Page 134 - Demo

Chapter 5132awareness, integration or interpretation of signals, such as the Multidimensional Assessment of Interoceptive Awareness (Mehling et al., 2018), might rather be reflective of the difficulty to make sense of bodily signals. In order to capture these subjectively experienced difficulties in individuals on the autism spectrum, the Interoception Sensory Questionnaire was developed as assessment tool for %u201cinteroceptive confusion%u201d. Here, interoceptive confusion has not only been found to be highly prevalent in individuals on the autism spectrum, but also increasing in severity the higher an individual%u2019s autistic trait levels in a non-autistic population (Fiene et al., 2018). These findings are in line with predictive coding theories on interoception in autism (Quattrocki & Friston, 2014; van de Cruys et al., 2014) which suggest that individuals on the autism spectrum would be hypersensitive to interoceptive signals, overrepresent them at low processing levels (i.e., distinct sensations) and have a reduced accuracy in their sensation due to highly precise and inflexible prediction errors, while the integration of signals to a global awareness might be constrained. As previously outlined, somatic awareness might build an important foundation for emotional awareness with regard to both our own and others%u2019 emotions (Kanbara & Fukunaga, 2016). Thus, sensing interoceptive signals less accurately or integrating them to a lesser degree could potentially explain differences in emotion recognition tasks that are observed between non-autistic individuals and individuals on the autism spectrum, or related to high autistic trait levels. The Role of Interoception in Processing Others%u2019 Emotions in AutismOnly few studies have investigated the role of interoception in processing others%u2019 emotions in autism. Focusing on (emotional) empathy as an outcome, two recent studies comparing individuals on the autism spectrum to non-autistic individuals have shown inconsistent findings: While no group differences in interoceptive sensibility measures, as well as no link to emotional empathy, have been observed in one study (Butera et al., 2023), the other study has found both reduced interoceptive sensibility and cardiac interoceptive accuracy in autism, with the latter showing a negative relation with empathy (Mul et al., 2018). Importantly, both studies have highlighted the relevance of co-occurring alexithymia, a trait encompassing difficulties in identifying and describing one%u2019s emotions (Nemiah et al., 1976), in explaining the link between altered interoceptive processing and potential difficulties in empathy related to autism. Alexithymia has consistently been linked to difficulties in emotion recognition (Jongen et al., 2014; Lane