Neural Circuits of Interoception Berntson, Gary G.; Khalsa, Sahib S.
Trends in neurosciences (Regular ed.),
January 2021, 2021-01-00, 20210101, Volume:
44, Issue:
1
Journal Article
Peer reviewed
Open access
The present paper considers recent progress in our understanding of the afferent/ascending neural pathways and neural circuits of interoception. Of particular note is the extensive role of rostral ...neural systems, including cortical systems, in the recognition of internal body states, and the reciprocal role of efferent/descending systems in the regulation of those states. Together these reciprocal interacting networks entail interoceptive circuits that play an important role in a broad range of functions beyond the homeostatic maintenance of physiological steady-states. These include the regulation of behavioral, cognitive, and affective processes across conscious and nonconscious levels of processing. We highlight recent advances and knowledge gaps that are important for accelerating progress in the study of interoception.
The nervous system receives ascending communication of interoceptive signals originating from the periphery via chemoreceptor, mechanoreceptor, and osmoreceptor pathways, several of which were discovered only recently.Visceral systems and associated interoceptive signals are regulated in part by descending central nervous system (CNS) control of the autonomic nervous system, yielding a reciprocal circuit that regulates bodily organs and a wide array of motor, cognitive, and affective processes.A gap in our understanding of how interoceptive signals are relayed through the CNS from the body centers on inputs to the nucleus tractus solitarius and higher relay pathways.The neural circuits of interoception are important for behavioral, cognitive, and emotional regulation across conscious and nonconscious levels of processing.
Background
The Multidimensional Assessment of Interoceptive Awareness (MAIA) is a self-report questionnaire developed by Dr. Mehling that has been widely used to assess multiple dimensions of ...interoceptive awareness. To further improve the MAIA, Mehling developed the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). The goal of this study is to systematically translate the MAIA-2 into Chinese and to investigate the psychometric properties of the Chinese version (MAIA-2C).
Materials and methods
The translation and adaptation of the questionnaire was conducted according to Beaton’s method. A total number of 627 participants were enrolled and completed the survey. The entire sample was randomly divided into a training sample (
n
= 300, 47.8%) and a validation sample (
n
= 327, 52.2%) for a cross-validation. Exploratory factor analysis (EFA) was used to identify the factor structure of the MAIA-2C in the training sample while confirmatory factor analysis (CFA) was used to test the factor structure obtained by EFA. The reliability of the MAIA-2C was indicated by Cronbach’s alpha. The convergent and discriminant validity were assessed by Pearson intercorrelations between the MAIA-2C and the Five-Facet Mindfulness Questionnaire (FFMQ) and State-Trait Anxiety Inventory-Trait anxiety (STAI-T).
Results
The EFA results showed an initial 10-factor model, but some items (1, 2, 3, 4, 15, and 16) were deleted because they did not yield the original subscale construct, eventually resulting in a 7-factor model. The CFA results represented a good model fit (χ
2
/df = 2.170, RMSEA = 0.060, SRMR = 0.0810, CFI = 0.890). The Cronbach’s alpha was 0.822 for the total scale and ranged from 0.656 to 0.838 for the subscales. The results of convergent and discriminant validity showed that most MAIA-2C subscales were correlated with the average score and subscales of FFMQ (
r
= −0.342∼0.535,
p
< 0.05), and all of the subscales of the MAIA-2C showed negative correlations with the STAI-T total score (
r
= −0.352∼−0.080,
p
< 0.05).
Conclusion
The MAIA-2C is a valid and reliable instrument for evaluating multiple dimensions of interoceptive awareness in a Chinese population.
Interventions and Manipulations of Interoception Weng, Helen Y.; Feldman, Jack L.; Leggio, Lorenzo ...
Trends in neurosciences (Regular ed.),
January 2021, 2021-01-00, 20210101, Volume:
44, Issue:
1
Journal Article
Peer reviewed
Open access
Interoceptive pathways may be manipulated at various levels to develop interventions to improve symptoms in a range of disorders. Primarily through the lens of the respiratory system, we outline ...various pathways that can be manipulated at neural, behavioral, and psychological levels to change the representation of and attention to interoceptive signals, which can alter interconnected physiological systems and improve functioning and adaptive behavior. Interventions can alter interoception via neuromodulation of the vagus nerve, slow breathing to change respiratory rate and depth, or awareness processes such as mindfulness-based interventions. Aspects of this framework may be applied to other physiological systems and future research may integrate interventions across multiple levels of manipulation or bodily systems.
Neuromodulation can tap into known interoceptive pathways for clinical benefit.Meditation with sustained interoceptive focus on breath sensations increases the neural activation of interoception networks (including insula) and decreases engagement of the default mode network, which supports self-referential processing.While sympatholytic medications often have intolerable side effects, interoceptive interventions may be a safe and well-tolerated modality to improve sympathetic regulation and thereby reduce the risk of hypertension and cardiovascular disease.Recent findings highlight possible underlying mechanisms of improved interoceptive awareness skills and emotion regulation in mindfulness-based interventions for the treatment of physical and mental health conditions.
Interoceptive body awareness (IA) is crucial for psychological well-being and plays an important role in many contemplative traditions. However, until recently, standardized self-report measures of ...IA were scarce, not comprehensive, and the effects of interoceptive training on such measures were largely unknown. The Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire measures IA with eight different scales. In the current study, we investigated whether and how these different aspects of IA are influenced by a 3-months contemplative intervention in the context of the ReSource project, in which 148 subjects engaged in daily practices of "Body Scan" and "Breath Meditation." We developed a German version of the MAIA and tested it in a large and diverse sample (n = 1,076). Internal consistencies were similar to the English version (0.56-0.89), retest reliability was high (rs: 0.66-0.79), and the MAIA showed good convergent and discriminant validity. Importantly, interoceptive training improved five out of eight aspects of IA, compared to a retest control group. Participants with low IA scores at baseline showed the biggest changes. Whereas practice duration only weakly predicted individual differences in change, self-reported liking of the practices and degree of integration into daily life predicted changes on most scales. Interestingly, the magnitude of observed changes varied across scales. The strongest changes were observed for the regulatory aspects of IA, that is, how the body is used for self-regulation in daily life. No significant changes were observed for the Noticing aspect (becoming aware of bodily changes), which is the aspect that is predominantly assessed in other IA measures. This differential pattern underscores the importance to assess IA multi-dimensionally, particularly when interested in enhancement of IA through contemplative practice or other mind-body interventions.
Our modern society, known as an advanced information society, is transforming our lives at an accelerating pace, and we are required to reevaluate our identity as individuals and develop a ...psychological container that allows us to be part of and hold a variety of selves within the individual. At its core is interoception that connects the external and internal worlds and tries to maintain a certain coherence as a human being. Interoception can be related to a certain extent through conscious awareness, and at the same time, it is positioned as a contact point between mind and body that obeys physiological and material laws.
The phenomenon of vocal fatigue and the types of patients that are at greatest risk for vocal fatigue are not fully understood. The goal was to investigate patient profiles such as voice disorder ...type, demographics (age and gender), singing identity, interoceptive awareness, and psychosocial impacts on the severity of vocal fatigue.
Prospective cohort study.
Ninety-five subjects with voice disorders were asked to complete Part 1 of the Vocal Fatigue Index (VFI-Part1), the Voice Handicap Index-10 (VHI-10), and the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2). The effects of voice disorder type (structural, neurological, functional), psychosocial impact, age, gender, self-reported singing identity, and interoceptive awareness on self-perceived vocal fatigue (VFI-Part1) were determined using multivariate linear regression.
Vocal fatigue had a significant psychosocial impact on patients with voice disorders, as measured by the VHI-10 (P < 0.001). However, there were no significant effects of vocal fatigue across any of the three voice disorder types (P’s >0.05). Age (P = 0.220), gender (P = 0.430), and self-identified singing experience (P = 0.360) also did not have significant effects on vocal fatigue. Additionally, there were no significant relationships between interoceptive awareness MAIA-2 sum scores (P = 0.056) or any of the MAIA-2 sub-scores (P’s > 0.05) and vocal fatigue severity (VFI-Part1).
Vocal fatigue has a significant psychosocial impact on patients with voice disorders. However, patient profiles, including voice disorder type, patient age, gender, singing identity, and level of interoceptive awareness do not appear to play a major role in vocal fatigue symptom reporting. These findings suggest caution should be exercised when attributing patient profiles to vocal fatigue presentation and severity. Studying pathophysiological mechanisms underlying vocal fatigue may help better distinguish unconscious bias in patient profiling from the etiology and severity of vocal fatigue.
Interoception, the sense of the physiological condition of the body, provides a basis for subjective feelings and emotions. Anterior insular cortex activity represents the state of the body and ...varies according to personality traits, such as emotional susceptibility (ES)-the tendency to experience feelings of discomfort and vulnerability when facing emotionally-laden stimuli. The accuracy of perceiving one's own bodily signals, or interoceptive accuracy (IAc), can be assessed with the heartbeat perception task (HPT), which is the experimental measure used by most of the existing research on interoception. However, IAc is only one facet of interoception. Interoceptive awareness (IAw) is the conscious perception of sensations from inside the body, such as heart beat, respiration, satiety, and the autonomic nervous system sensations related to emotions, which create the sense of the physiological condition of the body. We developed an Italian version of the recent self-report Multidimensional Assessment of Interoceptive Awareness (MAIA), tested its psychometric properties (reliability, dimensionality, and construct validity), and examined its relationship to ES, as assessed using the Emotional Susceptibility Scale, in a sample (n = 321) of healthy Italian psychology students (293 females, mean age: 20.5 years). In a subgroup of females (n = 135), we measured IAc with the HPT. We used a series of correlation/regression analyses to examine the complex interplay between the three constructs. We provide further evidence for a substantial independence of the IAc and IAw measures, confirming previous reports and current theoretical models that differentiate between IAc and IAw. Our analyses elucidate the complex relationship between distinct dimensions of IAw and ES, highlighting the need for continued efforts to shed more light on this topic.
The multidimensional assessment of interoceptive awareness (MAIA) is an instrument designed to assess interoceptive awareness. The aim of this study was to adapt the original MAIA scale to Spanish ...and to analyze its psychometric properties in a Chilean population. The MAIA was administered to 470 adults, aged 18-70 years, 76.6% women and 23.4% men, residents of the provinces of Valparaíso and Concepción, Chile. Exploratory factor analysis reduced the scale from 32 to 30 items. Confirmatory factor analysis supports a structure of eight interrelated factors (Noticing, Not-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Self- Regulation, Body Listening, and Trusting), similar to the original scale (χ(2) (371) = 659.78, p = 0.0001; CFI = 0.92, TLI = 0.91, RMSEA = 0.056 and SRMR = 0.059). The Spanish version showed appropriate indicators of construct validity and reliability, with a Cronbach's α of 0.90 for the total scale, and values between 0.40 and 0.86 for the different subscales. Similar to previous studies, low reliability was observed in two of the eight scales (Not-Distracting and Not-Worrying), thus further revision of these subscales is suggested. The Spanish version of MAIA proved to be a valid and reliable tool to investigate interoceptive awareness in the Chilean population.
Objective
Eating disorder (ED) symptoms and transdiagnostic vulnerability characteristics play a crucial role in the aetiology and maintenance of EDs. Over the last decade, researchers have started ...to model complex interrelations between symptoms using network models, but the literature is limited in that it has focused solely on symptoms and investigated‐specific disorders while ignoring transdiagnostic aspects of mental health.
Method
This study tackles these challenges by investigating network relations among core ED symptoms, comorbid clinical symptoms (depression and anxiety) and empirically supported vulnerability and protective mechanisms (personality traits, maladaptive cognitive schemata, perfectionism and resilience) in a sample of 2302 treatment‐seeking ED patients. We estimated a regularized partial correlation network to obtain conditional dependence relations among all variables. We estimated node centrality (interconnectivity) and node predictability (the overall magnitude of symptom inter‐relationships).
Results
The findings indicate a central role of overvigilance, excessive focus on inhibiting emotions and feelings, interoceptive awareness and perfectionism.
Conclusions
These results suggest that excessive control of bodily aspects by dietary restraint (possibly through inhibition) and interoceptive awareness may be important constructs that warrant future research in understanding vulnerability in EDs. We provide all code and data via the Open Science Framework.
Highlights
This network analysis revealed a relationship between body dissatisfaction and transdiagnostic vulnerability factors in ED patients
The results indicate a central role of personal standards (perfectionism), overvigilance and inhibition (maladaptive schemata), and the specific ED symptoms, ineffectiveness and interoceptive awareness
Using motivational strategies for bridging ED symptoms, adequate methods of self‐improvement and adaptive emotion regulation were recommended in the treatment of ED patients
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