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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.
Internal signals like one's heartbeats are centrally processed via specific pathways and both their neural representations as well as their conscious perception (interoception) provide key information for many cognitive processes. Recent empirical findings propose that neural processes in the insular cortex, which are related to bodily signals, might constitute a neurophysiological mechanism for the encoding of duration. Nevertheless, the exact nature of such a proposed relationship remains unclear. We aimed to address this question by searching for the effects of cardiac rhythm on time perception by the use of a duration reproduction paradigm. Time intervals used were of 0.5, 2, 3, 7, 10, 14, 25, and 40s length. In a framework of synchronization hypothesis, measures of phase locking between the cardiac cycle and start/stop signals of the reproduction task were calculated to quantify this relationship. The main result is that marginally significant synchronization indices (Sls) between the heart cycle and the time reproduction responses for the time intervals of 2, 3, 10, 14, and 25s length were obtained, while results were not significant for durations of 0.5, 7, and 40s length. On the single participant level, several subjects exhibited some synchrony between the heart cycle and the time reproduction responses, most pronounced for the time interval of 25s (8 out of 23 participants for 20% quantile). Better time reproduction accuracy was not related with larger degree of phase locking, but with greater vagal control of the heart. A higher interoceptive sensitivity (IS) was associated with a higher synchronization index (SI) for the 2s time interval only. We conclude that information obtained from the cardiac cycle is relevant for the encoding and reproduction of time in the time span of 2-25s. Sympathovagal tone as well as interoceptive processes mediate the accuracy of time estimation.
Objectives: Alexithymia is characterized by a difficulty in identifying and describing one's emotions. Recent research has associated differential effects of the alexithymia facets to hypothalamic pituitary adrenal (HPA) axis markers during stress. This study aimed to analyze how the facets of alexithymia interact with autonomic reactivity as well as self- and observer-rated anxiety during a social stress task. Methods: With the use of a public-speaking paradigm, skin conductance levels (SCLs) and heart rate (HR) during the defined periods of baseline, preparation, stress, and recovery were assessed in 60 volunteers (42 females, mean age 22.8) categorized as having either high (HDA) or low (LDA) degrees of alexithymia. Results: We found smaller SCLs during preparation and speech in the HDA group. Regression analyses indicated that only the alexithymia facet "difficulty in describing feelings" (DDF) was associated with smaller electrodermal responses. In the HDA group, self- and observer-rated anxiety was higher in the HDA than in the LDA group, which was attributable to higher scores in the subscales "difficulty in identifying feelings" (DIF) and "externally oriented thinking" (EOT). Conclusions: Our data support and specify the decoupling hypothesis of alexithymia by showing that the facets of alexithymia are differentially related to autonomic reactivity as well as self- and observer-rated anxiety during social stress.
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.
Abstract Alexithymia is characterized by a difficulty in identifying and describing one"s emotions. This study addressed the question of whether alexithymic tendencies are related to limited affective reactivity to briefly presented emotional stimuli. Skin conductance responses were assessed and backward masking was used to minimize elaborated processing of emotional pictures. Results indicated that alexithymic tendencies are associated with smaller electrodermal responses to briefly presented negative pictures. These effects were driven by difficulties in identifying and communicating emotions whereas externally orientated thinking was unrelated to affective reactivity. We conclude that there is an early processing deficit in response to negative stimuli in participants with high scores in alexithymia. Differences in the early emotional reactivity to arousing material could contribute to difficulties in emotional processes related to alexithymia.
The ability to perceive interoceptive signals plays a central role in many theories of emotions. The present study was designed to investigate the relationship between interoceptive awareness and the conscious processing and memory of emotional information. Heart-rate changes were recorded during baseline and affective picture presentation in two groups of participants, differing in cardiac awareness. After a 60-minute break, a recognition task was conducted. Statistical analyses revealed significantly stronger heart-rate deceleration to pleasant and unpleasant stimuli in participants with high interoceptive awareness. In the subsequent picture recognition task, participants with high interoceptive awareness demonstrated a superior recall of pleasant and unpleasant pictures, while no differences were found between interoceptive awareness groups for pictures of neutral content. Our results demonstrate a strong relationship between the perception of cardiac signals and both the processing as well as the recognition of emotional stimuli. High interoceptive awareness was related to increased physiological responses to emotional stimuli and is therefore an important mediating variable when investigating cardiovascular reactivity both in healthy subjects as well as in clinical populations.
Introduction:
Decision making results not only from logical analyses, but seems to be further guided by the ability to perceive somatic information (interoceptive accuracy). Relations between interoceptive accuracy and decision making have been exclusively studied in adults and with regard to complex, uncertain situations (as measured by the Iowa Gambling Task, IGT).
Methods:
In the present study, 1454 children (6-11 years) were examined at two time points (approximately 1 year apart) using an IGT as well as a delay-of-gratification task for sweets-items and toy-items. Interoceptive accuracy was measured using a child-adapted version of the Heartbeat Perception Task.
Results:
The present results revealed that children with higher, as compared to lower, interoceptive accuracy showed more advantageous choices in the IGT and delayed more sweets-items, but not toy-items, in a delay-of-gratification task at time point 2 but not at time point 1. However, no longitudinal relation between interoceptive accuracy and decision making 1 year later could be shown.
Discussion:
Results indicate that interoceptive accuracy relates to decision-making abilities in situations of varying complexity already in middle childhood, and that this link might consolidate across the examined 1-year period. Furthermore, the association of interoceptive accuracy and the delay of sweets-items might have implications for the regulation of body weight at a later age.
The perception of time is a fundamental part of human experience. Recent research suggests that the experience of time emerges from emotional and interoceptive (bodily) states as processed in the insular cortex. Whether there is an interaction between the conscious awareness of interoceptive states and time distortions induced by emotions has rarely been investigated so far. We aimed to address this question by the use of a retrospective time estimation task comparing two groups of participants. One group had a focus on interoceptive states and one had a focus on exteroceptive information while watching film clips depicting fear, amusement and neutral content. Main results were that attention to interoceptive processes significantly affected subjective time experience. Fear was accompanied with subjective time dilation that was more pronounced in the group with interoceptive focus, while amusement led to a quicker passage of time which was also increased by interoceptive focus. We conclude that retrospective temporal distortions are directly influenced by attention to bodily responses. These effects might crucially interact with arousal levels. Sympathetic nervous system activation affecting memory build-up might be the decisive factor influencing retrospective time judgments. Our data substantially extend former research findings underscoring the relevance of interoception for the effects of emotional states on subjective time experience.
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: Somatoform disorders are characterized by the presence of multiple somatic symptoms. While the accuracy of perceiving bodily signal (interoceptive awareness) is only sparely investigated in somatoform disorders, recent research has associated autonomic imbalance with cognitive and emotional difficulties in stress-related diseases. This study aimed to investigate how sympathovagal reactivity interacts with performance in recognizing emotions in faces (facial recognition task).
Methods: Using a facial recognition and appraisal task, skin conductance levels (SCLs), heart rate (HR) and heart rate variability (HRV) were assessed in 26 somatoform patients and compared to healthy controls. Interoceptive awareness was assessed by a heartbeat detection task.
Results: We found evidence for a sympathovagal imbalance in somatoform disorders characterized by low parasympathetic reactivity during emotional tasks and increased sympathetic activation during baseline. Somatoform patients exhibited a reduced recognition performance for neutral and sad emotional expressions only. Possible confounding variables such as alexithymia, anxiety or depression were taken into account. Interoceptive awareness was reduced in somatoform patients.
Conclusions: Our data demonstrate an imbalance in sympathovagal activation in somatoform disorders associated with decreased parasympathetic activation. This might account for difficulties in processing of sad and neutral facial expressions in somatoform patients which might be a pathogenic mechanism for increased everyday vulnerability.