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8 Integrating dimensions of interoception in neuropsychiatry

Abstract

Aikaterini (Katerina) Fotopoulou, PhD, is a Professor in Psychodynamic Neuroscience at University College London. Her lab focuses on topics and disorders that lie at the borders between neurology and psychology, funded initially by a Starting Investigator Grant ‘Bodily Self’ and more recently a Consolidator grant ‘METABODY’ from the European Research Council. See here for projects and publications (www.fotopoulou.com). Katerina is the founder of the International Association for the Study of Affective Touch (IASAT), fellow of the Association of Psychological Science, President of the Psychology Section of the British Science Foundation and the recipient of many wards such as the Early Career Award of the International Neuropsychology Society, and the Young Champions Award of the World Economic Forum.

Abstract In this interdisciplinary talk, I will put forward the idea that neuropsychiatric disorders such eating, somatic and functional symptom disorders that lie at the heart of the mental-physical heath interface can be best understood as disorders of the bodily self. More specifically, I will present experimental (explicit belief updating), computational (precision optimisation) and clinical (biofeedback intervention) evidence from studies in anorexia nervosa, revealing abnormalities in how low levels of interoceptive processing are integrated with higher-order, metacognitive beliefs about one’s self-efficacy and sense of control. As a result of such abnormalities in the expected uncertainty of interoceptive signals, patients experience a perpetual, intolerable uncertainty about their physiological, interoceptive states and their own ability to self-regulate, which they attempt to resolve by rigid behavioural control, such as eating restriction or excessive exercise in the case of eating disorders.

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