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Interoception and Mental Health: A Roadmap

Khalsa, Sahib S. and Adolphs, Ralph and Cameron, Oliver G. and Critchley, Hugo D. and Davenport, Paul W. and Feinstein, Justin S. and Feusner, Jamie D. and Garfinkel, Sarah N. and Lane, Richard D. and Mehling, Wolf E. and Meuret, Alicia E. and Nemeroff, Charles B. and Oppenheimer, Stephen and Petzschner, Frederike H. and Pollatos, Olga and Rhudy, Jamie L. and Schramm, Lawrence P. and Simmons, W. Kyle and Stein, Murray B. and Stephan, Klaas E. and Van den Bergh, Omer and Van Diest, Ilse and von Leupoldt, Andreas and Paulus, Martin P. (2018) Interoception and Mental Health: A Roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3 (6). pp. 501-513. ISSN 2451-9022. https://resolver.caltech.edu/CaltechAUTHORS:20180618-084823802

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Abstract

Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body’s internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. However, a number of conceptual and methodological challenges have made it difficult for interoceptive constructs to be broadly applied in mental health research and treatment settings. In November 2016, the Laureate Institute for Brain Research organized the first Interoception Summit, a gathering of interoception experts from around the world, with the goal of accelerating progress in understanding the role of interoception in mental health. The discussions at the meeting were organized around four themes: interoceptive assessment, interoceptive integration, interoceptive psychopathology, and the generation of a roadmap that could serve as a guide for future endeavors. This review article presents an overview of the emerging consensus generated by the meeting.


Item Type:Article
Related URLs:
URLURL TypeDescription
https://doi.org/10.1016/j.bpsc.2017.12.004DOIArticle
ORCID:
AuthorORCID
Adolphs, Ralph0000-0002-8053-9692
Additional Information:© 2017 Society of Biological Psychiatry. Published by Elsevier Inc. Under a Creative Commons license. Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) Received 23 August 2017, Revised 20 November 2017, Accepted 10 December 2017, Available online 28 December 2017. We express our sincere appreciation to the William K. Warren Foundation for supporting the Interoception Summit 2016 and to all of the Laureate Institute for Brain Research staff members for their assistance with facilitating the meeting. AEM reports the following disclosures: research/grant: National Institutes of Health (NIH) Grant No. 1U01EB021952-01; scientific advisory board: Anxiety and Depression Association of America. AvL reports the following disclosures: research/grants: Research Fund KU Leuven, Belgium (Grant Nos. STRT/13/002 and DBOF/14/021), an infrastructure grant from the Herculesstichting, Belgium (Grant No. AKUL/13/07), “Asthenes” long-term structural funding Methusalem grant (Grant No. METH/15/011) by the Flemish Government, Belgium. CBN reports the following disclosures: research/grant: NIH, Stanley Medical Research Institute; consulting (last 3 years): Xhale, Takeda, Taisho Pharmaceutical, Inc., Prismic Pharmaceuticals, Bracket (Clintara), Total Pain Solutions, Gerson Lehrman Group Healthcare & Biomedical Council, Fortress Biotech, Sunovion Pharmaceuticals, Inc., Sumitomo Dainippon Pharma, Janssen Research & Development, LLC, Magstim, Inc., Navitor Pharmaceuticals, Inc., TC MSO, Inc.; stockholder: Xhale, Celgene, Seattle Genetics, Abbvie, OPKO Health, Inc., Bracket Intermediate Holding Corporation, Network Life Sciences, Inc., Antares; scientific advisory boards: American Foundation for Suicide Prevention (AFSP), Brain and Behavior Research Foundation (formerly National Alliance for Research on Schizophrenia and Depression [NARSAD]), Xhale, Anxiety and Depression Association of America (ADAA), Skyland Trail, Bracket (Clintara), RiverMend Health, LLC, Laureate Institute for Brain Research, Inc.; board of directors: AFSP, Gratitude America, ADAA; income sources or equity of $10,000 or more: American Psychiatric Publishing, Xhale, Bracket (Clintara), CME Outfitters, Takeda; patents: method and devices for transdermal delivery of lithium (Patent No. US 6,375,990B1), method of assessing antidepressant drug therapy via transport inhibition of monoamine neurotransmitters by ex vivo assay (Patent No. US 7,148,027B2). HDC reports the following disclosures: research/grants: European Research Council Horizon 2020 Proof of Concept Grant “HeartRater: Tools for the systematic evaluation of interoceptive ability,” Medical Research Council (UK) MRC Confidence in Concept Grant “Identifying neural, cognitive, and phenomenological markers of auditory verbal hallucinations in borderline personality,” MQ (Mental Health) PsyImpact “Aligning Dimensions of Interoceptive Experience (ADIE) to prevent development of anxiety disorders in autism,” Dr. Mortimer and Theresa Sackler Foundation Sackler Centre for Consciousness Science, University of Sussex, BIAL Foundation Bursary “Microneurography as a tool for consciousness science”; scientific advisory boards: Emteq, Ltd., unpaid governor on board of charity “Reflecting nature in art & science”; board of directors: Codirector of Sackler Centre for Consciousness Science, University of Sussex. KES reports the following disclosures: research/grants: Deutsche Forschungsgemeinschaft, Transregional Collaborative Research Centre, “Ingestive Behaviour: Homeostasis and Reward,” René and Susanne Braginsky Foundation. LPS reports the following disclosures: scientific advisory board: Laureate Institute for Brain Research, Inc. JDF reports the following disclosures: research/grants: NIH Grant Nos. R01MH105662, R21MH110865, and R01HD087712; scientific advisory boards: International Obsessive-Compulsive Disorder Foundation Clinical and Scientific Advisory Board. JLR reports the following disclosures: research/grants: NIH Grant No. R01MD007807 and Oklahoma Center for the Advancement of Science and Technology Grant No. HR15-079. JSF reports the following disclosures: research/grants: NIH/National Institute of General Medical Sciences (NIGMS) Grant No. P20GM121312, Brain and Behavior Research Foundation (formerly NARSAD) Young Investigator Award. MBS reports the following disclosures: scientific advisory board: Laureate Institute for Brain Research, Inc.; editorial board: Depression and Anxiety, Biological Psychiatry. MPP reports the following disclosures: research/grants: the William K. Warren Foundation and NIH Grant No. R01DA016663, NIH/NIGMS Grant No. P20DA027834, and NIH Grant Nos. R01DA027797, R01DA018307, U01DA041089, and 1R01MH101453; consulting (last 3 years): has received royalties for an article about methamphetamine use disorder from UpToDate. OVdB reports the following disclosures: scientific advisory boards: Research Training Group 2271 of the Deutsche Forschungsgemeinschaft on “Expectation maintenance vs. change in the context of expectation violations: Connecting different approaches,” University of Marburg. RDL reports the following disclosures: research/grant: NIH. SSK reports the following disclosures: research/grants: NIH/National Institute of Mental Health Grant No. K23MH112949, NIH/NIGMS Grant No. P20GM121312, William K. Warren Foundation, Brain and Behavior Foundation (formerly NARSAD) Young Investigator Award. WEM reports the following disclosures: research/grants: NCIRE (Veterans Health Research Institute, San Francisco, California), Alzheimer’s Association, Mental Insight Foundation, the Pepper Foundation, University of California, San Francisco, Resource Allocation Program. WKS reports the following disclosures: research/grants: NIH Grant No. P20GM121312, Brain and Behavior Foundation (formerly NARSAD) Young Investigator Award. The remaining authors report no biomedical financial interests or potential conflicts of interest.
Funders:
Funding AgencyGrant Number
NIH1U01EB021952-01
Katholieke Universiteit LeuvenSTRT/13/002
Katholieke Universiteit LeuvenDBOF/14/021
HerculesstichtingAKUL/13/07
MethusalemMETH/15/011
Flemish GovernmentUNSPECIFIED
European Research Council (ERC)HeartRater
Medical Research Council (UK)UNSPECIFIED
Deutsche Forschungsgemeinschaft (DFG)2271
NIHR01MH105662
NIHR21MH110865
NIHR01HD087712
NIHR01MD007807
Oklahoma Center for the Advancement of Science and TechnologyHR15-079
NIHP20GM121312
Brain and Behavior Research FoundationUNSPECIFIED
William K. Warren FoundationUNSPECIFIED
NIHR01DA016663
NIHP20DA027834
NIHR01DA027797
NIHR01DA018307
NIHU01DA041089
NIH1R01MH101453
NIHK23MH112949
Veterans Health Research InstituteUNSPECIFIED
Alzheimer’s AssociationUNSPECIFIED
Mental Insight FoundationUNSPECIFIED
Pepper FoundationUNSPECIFIED
University of California, San FranciscoUNSPECIFIED
Subject Keywords:Biomarker; Computational psychiatry; Interoception; Mental health; Research Domain Criteria; Treatment
Issue or Number:6
Record Number:CaltechAUTHORS:20180618-084823802
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20180618-084823802
Official Citation:Sahib S. Khalsa, Ralph Adolphs, Oliver G. Cameron, Hugo D. Critchley, Paul W. Davenport, Justin S. Feinstein, Jamie D. Feusner, Sarah N. Garfinkel, Richard D. Lane, Wolf E. Mehling, Alicia E. Meuret, Charles B. Nemeroff, Stephen Oppenheimer, Frederike H. Petzschner, Olga Pollatos, Jamie L. Rhudy, Lawrence P. Schramm, W. Kyle Simmons, Murray B. Stein, Klaas E. Stephan, Omer Van den Bergh, Ilse Van Diest, Andreas von Leupoldt, Martin P. Paulus, Interoception and Mental Health: A Roadmap, Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, Volume 3, Issue 6, 2018, Pages 501-513, ISSN 2451-9022, https://doi.org/10.1016/j.bpsc.2017.12.004. (http://www.sciencedirect.com/science/article/pii/S2451902217302343)
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:87183
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:18 Jun 2018 21:10
Last Modified:03 Oct 2019 19:53

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