Interoception in anxiety and depression

• Published in: Brain Structure and Function Vol. 214; no. 5-6; pp. 451 - 463
• Main Authors: Paulus, Martin P., Stein, Murray B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.06.2010; Springer Nature B.V
• Subjects: Anatomy; Animals; Anxiety; Anxiety Disorders - physiopathology; Awareness - physiology; Biomedical and Life Sciences; Biomedicine; Body Image; Brain architecture; Brain research; Cell Biology; Cerebral Cortex - physiology; Cognition & reasoning; Depression; Depressive Disorder - physiopathology; Functional anatomy; Humans; Mental depression; Models, Neurological; Neurology; Neurosciences; Review; Reviews; Self Concept; Sensory neurons; Structure-function relationships; Visceral Afferents - physiology; Belief; Depression; Insula; Alliesthesia; Anxiety; Interoception
• ISSN: 1863-2653; 1863-2661; 1863-2661; 0340-2061
• DOI: 10.1007/s00429-010-0258-9

We review the literature on interoception as it relates to depression and anxiety, with a focus on belief, and alliesthesia. The connection between increased but noisy afferent interoceptive input, self-referential and belief-based states, and top-down modulation of poorly predictive signals is integrated into a neuroanatomical and processing model for depression and anxiety. The advantage of this conceptualization is the ability to specifically examine the interface between basic interoception, self-referential belief-based states, and enhanced top-down modulation to attenuate poor predictability. We conclude that depression and anxiety are not simply interoceptive disorders but are altered interoceptive states as a consequence of noisily amplified self-referential interoceptive predictive belief states.