Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-19T03:26:06.271Z Has data issue: false hasContentIssue false

The inner world of overactive monitoring: neural markers of interoception in obsessive–compulsive disorder

Published online by Cambridge University Press:  04 April 2017

A. Yoris
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina Anxiety and Trauma Clinic, INECO (Institute of Cognitive Neurology), Buenos Aires, Argentina
A. M. García
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina Faculty of Education, National University of Cuyo, Mendoza, Argentina
L. Traiber
Affiliation:
Anxiety and Trauma Clinic, INECO (Institute of Cognitive Neurology), Buenos Aires, Argentina
H. Santamaría-García
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina Centro de Memoria y Cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia Pontificia Universidad Javeriana, Bogotá, Colombia
M. Martorell
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
F. Alifano
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
R. Kichic
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina Anxiety and Trauma Clinic, INECO (Institute of Cognitive Neurology), Buenos Aires, Argentina
J. S. Moser
Affiliation:
Department of Psychology, Michigan State University, East Lansing, MI, USA
M. Cetkovich
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
F. Manes
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney, Australia
A. Ibáñez
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney, Australia Universidad Autónoma del Caribe, Barranquilla, Colombia Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile
L. Sedeño*
Affiliation:
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
*
*Address for correspondence: L. Sedeño, Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), C1078AAI, Pacheco de Melo 1860, Buenos Aires, Argentina. (Email: lucas.sedeno@gmail.com)

Abstract

Background

Obsessive–compulsive disorder (OCD) patients typically overmonitor their own behavior, as shown by symptoms of excessive doubt and checking. Although this is well established for the patients’ relationship with external stimuli in the environment, no study has explored their monitoring of internal body signals, a process known to be affected in anxiety-related syndromes. Here, we explored this issue through a cardiac interoception task that measures sensing of heartbeats. Our aim was to explore key behavioral and electrophysiological aspects of internal-cue monitoring in OCD, while examining their potential distinctiveness in this condition.

Method

We administered a heartbeat detection (HBD) task (with related interoceptive confidence and awareness measures) to three matched groups (OCD patients, panic disorder patients, healthy controls) and recorded ongoing modulations of two task-relevant electrophysiological markers: the heart evoked potential (HEP) and the motor potential (MP).

Results

Behaviorally, OCD patients outperformed controls and panic patients in the HBD task. Moreover, they exhibited greater amplitude modulation of both the HEP and the MP during cardiac interoception. However, they evinced poorer confidence and awareness of their interoceptive skills.

Conclusions

Convergent behavioral and electrophysiological data showed that overactive monitoring in OCD extends to the sensing of internal bodily signals. Moreover, this pattern discriminated OCD from panic patients, suggesting a condition-distinctive alteration. Our results highlight the potential of exploring interoceptive processes in the OCD spectrum to better characterize the population's cognitive profile. Finally, these findings may lay new bridges between somatic theories of emotion and cognitive models of OCD.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aouizerate, B, Guehl, D, Cuny, E, Rougier, A, Bioulac, B, Tignol, J, Burbaud, P (2004). Pathophysiology of obsessive–compulsive disorder: a necessary link between phenomenology, neuropsychology, imagery and physiology. Progress in Neurobiology 72, 195221.Google Scholar
American Psychiatric Association (1994). DSM-IV: Diagnostic and Statistical Manual. American Psychiatric Association: Washington, DC.Google Scholar
Aravena, P, Hurtado, E, Riveros, R, Cardona, JF, Manes, F, Ibanez, A (2010). Applauding with closed hands: neural signature of action–sentence compatibility effects. PLoS ONE 5, e11751.Google Scholar
Bannon, S, Gonsalvez, CJ, Croft, RJ, Boyce, PM (2002). Response inhibition deficits in obsessive–compulsive disorder. Psychiatry Research 110, 165174.Google Scholar
Barlow, DH, Campbell, LA (2000). Mixed anxiety–depression and its implications for models of mood and anxiety disorders. Comprehensive Psychiatry 41, 5560.Google Scholar
Belloch, A, Morillo, C, Luciano, JV, Garcia-Soriano, G, Cabedo, E, Carrio, C (2010). Dysfunctional belief domains related to obsessive–compulsive disorder: a further examination of their dimensionality and specificity. Spanish Journal of Psychology 13, 376388.CrossRefGoogle ScholarPubMed
Brener, J, Kluvitse, C (1988). Heartbeat detection: judgments of the simultaneity of external stimuli and heartbeats. Psychophysiology 25, 554561.Google Scholar
Brevers, D, Cleeremans, A, Bechara, A, Greisen, M, Kornreich, C, Verbanck, P, Noel, X (2013). Impaired self-awareness in pathological gamblers. Journal of Gambling Studies 29, 119129.CrossRefGoogle ScholarPubMed
Brunia, CH, Van den Bosch, WE (1984). Movement-related slow potentials. I. A contrast between finger and foot movements in right-handed subjects. Electroencephalography and Clinical Neurophysiology 57, 515527.CrossRefGoogle Scholar
Caldara, R, Deiber, MP, Andrey, C, Michel, CM, Thut, G, Hauert, CA (2004). Actual and mental motor preparation and execution: a spatiotemporal ERP study. Experimental Brain Research 159, 389399.CrossRefGoogle ScholarPubMed
Cameron, OG (2001). Interoception: the inside story – a model for psychosomatic processes. Psychosomatic Medicine 63, 697710.CrossRefGoogle Scholar
Canales-Johnson, A, Silva, C, Huepe, D, Rivera-Rei, A, Noreika, V, Garcia, MD, Silva, W, Ciraolo, C, Vaucheret, E, Sedeno, L, Couto, B, Kargieman, L, Baglivo, F, Sigman, M, Chennu, S, Ibanez, A, Rodriguez, E, Bekinschtein, TA (2015). Auditory feedback differentially modulates behavioral and neural markers of objective and subjective performance when tapping to your heartbeat. Cerebral Cortex 25, 44904503.CrossRefGoogle ScholarPubMed
Carrasco, M, Harbin, SM, Nienhuis, JK, Fitzgerald, KD, Gehring, WJ, Hanna, GL (2013). Increased error-related brain activity in youth with obsessive–compulsive disorder and unaffected siblings. Depression and Anxiety 30, 3946.Google Scholar
Coles, ME, Frost, RO, Heimberg, RG, Rheaume, J (2003). “Not just right experiences”: perfectionism, obsessive–compulsive features and general psychopathology. Behaviour Research and Therapy 41, 681700.Google Scholar
Coles, ME, Schofield, CA, Nota, JA (2015). Initial data on recollections of pathways to inflated responsibility beliefs in patients with obsessive–compulsive disorder. Behavioural and Cognitive Psychotherapy 43, 385395.Google Scholar
Couto, B, Adolfi, F, Velasquez, M, Mesow, M, Feinstein, J, Canales-Johnson, A, Mikulan, E, Martinez-Pernia, D, Bekinschtein, T, Sigman, M, Manes, F, Ibanez, A (2015). Heart evoked potential triggers brain responses to natural affective scenes: a preliminary study. Autonomic Neuroscience: Basic and Clinical 193, 132137.CrossRefGoogle ScholarPubMed
Couto, B, Salles, A, Sedeno, L, Peradejordi, M, Barttfeld, P, Canales-Johnson, A, Dos Santos, YV, Huepe, D, Bekinschtein, T, Sigman, M, Favaloro, R, Manes, F, Ibanez, A (2014). The man who feels two hearts: the different pathways of interoception. Social Cognitive and Affective Neuroscience 9, 12531260.Google Scholar
Craig, AD (2002). How do you feel? Interoception: the sense of the physiological condition of the body. Nature Reviews. Neuroscience 3, 655666.CrossRefGoogle Scholar
Craig, AD (2003). Interoception: the sense of the physiological condition of the body. Current Opinion in Neurobiology 13, 500505.CrossRefGoogle ScholarPubMed
Craig, AD (2004). Human feelings: why are some more aware than others? Trends in Cognitive Sciences 8, 239241.Google Scholar
Critchley, HD, Harrison, NA (2013). Visceral influences on brain and behavior. Neuron 77, 624638.Google Scholar
Critchley, HD, Wiens, S, Rotshtein, P, Ohman, A, Dolan, RJ (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience 7, 189195.CrossRefGoogle ScholarPubMed
Cucchi, M, Bottelli, V, Cavadini, D, Ricci, L, Conca, V, Ronchi, P, Smeraldi, E (2012). An explorative study on metacognition in obsessive–compulsive disorder and panic disorder. Comprehensive Psychiatry 53, 546553.Google Scholar
Deecke, L, Bashore, T, Brunia, CH, Grunewald-Zuberbier, E, Grunewald, G, Kristeva, R (1984). Movement-associated potentials and motor control. Report of the EPIC VI Motor Panel. Annals of the New York Academy of Sciences 425, 398428.Google Scholar
Deecke, L, Eisinger, H, Kornhuber, HH (1980). Comparison of Bereitschaftspotential, pre-motion positivity and motor potential preceding voluntary flexion and extension movements in man. Progress in Brain Research 54, 171176.CrossRefGoogle ScholarPubMed
Domschke, K, Stevens, S, Pfleiderer, B, Gerlach, AL (2010). Interoceptive sensitivity in anxiety and anxiety disorders: an overview and integration of neurobiological findings. Clinical Psychology Review 30, 111.Google Scholar
Dum, RP, Levinthal, DJ, Strick, PL (2009). The spinothalamic system targets motor and sensory areas in the cerebral cortex of monkeys. Journal of Neuroscience: the Official Journal of the Society for Neuroscience 29, 1422314235.Google Scholar
Dunn, BD, Dalgleish, T, Ogilvie, AD, Lawrence, AD (2007). Heartbeat perception in depression. Behaviour Research and Therapy 45, 19211930.Google Scholar
Ehlers, A, Breuer, P (1992). Increased cardiac awareness in panic disorder. Journal of Abnormal Psychology 101, 371382.Google Scholar
Endrass, T, Klawohn, J, Schuster, F, Kathmann, N (2008). Overactive performance monitoring in obsessive–compulsive disorder: ERP evidence from correct and erroneous reactions. Neuropsychologia 46, 18771887.Google Scholar
Endrass, T, Schuermann, B, Kaufmann, C, Spielberg, R, Kniesche, R, Kathmann, N (2010). Performance monitoring and error significance in patients with obsessive–compulsive disorder. Biological Psychology 84, 257263.Google Scholar
Endrass, T, Ullsperger, M (2014). Specificity of performance monitoring changes in obsessive–compulsive disorder. Neuroscience and Biobehavioral Reviews 46, 124138.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JB (2002). Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Patient Edition (SCID-I/P) . Biometrics Research, New York State Psychiatric Institute: New York.Google Scholar
Foa, EB, Huppert, JD, Leiberg, S, Langner, R, Kichic, R, Hajcak, G, Salkovskis, PM (2002). The Obsessive–Compulsive Inventory: development and validation of a short version. Psychological Assessment 14, 485496.CrossRefGoogle ScholarPubMed
Fukushima, H, Terasawa, Y, Umeda, S (2011). Association between interoception and empathy: evidence from heartbeat-evoked brain potential. International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology 79, 259265.CrossRefGoogle ScholarPubMed
García-Cordero, I, Sedeño, L, de la Fuente, L, Slachevsky, A, Forno, G, Klein, F, Lillo, P, Ferrari, J, Rodriguez, C, Bustin, J, Torralva, T, Baez, S, Yoris, A, Esteves, S, Melloni, M, Salamone, P, Huepe, D, Manes, F, García, AM, Ibañez, A (2016). Feeling, learning from, and being aware of inner states: interoceptive dimensions in neurodegeneration and stroke. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 371, 20160006.Google Scholar
Garfinkel, SN, Seth, AK, Barrett, AB, Suzuki, K, Critchley, HD (2015). Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology 104, 6574.Google Scholar
Gehring, WJ, Himle, J, Nisenson, LG (2000). Action-monitoring dysfunction in obsessive–compulsive disorder. Psychological Science 11, 16.Google Scholar
Gray, MA, Taggart, P, Sutton, PM, Groves, D, Holdright, DR, Bradbury, D, Brull, D, Critchley, HD (2007). A cortical potential reflecting cardiac function. Proceedings of the National Academy of Sciences USA 104, 68186823.CrossRefGoogle ScholarPubMed
Hajcak, G, Franklin, ME, Foa, EB, Simons, RF (2008). Increased error-related brain activity in pediatric obsessive–compulsive disorder before and after treatment. American Journal of Psychiatry 165, 116123.CrossRefGoogle ScholarPubMed
Hanna, GL, Carrasco, M, Harbin, SM, Nienhuis, JK, LaRosa, CE, Chen, P, Fitzgerald, KD, Gehring, WJ (2012). Error-related negativity and tic history in pediatric obsessive–compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry 51, 902910.Google Scholar
Hermans, D, Engelen, U, Grouwels, L, Joos, E, Lemmens, J, Pieters, G (2008). Cognitive confidence in obsessive–compulsive disorder: distrusting perception, attention and memory. Behaviour Research and Therapy 46, 98113.Google Scholar
Ibanez, A, Cardona, JF, Dos Santos, YV, Blenkmann, A, Aravena, P, Roca, M, Hurtado, E, Nerguizian, M, Amoruso, L, Gomez-Arevalo, G, Chade, A, Dubrovsky, A, Gershanik, O, Kochen, S, Glenberg, A, Manes, F, Bekinschtein, T (2013). Motor–language coupling: direct evidence from early Parkinson's disease and intracranial cortical recordings. Cortex 49, 968984.CrossRefGoogle ScholarPubMed
Janeck, AS, Calamari, JE, Riemann, BC, Heffelfinger, SK (2003). Too much thinking about thinking?: metacognitive differences in obsessive–compulsive disorder. Journal of Anxiety Disorders 17, 181195.Google Scholar
Janig, W (1996). Neurobiology of visceral afferent neurons: neuroanatomy, functions, organ regulations and sensations. Biological Psychology 42, 2951.Google Scholar
Johannes, S, Wieringa, BM, Mantey, M, Nager, W, Rada, D, Muller-Vahl, KR, Emrich, HM, Dengler, R, Munte, TF, Dietrich, D (2001). Altered inhibition of motor responses in Tourette syndrome and obsessive–compulsive disorder. Acta Neurologica Scandinavica 104, 3643.Google Scholar
Kaczkurkin, AN (2013). The effect of manipulating task difficulty on error-related negativity in individuals with obsessive–compulsive symptoms. Biological Psychology 93, 122131.CrossRefGoogle ScholarPubMed
Khalsa, SS, Rudrauf, D, Feinstein, JS, Tranel, D (2009). The pathways of interoceptive awareness. Nature Neuroscience 12, 14941496.Google Scholar
Kleckner, IR, Wormwood, JB, Simmons, WK, Barrett, LF, Quigley, KS (2015). Methodological recommendations for a heartbeat detection-based measure of interoceptive sensitivity. Psychophysiology 52, 14321440.Google Scholar
Kruczyk, M, Umer, HM, Enroth, S, Komorowski, J (2013). Peak finder metaserver – a novel application for finding peaks in ChIP-seq data. BMC Bioinformatics 14, 280.CrossRefGoogle ScholarPubMed
Leopold, C, Schandry, R (2001). The heartbeat-evoked brain potential in patients suffering from diabetic neuropathy and in healthy control persons. Clinical Neurophysiology 112, 674682.Google Scholar
Lin, Y, Moran, TP, Schroder, HS, Moser, JS (2015). The role of hand of error and stimulus orientation in the relationship between worry and error-related brain activity: implications for theory and practice. Psychophysiology 52, 12811292.Google Scholar
Manly, BFJ (2007). Randomization, Bootstrap, and Monte Carlo Methods in Biology. Chapman & Hall/CRC: Boca Raton, FL.Google Scholar
Mataix-Cols, D, Wooderson, S, Lawrence, N, Brammer, MJ, Speckens, A, Phillips, ML (2004). Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive–compulsive disorder. Archives of General Psychiatry 61, 564576.Google Scholar
Montoya, P, Schandry, R, Muller, A (1993). Heartbeat evoked potentials (HEP): topography and influence of cardiac awareness and focus of attention. Electroencephalography and Clinical Neurophysiology 88, 163172.Google Scholar
Moser, JS, Moran, TP, Schroder, HS, Donnellan, MB, Yeung, N (2013). On the relationship between anxiety and error monitoring: a meta-analysis and conceptual framework. Frontiers in Human Neuroscience 7, 466.CrossRefGoogle ScholarPubMed
Moulding, R, Anglim, J, Nedeljkovic, M, Doron, G, Kyrios, M, Ayalon, A (2011). The Obsessive Beliefs Questionnaire (OBQ): examination in nonclinical samples and development of a short version. Assessment 18, 357374.Google Scholar
Muller, LE, Schulz, A, Andermann, M, Gabel, A, Gescher, DM, Spohn, A, Herpertz, SC, Bertsch, K (2015). Cortical representation of afferent bodily signals in borderline personality disorder: neural correlates and relationship to emotional dysregulation. JAMA Psychiatry 72, 10771086.CrossRefGoogle ScholarPubMed
Nagai, M, Kishi, K, Kato, S (2007). Insular cortex and neuropsychiatric disorders: a review of recent literature. European Psychiatry: the Journal of the Association of European Psychiatrists 22, 387394.Google Scholar
Nichols, TE, Holmes, AP (2002). Nonparametric permutation tests for functional neuroimaging: a primer with examples. Human Brain Mapping 15, 125.Google Scholar
Odlaug, BL, Chamberlain, SR, Derbyshire, KL, Leppink, EW, Grant, JE (2014). Impaired response inhibition and excess cortical thickness as candidate endophenotypes for trichotillomania. Journal of Psychiatric Research 59, 167173.Google Scholar
Pollatos, O, Herbert, BM, Mai, S, Kammer, T (2016). Changes in interoceptive processes following brain stimulation. Philosophical Transaction of the Royal Society of London 371, 20160016.Google Scholar
Pollatos, O, Kirsch, W, Schandry, R (2005). Brain structures involved in interoceptive awareness and cardioafferent signal processing: a dipole source localization study. Human Brain Mapping 26, 5464.Google Scholar
Pollatos, O, Matthias, E, Schandry, R (2007). Heartbeat perception and P300 amplitude in a visual oddball paradigm. Clinical Neurophysiology 118, 22482253.CrossRefGoogle Scholar
Pollatos, O, Schandry, R (2004). Accuracy of heartbeat perception is reflected in the amplitude of the heartbeat-evoked brain potential. Psychophysiology 41, 476482.Google Scholar
Rabinak, CA, Holman, A, Angstadt, M, Kennedy, AE, Hajcak, G, Phan, KL (2013). Neural response to errors in combat-exposed returning veterans with and without post-traumatic stress disorder: a preliminary event-related potential study. Psychiatry Research 213, 7178.Google Scholar
Riesel, A, Endrass, T, Auerbach, LA, Kathmann, N (2015). Overactive performance monitoring as an endophenotype for obsessive–compulsive disorder: evidence from a treatment study. American Journal of Psychiatry 172, 665673.Google Scholar
Riesel, A, Endrass, T, Kaufmann, C, Kathmann, N (2011). Overactive error-related brain activity as a candidate endophenotype for obsessive–compulsive disorder: evidence from unaffected first-degree relatives. American Journal of Psychiatry 168, 317324.Google Scholar
Riesel, A, Kathmann, N, Endrass, T (2014). Overactive performance monitoring in obsessive–compulsive disorder is independent of symptom expression. European Archives of Psychiatry and Clinical Neuroscience 264, 707717.Google Scholar
Ronchi, R, Bello-Ruiz, J, Lukowska, M, Herbelin, B, Cabrilo, I, Schaller, K, Blanke, O (2015). Right insular damage decreases heartbeat awareness and alters cardio-visual effects on bodily self-consciousness. Neuropsychologia 70, 1120.Google Scholar
Ruscio, AM, Stein, DJ, Chiu, WT, Kessler, RC (2010). The epidemiology of obsessive–compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry 15, 5363.Google Scholar
Salkovskis, PM (1985). Obsessional–compulsive problems: a cognitive–behavioural analysis. Behaviour Research and Therapy 23, 571583.Google Scholar
Salkovskis, PM, Wroe, AL, Gledhill, A, Morrison, N, Forrester, E, Richards, C, Reynolds, M, Thorpe, S (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy 38, 347372.Google Scholar
Schandry, R, Bestler, M, Montoya, P (1993). On the relation between cardiodynamics and heartbeat perception. Psychophysiology 30, 467474.Google Scholar
Schandry, R, Sparrer, B, Weitkunat, R (1986). From the heart to the brain: a study of heartbeat contingent scalp potentials. International Journal of Neuroscience 30, 261275.CrossRefGoogle Scholar
Schandry, R, Weitkunat, R (1990). Enhancement of heartbeat-related brain potentials through cardiac awareness training. International Journal of Neuroscience 53, 243253.Google Scholar
Schrijvers, DL, De Bruijn, ER, Destoop, M, Hulstijn, W, Sabbe, BG (2010). The impact of perfectionism and anxiety traits on action monitoring in major depressive disorder. Journal of Neural Transmition (Vienna) 117, 869880.Google Scholar
Schulz, A, Koster, S, Beutel, ME, Schachinger, H, Vogele, C, Rost, S, Rauh, M, Michal, M (2015). Altered patterns of heartbeat-evoked potentials in depersonalization/derealization disorder: neurophysiological evidence for impaired cortical representation of bodily signals. Psychosomatic Medicine 77, 506516.Google Scholar
Schulz, A, Matthey, JH, Vogele, C, Schaan, V, Schachinger, H, Adler, J, Beutel, ME, Michal, M (2016). Cardiac modulation of startle is altered in depersonalization-/derealization disorder: evidence for impaired brainstem representation of baro-afferent neural traffic. Psychiatry Research 240, 410.Google Scholar
Sedeno, L, Couto, B, Melloni, M, Canales-Johnson, A, Yoris, A, Baez, S, Esteves, S, Velasquez, M, Barttfeld, P, Sigman, M, Kichic, R, Chialvo, D, Manes, F, Bekinschtein, TA, Ibanez, A (2014). How do you feel when you can't feel your body? Interoception, functional connectivity and emotional processing in depersonalization–derealization disorder. PLOS ONE 9, e98769.Google Scholar
Shao, S, Shen, K, Wilder-Smith, EP, Li, X (2011). Effect of pain perception on the heartbeat evoked potential. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology 122, 18381845.Google Scholar
Simons, RF (2010). The way of our errors: theme and variations. Psychophysiology 47, 114.Google Scholar
Song, A, Jung, WH, Jang, JH, Kim, E, Shim, G, Park, HY, Choi, CH, Kwon, JS (2011). Disproportionate alterations in the anterior and posterior insular cortices in obsessive–compulsive disorder. PLoS ONE 6, e22361.Google Scholar
Spielberger, CD, Gorsuch, RL, Lushene, RE (1970). Manual for the Stait-Trait Anxiety Inventory. Consulting Psychological Press: Palo Alto, CA.Google Scholar
Starcevic, V, Berle, D, Brakoulias, V, Sammut, P, Moses, K, Milicevic, D, Hannan, A (2011). Functions of compulsions in obsessive–compulsive disorder. Australian and New Zealand Journal of Psychiatry 45, 449457.Google Scholar
Stern, ER, Liu, Y, Gehring, WJ, Lister, JJ, Yin, G, Zhang, J, Fitzgerald, KD, Himle, JA, Abelson, JL, Taylor, SF (2010). Chronic medication does not affect hyperactive error responses in obsessive–compulsive disorder. Psychophysiology 47, 913920.Google Scholar
Terasawa, Y, Kurosaki, Y, Ibata, Y, Moriguchi, Y, Umeda, S (2015). Attenuated sensitivity to the emotions of others by insular lesion. Frontiers in Psychology 6, 1314.Google Scholar
Terhaar, J, Viola, FC, Bar, KJ, Debener, S (2012). Heartbeat evoked potentials mirror altered body perception in depressed patients. Clinical Neurophysiology 123, 19501957.Google Scholar
Vartanian, LR, Germeroth, LJ (2011). Accuracy in estimating the body weight of self and others: impact of dietary restraint and BMI. Body Image 8, 415418.Google Scholar
Vaughan, HG Jr., Costa, LD, Ritter, W (1968). Topography of the human motor potential. Electroencephalography and Clinical Neurophysiology 25, 110.CrossRefGoogle ScholarPubMed
Weinberg, A, Olvet, DM, Hajcak, G (2010). Increased error-related brain activity in generalized anxiety disorder. Biological Psychology 85, 472480.Google Scholar
Weiss, S, Sack, M, Henningsen, P, Pollatos, O (2014). On the interaction of self-regulation, interoception and pain perception. Psychopathology 47, 377382.Google Scholar
Wiens, S, Palmer, SN (2001). Quadratic trend analysis and heartbeat detection. Biological Psychology 58, 159175.Google Scholar
Willem Van der Does, AJ, Antony, MM, Ehlers, A, Barsky, AJ (2000). Heartbeat perception in panic disorder: a reanalysis. Behaviour Research and Therapy 38, 4762.Google Scholar
Xiao, Z, Wang, J, Zhang, M, Li, H, Tang, Y, Wang, Y, Fan, Q, Fromson, JA (2011). Error-related negativity abnormalities in generalized anxiety disorder and obsessive–compulsive disorder. Progress in Neuro-psychopharmacology and Biological Psychiatry 35, 265272.Google Scholar
Yoris, A, Esteves, S, Couto, B, Melloni, M, Kichic, R, Cetkovich, M, Favaloro, R, Moser, J, Manes, F, Ibanez, A, Sedeno, L (2015). The roles of interoceptive sensitivity and metacognitive interoception in panic. Behavioral and Brain Functions: BBF 11, 14.Google Scholar
Zaki, J, Davis, JI, Ochsner, KN (2012). Overlapping activity in anterior insula during interoception and emotional experience. NeuroImage 62, 493499.Google Scholar
Zigmond, AS, Snaith, RP (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361370.Google Scholar
Zinbarg, RE, Barlow, DH (1996). Structure of anxiety and the anxiety disorders: a hierarchical model. Journal of Abnormal Psychology 105, 181193.Google Scholar
Supplementary material: File

Yoris supplementary material

Yoris supplementary material 1

Download Yoris supplementary material(File)
File 2.7 MB