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Interoceptive impairments do not lie at the heart of autism or alexithymia.

ABSTRACT: Quattrocki and Friston (2014) argued that abnormalities in interoception-the process of representing one's internal physiological states-could lie at the heart of autism, because of the critical role interoception plays in the ontogeny of social-affective processes. This proposal drew criticism from proponents of the alexithymia hypothesis, who argue that social-affective and underlying interoceptive impairments are not a feature of autism per se, but of alexithymia (a condition characterized by difficulties describing and identifying one's own emotions), which commonly co-occurs with autism. Despite the importance of this debate for our understanding of autism spectrum disorder (ASD), and of the role of interoceptive impairments in psychopathology, more generally, direct empirical evidence is scarce and inconsistent. Experiment 1 examined in a sample of 137 neurotypical (NT) individuals the association among autistic traits, alexithymia, and interoceptive accuracy (IA) on a standard heartbeat-tracking measure of IA. In Experiment 2, IA was assessed in 46 adults with ASD (27 of whom had clinically significant alexithymia) and 48 NT adults. Experiment 1 confirmed strong associations between autistic traits and alexithymia, but yielded no evidence to suggest that either was associated with interoceptive difficulties. Similarly, Experiment 2 provided no evidence for interoceptive impairments in autistic adults, irrespective of any co-occurring alexithymia. Bayesian analyses consistently supported the null hypothesis. The observations pose a significant challenge to notions that interoceptive impairments constitute a core feature of either ASD or alexithymia, at least as far as the direct perception of interoceptive signals is concerned. (PsycINFO Database Record

SUBMITTER: Nicholson TM

PROVIDER: S-EPMC6089261 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Interoceptive impairments do not lie at the heart of autism or alexithymia.

Nicholson Toby M TM Williams David M DM Grainger Catherine C Christensen Julia F JF Calvo-Merino Beatriz B Gaigg Sebastian B SB

Journal of abnormal psychology 20180801 6

Quattrocki and Friston (2014) argued that abnormalities in interoception-the process of representing one's internal physiological states-could lie at the heart of autism, because of the critical role interoception plays in the ontogeny of social-affective processes. This proposal drew criticism from proponents of the alexithymia hypothesis, who argue that social-affective and underlying interoceptive impairments are not a feature of autism per se, but of alexithymia (a condition characterized by ...[more]

PMID: 30102067

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Project description:Interoception is the perception of internal bodily signals. It is considered fundamental to developing emotional awareness. For this reason, interoceptive deficits are often associated with alexithymia, a condition characterized by difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and an externally-oriented style of thinking (EOT). Yet, the atypical interoception found in alexithymia might be of a similar type and/or more serious than those found in other partially overlapping constructs that entail emotional difficulties and behavioural patterns associated with specific emotional styles. Our study explores this issue by examining the relationship between the interoceptive deficits associated with alexithymia and the Big Five personality traits. A non-clinical sample (N = 504) completed the Toronto Alexithymia Scale, the Big Five Inventory and the Multidimensional Assessment of Interoceptive Awareness. Data were analysed using a network analytic approach that conceives psychological traits as networks of interacting symptoms. The estimated network highlighted that EOT is the alexithymia component least associated with interoception and most associated with lower Openness to Experience. Conversely, DIF and Neuroticism are, respectively, the dimensions of alexithymia and the Big Five most highly associated with interoception. We also compared interoceptive abilities in the four groups of participants whose scores were a) high for both alexithymia and neuroticism, b) high only for alexithymia c), high only for neuroticism, and d) low for both. High alexithymia was especially associated with the tendency to ignore sensations of pain or discomfort, while neuroticism was more indicative of the tendency to worry about these sensations. These results suggest that while high alexithymia and neuroticism share some interoceptive deficits, others are unique to alexithymia and contribute to overall lower interoceptive ability in this condition. Our findings suggest that interventions to enhance awareness of bodily sensations can be beneficial especially for profiles who present high neuroticism and alexithymia.

Project description:Alexithymia, or a reduced ability to label and describe one's emotions, is a transdiagnostic construct associated with poor psychosocial outcomes. Currently, the mechanisms underlying affective deficits associated with alexithymia are unclear, hindering targeted treatment delivery. Recent research suggests deficient interoceptive awareness, or reduced awareness of one's internal bodily state, may be key in the etiology of alexithymia. It has long been demonstrated that mindfulness meditation can alter perceptions of one's own emotions and bodily cues. Therefore, it is possible that mindfulness meditation may reduce affective deficits associated with alexithymia by improving interoceptive awareness. In this study, we aimed to (1) elucidate the role of interoceptive accuracy and sensibility, two dimensions of interoceptive awareness, in alexithymia, and (2) test the efficacy of a brief mindfulness meditation for improving interoceptive accuracy, interoceptive sensibility, and emotional awareness. Seventy six young adults completed a baseline heartbeat detection task, to assess interoceptive accuracy and sensibility, and the Toronto Alexithymia Scale-20 item. They were randomly assigned to a brief mindfulness-based body scan meditation intervention or control condition. Afterwards, participants completed tasks assessing emotional awareness (i.e., affect labeling, emotional granularity) and follow-up heartbeat detection task. Relationships between alexithymia and interoceptive accuracy and sensibility were best described as quadratic (p = 0.002) and linear (p = 0.040), respectively. Participants in both conditions showed robust improvements in interoceptive accuracy from baseline to follow-up (p < 0.001; η p 2 = 0.15); however, there were no group (meditation or control) differences in degree of improvement. Similarly, there were no group differences in affect labeling or emotional granularity. These preliminary results suggest that heightened alexithymia may be associated with either relatively high or low interoceptive accuracy. The meditation condition did not result in improved interoceptive accuracy or sensibility above and beyond that of a control group. Improvements in interoceptive accuracy, interoceptive sensibility, and emotional awareness may require longer or more interactive intervention approaches. More research is needed to parse the potentially complex relationship between alexithymia and interoceptive awareness, and to develop targeted treatment approaches to ameliorating associated affective deficits.

Dataset Information

Interoceptive impairments do not lie at the heart of autism or alexithymia.

Publications

Interoceptive impairments do not lie at the heart of autism or alexithymia.

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