Abstract
Interoception in autism is receiving increasing research attention. Previously, differences were identified in autism on both objective and subjective measures of interoception, and an association with anxiety. Yet, it is currently unknown how interoception relates to core autism features. Here, in 49 autistic children, we consider how interoceptive accuracy (measured with heartbeat detection tasks) and sensibility (subjective judgements of awareness) relate to overall severity on the Autism Diagnostic Observation Schedule, and symptom domains of social-affective and repetitive, restricted behaviors. Socio-affective features were related to interoceptive sensibility, while repetitive restricted behaviors were related to interoceptive accuracy. This dissociation suggests disparate interoceptive mechanisms for the formation and/or maintenance of autistic features.
Highlights
We hypothesized that there would be a relationship between core autism features and interoceptive differences in autism
We predicted that we would observe decreasing interoceptive accuracy but increasing interoceptive sensibility as autism severity increased. This would result in a positive association between interoceptive trait prediction error (ITPE)—the discrepancy between interoceptive accuracy and interoceptive sensibility—and core autistic features, especially in the social affective (SA) domain
In partial support of our hypotheses, the results indicated that there was a positive association between autism severity, as measured using calibrated severity scores from the Autism Diagnostic Observation Schedule—2nd edition (ADOS-2) (Lord et al 2012) and interoceptive differences in the domain of interoceptive sensibility
Summary
Feedback of afferent visceral signals to the brain (Critchley and Harrison 2013).The personal accounts of autistic individuals and their caregivers suggest a range of pervasive difficulties with the awareness and integration of interoceptive signals (Elwin et al 2012; Gerland 1997; Musser 2018). Garfinkel and colleagues proposed a threedimensional construct of interoception (Garfinkel and Critchley 2013; Garfinkel et al 2015) Within this model, paradigms that objectively quantify participants’ performance in detecting internal events represent measures of ‘interoceptive accuracy’ (Garfinkel et al 2015). The trial-wise correspondence between performance and confidence on objective tasks, referred to as ‘interoceptive awareness’, is thought
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