Interoception and Its Interaction with Self, Other, and Emotion Processing: Implications for the Understanding of Psychosocial Deficits in Borderline Personality Disorder

Löffler, Annette; Foell, Jens; Bekrater-Bodmann, Robin

doi:10.1007/s11920-018-0890-2

Cited by 44 publications

(44 citation statements)

References 109 publications

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“…The findings described here have implications in diverse clinical contexts, including stroke rehabilitation, adjustment to limb loss, neglect, anosognosia (unawareness of some disability) and asomatognosia (denied ownership of a body part), in that positions of individuals along an axis from autism to typicality to psychotic-affective conditions should impact upon the efficacy and mechanisms of embodiment, and in that, as suggested, sensory acuities may strongly mediate these processes. The results also support the development of novel perspectives and therapies for autism, schizophrenia, and anorexia, that are based on experimental alterations to perception, self-perception and self-other boundaries [40, 197–199]; for example, the internal ‘emptiness’ expressed by many subjects with borderline personality and schizophrenia [184, 187] may be due to reduced efficacy and cognitive influence of interoception [33] that can be ameliorated by training [200]. Similarly, the mechanisms that ‘protect’ autism spectrum individuals from the psychotic nature of the rubber hand illusion (including amygdala effects [83]) may be useful for treatment of individuals with psychosis, or those at high risk.…”

Section: Discussionsupporting

confidence: 55%

Autism and psychosis as diametrical disorders of embodiment

Crespi

Dinsdale

2019

Evolution, Medicine, and Public Health

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Humans have evolved an elaborate system of self-consciousness, self-identity, self-agency, and self-embodiment that is grounded in specific neurological structures including an expanded insula. Instantiation of the bodily self has been most-extensively studied via the ‘rubber hand illusion’, whereby parallel stimulation of a hidden true hand, and a viewed false hand, leads to the felt belief that the false hand is one’s own. Autism and schizophrenia have both long been regarded as conditions centrally involving altered development of the self, but they have yet to be compared directly with regard to the self and embodiment. Here we synthesize the embodied cognition literature for these and related conditions, and describe evidence that these two sets of disorders exhibit opposite susceptibilities from typical individuals to the rubber hand illusion: reduced on the autism spectrum and increased in schizophrenia and other psychotic-affective conditions. Moreover, the opposite illusion effects are mediated by a consilient set of associated phenomena, including empathy, interoception, anorexia risk and phenotypes, and patterns of genetic correlation. Taken together, these findings: (1) support the diametric model of autism and psychotic-affective disorders, (2) implicate the adaptive human system of self-embodiment, and its neural bases, in neurodevelopmental disorders, and suggest new therapies, and (3) experimentally-ground bayesian predictive coding models with regard to autism compared to psychosis.

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Section: Discussionsupporting

confidence: 55%

Autism and psychosis as diametrical disorders of embodiment

Crespi

Dinsdale

2019

Evolution, Medicine, and Public Health

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“…Similarly, several studies have been conducted with eating disorder subjects (Jenkinson et al 2018) and reviewed sensory processing deficits in bulimia (Klabunde et al 2017), general interoceptive appraisal dysfunctions (Brown et al 2017), and reduced interoceptive accuracy (Kunstman et al 2016). Interoceptive dysfunctions of various kinds have also been found in individuals with obsessive compulsive disorder (Yoris et al 2017), borderline personality disorder (Loffler et al 2018), and female sexual arousal disorder (Handy & Meston 2018). Several medical conditions have also been linked to interoceptive processing deficits.…”

Section: Clinical Examples Of Interoceptive Dysfunctionmentioning

confidence: 99%

An Active Inference Approach to Interoceptive Psychopathology

Paulus

Feinstein

Khalsa

2019

Annu. Rev. Clin. Psychol.

233

212

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Interoception refers to the process by which the nervous system senses and integrates signals originating from within the body, providing a momentary mapping of the body's internal landscape and its relationship to the outside world. Active inference is based on the premise that afferent sensory input to the brain is constantly shaped and modified by prior expectations. In this review we propose that interoceptive psychopathology results from two primary interoceptive dysfunctions: First, individuals have abnormally strong expectations of the situations that elicit bodily change (i.e., hyperprecise priors), and second, they have great difficulty adjusting these expectations when the environment changes (i.e., context rigidity). Here we discuss how these dysfunctions potentially manifest in mental illness and how interventions aimed at altering interoceptive processing can help the brain create a more realistic model of its internal state.

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“…One aspect of selfhood that may have relevance for pathologies of self in BPD is the experience of body ownership. Indeed, abnormal bodily experiences in BPD are common, including bodily dissociation [5], altered pain perception [6],and deficits in interoception (the awareness and processing of internal bodily signals) [7].…”

Section: Bodily Experience Is Disrupted In Bpdmentioning

confidence: 99%

Induced illusory body ownership in Borderline Personality Disorder

Neustadter

Fineberg

Leavitt

et al. 2019

Preprint

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word count: 261 34 35 Main Text Word Count: 5512 Abstract 46Background: One aspect of selfhood that may have relevance for Borderline Personality 47 Disorder (BPD) is variation in sense of body ownership. We employed the rubber hand illusion 48 (RHI) to manipulate sense of body ownership in BPD. We extended previous research on 49 illusory body ownership in BPD by testing: 1) two illusion conditions: asynchronous & 50 synchronous stimulation, 2) relationship between Illusion experience and core BPD symptoms, 51 and 3) relationship between illusion experience maladaptive personality traits. 53Methods: Participants (24 BPD, 21 control) underwent RHI procedures. We measured illusion 54 strength (questionnaire responses), proprioceptive drift (perceived shift in physical hand 55 position), BPD symptoms (DIB-R score), and maladaptive personality traits (PID-5). 57Results: For subjective illusion strength, we found a main effect of group (BPD > HC, F = 11.94 58 p = 0.001), and condition (synchronous > asynchronous, F(1,43) = 22.80, p < 0.001). There was 59 a group x condition interaction for proprioceptive drift (F(1,43) = 6.48, p = 0.015) such that 60 people with BPD maintained illusion susceptibility in the asynchronous condition. Borderline 61 symptom severity correlated with illusion strength within the BPD group, and this effect was 62 specific to affective symptoms (r = 0.481, p < 0.01). Across all participants, trait psychoticism 63 correlated with illusion strength (r = 0.481, p <0.01). 65Conclusion: People with BPD are more susceptible to illusory body ownership than are healthy 66 controls. This result is consistent with the robust clinical literature describing aberrant physical 67 and emotional experience of self in BPD. A predictive coding interpretation of these results 68 holds promise to develop testable mechanistic hypotheses for experiences of disrupted bodily 69 self in BPD. 70 71 72 73 74 75 76 77 78 79 3 1. Introduction 80 1.1. The embodied self in Borderline Personality Disorder 81 1.1.1. Self-disturbance is a core feature of BPD 82 Aberrations of self-experience and identity are considered a core symptoms of 83 Borderline Personality Disorder (BPD) [1]. Self-disturbance is characterized by a markedly 84 persistent unstable sense of self that can be realized by dramatic shifts in self-image, shifting 85 goals and values, and feelings of emptiness, dissociation, and non-existence [2, 3]. These 86 experiences are distressing and dangerous; in a qualitative study, Brown et al. [4] found that 87 more than 50% of women with BPD and history of self-harm endorsed disturbances in self-88 experience, such as emptiness, numbness, or feeling dead, as reasons for non-suicidal self-89 injury . 90 91 1.1.2. Bodily experience is disrupted in BPD 92 One aspect of selfhood that may have relevance for pathologies of self in BPD is the experience 93 of body ownership. Indeed, abnormal bodily experiences in BPD are common, including bodily 94 dissociation [5], altered pain perception [6],and deficits in interoception...

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Interoception and Its Interaction with Self, Other, and Emotion Processing: Implications for the Understanding of Psychosocial Deficits in Borderline Personality Disorder

Cited by 44 publications

References 109 publications

Autism and psychosis as diametrical disorders of embodiment

Autism and psychosis as diametrical disorders of embodiment

An Active Inference Approach to Interoceptive Psychopathology

Induced illusory body ownership in Borderline Personality Disorder

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