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The inner world of overactive monitoring: neural markers of interoception in obsessive–compulsive disorder
Open accessAbstract
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.
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“Interoceptive abnormalities are noted in psychoses (Brosey and Woodward, 2017), obsessive-compulsive disorders (Yoris et al., 2017) and eating disorders (Jenkinson et al., 2018).”
From Physiological feelings (2019) · cites this paper as Yoris et al., 2017
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“While the majority of clinical conditions are associated with reduced interoceptive accuracy, interoceptive accuracy has been found to be increased in anxiety and panic disorder (for reviews, see Domschke et al., 2010; Paulus and Stein, 2010) and in OCD (Yoris et al., 2017).”
From Atypical interoception as a common risk factor for psychopathology: A review (2021) · cites this paper as Yoris et al., 2017
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“consistent with research findings that individuals with OCD over-monitor their internal bodily signals, such as heart beats [65].”
From Habit as a therapeutic component in psychological treatment for obsessive-compulsive disorder: A randomised controlled feasibility study. (2026) · cites this paper as [65]
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Vartanian, L. R., & Germeroth, L. J. (2011) · Body Image · doi:10.1016/j.bodyim.2011.06.007 · Cited by 17
Peak Finder Metaserver - a novel application for finding peaks in ChIP-seq data
Kruczyk, M., Umer, H. M., Enroth, S., & Komorowski, J. (2013) · BMC Bioinformatics · doi:10.1186/1471-2105-14-280 · Cited by 14
Coles, M. E., Schofield, C. A., & Nota, J. A. (2014) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465813001112 · Cited by 11
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Cited by
Sorted by citations
An Active Inference Approach to Interoceptive Psychopathology
Paulus, M. P., Feinstein, J. S., & Khalsa, S. S. (2019) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050718-095617 · Cited by 394
“Interoceptive dysfunctions of various kinds have also been found in individuals with obsessive compulsive disorder (Yoris et al. 2017), borderline personality disorder (Loffler et al. 2018), and female sexual arousal disorder (Handy & Meston 2018).”
BackgroundColl, M.-P., Hobson, H., Bird, G., & Murphy, J. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.12.012 · Cited by 262
The neuroscience of body memory: From the self through the space to the others
Riva, G. (2017) · Cortex · doi:10.1016/j.cortex.2017.07.013 · Cited by 252
Pace-Schott, E. F., Amole, M. C., Aue, T., Balconi, M., Bylsma, L. M., Critchley, H., Demaree, H. A., Friedman, B. H., Gooding, A. E. K., Gosseries, O., et al. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.05.002 · Cited by 221
“Interoceptive abnormalities are noted in psychoses (Brosey and Woodward, 2017), obsessive–compulsive disorders (Yoris et al., 2017) and eating disorders (Jenkinson et al.”
Atypical interoception as a common risk factor for psychopathology: A review
Brewer, R., Murphy, J., & Bird, G. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.07.036 · Cited by 180
Metadata
- Authors
- Yoris, A., García, A. M., Traiber, L., Santamaría-García, H., Martorell, M., Alifano, F., Kichic, R., Moser, J. S., Cetkovich, M., Manes, F., Ibáñez, A., & Sedeño, L.
- Affiliations
- Consejo Nacional de Investigaciones Científicas y Técnicas (AR)
- Instituto de Neurología Cognitiva (AR)
- Favaloro University (AR)
- Michigan State University (US)
- Corresponding author
- Sedeño, L.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-04-04
- Volume
- 47
- Issue
- 11
- Pages
- 1957-1970
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2604761667
- Cited by
- 124
- References
- 97
- Citations by year
- 2026: 13 · 2025: 8 · 2024: 9 · 2023: 17 · 2022: 8 · 2021: 12 · 2020: 14 · 2019: 27 · 2018: 10 · 2017: 6
- FWCI
- 19.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Americanae (AECID Library) (submittedVersion, cc-by-nc-nd)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-nd)
- CONICET Digital (CONICET) (submittedVersion, cc-by-nc-sa)
- Funders
- Fundación INECO (15150012)
- Consejo Nacional de Investigaciones Científicas y Técnicas (1130920, 15150012)
- Comisión Nacional de Investigación Científica y Tecnológica (FONDAP-15150012, 1140114, 15150012, 1130920)
- Fondo para la Investigación Científica y Tecnológica (2012-0412, 2012‐1309, PICT 2012)
- Fondo de Financiamiento de Centros de Investigación en Áreas Prioritarias (15150012)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, interoception, heartbeat detection, motor potential, interoceptive awareness, panic disorder
- MeSH terms
- Adult, Evoked Potentials, Female, Heart Rate, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Panic Disorder, Evoked Potentials, Motor, Young Adult, Interoception
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