 2018). However, interoceptive accuracy (a lower, physiological level of emotional awareness, which is often measured using heart beat counts) might be increased in individuals with high levels of alexithymia (Ernst et al, 2013; Scarpazza et al, 2017), in line with their tendency to overly focus on bodily signals.…”

Section: Introductionmentioning

confidence: 58%

The Multifaceted Nature of Alexithymia – A Neuroscientific Perspective

Goerlich

2018

Front. Psychol.

103

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Neuroscientific studies have mostly employed the 20-item Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994a) for the assessment of alexithymia, a self-report scale that assesses the alexithymia facets difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. These facets can be considered to capture difficulties in the cognitive processing of emotions associated with alexithymia. However, Nemiah and Sifneos’ original conceptualization of alexithymia included also an affective component, a lack of imaginative capacities, which cannot be assessed using the TAS-20. Aiming to capture the entire alexithymia construct, the Bermond–Vorst Alexithymia Questionnaire (BVAQ; Vorst and Bermond, 2001) was developed, a self-report scale which assesses two affective facets (difficulty fantasizing and difficulty emotionalizing) in addition to three cognitive facets. Based on these facets, an affective and a cognitive dimension of alexithymia can be distinguished. By now, several neuroscientific studies have investigated the neural signatures of the different facets and dimensions of alexithymia. Here, I provide an overview of the history of the alexithymia facets and dimensions and review findings provided by functional and structural magnetic resonance imaging (MRI) studies that differentiated between the alexithymia facets and/or its affective and cognitive dimensions. I then provide a synopsis of the current neuroscientific evidence for dissociable substrates of alexithymia facets and dimensions. Finally, the scientific value and clinical implications of these findings are discussed.

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The Feeling of Me Feeling for You: Interoception, Alexithymia and Empathy in Autism

Cited by 145 publications

References 83 publications

The neurobiology of interoception in health and disease

The neurobiology of interoception in health and disease

The Mimicry Among Us: Intra- and Inter-Personal Mechanisms of Spontaneous Mimicry

The Multifaceted Nature of Alexithymia – A Neuroscientific Perspective

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