A meta-analysis on the relationship between interoceptive awareness and alexithymia: Distinguishing interoceptive accuracy and sensibility.

Trevisan, Dominic A.; Altschuler, Melody R; Bagdasarov, A.A.; Carlos, Carter; Duan, Suqian; Hamo, Ester; Kala, Shashwat; McNair, Morgan L.; Parker, Termara; Stahl, Dylan; Winkelman, Tatiana; Zhou, Melissa; McPartland, James C.

doi:10.1037/abn0000454

Cited by 75 publications

(79 citation statements)

References 55 publications

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“…The subscale has previously been used in interoception research, including in autistic populations, but has not previously been used in people with AN (8,31). A recent metaanalysis found that the BPQ was significantly positively associated with alexithymia (43).…”

Section: Interoceptive Sensibilitymentioning

confidence: 99%

“…Alexithymia is associated with lower interoceptive accuracy, to the extent that it has been hypothesised to be the product of impaired interoception (21,41,42). Furthermore, this relationship may be specific to clinical populations: a recent meta-analysis found no relationship between interoception in control populations, but found that lowered interoception was related to heightened alexithymia in EDs and autism (43). However, this study used a broad definition of interoception, described as "interoceptive awareness," including attention, detection, magnitude, discrimination, accuracy, insight, sensibility, and selfreport abilities surrounding bodily cues (7).…”

Section: Introductionmentioning

confidence: 99%

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Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

2020

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Background: Previous research on whether interoception is altered in anorexia nervosa (AN) using the heartbeat tracking task has yielded inconsistent results. However, no previous research has examined whether interoception is associated with alexithymia and autistic traits in AN, conditions which are more prevalent in this population and thought to be related to performance in this task. The aim of this study was to explore whether altered interoception in AN is associated with alexithymia and autistic traits. Methods: We assessed interoceptive accuracy using the heartbeat tracking task in n = 37 people with AN, and n = 37 age and gender matched healthy controls (HC), and explored within the AN group if interoceptive accuracy was related to self-rated alexithymia or autistic traits. We also assessed self-reported interoceptive ability, and the relationship between subjective and actual performance. Results: Heartbeat tracking task performance was not found to be altered in the AN group compared to the HC group. However, confidence ratings in task performance in the AN group were lower compared to the HC group. Unlike the HC group, confidence ratings in the AN group did not correlate with task performance. Within the AN group there was no relationship between interoceptive accuracy, alexithymia, and autistic traits, after controlling for the potential confounders of anxiety and depression. There was a relationship between confidence ratings and illness severity in the AN group. Conclusion: The results found no differences between heartbeat tracking task performance in people with AN compared to HC. There was no association between task performance, alexithymia and autistic traits in AN. Results do suggest that people with AN exhibit lowered confidence in their task performance, and that they may lack insight into this performance compared to HC. The findings are discussed in the context of potential significant limitations of the heartbeat tracking task, with recommendations for future research into interoception in AN.

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Section: Interoceptive Sensibilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

2020

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“…Both ASD and alexithymia are independently associated with heightened anxiety [Berthoz, Consoli, Perez‐Diaz, & Jouvent, 1999; Mandell, 2008] and poorer self‐reported interoceptive sensibility or attention) [DuBois et al, 2016; Mul, Stagg, Herbelin, & Aspell, 2018; Quattrocki & Friston, 2014; Trevisan et al, 2019]. While there are likely multiple reasons for heightened anxiety in ASD associated with core symptom domains (e.g., anxiety from social situations, or anxiety resulting from changes in routines and plans), poor awareness of one's emotions in both ASD and alexithymia would make it difficult to regulate negative emotions and remediate life problems or situations that contribute to anxiety [Swart, Kortekaas, & Aleman, 2009].…”

Section: Our Central Argumentmentioning

confidence: 99%

“…Dysfunctional interoception is theorized to be a relevant mechanism contributing to certain features of autism spectrum disorder [ASD; DuBois, Ameis, Lai, Casanova, & Desarkar, 2016; Quattrocki & Friston, 2014] and alexithymia (i.e., difficulties identifying and describing one's emotions) [Shah, Hall, Catmur, & Bird, 2016; Trevisan et al, 2019], a condition that frequently occurs with ASD [Griffin, Lombardo, & Auyeung, 2016; Hill, Berthoz, & Frith, 2004]. For example, since interoception is hypothesized as being necessary for constructing representations of the “self,” a failure to do so would be expected to (a) inhibit a child's ability to develop skills necessary for self‐reflection, emotional awareness, and homeostatic regulation, and (b) disrupt assimilation of interoceptive and “exteroceptive cues” (i.e., perception of the external world) necessary for observational learning and social communication [Noel, Lytle, Cascio, & Wallace, 2018; Quattrocki & Friston, 2014].…”

Section: Introductionmentioning

confidence: 99%

Adaptive and Maladaptive Bodily Awareness: Distinguishing Interoceptive Sensibility and Interoceptive Attention from Anxiety‐Induced Somatization in Autism and Alexithymia

2020

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There is growing interest in “interoception” (i.e., detection and interpretation of internal body signals) as a relevant mechanism contributing to certain symptoms and features of autism spectrum disorder (ASD) and alexithymia. However, inconsistent measurement and operationalization of interoception has led to confusion and inconsistent findings in the literature. In this commentary, we present alternative interpretations of findings from existing studies to demonstrate that ASD and alexithymia are conditions associated with reduced adaptive forms of interoceptive attention (i.e., attention toward bodily signals) but heightened maladaptive forms of interoceptive attention related to anxiety‐induced somatization. Differentiating adaptive and maladaptive forms of interoceptive attention reveals a clearer pattern of findings in the research literature for further investigation of interoceptive processes that are involved in the neurobiology of ASD. However, interoception is a complex and multi‐faceted construct that requires continual refinement in conceptualization and operationalization. Interoception research may benefit from self‐report measures that clearly differentiate adaptive and maladaptive forms of bodily awareness. Lay Summary Some research suggests that autistic people have difficulty understanding bodily feelings such as hunger, illness, or emotions, whereas some studies have reported the opposite pattern of findings. We argue that this latter subset of studies reached false conclusions from using measures of bodily awareness that largely measure physical symptoms of anxiety. While attention to unpleasant bodily signals is an important ability necessary for maintaining healthy bodily functioning, excessive attention, and worry toward bodily signals can increase anxiety and be harmful.

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“…This style of bodily awareness is apparently maladaptive and has traditionally been assessed, due to lack of better instruments, by having patients check a list of anxiety-related symptoms (Porges, 1993). Possibly in part due to the prominence of its author and his polyvagal theory among body-oriented psychotherapists, and despite that fact that his highly popular theory has been seriously questioned, if not thoroughly debunked (Grossman, 2016;Grossman & Deuring, 2020), Porges's questionnaire is still applied in bodily awareness and interoception-related research and has led to considerable confusion in the literature (Mehling, 2016;Trevisan et al, 2019). However, the evenhanded (Williams, 2010), adaptive (salutogenic) style of attention toward bodily sensations, generally labeled "mindful," which is the hallmark of the increasingly popular approaches discussed in this special issue of Kinesiology Review, is clearly not captured by this legacy measure and required the development of new instruments (see the systematic review in Mehling et al, 2009).…”

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confidence: 99%

If It All Comes Down to Bodily Awareness, How Do We Know? Assessing Bodily Awareness

Mehling¹

2020

Kinesiology Review

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A purported key mechanism of action in most mind–body movement approaches is the maturation and development of bodily awareness. This is an experiential learning process with its own phenomenology, underlying neurological processes, and challenges for scientific study. This report focuses on the assessment of changes in bodily awareness, which is of key importance for the documentation of this learning process for both research and clinical application. Objective assessments requiring lab equipment are briefly reviewed. Qualitative assessments can be performed by interviews, focus groups, and second-person observation of movement performance. In addition, systematically developed self-report questionnaires have become available in recent years, have undergone extensive validation, and are presented here.

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A meta-analysis on the relationship between interoceptive awareness and alexithymia: Distinguishing interoceptive accuracy and sensibility.

Cited by 75 publications

References 55 publications

Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

Interoception in Anorexia Nervosa: Exploring Associations With Alexithymia and Autistic Traits

Adaptive and Maladaptive Bodily Awareness: Distinguishing Interoceptive Sensibility and Interoceptive Attention from Anxiety‐Induced Somatization in Autism and Alexithymia

If It All Comes Down to Bodily Awareness, How Do We Know? Assessing Bodily Awareness

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