The role of interoception in addiction: a critical review.
Interoception refers to a collection of processes by which the state of the body is transmitted back to the brain, giving rise to awareness of the internal milieu, and motivating behavioural responses to homeostatically regulate internal state. Recent work has begun to explore the relevance of this construct to drug addiction: drugs of abuse and drug-related stimuli induce pronounced peripheral changes, and damage to a brain region known to support interoception (the insula) disrupts nicotine dependence. This article critically reviews existing accounts of addiction that suggest impaired interoception contributes to drug abuse. Conceptually, we argue that existing addiction interoception models could be usefully extended by considering (i) the multiple components of the bodily feedback system (signal, perception, and appraisal) and (ii) how individual differences in these three components impact on cognitive-affective processing in addiction. Empirically, whilst no studies have examined direct behavioural measures of interoception in addicted populations, several indirect lines of experimental work that pertain to this altered interoception hypothesis are presented. Clinical implications are discussed.
Department of Clinical Psychology and Institute of Neuroscience F. Olóriz, University of Granada, Granada, Spain; Behavioural and Clinical Neuroscience Institute, Department of Experimental Psychology, University of Cambridge, Cambridge, United Kingdom. averdejo@ugr.es
Antonio
A
Verdejo-Garcia
Luke
L
Clark
Barnaby D
BD
Dunn
D000818:Animals; D001364:Awareness / Q000502:physiology; D016739:Behavior, Addictive / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D006801:Humans; D010465:Perception / Q000502:physiology*; D012201:Reward; D019966:Substance-Related Disorders / Q000503:physiopathology* / Q000523:psychology