Interoception, the ability to feel the body’s internal sensations, is an essential aspect of emotional experience. There is mounting evidence that interoception is impaired in common mental health disorders and that poor interoceptive awareness is a major contributor to emotional reactivity, calling for clinical interventions to address this deficit. The manuscript presents a comprehensive theoretical review, drawing on multidisciplinary findings to propose a metatheory of reinforcement mechanisms applicable across a wide range of disorders. We present a reconsideration of operant conditioning (...) through the co-emergence model of reinforcement, which is a neurophenomenological account of the interaction between cognition and interoception, and its consequences on behavior. The model suggests that during memory processing, the retrieval of autobiographical memory (including maladaptive cognition) is dependent upon its co-emerging interoceptive cues occurring at the encoding, consolidation and reconsolidation stages. Accordingly, “interoceptive reinforcement” during emotional distress is a common factor to all emotional disorders and a major cause for relapse. We propose that interoceptive desensitization has transdiagnostic benefits, readily achievable through the cultivation of equanimity during mindfulness training and can be integrated in cognitive and behavioral interventions to permit a transdiagnostic applicability. We summarize the contributions of this approach into 10 specific and testable propositions. (shrink)

ObjectivePrevious research has shown reduced interoceptive accuracy in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of IAcc on depression and attention.MethodsThirty-six depressed patients from the Psychosomatic Clinic in Windach were matched with 36 healthy controls according to age and sex and were assessed at Ulm University. All (...) participants completed the Beck Depression Inventory-II, the heartbeat perception task to examine IAcc, and the d2 test assessing selective attention.ResultsDepressed patients showed attention deficits—both for general visual attention and IAcc—compared to healthy controls. The mediation analyses revealed that the relationship between depression and attention is not mediated via IAcc. Furthermore, depression predicts IAcc and attention, but these effects are direct and largely unaffected by the respective other variable.DiscussionThe results of the present study highlight both interoceptive as well as attention deficits in depressed patients. No clear mediation between these variables could be shown in this study. More elaborative research is needed to clarify whether different approaches to improve IAcc are effective for these deficits in depressed patients and could therefore be of importance as an additional aspect of therapy in depression. (shrink)

Risky behaviour may be associated with visceral experiences, such as increased heart rate. Previous studies examining the relationship between perception of such signals (interoception) and risk-taking typically used behavioural tasks with potential for monetary reward. This approach may be less informative for understanding general risk propensity. In addition, such research does not usually consider the varied ways individuals engage with interoceptive signals. However, examining these different forms of engagement may help us understand how subjective experience of interoception influences risk-taking. As (...) such, we performed two surveys (n = 471, primarily young adults) to examine the relationship between self-reported engagement with interoceptive signals (measured using the Multidimensional Assessment of Interoceptive Awareness) and a generalised measure of risk propensity (the General Risk Propensity Scale). Results indicated that different ways of interpreting or engaging with interoceptive signals were differentially associated with risk propensity. In particular, they provide preliminary evidence that those with the ability to ignore or not worry about visceral signals when they are uncomfortable display greater risk propensity (and these effects may possibly be gender-specific). (shrink)

The capacity to perceive internal bodily states is linked to emotional awareness and effective emotional regulation. We explore individual differences in emotional awareness in relation to the fading affect bias, which refers to the greater dwindling of unpleasant compared to pleasant emotions in autobiographical memory. We consider interoceptive awareness and alexithymia in relation to the FAB, and private event rehearsal as a mediating process. With increasing interoceptive awareness, there was an enhanced FAB, but with increasing alexithymia, there was a decreased (...) FAB. Further, the effects of interoceptive awareness were partially mediated by private rehearsal of pleasant events. We provide novel evidence that capacity for emotional awareness and thus effective processing is an important factor predictive of the FAB. Moreover, our results imply an important role for maintaining positive affect in the FAB. Our findings offer new insights into the effects of interoception and alexithymia on autobiographical memory, and support concepts of the FAB emerging as a result of adaptive emotional regulation processes. (shrink)

Research on bodily awareness has focused on body illusions with an aim to explore the possible dissociation of our bodily awareness from our own body. It has provided insights into how our sensory modalities shape our sense of embodiment, and it has raised important questions regarding the malleability of our sense of ownership over our own body. The issue, however, is that this research fails to consider an important distinction in how we experience our body. There are indeed two ways (...) in which we can be aware of our body: via observational awareness, which involves attending to the body as an object, and via non-observational awareness, where the body is given as the subject of experience and does not involve attention. The research to date has focused on the former—observational bodily awareness—and has left the latter—non-observational bodily awareness—in the dark. This is detrimental to ever formulating a complete account of how we are aware of our body. It is understandable, however, because of the inherent problem in studying non-observational bodily awareness: how would you instruct subjects to report on their unattended bodily awareness? In view to resolving this problem, I propose here a working hypothesis on the basis of research on interoception and the rubber hand illusion, and on the effect of meditation on awareness and attention. This working hypothesis can show us a way to begin studying non-observational bodily awareness, and finally build a complete theory of bodily awareness. (shrink)