Interoception in anxiety and depression

Paulus, Martin P.; Stein, Murray B.

doi:10.1007/s00429-010-0258-9

Cited by 709 publications

(741 citation statements)

References 162 publications

(176 reference statements)

Supporting

Mentioning

645

Contrasting

Unclassified

Order By: Relevance

“…The anterior insula is critical for interoception (Craig, 2009) and integration of emotional information (Lamm and Singer, 2010). Recent theoretical models have highlighted the role of the insula in maintaining problematic anxiety (Paulus and Stein, 2010). The identification of these regions as predictive by the random forest model provides face validity given their role in emotion regulation and anxiety pathology.…”

Section: Discussionmentioning

confidence: 99%

Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Ball

Stein

Ramsawh

et al. 2013

Neuropsychopharmacol

104

View full text Add to dashboard Cite

The possibility of individualized treatment prediction has profound implications for the development of personalized interventions for patients with anxiety disorders. Here we utilize random forest classification and pre-treatment functional magnetic resonance imaging (fMRI) data from individuals with generalized anxiety disorder (GAD) and panic disorder (PD) to generate individual subject treatment outcome predictions. Before cognitive behavioral therapy (CBT), 48 adults (25 GAD and 23 PD) reduced (via cognitive reappraisal) or maintained their emotional responses to negative images during fMRI scanning. CBT responder status was predicted using activations from 70 anatomically defined regions. The final random forest model included 10 predictors contributing most to classification accuracy. A similar analysis was conducted using the clinical and demographic variables. Activations in the hippocampus during maintenance and anterior insula, superior temporal, supramarginal, and superior frontal gyri during reappraisal were among the best predictors, with greater activation in responders than non-responders. The final fMRI-based model yielded 79% accuracy, with good sensitivity (0.86), specificity (0.68), and positive and negative likelihood ratios (2.73, 0.20). Clinical and demographic variables yielded poorer accuracy (69%), sensitivity (0.79), specificity (0.53), and likelihood ratios (1.67, 0.39). This is the first use of random forest models to predict treatment outcome from pre-treatment neuroimaging data in psychiatry. Together, random forest models and fMRI can provide single-subject predictions with good test characteristics. Moreover, activation patterns are consistent with the notion that greater activation in cortico-limbic circuitry predicts better CBT response in GAD and PD.

show abstract

Section: Discussionmentioning

confidence: 99%

Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Ball

Stein

Ramsawh

et al. 2013

Neuropsychopharmacol

104

View full text Add to dashboard Cite

show abstract

“…These interoceptive prediction errors have been associated with heightened anxiety and can act as a potent motivation to avoid the triggering stimulus‐ such as food or tastes (Kaye et al, 2004; Paulus & Stein, 2010). This could indicate that sensory prediction errors in AN are not isolated to interoception, but also exist in other, exteroceptive, sensory domains, such as taste, warranting further research.…”

Section: Discussionmentioning

confidence: 99%

Taste sensitivity in anorexia nervosa: A systematic review

Kinnaird

Stewart

Tchanturia

2018

Intl J Eating Disorders

View full text Add to dashboard Cite

ObjectiveThere is evidence for altered processing of taste in anorexia nervosa, particularly in the areas of reward processing and hedonic sensitivity. However, research on whether people with anorexia nervosa identify taste stimuli accurately, known as taste sensitivity, has yielded mixed findings. The objective of this study was to synthesize the literature on taste sensitivity in this disorder to provide a basis for future discussion on whether altered taste sensitivity may be also implicated in wider atypical taste processing in anorexia.MethodElectronic databases were searched systematically to identify published research examining taste sensitivity in anorexia. Search terms were “anorexia nervosa”, or “eating disorder”, combined with “taste”. 18 studies met inclusion criteria.ResultsThe review of the findings suggest that individuals with AN may experience reduced taste sensitivity that may improve following recovery. However, there was a significant variability in results across studies, potentially reflecting methodological problems including low sample sizes, experimental designs, and uncontrolled confounding variables. Discussion: This review suggests that altered taste sensitivity could represent a component in the wider altered taste processing observed in anorexia nervosa. However, the heterogeneity of findings highlight the need for future research to consider methodological issues raised by this review.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In recent years, the role of the insular cortex in homeostatic integration, interoception and emotional perception has been explored (Craig, 2009;Paulus and Stein, 2010). Activation of the insular cortex has been broadly reported in the context of negative and aversive emotional experiences and has been hypothesized to play a key role in linking belief systems to perceptions of internal states (Paulus and Stein, 2010). Consequently, functional alterations of the insula are assumed to contribute to manifestations of anxiety disorders, where valence and meaning of spontaneously fluctuating bodily signals are often misinterpreted to indicate threatening and anxiety-provoking deviations from a homeostatic equilibrium.…”

Section: Discussionmentioning

confidence: 99%

Altered emotional and BOLD responses to negative, positive and ambiguous performance feedback in OCD

Becker

Nitsch

Schlößer

et al. 2013

Social Cognitive and Affective Neuroscience

View full text Add to dashboard Cite

While abnormal processing of performance feedback has been associated with obsessive-compulsive disorder (OCD), neural responses to different kinds of feedback information, especially to ambiguous feedback are widely unknown. Using fMRI and a performance adaptive time-estimation task, we acquired blood oxygenation level-dependant responses and emotional ratings to positive, negative and ambiguous performance feedback in patients and healthy controls. Negative and ambiguous feedback led to increased levels of anxiety, guilt and shame in patients. Both negative and ambiguous feedback, as compared to positive feedback, induced increased activation of the insular cortex in patients. Furthermore, patients showed no differential activation to negative feedback in the putamen and to ambiguous feedback in the ventromedial prefrontal cortex (VMPFC). Finally, negative feedback induced increased activation in the midcingulate cortex in patients compared to controls. Findings indicate that both negative and ambiguous performance feedbacks are associated with abnormal negative emotions and altered brain activation, in particular increased insula activation, while activation in the putamen and VMPFC does not differentiate between feedback types in OCD patients. This suggests a parallel pattern of increased and decreased neural sensitivity to different kinds of feedback information and a general emotional hyperresponsivity to negative and ambiguous performance feedback in OCD.

show abstract

Interoception in anxiety and depression

Cited by 709 publications

References 162 publications

Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Taste sensitivity in anorexia nervosa: A systematic review

Altered emotional and BOLD responses to negative, positive and ambiguous performance feedback in OCD

Contact Info

Product

Resources

About