Is it all top-down? Influence of cognition and categorization on interoceptive sensitivity and bias in health anxiety
Final Report Abstract
Our body is in a constant process of change in order to be optimally adapted to all requirements. For this, external and internal stimuli must be processed efficiently. The unconscious and conscious processing of all body signals is called interoception. According to the predictive coding theory, interoception is a constructive process. Our conscious perceptions of body sensations and symptoms emerge from a matching of predictions about our bodily signals formed in our brains and the signals themselves sent from the body to the brain. The simulation-based approach is particularly fast and thus efficient. Under certain circumstances, however, our conscious perceptions may be decoupled from actual bodily signals and more in line with our brain's predictions. This is especially the case when bodily signals are ambiguous and predictions are assigned a high probability. Accordingly, symptoms may arise because our brain assumes that they occur in specific contexts. In the present project we investigated the influenceability of body perception in the context of illness anxiety. For this purpose, we tested and (further) developed various experiments on tactile, breathing, and heartbeat perception. Thereby, perceptual sensitivity and response biases were separated. Within response biases, a wait-and-see approach is distinguished from a tendency to rather affirm bodily sensations (better-safe-than-sorry-strategy). An unconsciously threatoriented liberal decision criterion in the sense of a "better-safe-than-sorry"-strategy is traded as a possible risk factor for illness anxiety and somatic symptom and related disorders. In one study of the project, negative expectancies about the harmfulness of wi-fi radiation led to more illusory body sensations in tactile perception experiment. When subjects falsely assumed exposure to a strong electromagnetic field, processing of tactile stimuli became more liberal at the perceptual threshold. While tactile sensation increased slightly during multisensory integration in patients with illness anxiety compared to participants without illness anxiety, it tended to decrease somewhat more during simultaneous processing of illness-relevant (versus neutral) words. Contextually or affectively-motivationally reduced awareness could further increase the distortion of bodily sensations. Finally, patients also exhibited a response bias when interoceptive sensations of breathing were arbitrarily grouped into categories. During the implementation of the project, it became clear that valid assessment of (bias in) body perception remains a major challenge. Future scientific work should therefore continue on a consistent definition, nomenclature, and operationalization of interoception across different body domains.
Publications
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Somatosensory Illusions Elicited by Sham Electromagnetic Field Exposure: Experimental Evidence for a Predictive Processing Account of Somatic Symptom Perception. Psychosomatic Medicine, 83(1), 94-100.
Wolters, Carolin; Harzem, Jana; Witthöft, Michael; Gerlach, Alexander L. & Pohl, Anna
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Cardiac interoception: A novel signal detection approach and relations to somatic symptom distress.. Psychological Assessment, 33(8), 705-715.
Pohl, Anna; Hums, Anna-Clara; Kraft, Gina; Köteles, Ferenc; Gerlach, Alexander L. & Witthöft, Michael
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The interplay of interoceptive accuracy, facets of interoceptive sensibility, and trait anxiety: A network analysis. Personality and Individual Differences, 183, 111133.
Slotta, Timo; Witthöft, Michael; Gerlach, Alexander L. & Pohl, Anna
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Interoceptive accuracy and bias in somatic symptom disorder, illness anxiety disorder, and functional syndromes: A systematic review and meta-analysis. PLOS ONE, 17(8), e0271717.
Wolters, Carolin; Gerlach, Alexander L. & Pohl, Anna
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Symptom Perception in Pathological Illness Anxiety: Tactile Sensitivity and Bias. Psychosomatic Medicine, 85(1), 79-88.
Wolters, Carolin; Slotta, Timo; Ratayczak, Judith; Witthöft, Michael; Gerlach, Alexander L. & Pohl, Anna
