Catherine Part 2 Flashcards
How onteroception links to MH
It is trans diagnostic as same symptom across many conditions. It allows for accurate experience of body and trust it, allows to engage in activities. Could be issues in processing or reporting signals
Intero sensibility
Elliot and pfiefer 22: maia 2 and body awareness qs. Intero correlated W anxiety in covid as ppl paying more attention to body, feeling more anxiety. In the maia- less trust, attention and worry led to more interoception die to hyper vigilance - attending to body too much
Intero accuracy
Adams 22: meta anal found no link between accuracy and anxiety - so may not be ability to detect but how you interpret/how you think, yoris 2015: anxiety and controls had no diff in accuracy hb but diff in meta cog
Neural indicator
Pang et al 2019: measured HEP at rest W eyes open (extero) or closed (intero). In control HEP greater in intero but no diff in expert die to hyper vigilance (always monitoring)- higher cortical response to hb
Insular diffs in anxiety
Atkin 2007: meta anal for social phobia, spec phobia or ptsd. All 3 have hyperactivity in amygdala and insula, pattern same as fear response in healthy (more attention to fear. Berlicchi 2009: corporeal awareness is perception and eval of own and others body- being aware maintains homeo
Intero not passive and predictive theories
Intero models not passive from visceral sensations but constructed in brain using afferent and efferent. Predictive theories say perception shaped by beliefs about world and its mismatches from sensory input e.g. think cup heavy but not when pick it up. Predictive coding theory: compare experiences to prediction rather than processing all info and faster than sensory. Prediction errors lead to malad cogs
Inaugural moment and what happens W errors
Inaugural moment is the initial sensory map W no experience (as baby)- involves insular, amyg, anterioir cingulate, VMPFC. Small errors ignored but large detecting and either adapt predictions or adapt physical state. Errors detected by insular, connections can activate sympathetic hyperarousal and worry
Geuter 2017
Heat pain paradigm: give ps heat to cause pain, gave cue before which either matched the level or mismatched the pain. Tested different models: either ignore cue, just use stim intensity then stim plus heat plus predictive coding. Posterior showed Stim intensity model (just gets afferent from body). Anterioir showed predictive model as connected to other areas
Psych disorder
Uncorrected prediction errors can lead to avoidance, rumination. Somatic error is error in sensory. Ppl who focus more on body predict future aversive states which triggers anxiety and avoidance
Panic disorder
dizziness, dyspnea, palpitation, impending doom .Uchinda 2008: increased grey matter in insula in pd compared to controls . Normal increases in hr lead to them thinking heart attack, leads to increase in hr and miss attribute co occurring events anxiety which leads to avoidance. Pauli 91: pd and controls did ecg- similar variation in he but pd rated higher anxiety, then led to increase in hr. but pd had similar cardiac perceptions than controls (attending more than normal?) increase hr and anxiety to minimise mismatch
Things that cause errors
Beliefs/priories: anticipation of aversive body states. Self processing- worry linked to increase in pfc, striatum and insula. Guilt linked to anterioir, sad linked to ventral insula. Somatic error hyp: compensatory behaviour- can be actions to reduce distress, brain over regs system so predictions detached from body state
Pd In mri
Dresler 2011: ps having panic attacks in mri, first removed at start, other in the middle. First had decrease in pfc (cognition cause of panic attack). Second showed insula and amygdala activity (feelings of discomfort and panic interpreting).
Tutorial
Sens: how signals detected and interpreted. Accuracy/sensitivity: accuracy of signals compared to objective measurement. Awareness: how good you are and how you think how good you are . Sens measured using MAIA, accuracy measured using hb, fmri, eeg . W: doesn’t represent all interoception e.g not just hr , hr can be felt in diff places e.g some feel in temples, others whole body. Practical issues: ppl guess 1/second, counting and reported at end diff to tapping each time feel hb, f more intero than m but less accurate
The different eating disorders and link to intero
Anorexia: Low body weight, restriction.Bulimia: binge episodes, compensatory action. Binge eating disorder: binge episodes, no compensatory actions. if fail to feel hunger, leads to restriction. If fail to detect fullness leads to bingeing. Can’t differentiate between emotions, body sensation, emotional reg and alexithymia (can’t name emotions)
Anorexia
Heterogeneous- many contributing factors and presents differently. Over evaluation of shape/weight, disturbed eating, impairment of health and brain function, bmi lower than 18.5, resistant to treatment, high mortality. Dsm: restriction less than body needs, low weight, fear of gaining, don’t see seriousness, self objectification, can’t self sooth, empathise W others, flattened affect (dep)
Intero and anorexia - hilda
Hilda brich 62: a failure of recognising bodily states , part of long standing measures for ED inventory: has interoceptive deficits scale, lack of id emotions and sensations of hunger and fullness. Confusion and mistrusts of bodily functioning.Research doesnt dissociate between diff types of intero- w
Sensibility - jenkisnon
Jenkinson 2018: meta anal across Ed’s, used Ed intero scale. Anorexia had sig lower scores. Bulimia similar but binge eating smaller effect size. Higher alexithymia linked to lower intero- lower intero important for targeting as a risk factor
Accuracy -pollatos anorexia
Pollatos 2008: anorexia show reduction in accurately perceiving hb. Less intense emotional states and body signals but findings mixed as eshkevari found no diff, kinnaird found no diff in accuracy but awareness diff
Awareness- ed and good they think they are-lernia
Lernia 2018: case study, counted hb, asked how confident they were and measured intero sens using maia. No diff but trend toward lower acccuracy, although more confident about their guesses. But less able to self regulate and less trust of body from maia (sens). Controls less confident (good awareness as related to how they actually did)- means detachment between perception and awareness
Neural level
Lutz 2019: anorexia and controls did hb counting and eeg. No diff in accuracy but diff in hep/neural response - don’t know what this means but there R wave heart, HEP brain
Affective touch-spinothalamic
Affective touch involves c tactile afferent, slow, no myelination. These modulate pain like itch scratch. Crucianelli 2016: anorexia given affective/neutral touch and shown diff expressions. Feelings of pleasantness of the touch lower in anorexia but mod by social context- bottom up
Insular -murialo
Murialdo 2007: tilt table test- hr and blood psi should increase when stand up. Ed had lower psi and symp cardiac activity didn’t increase, did in controls. Cardiac diffs similar in Ed’s but only anorexia emancipated e.g. diff not due to bmi
Fischer 2016- treatment
Anorexia ps did cbt to help normalise eating and gain weight. Tested start, middle and end, measured accuracy W hr, sens W intero awareness scale from Ed inventory. Improvement in bmi and depression but accuracy and sens didn’t - intero processed diff, more likely to relapse
Kerr 2016
Anorexia did intero tasks for hr, stomach and bladder. Measured anxious rumination and extero (intensity of colour change). Activity in dorsal mid insular was reduced in anorexia when attending stomach. In hr, anorexia had higher activity in anterioir insular compared to controls, no diff in bladder. Increase activation during anxiety in dorsal mid and activity in stomach correlated W anxiety. Means hyperviigalnce to gastric sensations (already high)- low hr means flat affect
Khalsa 2015
Given isopropterenol (adrenreceptor antagonist) to increase hr or saline for control. Rated perception of hr and breathing intensity before or after meal. Even in control, saw stronger ratings in pre meal as anticipate eating, predictive negative state, leads to anxiety/avoidance
Self objectification
Competition of cues hyp: have finite of attentional resource so emphasis on body distract from internal signals- leads to self objectification. Over reliance on extero leads to more objectification and body checking so fail to update perception of body via senses (intero errors unresolved-relapse) basically less intero so rely on extero
Treatment
Oberdorfer: anorexia ps in recovery show diff in insula when anticipating food and decreased response to taste of food stim
Both extero and intero body sensations continue following weight restoration
Intero resistant to treatment but can change due to plasticity. So could use intero exposure- repeat triggers
