Page 27 - Demo

1General introduction25measures of interoception are distinguished (see also Forkmann et al., 2016), namely interoceptive accuracy (i.e., the objective accuracy in the detection of interoceptive signals), interoceptive sensibility (i.e., the self-reported, subjective tendency to focus and be aware of interoceptive signals) and interoceptive awareness (i.e., the ability to assess one%u2019s interoceptive accuracy correctly). Importantly, the self-reported tendency to attend to bodily signals in daily life does not necessarily translate to a more accurate detection, as the above-mentioned overestimation of bodily responses in social anxiety illustrates. To capture this dissociation, Murphy and colleagues (2019) developed a 2x2 factor model of interoceptive ability, with the first factor (%u2018What is measured?%u2019) distinguishing between accuracy and attention. The second factor (%u2018How is it measured?%u2019) contrasts beliefs regarding one%u2019s performance (i.e., self-reports) with one%u2019s actual performance (i.e., objective measures). Although individuals with Anxiety Disorders overall (Domschke et al., 2010) or non-diagnosed individuals with high social anxiety trait levels (Stevens et al., 2011) tend to be more accurate in sensing their heartbeats in experimental tasks than control participants, individuals with social anxiety specifically seem to perform as well (Antony et al., 1995) or even worse (Gaebler et al., 2013) than control participants. Similarly, individuals on the autism spectrum perform worse in interoception tasks compared to controls (Failla et al., 2020; Garfinkel et al., 2016). At the same time, some individuals on the autism spectrum report to overperceive specific body signals (Garfinkel et al., 2016), while having difficulties in their integration to a coherent percept and in their interpretation (e.g., Fiene et al., 2018). This observation has been delineated in the framework of the weak (central) coherence account of autism (Happ%u00e9 & Frith, 2006), which describes a bias to processing local features (here: distinct body signals) and difficulties to integrating those to a global form (here: physiological state; see T. R. Hatfield et al., 2019). The overrepresentation of distinct body signals is also central to a predictive coding perspective on altered interoceptive processing in autism, namely the idea of highly inflexible precise prediction errors (Van de Cruys et al., 2017). Simplified, by constantly reinforcing irrelevant body signals (via high precision), body signals of actual interest do not %u201cstand out%u201d. In contrast to this altered integration of low-level information (bottom-up), top-down processing rather seems to be affected in anxiety, operationalizing it as %u201caltered interoceptive state[s] as a consequence of noisily amplified self-referential interoceptive predictive belief states%u201d (Paulus & Stein, 2010, p. 451). The idea that self biases in social anxiety