Interoception and Autonomic Correlates during Social Interactions. Implications for Anorexia

Abstract

The aim of this study is to investigate the bodily-self in Restrictive Anorexia, focusing on two basic aspects related to the bodily self: autonomic strategies in social behavior, in which others' social desirability features, and social cues (e.g., gaze) are modulated, and interoception (i.e., the sensitivity to stimuli originating inside the body). Furthermore, since previous studies carried out on healthy individuals found that interoception seems to contribute to the autonomic regulation of social behavior, as measured by Respiratory Sinus Arrhythmia (RSA), we aimed to explore this link in anorexia patients, whose ability to perceive their bodily signal seems to be impaired. To this purpose, we compared a group of anorexia patients (ANg; restrictive type) with a group of Healthy Controls (HCg) for RSA responses during both a resting state and a social proxemics task, for their explicit judgments of comfort in social distances during a behavioral proxemics task, and for their Interoceptive Accuracy (IA). The results showed that ANg displayed significantly lower social disposition and a flattened autonomic reactivity during the proxemics task, irrespective of the presence of others' socially desirable features or social cues. Moreover, unlike HCg, the autonomic arousal of ANg did not guide behavioral judgments of social distances. Finally, IA was strictly related to social disposition in both groups, but with opposite trends in ANg. We conclude that autonomic imbalance and its altered relationship with interoception might have a crucial role in anorexia disturbances.

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

“…Contrary to the hypothesis that people with AN would exhibit lowered cardiac interoceptive accuracy compared to HC, the study found no significant differences between groups in heartbeat tracking performance. This is in line with a number of recent studies, including two that were published after the hypotheses for the current study were generated (12)(13)(14). The findings of the present study, and more recent research, contrast with previous research using the heartbeat tracking task in AN which found lowered accuracy in this population (10,11).…”

“…Using the heartbeat tracking task, two initial studies found that people with AN had lower interoceptive accuracy (10,11). By contrast, three more recent studies using the same measure found no significant differences between people with AN and healthy controls (HC) (12)(13)(14). One previous study has used a heartbeat discrimination task, finding no differences between people with AN and HC (15).…”

“…An additional difficulty in using this test to measure interoceptive accuracy in AN is the potential influence of related clinical variables. For example, previous research has considered the role of depression and anxiety when exploring this area, variables known to be associated with altered interoceptive accuracy (11,12,26,27). However, to date, no research has explored whether there is an association between alexithymia, autistic traits and interoception in AN.…”

Associations between interoceptive sensitivity, intuitive eating, and body mass index in patients with anorexia nervosa and normal‐weight controls

“…In contrast to previous reports (Fischer et al, ; Pollatos et al, ), but in line with others (Ambrosecchia et al, ; Eshkevari et al, ), we did not find evidence for lower heartbeat perception in AN patients compared with HCs using a heartbeat perception task. This may be due to sample differences (e.g., inpatient vs. outpatient, smaller sample sizes, or presence of comorbidities) and resulting heterogeneity in weight and treatment progress.…”

“…Yet the known limitations of self‐report have driven the search for more objective measures. One psychophysiological indicator of interoceptive processes—accuracy of heartbeat perception (e.g., Schandry, )—yielded more heterogeneous results: Although some studies indeed found lower accuracy in perceiving heartbeats in AN (e.g., Fischer et al, ; Pollatos et al, ), others did not find evidence for altered heartbeat perception (e.g., Ambrosecchia et al, ; Eshkevari, Rieger, Musiat, & Treasure, ). Thus, moderating factors might contribute to such heterogeneity.…”