In the present study we provide the first empirical evidence that viscero-sensory feedback from an internal organ is associated with decision-making processes. Participants with accurate vs. poor perception of their heart activity were compared with regard to their performance in the Iowa Gambling Task. During this task, participants have to choose between four card decks. Decks A and B yield high gains and high losses, and if played continuously, result in net loss. In contrast, decks C and D yield small gains and also small losses, but result in net profit if they are selected continuously. Accordingly, participants have to learn to avoid the net loss options in favor of the net gain options. In our study, participants with good cardiac perception chose significantly more of the net gain and fewer of the net loss options. Our findings document the substantial role of visceral feedback in decision-making processes in complex situations.
The baroreflex consists of a negative feedback loop adjusting heart activity to blood pressure fluctuations. This review is concerned with interactions between baroreflex function and behavior. In addition to changes in baroreflex cardiac control subject to behavioral manipulations, interindividual differences in reflex function predicted psychological and central nervous features. The sensitivity of the reflex was inversely related to cognitive performance, evoked potential amplitudes, experimental pain sensitivity, and the severity of clinical pain. Possible variables moderating the strength of the associations are tonic blood pressure, gender, and psychiatric disease. It is suggested that these observations reflect inhibition of higher brain function by baroreceptor afferents. While in many cases increased baroreflex function implies stronger inhibition, individual and situational factors modulate the behavioral impact of cardiac regulation.
The study provides evidence of emotionally driven selective attention in FMS. Attentional bias to negative information may play an important role in the vicious circle between negative affective state and pain augmentation. In the management of FMS pain, strategies aiming at conscious direction of attention may be helpful, e.g., imagery techniques or mindfulness training.
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