Computerized Exposure Therapy for Spider Phobia: Effects of Cardiac Timing and Interoceptive Ability on Subjective and Behavioral Outcomes

Watson, David; Garfinkel, Sarah N.; Praag, Cassandra Gould van; Willmott, Daniel; Wong, Katherine; Meeten, Frances; Critchley, Hugo

doi:10.1097/psy.0000000000000646

Cited by 13 publications

(11 citation statements)

References 82 publications

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“…In states of cardiovascular arousal (including emotional stress), the baroreflex is suppressed, allowing heart rate and blood pressure to rise together. While experimentally increasing heart rate induces prioritisation of fear processing across different measures (Pezzulo et al, 2018), similar results have also been observed by simply synchronising the presentation of fearful stimuli to cardiac systole (Garfinkel et al, 2014;Garfinkel & Critchley, 2016;Watson et al, 2019).…”

Section: Introductionsupporting

confidence: 65%

“…In line with past research (Barlas, Hockley, & Obhi, 2018;Kulakova, Khalighinejad, & Haggard, 2017;Moreton, Callan, & Hughes, 2017;Takahata et al, 2012;Tanaka & Kawabata, 2019;Yoshie & Haggard, 2017), we expected elevated agency in the free vs. instructed conditions and also following wins rather than losses, especially for the explicit agency measure. From the past evidence suggesting that cardiac systole is associated with enhanced perception of threat-related events (Azevedo et al, 2017;Garfinkel et al, 2014;Watson et al, 2019) and inhibition of motor responses (Rae et al, 2018), we hypothesised that systolic signalling would lead to diminished SoA judgements.…”

Section: Aimsmentioning

confidence: 99%

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Feeling in Control: The Role of Cardiac Timing in the Sense of Agency

Herman

Tsakiris

2020

Affec Sci

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The sense of agency describes the experience of controlling one’s body to cause desired effects in the world. We explored whether this is influenced by interoceptive processes. Specifically, we investigated whether the sense of agency changes depending on where, in the cardiac cycle (systole or diastole), the action was executed and where the outcome of the action occurred. In two experiments, participants completed decision-making task to win/lose money. Explicit (ratings of control) and implicit (temporal judgement) measures of agency were differentially affected by cardiovascular state. Implicit agency scores were affected by the cardiac phase at the point of action execution. Explicit ratings of control were affected by the type of (free vs. instructed) and by outcome valence (win vs. lose). The time of the action was uniformly distributed across the cardiac cycle. These results show interoceptive impact on agency, but that cardiac cycle may affect explicit and implicit agency differently.

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Section: Introductionsupporting

confidence: 65%

Section: Aimsmentioning

confidence: 99%

Feeling in Control: The Role of Cardiac Timing in the Sense of Agency

Herman

Tsakiris

2020

Affec Sci

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“…Interoceptive treatments are bodily focused integrated treatments based on the Embodied Cognition framework and the concept of multisensory integration (Riva et al, 2017; Riva and Dakanalis, 2018). They have been used to reduce symptoms severity in somatoform disorders (Schaefer et al, 2014), and they have recently been applied to different conditions with promising results (Watson et al, 2018). Technology can be helpful in this process (Azevedo et al, 2017; Riva and Gaudio, 2018) too.…”

Section: Case Discussion and Conclusionmentioning

confidence: 99%

Interoceptive Axes Dissociation in Anorexia Nervosa: A Single Case Study With Follow Up Post-recovery Assessment

et al. 2019

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Anorexia nervosa (AN) is a disorder characterized by alterations in body perception. Recent literature suggested that AN can also impair the processing of stimuli from inside the body (i.e., interoceptive) however, very few studies performed a complete interoceptive assessment exploring the evolution of the interoceptive dimensions before and after the subject’s recovery. To address this gap in knowledge, this study presented the case of Diana, a 25 years old woman affected by AN. At hospital admission, Diana performed a complete interoceptive assessment for accuracy (IAc), metacognitive awareness (IAw), sensibility (IAs), and interoceptive buffer saturation (IBs) – a new index that behaviourally evaluated the amount of interoceptive processing. Measures were repeated at the end of an outpatients rehabilitative hospital program, after Diana’s recovery. Results were confronted with a control (N = 4) of healthy female subjects. Analyses indicated severe deficits in accuracy, buffer saturation, and sensibility compared to control group. Conversely, metacognitive awareness was pathologically enhanced. After the rehabilitative hospital program, Diana’s clinical condition was largely improved and this reflected back on the interoceptive patterns that appeared restored, with no difference in interoceptive accuracy and metacognition compared to the control group. In conclusion, results indicated a very specific dissociation between interoceptive axes in AN with pervasive deficits in perception and processing that were accompanied by a pathologically enhanced confidence in the wrong perceptions. This case study reported an interesting and unique clinical pattern with a severe dissociation between interoceptive perceptions that nonetheless appeared restored after the subject’s recovery, highlighting the role of interoceptive assessment in the clinical evolution of AN.

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“…For example, baroreceptor stimulation reliably decreases pain ratings (Dworkin et al, 1994). Likewise, Garfinkel et al (2013) have shown that memory for target words presented at high speeds suffered from interference when presented during systole compared to those presented during diastole, whereas detection, learning, and even exposure therapy for fearful stimuli are enhanced by presentation of stimuli at systole (Garfinkel et al, 2014; Pfeifer et al, 2017; Watson et al, 2019). This paradigm has been adapted to show that race-driven misidentifications of threat during a weapons identification task and a first-person shooter task were significantly increased by presentation during systole (Azevedo et al, 2017).…”

Section: Novel Implications From the Theory Of Constructed Emotion Fomentioning

confidence: 99%

Applying the Theory of Constructed Emotion to Police Decision Making

et al. 2019

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Law enforcement personnel commonly make decisions in stressful circumstances, where the costs associated with errors are high and sometimes fatal. In this paper, we apply a powerful theoretical approach, the theory of constructed emotion (TCE), to understand decision making under evocative circumstances. This theory posits that the primary purpose of a brain is to predictively regulate physiological resources to coordinate the body’s motor activity and learning in the short term, and to meet the body’s needs for growth, survival, and reproduction in the long term. This process of managing the brain and body’s energy needs, called allostasis, is based on the premise that a brain anticipates bodily needs and attempts to meet those needs before they arise (e.g., vestibular activity that raises sympathetic nervous system activity before standing), because this is more efficient than responding to energetic needs after the fact. In this view, all mental events—cognition, emotion, perception, and action—are shaped by allostasis, and thus all decision making is embodied, predictive, and concerned with balancing energy needs. We also posit a key role for the autonomic nervous system (ANS) in regulating short-term energy expenditures, such that the ANS influences experience and behavior under stressful circumstances, including police decision making. In this paper, we first explain the core features of the TCE, and then offer insights for understanding police decision making in complex, real-world situations. In so doing, we describe how the TCE can be used to guide future studies of realistic decision making in occupations in which people commonly make decisions in evocative situations or under time pressure, such as in law enforcement.

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Computerized Exposure Therapy for Spider Phobia: Effects of Cardiac Timing and Interoceptive Ability on Subjective and Behavioral Outcomes

Abstract: (2019) Computerized exposure therapy for Spider Phobia: Effects of cardiac timing and interoceptive ability on subjective and behavioral outcomes. Psychosomatic Medicine, 81 (1). pp. 90-99.

Cited by 13 publications

References 82 publications

Feeling in Control: The Role of Cardiac Timing in the Sense of Agency

Feeling in Control: The Role of Cardiac Timing in the Sense of Agency

Interoceptive Axes Dissociation in Anorexia Nervosa: A Single Case Study With Follow Up Post-recovery Assessment

Applying the Theory of Constructed Emotion to Police Decision Making

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