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OBJECTIVE: Interoceptive awareness is known to be impaired in eating disorders. To date, it has remained unclear whether this variable is related to the construct of interoceptive sensitivity. Interoceptive sensitivity is considered to be an essential variable in emotional processes. The objective of the study was to elucidate this potential relationship and to clarify whether general interoceptive sensitivity is reduced in anorexia nervosa. METHODS: Using a heartbeat perception task, interoceptive sensitivity was assessed in 28 female patients with anorexia nervosa and 28 matched healthy controls. Questionnaires assessing interoceptive awareness (EDI) and several other variables were also administered. RESULTS: Patients with anorexia nervosa displayed significantly decreased interoceptive sensitivity. They also had more difficulties in interoceptive awareness. CONCLUSIONS: In addition to a decreased ability to recognize certain visceral sensations related to hunger, there is a generally reduced capacity to accurately perceive bodily signals in anorexia nervosa. This highlights the potential importance of interoceptive sensitivity in the pathogenesis of eating disorders.
OBJECTIVES: To elucidate the potential relationship between classification of emotional faces and impaired central processing in eating disorders and to investigate the potential mediatory role of alexithymia and depression in this relationship. METHODS: Visual-evoked potentials (VEPs) to emotional faces and classification performance were assessed in 12 anorexic females and matched healthy controls. RESULTS: Patients with anorexia nervosa showed no modulation of emotional face processing and displayed significantly increased N200 amplitudes in response to all emotional categories and decreased VEPs in response to unpleasant emotional faces in the P300 time range as compared with healthy controls. They also made more mistakes in emotional face recognition, in particular, for neutral, sad, and disgusted content. CONCLUSIONS: There are marked differences in evoked potentials and emotion recognition performances of patients with anorexia nervosa and controls in facial processing. Differences in brain dynamics might contribute to difficulties in the correct recognition of facially expressed emotions, deficits in social functioning, and in turn the maintenance of eating disorders.
Compared with visual and auditory imagery, little is known about olfactory imagery. There is evidence that respiration may be altered by both olfactory perception and olfactory imagery. In order to investigate this relationship, breathing parameters (respiratory minute volume, respiratory amplitude, and breathing rate) in human subjects during olfactory perception and olfactory imagery were investigated. Fifty-six subjects having normal olfactory function were tested. Nasal respiration was measured using a respiratory pressure sensor. Using an experimental block design, we alternately presented odors or asked the subjects to imagine a given smell. Four different pleasant odors were used: banana, rose, coffee, and lemon odor. We detected a significant increase in respiratory minute volume between olfactory perception and the baseline condition as well as between olfactory imagery and baseline condition. Additionally we found significant differences in the respiratory amplitude between imagery and baseline condition and between odor and imagery condition. Differences in the breathing rate between olfactory perception, olfactory imagery, and baseline were not statistically significant. We conclude from our results that olfactory perception and olfactory imagery both have effects on the human respiratory profile and that these effects are based on a common underlying mechanism.
Olfactory performance of patients with anorexia nervosa and healthy subjects in hunger and satiety
(2008)
The aim of this study was to compare the olfactory performance of anorectic patients and healthy controls with regard to the state of satiety. Using the Sniffin" Sticks, sensitivity to a nonfood odor (n-butanol) and to a food- related odor (isoamyl acetate) was assessed in 12 anorectic females and compared with 24 healthy controls. Threshold tests were performed in a hungry as well as in a satiated state, odor discrimination and odor identification only when satiated. Pleasantness of the odors was recorded. In terms of the non-food odor n-butanol, the olfactory sensitivity of anorectic patients and controls did not differ. Patients with anorexia nervosa had a significantly lower detection threshold for the food-related odor, but only in the hungry condition. Anorectic patients showed significant deficits in odor discrimination and identification, and under-evaluated the pleasantness of isoamyl acetate. Our results suggest an impaired projection from secondary to tertiary olfactory structures in anorexia nervosa, based upon the dichotomy of performance between detection threshold and odor discrimination/dentification. The reduced pleasantness of isoamyl acetate indicates a decreased olfactory responsiveness to food stimuli in anorexia nervosa.
The ability to cognitively regulate emotional responses to aversive events is essential for mental and physical health. One prerequisite of successful emotion regulation is the awareness of emotional states, which in turn is associated with the awareness of bodily signals [interoceptive awareness (IA)]. This study investigated the neural dynamics of reappraisal of emotional responses in 28 participants who differed with respect to IA. Electroencephalography was used to characterize the time course of emotion regulation. We found that reappraisal was accompanied by reduced arousal and significant modulation of late neural responses. What is more, higher IA facilitated downregulation of affect and was associated with more pronounced modulation of underlying neural activity. Therefore, we conclude that IA not only advances the consolidation of somatic markers required for guiding individual behaviour but also creates processing advantages in tasks referring to these bodily markers.
The processing of afferent bodily signals is not only of great importance for the control of homeostatic and adaptive processes within the body but, in combination with the perceptibility of internal, bodily reactions ("interoceptive sensitivity"), also influences the regulation of complex cognitive, emotional and behavioral processes. This review article outlines the theoretical basis of interoceptive sensititivity and illustrates recent neuroscientific research and results.
On the relationship between interoceptive awareness and the attentional processing of visual stimuli
(2009)
Mental processes related to visceral activity have gained growing interest during the last few years. The following study is the first to investigate possible interactions between interoceptive awareness and measures of attentional performance. We tested the hypothesis whether interoceptive awareness is positively related to indices of selective and divided attentional performances. Using a heartbeat perception task, 29 healthy female participants were separated into two groups scoring either high or low in an interoceptive awareness task. Attentional performance was assessed by several tests including the 'd2 test of attention' and subtests from the 'TAP: Test Battery for Attentional Performance'. We observed a significantly better performance in selective and divided attention for participants with high interoceptive awareness. Our data suggests that interoceptive awareness is related to a better performance especially in tasks assessing selective and divided attention. We conclude 1) that perception of bodily states might be a crucial determinant for the processing of external, visual stimuli, 2) that the ability to perceive internal signals might be an indicator of self-focused attention, and 3) that bodily signals may use, at least in part, similar processing resources as signals from the attention system.
The aim of the present study was to investigate the test-retest reliability of the olfactory detection threshold subtest of the Sniffin" Sticks test battery, if administered repeatedly on 4 time points. The detection threshold test was repeatedly conducted in 64 healthy subjects. On the first testing session, the threshold test was accomplished 3 times (T(1) = 0 min, T(2) = 35 min, and T(3) = 105 min), representing a short-term testing. A fourth threshold test was conducted on a second testing session (T(4) = 35.1 days after the first testing session), representing a long-term testing. The average scores for olfactory detection threshold for n-butanol did not differ significantly across the 4 points of time. The test-retest reliability (Pearson"s r) between the 4 time points of threshold testing were in a range of 0.43-0.85 (P < 0.01). These results support the notion that the olfactory detection threshold test is a highly reliable method for repeated olfactory testing, even if the test is repeated more than once per day and over a long-term period. It is concluded that the olfactory detection threshold test of the Sniffin" Sticks is suitable for repeated testing during experimental or clinical studies.
BACKGROUND: Feedback from the body is assumed to be altered in depression. Nevertheless, empirical studies investigating this assumed relationship remain sparse. This study aimed to examine interrelations between the ability to perceive heartbeats accurately (interoceptive awareness), depressive symptoms, and anxiety in healthy participants. METHODS: A well-validated heartbeat perception task to measure interoceptive awareness together with two questionnaires indexing anxiety and depression were administered to 119 participants. RESULTS: As main results we observed a negative correlation between heartbeat perception and depression. Only when focussing on high anxiety levels this negative correlation coefficient between depression and interoception remained significant. CONCLUSIONS: Our results highlight the possible relationship between depressive symptoms and interoceptive awareness and may have further implications for theoretical models of anxiety disorders and their treatment. Further research is required to examine the potential consequences of altering interoceptive awareness in healthy subjects in relation to depression and anxiety.
Applied to the nasal mucosa in low concentrations, nicotine vapor evokes odorous sensations (mediated by the olfactory system) whereas at higher concentrations nicotine vapor additionally produces burning and stinging sensations in the nose (mediated by the trigeminal system). The objective of this study was to determine whether intranasal stimulation with suprathreshold concentrations of S(-)-nicotine vapor causes brain activation in olfactory cortical areas or if trigeminal cortical areas are also activated. Individual olfactory detection thresholds for S(-)-nicotine were determined in 19 healthy occasional smokers using a computer-controlled air-dilution olfactometer. Functional magnetic resonance images were acquired using a 1.5T MR scanner with applications of nicotine in concentrations at or just above the individual"s olfactory detection threshold. Subjects reliably perceived the stimuli as being odorous. Accordingly, activation of brain areas known to be involved in processing of olfactory stimuli was identified. Although most of the subjects never or only rarely observed a burning or painful sensation in the nose, brain areas associated with the processing of painful stimuli were activated in all subjects. This indicates that the olfactory and trigeminal systems are activated during perception of nicotine and it is not possible to completely separate olfactory from trigeminal effects by lowering the concentration of the applied nicotine. In conclusion, even at low concentrations that do not consistently lead to painful sensations, intranasally applied nicotine activates both the olfactory and the trigeminal system.