The relationship between social anxiety and heartbeat evoked potential amplitude

Judah, Matt R.; Shurkova, Ekaterina Y.; Hager, Nathan; White, Evan J.; Taylor, Danielle L.; Grant, DeMond M.

doi:10.1016/j.biopsycho.2018.09.013

Cited by 27 publications

(29 citation statements)

References 50 publications

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“…Patients with OCD exhibit greater HEP amplitude modulation during cardiac interoception, indicating that hyperactive monitoring in OCD extends to the sensing of internal bodily signals (68). Enhanced HEP amplitude during false feedback of accelerated heart rate in a study of social anxiety is consistent with the theoretical prediction of increased self-focus driven by concerns of somatic symptoms (69). The reduced HEP amplitudes indicative of deficient attentive processing of bodily experiences in patients with depression and depersonalization/derealization disorder (DPD) (40, 42, 70) support our results as well.…”

Section: Discussionsupporting

confidence: 78%

“…Higher HEP amplitudes during the EO state in patients with GAD may reflect excessive cortical processing of afferent cardiac signals when external visual information needs to be processed. This phenomenon may be attributed to unconscious attentional bias toward anxiety-related body sensations in GAD, similar to the increased interoceptive processing in insomnia (ID) (48), obsessive-compulsive disorder (OCD) (68), and the social anxiety disorder (69). Insomnia is characterized with physiological and cortical hyperarousal, and the higher amplitude of late HEP component in ID than controls at frontal electrodes during EC and EO resting states was interpreted as a possible attentive processing of afferent stimuli (48).…”

Section: Discussionmentioning

confidence: 99%

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Altered Interoceptive Processing in Generalized Anxiety Disorder—A Heartbeat-Evoked Potential Research

Pang

Tang

et al. 2019

Front. Psychiatry

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Generalized anxiety disorder (GAD) is one of the most common anxiety disorders. The brain’s dysfunctional processing of interoceptive information is increasingly recognized as an important component of anxiety disorders. However, the neural mechanisms remain insufficiently understood. In the present study, patients with GAD and healthy control participants underwent an eyes-closed (EC) resting state (interoception) and eyes-open (EO) resting state (exteroception) without paying conscious attention to heartbeat. Electrocardiography (ECG) and electroencephalography (EEG) signals were recorded at the same time. The results show that in healthy controls, the heartbeat-evoked brain potential (HEP) was modulated by the conditions, with a significantly higher amplitude under EC than EO, while this was not the case in GAD patients. Further analysis revealed that the dysfunction of HEP modulation in GAD patients may be attributed to excessive interoceptive processing under EO, with a marginally higher HEP in GAD than in the healthy controls. Finally, the right prefrontal HEP amplitude during EC condition was significantly correlated with the severity of the patients’ anxiety symptoms. Our results suggest that altered cortical processing of interoceptive signals may play an important role in the pathophysiology of generalized anxiety disorder.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Altered Interoceptive Processing in Generalized Anxiety Disorder—A Heartbeat-Evoked Potential Research

Pang

Tang

et al. 2019

Front. Psychiatry

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“…Studies included in systematic review only (Baranauskas et al, 2017;Schandry et al, 1986;Yuan et al, 2007) Studies included in both systematic review and meta-analysis (Canales-Johnson et al, 2015;de la Fuente et al, 2019;Fukushima et al, 2011;García-Cordero et al, 2017;Gray et al, 2007;Huang et al, 2018;Ito et al, 2019;Judah et al, 2018;Katkin et al, 1991;Leopold Schandry, 2001;Luft Bhattacharya, 2015;Lutz et al, 2019;MacKinnon et al, 2013;Mai et al, 2018;Marshall et al, 2017Marshall et al, , 2018Montoya et al, 1993;Müller et al, 2015;Pang et al, 2019;Park et al, 2016;Perogamvros et al, 2019;Petzschner et al, 2019;Pollatos et al, 2005Pollatos et al, , 2016Pollatos Schandry, 2004;Salamone et al, 2018;R. Schandry Weitkunat, 1990;Schulz et al, 2013Schulz et al, , 2018Schulz, Ferreira de Sá, et al, 2015;Schulz, Köster, et al, 2015;Sel et al, 2017;Shao et al, 2011;Terhaar et al, 2012;Villena-González et al, 2017;Wei et al, 2016;A.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of the relationship between the heartbeat-evoked potential and interoception

Coll

Hobson

Bird

et al. 2021

Neuroscience & Biobehavioral Reviews

129

128

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“…Consistent with these theoretical considerations, altered HEPs have been found in psychopathological disorders that are clinically characterized by reduced capacity for interoception and poor awareness of own feelings. For instance, smaller HEP amplitudes have been observed in depression compared to controls [30], whereas increased amplitudes have been reported in social anxiety disorder [31,32]. To date, only a few studies have investigated interoception in BPD.…”

Section: Introductionmentioning

confidence: 99%

Altered interoception in patients with borderline personality disorder: a study using heartbeat-evoked potentials

Flasbeck

Popkirov

Ebert

et al. 2020

bord personal disord emot dysregul

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Background Patients with borderline personality disorder (BPD) experience difficulties in emotional awareness (alexithymia), and often develop dissociative symptoms, which may reflect broader deficits in interoceptive awareness. Whether this is associated with alterations in cortical processing of interoception is currently unknown. Methods We utilized an electrophysiological marker of interoception, i.e. heartbeat-evoked potentials (HEP), and examined its relationship with electrocardiographic correlates of autonomic nervous system (ANS) functioning (heart rate variability), and with self-report measures of alexithymia, dissociation and borderline symptom severity in patients with BPD. Results Individuals with BPD had higher HEP amplitudes over frontal electrodes compared to healthy controls. Sympathetic ANS activity was greater in BPD patients than in controls. Across groups, HEP amplitudes were associated with parasympathetic activity over central electrodes and correlated with alexithymia over frontal electrodes. Conclusions These findings support the idea that difficulties in emotional awareness in BPD are reflected in altered frontal electrophysiological markers of interception. Therefore, emotional awareness can be understood as failures of modulation between interoceptive and exteroceptive attention. Future research may aim to investigate whether altered interoception and its electrophysiological correlates are malleable by therapeutic intervention.

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The relationship between social anxiety and heartbeat evoked potential amplitude

Cited by 27 publications

References 50 publications

Altered Interoceptive Processing in Generalized Anxiety Disorder—A Heartbeat-Evoked Potential Research

Altered Interoceptive Processing in Generalized Anxiety Disorder—A Heartbeat-Evoked Potential Research

Systematic review and meta-analysis of the relationship between the heartbeat-evoked potential and interoception

Altered interoception in patients with borderline personality disorder: a study using heartbeat-evoked potentials

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