TY - JOUR
T1 - The inner world of overactive monitoring
T2 - Neural markers of interoception in obsessive-compulsive disorder
AU - Yoris, A.
AU - García, A. M.
AU - Traiber, L.
AU - Santamaría-García, H.
AU - Martorell, M.
AU - Alifano, F.
AU - Kichic, R.
AU - Moser, J. S.
AU - Cetkovich, M.
AU - Manes, F.
AU - Ibáñez, A.
AU - Sedeño, L.
N1 - Publisher Copyright:
© 2017 Cambridge University Press.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background. Obsessive-compulsive disorder (OCD) patients typically overmonitor their own behavior, as shown by symptoms of excessive doubt and checking. Although this is well established for the patients' relationship with external stimuli in the environment, no study has explored their monitoring of internal body signals, a process known to be affected in anxiety-related syndromes. Here, we explored this issue through a cardiac interoception task that measures sensing of heartbeats. Our aim was to explore key behavioral and electrophysiological aspects of internal-cue monitoring in OCD, while examining their potential distinctiveness in this condition. Method. We administered a heartbeat detection (HBD) task (with related interoceptive confidence and awareness measures) to three matched groups (OCD patients, panic disorder patients, healthy controls) and recorded ongoing modulations of two task-relevant electrophysiological markers: the heart evoked potential (HEP) and the motor potential (MP). Results. Behaviorally, OCD patients outperformed controls and panic patients in the HBD task. Moreover, they exhibited greater amplitude modulation of both the HEP and the MP during cardiac interoception. However, they evinced poorer confidence and awareness of their interoceptive skills. Conclusions. Convergent behavioral and electrophysiological data showed that overactive monitoring in OCD extends to the sensing of internal bodily signals. Moreover, this pattern discriminated OCD from panic patients, suggesting a condition-distinctive alteration. Our results highlight the potential of exploring interoceptive processes in the OCD spectrum to better characterize the population's cognitive profile. Finally, these findings may lay new bridges between somatic theories of emotion and cognitive models of OCD.
AB - Background. Obsessive-compulsive disorder (OCD) patients typically overmonitor their own behavior, as shown by symptoms of excessive doubt and checking. Although this is well established for the patients' relationship with external stimuli in the environment, no study has explored their monitoring of internal body signals, a process known to be affected in anxiety-related syndromes. Here, we explored this issue through a cardiac interoception task that measures sensing of heartbeats. Our aim was to explore key behavioral and electrophysiological aspects of internal-cue monitoring in OCD, while examining their potential distinctiveness in this condition. Method. We administered a heartbeat detection (HBD) task (with related interoceptive confidence and awareness measures) to three matched groups (OCD patients, panic disorder patients, healthy controls) and recorded ongoing modulations of two task-relevant electrophysiological markers: the heart evoked potential (HEP) and the motor potential (MP). Results. Behaviorally, OCD patients outperformed controls and panic patients in the HBD task. Moreover, they exhibited greater amplitude modulation of both the HEP and the MP during cardiac interoception. However, they evinced poorer confidence and awareness of their interoceptive skills. Conclusions. Convergent behavioral and electrophysiological data showed that overactive monitoring in OCD extends to the sensing of internal bodily signals. Moreover, this pattern discriminated OCD from panic patients, suggesting a condition-distinctive alteration. Our results highlight the potential of exploring interoceptive processes in the OCD spectrum to better characterize the population's cognitive profile. Finally, these findings may lay new bridges between somatic theories of emotion and cognitive models of OCD.
KW - Heart evoked potential
KW - interoception
KW - motor potential
KW - obsessive-compulsive disorder
KW - overactive monitoring
UR - http://www.scopus.com/inward/record.url?scp=85017133980&partnerID=8YFLogxK
U2 - 10.1017/S0033291717000368
DO - 10.1017/S0033291717000368
M3 - Article
C2 - 28374658
AN - SCOPUS:85017133980
SN - 0033-2917
VL - 47
SP - 1957
EP - 1970
JO - Psychological Medicine
JF - Psychological Medicine
IS - 11
ER -