The Japanese journal of neuropsychology

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ArticleTitle	Psychiatric symptoms and interoception
Language	J
AuthorList	Akihiro Koreki
Affiliation	National Hospital Organization Shimofusa Psychiatric Medical Center
Publication	Japanese Journal of Neuropsychology: 35 (4), 187-196, 2019
Received
Accepted
Abstract	Interoception refers to processing and central representation of afferent internal bodily signals, such as the heartbeat and respiration. It was originally proposed for homeostasis; however, its role extends beyond homeostasis, and it is recently recognised as being associated with various brain functions, such as emotion, decision-making, body image, action, and memory. Interoceptive signals are transmitted to the brain via sympathetic/parasympathetic nerves and are processed mainly in the insular cortex. It is proposed that the subjective aspect of interoception develops through a posterior-to-anterior progression of integration. Various methods are used to assess interoception. With regard to neuropsychological methods, the following three dimensions are commonly assessed: accuracy (objective performance), sensibility (questionnaire-assessed subjective beliefs), and awareness (metacognition). A common neuropsychological method used for this purpose is the heartbeat counting task for which participants were instructed to count the number of times they felt their heartbeat during various measurement periods. Interoceptive accuracy was calculated based on the discrepancy between the number of reported and actual heartbeats during these measurement periods. Interoceptive abnormalities were observed in patients with psychiatric disorders, such as schizophrenia, anxiety disorder, depression, autism, addiction, eating disorder, borderline personality disorder, and dissociative disorder. These researches could offer new insights into a potential therapeutic target in patients with these diseases.
Keywords	Interoception, Insular cortex, Homeostasis, Baroreceptor, Emotion