Probing corporeal awareness in women through virtual reality induction of embreathment illusion.

We capitalized on the respiratory bodily illusion that we discovered in a previous study and called 'Embreathment' where we showed that breathing modulates corporeal awareness in men. Despite the relevance of the issue, no such studies are available in women. To bridge this gap, we tested whether the synchronization of avatar-participant respiration patterns influenced females' bodily awareness. We collected cardiac and respiratory interoceptive measures, administered body (dis)satisfaction questionnaires, and tracked participants' menstrual cycles via a mobile app. Our approach allowed us to characterize the 'Embreathment' illusion in women, and explore the relationships between menstrual cycle, interoception and body image. We found that breathing was as crucial as visual appearance in eliciting feelings of ownership and held greater significance than any other cue with respect to body agency in both women and men. Moreover, a positive correlation between menstrual cycle days and body image concerns, and a negative correlation between interoceptive sensibility and body dissatisfaction were found, confirming that women's body dissatisfaction arises during the last days of menstrual cycle and is associated with interoception. These findings have potential implications for corporeal awareness alterations in clinical conditions like eating disorders and schizophrenia.

The thermoception task: a thermal imaging-based procedure for measuring awareness of changes in peripheral body temperature.

Although thermal body signals provide crucial information about the state of an organism and changes in body temperature may be a sign of affective states (e.g., stress, pain, sexual arousal), research on thermal awareness is limited. Here we developed a task measuring awareness of changes in peripheral body temperature (thermal interoception) and compared it to the classical heartbeat counting task (cardiac interoception). With an infrared light bulb we delivered stimuli of different temperature intensities to the right hand of 31 healthy participants. Thermal interoceptive accuracy, i.e., the difference between participants' real and perceived change in hand temperature, showed good interindividual variability. We found that thermal interoception did not correlate with (and was generally higher than) cardiac interoception, suggesting that different interceptive channels provide separate contributions to awareness of bodily states. Moreover, the results hint at the great salience of thermal signals and the need for thermoregulation in day-to-day life. Finally, thermal interoceptive accuracy was associated with self-reported awareness of body temperature changes and with the ability to regulate distress by focusing on body sensations. Our task has the potential to significantly increase current knowledge about the role of interoception in cognition and behavior, particularly in social and emotional contexts.NEW & NOTEWORTHY We developed a novel task measuring awareness of changes in peripheral body temperature (i.e., thermal interoception). To avoid tactile confounds present in existing thermoceptive tasks, we used an infrared light bulb to deliver stimuli of different temperature intensities to the hand of participants and asked them to judge the perceived change in their hand temperature. Performance in the task showed good interindividual variability, did not correlate with cardiac interoceptive tasks, and was associated with self-reported thermosensitivity.

Development and validation of the Exteroceptive Body Awareness (EBA-q) questionnaire.

The conscious processing of body signals influences higher-order psychological and cognitive functions, including self-awareness. Dysfunctions in the processing of these signals has been connected to neurological and psychiatric disorders characterized by altered states of self-consciousness. Studies indicate that perceiving the body through interoceptive signals (e.g., from internal organs such as heartbeat and breathing) is distinct from perceiving the body through exteroceptive signals (e.g., by relying on visual, tactile and olfactory cues). While questionnaires are available for assessing interoception, there are no validated self-report instruments for measuring bodily exterception. To fill this gap, we performed three studies to develop and validate a novel scale designed to assess bodily self-consciousness based on the processing of exteroceptive bodily signals. Exploratory factor analysis (Study 1, N = 302) led to an 18-item questionnaire comprised of four factors. We called this instrument Exteroceptive Body Awareness questionnaire (EBA-q). Confirmatory factor analysis (Study 2, N = 184) run on a second sample showed an acceptable fit for a bifactor model, suggesting researchers may use the questionnaire as a unidimensional scale reflecting exteroceptive bodily self-consciousness, or use each of its four sub-scales, reflecting "visuo-tactile body awareness", "spatial coordination", "awareness of body changes" and "awareness of clothing fit". Overall EBA-q showed good internal consistency. Convergent and divergent validity were assessed via cross-validation with existing body awareness questionnaires (Study 3, N = 366) and behavioral measures (Study 3, N = 64) of exteroceptive and interoceptive bodily self-consciousness. Research applications are discussed within a multi-faceted model of exteroception and interoception as distinct, but at the same time interconnected, dimensions of bodily self-consciousness.

A longitudinal study of interoception changes in the times of COVID-19: Effects on psychophysiological health and well-being.

Background: Interoception - the processing of the internal state of the body - has been consistently tied to well-being and mental health, which in turn have been severely challenged by the COVID-19 pandemic. Moreover, the fact that symptoms of COVID-19 (high temperature, shortness of breath, fatigue, and even gastro-intestinal problems) directly alter interoceptive signals has fueled people's tendency to constantly check their internal bodily state. Objectives: In this longitudinal study we tested for changes in interoception and psychophysiological health and well-being during different stages of the pandemic in 2020 and assessed their potential association. To highlight this association, we combined both subjective (i.e., self-reported questionnaires) and objective (i.e., measures of heart rate variability, HRV and of interoceptive accuracy) measures. Methods: 245 Italian participants who had completed the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) prior to the onset of the pandemic, repeated the questionnaire during the first national lockdown in Italy, and four months after restrictions. Participants also completed survey measures of depression (PHQ-9), anxiety (STAI), and sleep disturbance (PSQI). A sub-sample of 28 participants, who had completed the heartbeat counting task (HCT) and a measure of heart rate variability (HRV), was tested again remotely, in the same time windows, using phone applications and photoplethysmography. Results: While performance in the HCT remained unvaried, MAIA-2 scores consistently increased from before the pandemic to the national lockdown, and remained largely unvaried after four months. The national lockdown was associated with the lowest psychophysiological health and well-being, as evidenced by a decrease in HRV compared to before the pandemic and by higher scores in self-reported depression, anxiety, and sleep disturbance compared to four months after the lockdown. Interestingly, psychophysiological health and well-being were predicted by specific regulatory components of interoception (e.g., the ability to regulate distress by focusing on body sensations and experiencing one's body as safe and trustworthy). Conclusions: Our results suggest an increased attention towards visceral signals during the COVID-19 pandemic, and highlight the positive role of specific components of interoception in contributing to well-being, suggesting that novel interventions aimed at increasing interoception may be developed to protect against stressful life events such as COVID-19.

Gut markers of bodily self-consciousness in men.

Bodily self-consciousness, the state of mind that allows humans to be aware of their own body, forms the backdrop for almost every human experience, yet its underpinnings remain elusive. Here we combine an ingestible, minimally invasive capsule with surface electrogastrography to probe if gut physiology correlates with bodily self-consciousness in a sample of healthy men during a virtual bodily illusion. We discover that specific patterns of stomach and bowel activity (temperature, pressure, and pH) covary with specific facets of bodily self-consciousness (feelings of body location, agency, and disembodiment). These results uncover the hitherto untapped potential of minimally invasive probes to study the link between mental and gut states and show the significance of deep visceral organs in the self-conscious perception of ourselves as embodied beings.

Body image dissatisfaction and interoceptive sensibility significantly predict postpartum depressive symptoms.

BACKGROUND: During pregnancy women experience rapid and unique changes in body weight, shape and size over a relatively short time period. While research focused on the role of external bodily modifications during pregnancy, research on internal bodily variations is missing. METHODS: In a longitudinal study, we recruited healthy pregnant women and measured whether and how depressive symptoms, body image dissatisfaction and the subjective tendency to focus on one's own internal bodily sensations, i.e., interoceptive sensibility, changed during pregnancy and postpartum. Pregnant women filled online self-report questionnaires during pregnancy (i.e. second and third trimester) and after (i.e. six weeks) the delivery, including the Body Areas Satisfaction Scale, the Multidimensional Assessment of Interoceptive Awareness, and the Edinburgh Postnatal Depression Scale. RESULTS: While depressive symptoms remained stable in the peripartum, body image dissatisfaction increased in the postpartum compared to the pregnancy period, and interoceptive sensibility increased over pregnancy. Findings showed that the increase of body dissatisfaction through the peripartum and the levels of interoceptive sensibility in the early phase of pregnancy predicted depressive symptoms in the postpartum. LIMITATIONS: Interoception was evaluated as a subjective measure (i.e., interoceptive sensibility). Future studies may include objective measures of interoceptive accuracy and interoceptive awareness. CONCLUSIONS: The current study supports the importance of body image dissatisfaction and interoceptive sensibility in the development of postpartum depressive symptoms. Future studies need to investigate if interventions aimed to increase interoceptive sensibility might be useful in preventing depressive symptoms and identify the mechanisms that can lead to these changes.

Interoceptive influences on the production of self-serving lies in reputation risk conditions.

Bodily signals influence high-order cognitive and emotional processes, including social decision making. Here, we examined whether individual differences in the capacity to read signals from inside (interoception) and outside the body (exteroception) predicted participants' (dis)honesty. Deceptive behavior was measured in a card game where participants were tempted to lie to another person for financial gain in two conditions, i.e., under high vs. low risk of being seen by the other player (reputation risk). Participants completed the Heartbeat Counting Task (cardiac interoception) and a variation of the Body-Scaled Action Task (visual exteroception). Overall, when participants believed their reputation was at risk (i.e., the other player knew they lied) they told significantly less egoistic lies compared to when their choices were secret. This effect was significantly moderated by cardiac interoception. While low interoceptive participants told less egoistic lies when their reputation was at risk, high cardiac interoceptive participants did not change their behavior depending on the reputation risk conditions. We also found that cardiac interoception and visual exteroception did not correlate. Together our findings suggest that although integrated, interoception and exteroception constitute distinct facets of corporal awareness, and that high cardiac interoception shapes moral behavior by making people less concerned about their social reputation during spontaneous lies.

Conspiracy mentality and political orientation across 26 countries.

People differ in their general tendency to endorse conspiracy theories (that is, conspiracy mentality). Previous research yielded inconsistent findings on the relationship between conspiracy mentality and political orientation, showing a greater conspiracy mentality either among the political right (a linear relation) or amongst both the left and right extremes (a curvilinear relation). We revisited this relationship across two studies spanning 26 countries (combined N = 104,253) and found overall evidence for both linear and quadratic relations, albeit small and heterogeneous across countries. We also observed stronger support for conspiracy mentality among voters of opposition parties (that is, those deprived of political control). Nonetheless, the quadratic effect of political orientation remained significant when adjusting for political control deprivation. We conclude that conspiracy mentality is associated with extreme left- and especially extreme right-wing beliefs, and that this non-linear relation may be strengthened by, but is not reducible to, deprivation of political control.

The inside of me: interoceptive constraints on the concept of self in neuroscience and clinical psychology.

Humans are unique in their ability to think about themselves and carry a more or less clear notion of who they are in their mind. Here we review recent evidence suggesting that the birth, maintenance, and loss of the abstract concept of 'self' is deeply tied to interoception, the sense of internal physiological signals. Interoception influences multiple facets of the self-concept, cutting across its material, social, moral, and agentive components. Overall, we argue that interoception contributes to the stability of the self-concept over time, unifying its layers and constraining the degree to which it is susceptible to external influences. Hence, the core features of the self-concept are those that correlate more with inner bodily states. We discuss the implications that this may have for theories of embodied cognition as well as for the understanding of psychiatric disorders in which the concept of self appears fragmented or loose. Finally, we formulate some empirical predictions that could be tested in future studies to shed further light on this emerging field.

Freedom to act enhances the sense of agency, while movement and goal-related prediction errors reduce it.

The Sense of Agency (SoA) is the experience of controlling one's movements and their external consequences. Accumulating evidence suggests that freedom to act enhances SoA, while prediction errors are known to reduce it. Here, we investigated if prediction errors related to movement or to the achievement of the goal of the action exert the same influence on SoA during free and cued actions. Participants pressed a freely chosen or cued-colored button, while observing a virtual hand moving in the same or in the opposite direction-i.e., movement-related prediction error-and pressing the selected or a different color-i.e., goal-related prediction error. To investigate implicit and explicit components of SoA, we collected indirect (i.e., Synchrony Judgments) and direct (i.e., Judgments of Causation) measures. We found that participants judged virtual actions as more synchronous when they were free to act. Additionally, movement-related prediction errors reduced both perceived synchrony and judgments of causation, while goal-related prediction errors impaired exclusively the latter. Our results suggest that freedom to act enhances SoA and that movement and goal-related prediction errors lead to an equivalent reduction of SoA in free and cued actions. Our results also show that the influence of freedom to act and goal achievement may be limited, respectively, to implicit and explicit SoA, while movement information may affect both components. These findings provide support to recent theories that view SoA as a multifaceted construct, by showing that different action cues may uniquely influence the feeling of control.

Face individual identity recognition: a potential endophenotype in autism.

BACKGROUND: Face individual identity recognition skill is heritable and independent of intellectual ability. Difficulties in face individual identity recognition are present in autistic individuals and their family members and are possibly linked to oxytocin polymorphisms in families with an autistic child. While it is reported that developmental prosopagnosia (i.e., impaired face identity recognition) occurs in 2-3% of the general population, no prosopagnosia prevalence estimate is available for autism. Furthermore, an autism within-group approach has not been reported towards characterizing impaired face memory and to investigate its possible links to social and communication difficulties. METHODS: The present study estimated the prevalence of prosopagnosia in 80 autistic adults with no intellectual disability, investigated its cognitive characteristics and links to autism symptoms' severity, personality traits, and mental state understanding from the eye region by using standardized tests and questionnaires. RESULTS: More than one third of autistic participants showed prosopagnosia. Their face memory skill was not associated with their symptom's severity, empathy, alexithymia, or general intelligence. Face identity recognition was instead linked to mental state recognition from the eye region only in autistic individuals who had prosopagnosia, and this relationship did not depend on participants' basic face perception skills. Importantly, we found that autistic participants were not aware of their face memory skills. LIMITATIONS: We did not test an epidemiological sample, and additional work is necessary to establish whether these results generalize to the entire autism spectrum. CONCLUSIONS: Impaired face individual identity recognition meets the criteria to be a potential endophenotype in autism. In the future, testing for face memory could be used to stratify autistic individuals into genetically meaningful subgroups and be translatable to autism animal models.

Blood pressure-related hypoalgesia: a systematic review and meta-analysis.

OBJECTIVE: Spontaneous or experimentally induced high blood pressure (BP) is associated with reduced pain perception, known as BP-related hypoalgesia. Despite its clinical implications, such as the interference with early detection of myocardial infarction in 'at risk' groups, the size of the association between high BP and pain has not yet been quantified. Moreover, the distinct association between high BP and physiological or psychological components of pain has not yet been considered so far. The aim of this study was to overcome this gap by performing separate meta-analyses on nociceptive response versus quantifiable perceptual measures of pain in relation to high BP. METHODS: PubMed and Web of Knowledge databases were searched for English language studies conducted in humans. Fifty-nine studies were eligible for the analyses. Pooled effect sizes (Hedges' g) were compared. Random effect models were used. Results show that higher BP is significantly associated with lower nociceptive response (g = 0.38; k = 6) and reduced pain perception, assessed by quantifiable measures (g = 0.48; k = 59). RESULTS: The association between BP and pain perception, derived from highly heterogeneous studies, was characterized by significant publication bias. BP assessment, pain assessment, site of pain stimulation, percentage of female participants in the sample, and control for potential confounders were significant moderators. CONCLUSION: Current meta-analytic results confirm the presence of BP-related hypoalgesia and point towards the need for a better understanding of its underlying mechanisms.

Oculomotor behavior tracks the effect of ideological priming on deception.

The decision to lie to another person involves a conflict between one's own and others' interest. Political ideology may foster self-promoting or self-transcending values and thus may balance or fuel self vs. other related conflicts. Here, we explored in politically non-aligned participants whether oculomotor behavior may index the influence on moral decision-making of prime stimuli related to left and right-wing ideologies. We presented pictures of Italian politicians and ideological words in a paradigm where participants could lie to opponents with high vs. low socio-economic status to obtain a monetary reward. Results show that left-wing words decreased self-gain lies and increased other-gain ones. Oculomotor behavior revealed that gazing longer at politicians' pictures led participants to look longer at opponent's status-related information than at game's outcome-related information before the decision. This, in turn, caused participants to lie less to low status opponents. Moreover, after lying, participants averted their gaze from high status opponents and maintained it towards low status ones. Our results offer novel evidence that ideological priming influences moral decision-making and suggest that oculomotor behavior may provide crucial insights on how this process takes place.

The "embreathment" illusion highlights the role of breathing in corporeal awareness.

Recent theories posit that physiological signals contribute to corporeal awareness, the basic feeling that one has a body (body ownership) that acts according to one's will (body agency) and occupies a specific position (body location). Combining physiological recordings with immersive virtual reality, we found that an ecological mapping of real respiratory patterns onto a virtual body illusorily changes corporeal awareness. This new way of inducing a respiratory bodily illusion, called "embreathment," revealed that breathing is almost as important as visual appearance for inducing body ownership and more important than any other cue for body agency. These effects were moderated by individual levels of interoception, as assessed through a standard heartbeat-counting task and a new "pneumoception" task. By showing that respiratory, visual, and spatial signals exert a specific and weighted influence on the fundamental feeling that one is an embodied agent, we pave the way for a comprehensive hierarchical model of corporeal awareness.NEW & NOTEWORTHY Our body is the only object we sense from the inside; however, it is unclear how much inner physiology contributes to the global sensation of having a body and controlling it. We combine respiration recordings with immersive virtual reality and find that making a virtual body breathe like the real body gives an illusory sense of ownership and agency over the avatar, elucidating the role of a key physiological process like breathing in corporeal awareness.

The enfacement illusion boosts facial mimicry.

Facial mimicry, the automatic imitation of another person's emotion, is a mechanism underlying emotion recognition and emotional contagion, a phylogenetically conserved form of empathy that precedes later developing empathic skills. We tested the possibility to increase facial mimicry by blurring self-other distinction via the enfacement illusion. To do so we delivered synchronous, versus asynchronous, visuo-tactile interpersonal multisensory stimulation on the observer and expresser's faces and then recorded surface facial EMG while participants observed videos of happy and sad facial expressions displayed by the expresser. Our results show that synchronous visuo-tactile stimulation can indeed enhance facial mimicry and that this depends on participants' baseline tendency to mimic.. Our findings could set the basis for developing novel interventions for conditions characterized by reduced empathic and emotion recognition skills, including autism and schizophrenia.

Bound to the group and blinded by the leader: ideological leader-follower dynamics in a trust economic game.

Understanding the dynamics of trustworthiness in ideological contexts could influence human societies, affect electoral campaigns and ultimately impact democracy. We tested trust behaviour towards political leaders in a sample of 121 opposing/supporting voters assigned as trustors in an iterative trust game (TG). In two experiments, a famous Italian conservative leader (i.e. Silvio Berlusconi) or a famous non-politician were used as trustees in a predefined un/trustworthy TG, while trustors believed that mathematical algorithms reproduced trustee's real behaviour. Results revealed that depending on the group, voters either relied on the situation and adjusted to the behaviour of the out-group leader (in our case left-wing voters), or on their disposition for group-loyalty with respect for authority, thus failing to adjust to the behaviour of the in-group leader (in our case right-wing voters). Our findings suggest that: (i) complex voter-leader relations in politics are reflected in the simple trustor-trustee financial interactions from behavioural economics, and (ii) being bound to one's group and one's leader may affect the trust economic decisions of the followers.

An interoceptive illusion of effort induced by false heart-rate feedback.

Interoception, or the sense of the internal state of the body, is key to the adaptive regulation of our physiological needs. Recent theories contextualize interception within a predictive coding framework, according to which the brain both estimates and controls homeostatic and physiological variables, such as hunger, thirst, and effort levels, by orchestrating sensory, proprioceptive, and interoceptive signals from inside the body. This framework suggests that providing false interoceptive feedback may induce misperceptions of physiological variables, or "interoceptive illusions." Here we ask whether it is possible to produce an illusory perception of effort by giving participants false acoustic feedback about their heart-rate frequency during an effortful cycling task. We found that participants reported higher levels of perceived effort when their heart-rate feedback was faster compared with when they cycled at the same level of intensity with a veridical feedback. However, participants did not report lower effort when their heart-rate feedback was slower, which is reassuring, given that failing to notice one's own effort is dangerous in ecologically valid conditions. Our results demonstrate that false cardiac feedback can produce interoceptive illusions. Furthermore, our results pave the way for novel experimental manipulations that use illusions to study interoceptive processing.

Left Threatened by Right: Political Intergroup Bias in the Contemporary Italian Context.

Using different evaluation targets (i.e., politicians' pictures, ideological words, items referring to features attributed to political ingroup/outgroup) we characterized the intergroup bias among political groups in the Italian context (Study 1-2-3) and tested a model that may account for the bias itself (Study 3). For all evaluation targets, left-wing participants - compared to right-wing participants - showed a greater intergroup bias, expressing more negative emotions toward the outgroup. The process was influenced by a greater perceived threat of the outgroup. Conversely, right-wing participants expressed the bias only when presented with ideological words. Our results provide a detailed description of how intergroup bias in Italy is differently expressed by the two ideological groups depending on the targets used to represent the political counterpart. Moreover, the results show that the stronger bias expressed by left-wing participants is driven by perceived threat of the outgroup.

Characterizing Body Image Distortion and Bodily Self-Plasticity in Anorexia Nervosa via Visuo-Tactile Stimulation in Virtual Reality.

We combined virtual reality and multisensory bodily illusion with the aim to characterize and reduce the perceptual (body overestimation) and the cognitive-emotional (body dissatisfaction) components of body image distortion (BID) in anorexia nervosa (AN). For each participant (20 anorexics, 20 healthy controls) we built personalized avatars that reproduced their own body size, shape, and verisimilar increases and losses of their original weight. Body overestimation and dissatisfaction were measured by asking participants to choose the avatar that best resembled their real and ideal body. Results show higher body dissatisfaction in AN, caused by the desire of a thinner body, and no body-size overestimation. Interpersonal multisensory stimulation (IMS) was then applied on the avatar reproducing participant's perceived body, and on the two avatars which reproduced increases and losses of 15% of it, all presented with a first-person perspective (1PP). Embodiment was stronger after synchronous IMS in both groups, but did not reduce BID in participants with AN. Interestingly, anorexics reported more negative emotions after embodying the fattest avatar, which scaled with symptoms severity. Overall, our findings suggest that the cognitive-emotional, more than the perceptual component of BID is severely altered in AN and that perspective (1PP vs. 3PP) from which a body is evaluated may play a crucial role. Future research and clinical trials might take advantage of virtual reality to reduce the emotional distress related to body dissatisfaction.