The dynamics of violations interoception in patients with anorexia nervosa during treatment

Anorexia nervosa is a disorder, that mostly starts at teenage years. In addition, one of the most important feature of that period is transformation of size and shape of a teenager’s body, that leads to changes in his perception of his own body. Anorexia nervosa is also characterized by tranformation of interoceptive processing, and it is a phenomena which predisposes and maintains eating disorder. We studied the features of interception (accuracy, sensibility, awareness) of girls who suffer anorexia nervosa under therapy and during the catamnesis. Also had been provided study of interoceptive accuracy in stress situation, connected with eating (800 kcal). Significant differences in interoceptive indicators in dynamic between the control group and research group was found.

1. Pichikov AA, Popov YuV. Algoritmy okazaniya statsionarnoy pomoshchi devushkam-podrostkam s nervnoy anoreksiyey. Sbornik metodicheskikh rekomendatsiy: Diagnostika i lecheniye psikhicheskikh i narkologicheskikh rasstroystv — sovremennyye podkhody. Pod obshchey red. N.G. Neznanova. SPb.: Kosta; 2018: 145-164. (In Russ.).

2. Chernigovskiy V.N. Interotseptsiya. Leningrad: Nauka; 1985. (In Russ.).

3. Avery J.A., Kerr K.L., Ingeholm J.E., Burrows K., Bodurka J., Simmons W.K. A common gustatory and interoceptive representation in the human midinsula. Human Brain Mapping. 2015; 36(8): 2996¬3006. doi:10.1002/hbm.22823

4. Bertoud H.R. The vagus nerve, food intake and obesity. Regulatory Peptides. 2008; 149(1-3):15-25. doi:10.1016/j.regpep.2007.08.024

5. Craig A.D. How do you feel? Interoception: The sense of the physiological condition of the body. Nature Reviews Neuroscience. 2002; 3(8): 655-666. doi.org/10.1038/nrn894

6. Eggart M., Lange A., Binser M.J., Queri S., Muller-Oerlinghausen B. Major Depressive Disorder Is Associated with Impaired Interoceptive Accuracy: A Systematic Review. Brain Sci. 2019; 6:131. doi: 10.3390/brainsci9060131.Review

7. Garfinkel S.N., Manassei M.F., Hamilton-Fletcher G. et al. Interoceptive dimensions across cardiac and respiratory axes. Philosophical Transactions of the Royal Society B. 2016; 371. doi:10.1098/rstb.2016.0014

8. Garfinkel S.N., Seth A.K., Barrett A.B., Suzuki K., Critchley H.D. Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology. 2015; 104:65-74. doi.org/10.1016/j.biopsycho.2014.11.004

9. Garfinkel S.N., Tiley C., O’Keeffe S., Harrison N.A., Seth A.K., Critchley H.D. Discrepancies between dimensions of interoception in autism: Implications for emotion and anxiety. Biological Psychology. 2016; 114:117-126. doi:10.1016/j.biopsycho.2015.12.003

10. Herbert B.M., Blechert J., Hautzinger M., Matthias E., Herbert C. Intuitive eating is associated with interoceptive sensitivity — effects on body mass index. Appetite. 2013; 70:22-30. doi:10.1016/j.appet.2013.06.082

11. Herbert B.M., Muth E.R., Pollatos O., Herbert C. Interoception across modalities: On the relationship between cardiac awareness and the sensitivity for gastric functions. PloS One. 2012; 7:36646. doi:10.1371/journal.pone.0036646

12. Khalsa S.S., Craske M.G., Li W., Vangala S., Strober M., Feusner J.D. Altered interoceptive awareness in anorexia nervosa: Effects of meal anticipation, consumption and bodily arousal. International Journal of Eating Disorders. 2015; 48(7): 889-897. doi:10.1002/eat.22387

13. Khalsa S.S., Lapidus R.C. Can interoception improve the pragmatic search for biomarkers in psychiatry?. Frontiers in Psychiatry. 2016; 7:121. doi:10.3389/fpsyt.2016.00121

14. Murphy J., Brewer R., Catmur C., Bird G. Interoception and psychopathology: A developmental neuroscience perspective. Developmental Cognitive Neuroscience. 2017; 23:45-56. doi:10.1016/j.dcn.2016.12.006

15. Paulus M.P., Feinstein J.S., Khalsa S.S. An Active Inference Approach to Interoceptive Psychopathology. Annu Rev Clin Psychol. 2019; 15:97-122. doi: 10.1146/annurev-clinpsy-050718-095617

16. Pollatos O., Gramann K., Schandry R. Neural systems connecting interoceptive awareness and feelings. Human Brain Mapping. 2007; 28(1): 9-18. doi:10.1002/hbm.20258

17. Riva G., Dakanalis A. Altered processing and integration of multisensory bodily representations and signals in eating disorders: a possible path toward the understanding of their underlying causes. Front Hum Neurosci. 2018; 12:49. doi: 10.3389/fnhum.2018.00049

18. Riva G., Gaudio S. Locked to a wrong body: eating disorders as the outcome of a primary disturbance in multisensory body integration. Conscious. Cogn. 2018; 59:57-59. doi: 1016/j.concog.2017.08.006

19. Riva G., Serino S., Di Lernia D., Pavone E.F., Dakanalis A. Embodied medicine: mens sana in corpore virtuale sano. Front. Hum. Neurosci. 2017; 11:120. doi: 10.3389/fnhum.2017.00120

20. Schaefer M., Egloff B., Gerlach A.L., Witthoft M. Improving heartbeat perception in patients with medically unexplained symptoms reduces symptom distress. Biol. Psychol. 2014; 101:69-76. doi: 10.1016/j.biopsycho.2014.05.012

21. Schandry R. Heart beat perception and emotional experience. Psychophysiology. 1981; 18:483-488. doi.org/10.1111/j.1469-8986.1981.tb02486.x

22. Van Dyck Z, Vogele C., Blechert J., Lutz A.P., Schulz A., Herbert B.M. The water load test as a measure of gastric interoception: Development of a two-stage protocol and application to a healthy female population. PloS One. 2016; 11:0163574. doi:10.1371/journal.pone.0163574

23. Watson D.R., Garfinkel S.N., Willmott D., Wong K., Meeten F., Critchley H. Computerized exposure therapy for spider phobia: effects of cardiac timing and interoceptive ability on subjective and behavioral outcomes. Psychosomatic Med. 2019; 81: 90-99. doi: 10.1097/PSY.0000000000000646