Interoception in anxiety and depression.
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.
Paulus
Martin P
MP
Department of Psychiatry, University of California, San Diego, 8939 Villa La Jolla Drive, La Jolla, CA 92037, USA. mpaulus@ucsd.edu
Stein
Murray B
MB
D000818:Animals; D001008:Anxiety Disorders / Q000503:physiopathology*; D001364:Awareness / Q000502:physiology*; D001828:Body Image; D002540:Cerebral Cortex / Q000502:physiology*; D003866:Depressive Disorder / Q000503:physiopathology*; D006801:Humans; D008959:Models, Neurological; D012649:Self Concept; D017833:Visceral Afferents / Q000502:physiology*