title: The roles of interoceptive sensitivity and metacognitive interoception in panic.
abstract: BACKGROUND
  Interoception refers to the ability to sense body signals. Two interoceptive dimensions have been recently proposed: (a) interoceptive sensitivity (IS) -objective accuracy in detecting internal bodily sensations (e.g., heartbeat, breathing)-; and (b) metacognitive interoception (MI) -explicit beliefs and worries about one's own interoceptive sensitivity and internal sensations. Current models of panic assume a possible influence of interoception on the development of panic attacks. Hypervigilance to body symptoms is one of the most characteristic manifestations of panic disorders. Some explanations propose that patients have abnormal IS, whereas other accounts suggest that misinterpretations or catastrophic beliefs play a pivotal role in the development of their psychopathology. Our goal was to evaluate these theoretical proposals by examining whether patients differed from controls in IS, MI, or both. Twenty-one anxiety disorders patients with panic attacks and 13 healthy controls completed a behavioral measure of IS motor heartbeat detection (HBD) and two questionnaires measuring MI.
  
  
  RESULTS
  Patients did not differ from controls in IS. However, significant differences were found in MI measures. Patients presented increased worries in their beliefs about somatic sensations compared to controls. These results reflect a discrepancy between direct body sensing (IS) and reflexive thoughts about body states (MI).
  
  
  CONCLUSIONS
  Our findings support the idea that hypervigilance to body symptoms is not necessarily a bottom-up dispositional tendency (where patients are hypersensitive about bodily signals), but rather a metacognitive process related to threatening beliefs about body/somatic sensations.
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. ayoris@ineco.org.ar.|Anxiety and Trauma Clinic, INECO (Institute of Cognitive Neurology), C1078AAI, Buenos Aires, Argentina. ayoris@ineco.org.ar.|National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina. ayoris@ineco.org.ar.
authors.forename: Adrián
authors.initials: A
authors.lastname: Yoris
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. solesteves@gmail.com.
authors.forename: Sol
authors.initials: S
authors.lastname: Esteves
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. couto.blas@gmail.com.|UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile. couto.blas@gmail.com.|National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina. couto.blas@gmail.com.
authors.forename: Blas
authors.initials: B
authors.lastname: Couto
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. margherita.melloni@gmail.com.|UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile. margherita.melloni@gmail.com.|National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina. margherita.melloni@gmail.com.
authors.forename: Margherita
authors.initials: M
authors.lastname: Melloni
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. rkichic@ineco.org.ar.|Anxiety and Trauma Clinic, INECO (Institute of Cognitive Neurology), C1078AAI, Buenos Aires, Argentina. rkichic@ineco.org.ar.
authors.forename: Rafael
authors.initials: R
authors.lastname: Kichic
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. mcetkovich@ineco.org.ar.|Anxiety and Trauma Clinic, INECO (Institute of Cognitive Neurology), C1078AAI, Buenos Aires, Argentina. mcetkovich@ineco.org.ar.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cetkovich
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. rfavaloro@ffavaloro.org.
authors.forename: Roberto
authors.initials: R
authors.lastname: Favaloro
authors.affiliation: Department of Psychology, Michigan State University, East Lansing, MI, USA. jmoser@msu.edu.
authors.forename: Jason
authors.initials: J
authors.lastname: Moser
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. fmanespersonal@gmail.com.|UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile. fmanespersonal@gmail.com.|National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina. fmanespersonal@gmail.com.|Australian Research Council (ACR) Centre of Excellence in Cognition and its Disorders, Macquarie University, NSW 2109, Sydney, Australia. fmanespersonal@gmail.com.
authors.forename: Facundo
authors.initials: F
authors.lastname: Manes
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. aibanez@ineco.org.ar.|UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile. aibanez@ineco.org.ar.|National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina. aibanez@ineco.org.ar.|Universidad Autónoma del Caribe, Barranquilla, Colombia. aibanez@ineco.org.ar.|Australian Research Council (ACR) Centre of Excellence in Cognition and its Disorders, Macquarie University, NSW 2109, Sydney, Australia. aibanez@ineco.org.ar.
authors.forename: Agustin
authors.initials: A
authors.lastname: Ibanez
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience (LPEN), INECO (Institute of Cognitive Neurology) and Institute of Neuroscience, Favaloro, Favaloro University, Pacheco de Melo 1860, Buenos Aires, C1078AAI, Argentina. lucas.sedeno@gmail.com.|UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile. lucas.sedeno@gmail.com.|National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina. lucas.sedeno@gmail.com.
authors.forename: Lucas
authors.initials: L
authors.lastname: Sedeño
mesh_terms: D000328:Adult; D000339:Affect; D001008:Anxiety Disorders / Q000503:physiopathology / Q000523:psychology; D058443:Catastrophization / Q000523:psychology; D003071:Cognition / Q000502:physiology; D005260:Female; D006339:Heart Rate; D006801:Humans; D065812:Interoception; D008297:Male; D016584:Panic Disorder / Q000503:physiopathology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D012677:Sensation