Interoceptive sensitivity in anxiety and anxiety disorders: An overview and integration of neurobiological findings

Clinical Psychology Review

Volumn 30, Issue 1, 2010, Pages 1-11

  Domschke, Katharina ^a   Stevens, Stephan ^b   Pfleiderer, Bettina ^a   Gerlach, Alexander L ^a  

^a UNIVERSITY OF MÜNSTER   (Germany)

^b JUSTUS LIEBIG UNIVERSITY   (Germany)

Author keywords

Anxiety; Anxiety disorders; Biofeedback; Heartbeat perception; Interoception; Interoceptive neural network

Indexed keywords

BETA ADRENERGIC RECEPTOR BLOCKING AGENT; FLUOXETINE; METOPROLOL; PINDOLOL; PLACEBO;

ACUTE STRESS DISORDER; ADJUSTMENT DISORDER; AGORAPHOBIA; AMYGDALOID NUCLEUS; ANXIETY; ANXIETY DISORDER; AUTONOMIC INNERVATION; BETA ADRENERGIC STIMULATION; CINGULATE GYRUS; COGNITIVE THERAPY; ELECTROENCEPHALOGRAPHY; EMOTION; FEEDBACK SYSTEM; FUNCTIONAL MAGNETIC RESONANCE IMAGING; GENERALIZED ANXIETY DISORDER; HEART BEAT; HUMAN; HYPOTHALAMUS; INSULA; INTEROCEPTION; MAJOR DEPRESSION; NERVE CELL NETWORK; NEUROBIOLOGY; ORBITAL CORTEX; PANIC; PERCEPTION; POSITRON EMISSION TOMOGRAPHY; PREFRONTAL CORTEX; REVIEW; SOCIAL PHOBIA; SOMATOSENSORY CORTEX; STATE TRAIT ANXIETY INVENTORY;

ANXIETY; ANXIETY DISORDERS; ATTENTION; AWARENESS; BRAIN; EMOTIONS; HEART RATE; HUMANS; PERCEPTION;

EID: 71249154811     PISSN: 02727358     EISSN: 18737811     Source Type: Journal    
DOI: 10.1016/j.cpr.2009.08.008     Document Type: Review

References (156)

1. Anderson E.R., and Hope D.A. The relationship among social phobia, objective and perceived physiological reactivity, and anxiety sensitivity in an adolescent population. Journal of Anxiety Disorders 23 (2009) 18-26
2. Andor T., Gerlach A.L., and Rist F. Superior perception of phasic physiological arousal and the detrimental consequences of the conviction to be aroused on worrying and metacognitions in GAD. Journal of Abnormal Psychology 117 (2008) 193-205
3. Andor F., Glockner-Rist A., Gerlach A.L., and Rist F. Symptom-specific subgroups of panic disorder. Zeitschrift fur Klinische Psychologie und Psychotherapie 37 (2008) 161-171
4. Antony M., Brown T., Craske M., Barlow D., Mitchell W., and Meadows E. Accuracy of heartbeat perception in panic disorder, social phobia, and nonanxious subjects. Journal of Anxiety Disorders 9 (1995) 355-371
5. Antony M., Meadows E., Brown T., and Barlow D. Cardiac awareness before and after cognitive-behavioral treatment for panic disorder. Journal of Anxiety Disorders 8 (1994) 341-350
6. Asmundson G.J., Sandler L.S., Wilson K.G., and Norton G.R. Panic attacks and interoceptive acuity for cardiac sensations. Behaviour Research and Therapy 31 (1993) 193-197
7. Bandelow B., Zohar J., Hollander E., Kasper S., and Moller H.J. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders. World Journal of Biological Psychiatry 3 (2002) 171-199
8. Barlow D. Anxiety and ist disorders: The nature and treatment of anxiety and panic (1988), Guilford Press, New York
9. Barsky A.J., Cleary P.D., Sarnie M.K., and Ruskin J.N. Panic disorder, palpitations, and the awareness of cardiac activity. The Journal of Nervous and Mental Disease 182 (1994) 63-71
10. Beck A.T., Emery G., and Greenberg R.L. Anxiety disorders and phobias: A cognitive perspective (1985), Basic Books, New York, NY, USA
11. Bennarroch E. Functional anatomy of the central autonomic network. Central autonomic network: Functional organization and clinical correlations (1997), Futura Publishing Company Inc, Armonk, NY, USA 29-60
12. Biver F., Wikler D., Lotstra F., Damhaut P., Goldman S., and Mendlewicz J. Serotonin 5-HT2 receptor imaging in major depression: focal changes in orbito-insular cortex. The British Journal of Psychiatry : the Journal of Mental Science 171 (1997) 444-448
13. Blackwell B. Realtion of heart rate control to heartbeat perception. Biofeedback and Self-Regulation 2 (1977) 317-392
14. Bouton M.E., Mineka S., and Barlow D.H. A modern learning theory perspective on the etiology of panic disorder. Psychological Review 108 (2001) 4-32
15. Brener J., and Kluvitse C. Heartbeat detection: Judgments of the simultaneity of external stimuli and heartbeats. Psychophysiology 25 (1988) 554-561
16. Butler G., Fennell M., and Hackmann A. Cognitive-behavioral therapy for anxiety disorders (guides to individualized evidence-based treatment) (2008), Guilford Press, New York, NY
17. Cameron O.G. Interoception: the inside story-a model for psychosomatic processes. Psychosomatic Medicine 63 (2001) 697-710
18. Cameron O.G., Huang G.C., Nichols T., Koeppe R.A., Minoshima S., Rose D., et al. Reduced gamma-aminobutyric acid(A)-benzodiazepine binding sites in insular cortex of individuals with panic disorder. Archives of General Psychiatry 64 (2007) 793-800
19. Cameron O.G., and Minoshima S. Regional brain activation due to pharmacologically induced adrenergic interoceptive stimulation in humans. Psychosomatic Medicine 64 (2002) 851-861
20. Cannon W.B. The James-Lange theory of emotion: A critical examination and an alternative theory. American Journal of Psychology 39 (1927) 106-124
21. Carroll D., and Evans L. Effects of heart-rate biofeedback and false feedback on reactions to stressful stimulation. Perceptual and Motor Skills 53 (1981) 387-393
22. Carroll D., and Whellock J. Heart rate perception and the voluntary control of heart rate. Biological Psychology 11 (1980) 169-180
23. Cattell R.B. Scala di ansieta (1969) Firenze, Organizzazioni Speciali
24. Cecchetto D.F., and Saper C.B. Role of the cerebral cortex in autonomic function. In: Loewy A.D., and Spyer K.M. (Eds). Central regulation of autonomic functions (1990), Oxford University Press, Oxford, UK 208-223
25. Chambers J.A., Power K.G., and Durham R.C. The relationship between trait vulnerability and anxiety and depressive diagnoses at long-term follow-up of Generalized Anxiety Disorder. Journal of Anxiety Disorders 18 (2004) 587-607
26. Chambless D.L., Beck A.T., Gracely E.J., and Grisham J.R. Relationship of cognitions to fear of somatic symptoms: A test of the cognitive theory of panic. Depression and Anxiety 11 (2000) 1-9
27. Chambless D.L., Caputo G.C., Bright P., and Gallagher R. Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology 52 (1984) 1090-1097
28. Charney D.S. Neuroanatomical circuits modulating fear and anxiety behaviors. Acta Psychiatrica Scandinavica Supplementum 417 (2003) 38-50
29. Clark D.M. A cognitive approach to panic. Behaviour Research and Therapy 24 (1986) 461-470
30. Clark D.M., Salkovskis P.M., Ost L.G., Breitholtz E., Koehler K.A., Westling B.E., et al. Misinterpretation of body sensations in panic disorder. Journal of Consulting and Clinical Psychology 65 (1997) 203-213
31. Craig A.D. How do you feel? Interoception: The sense of the physiological condition of the body. Nature Reviews Neuroscience 3 (2002) 655-666
32. Craig A.D. Interoception: The sense of the physiological condition of the body. Current Opinion in Neurobiology 13 (2003) 500-505
33. Craig A.D. Human feelings: Why are some more aware than others?. Trends in Cognitive Sciences 8 (2004) 239-241
34. Craig A.D. How do you feel-now? The anterior insula and human awareness. Nature Reviews Neuroscience 10 (2009) 59-70
35. Craske M.G., Lang A.J., Tsao J.C., Mystkowski J.L., and Rowe M.K. Reactivity to interoceptive cues in nocturnal panic. Journal of Behavior Therapy and Experimental Psychiatry 32 (2001) 173-190
36. Critchley H.D., Corfield D.R., Chandler M.P., Mathias C.J., and Dolan R.J. Cerebral correlates of autonomic cardiovascular arousal: A functional neuroimaging investigation in humans. Journal of Physiology 523 (2000) 259-270
37. Critchley H.D., Rotshtein P., Nagai Y., O'Doherty J., Mathias C.J., and Dolan R.J. Activity in the human brain predicting differential heart rate responses to emotional facial expressions. Neuroimage 24 (2005) 751-762
38. Critchley H.D., Wiens S., Rotshtein P., Ohman A., and Dolan R.J. Neural systems supporting interoceptive awareness. Nature Neuroscience 7 (2004) 189-195
39. Damasio A.R. The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical Transactions of the Royal Society of London (Series B) 351 (1994) 1413-1420
40. Damsa C., Kosel M., and Moussally J. Current status of brain imaging in anxiety disorders. Current Opinion in Psychiatry 22 (2009) 96-110
41. De Berardis D., Campanella D., Gambi F., La R.R., Sepede G., Core L., et al. Alexithymia, fear of bodily sensations, and somatosensory amplification in young outpatients with panic disorder. Psychosomatics 48 (2007) 239-246
42. DePascalis V., Alberti M.L., and Pandolfo R. Anxiety, perception, and control of heart rate. Perceptual and Motor Skills 59 (1984) 203-211
43. DePascalis V., Palumbo G., and Ronchitelli V. Heartbeat perception, instructions, and biofeedback in the control of heart rate. International Journal of Psychophysiology 11 (1991) 179-193
44. Domschke K., and Deckert J. Molecular and imaging genetic markers in panic disorder. In: Ritsner M. (Ed). The handbook of neuropsychiatric biomarkers, endophenotypes, and genes (2009), Springer, New York
45. Drevets W.C. Neuroimaging abnormalities in the amygdala in mood disorders. Annals of the New York Academy of Sciences 985 (2003) 420-444
46. Dunn B.D., Dalgleish T., and Lawrence A.D. The somatic marker hypothesis: A critical evaluation. Neuroscience and Biobehavioral Reviews 30 (2006) 239-271
47. Ehlers A. Somatic symptoms and panic attacks: A retrospective study of learning experiences. Behaviour Research and Therapy 31 (1993) 269-278
48. Ehlers A. A 1-year prospective study of panic attacks: Clinical course and factors associated with maintenance. Journal of Abnormal Psychology 104 (1995) 164-172
49. Ehlers A. Why Van der Does, Van Dyck and Spinhoven (1997) did not demonstrate that superior heartbeat perception in panic disorder is partly an artefact. Journal of Affective Disorders 49 (1998) 241-247
50. Ehlers A., and Breuer P. Increased cardiac awareness in panic disorder. Journal of Abnormal Psychology 101 (1992) 371-382
51. Ehlers A., and Breuer P. How good are patients with panic disorder at perceiving their heartbeats?. Biological Psychology 42 1-2 (1996) 165-182
52. Ehlers A., Breuer P., Dohn D., and Fiegenbaum W. Heartbeat perception and panic disorder: Possible explanations for discrepant findings. Behaviour Research and Therapy 33 (1995) 69-76
53. Ehlers A., Margraf J., Roth W.T., Taylor C.B., and Birbaumer N. Anxiety induced by false heart rate feedback in patients with panic disorder. Behaviour Research and Therapy 26 (1988) 1-11
54. Ehlers A., Mayou R.A., Sprigings D.C., and Birkhead J. Psychological and perceptual factors associated with arrhythmias and benign palpitations. Psychosomatic Medicine 62 (2000) 693-702
55. Eley T.C., Gregory A.M., Clark D.M., and Ehlers A. Feeling anxious: A twin study of panic/somatic ratings, anxiety sensitivity and heartbeat perception in children. Journal of Child Psychology and Psychiatry, and Allied Disciplines 48 (2007) 1184-1191
56. Eley T.C., Stirling L., Ehlers A., Gregory A.M., and Clark D.M. Heart-beat perception, panic/somatic symptoms and anxiety sensitivity in children. Behaviour Research and Therapy 42 (2004) 439-448
57. Etkin A., and Wager T.D. Functional neuroimaging of anxiety: A meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. The American Journal of Psychiatry 164 (2007) 1476-1488
58. Fairclough S.H., and Goodwin L. The effect of psychological stress and relaxation on interoceptive accuracy: Implications for symptom perception. Journal of Psychosomatic Research 62 (2007) 289-295
59. Fleet R.P., Dupuis G., Marchand A., Burelle D., Arsenault A., and Beitman B.D. Panic disorder in emergency department chest pain patients: Prevalence, comorbidity, suicidal ideation, and physician recognition. The American Journal of Medicine 101 (1996) 371-380
60. Gentili C., Gobbini M.I., Ricciardi E., Vanello N., Pietrini P., Haxby J.V., et al. Differential modulation of neural activity throughout the distributed neural system for face perception in patients with Social Phobia and healthy subjects. Brain Research Bulletin 77 (2008) 286-292
61. Gerlach A.L., Mourlane D., and Rist F. Public and private heart rate feedback in social phobia: A manipulation of anxiety visibility. Cognitive Behaviour Therapy 33 (2004) 36-45
62. Gilbert C. Skin conductance feedback and panic attacks. Biofeedback and Self-Regulation 11 (1986) 251-254
63. Godemann F., Butter C., Lampe F., Linden M., Schlegl M., Schultheiss H.P., et al. Panic disorders and agoraphobia: Side effects of treatment with an implantable cardioverter/defibrillator. Clinical Cardiology 27 (2004) 321-326
64. Gottesman I.I., and Gould T.D. The endophenotype concept in psychiatry: Etymology and strategic intentions. The American Journal of Psychiatry 160 (2003) 636-645
65. Gregor K.L., and Zvolensky M.J. Anxiety sensitivity and perceived control over anxiety-related events: Evaluating the singular and interactive effects in the prediction of anxious and fearful responding to bodily sensations. Behaviour Research Therapy 46 (2008) 1017-1125
66. Hammond D.C. Neurofeedback with anxiety and affective disorders. Child and Adolescent Psychiatric Clinics of North America 14 (2005) 105-123
67. Harbauer-Raum U. Wahrnehmung von Herzschlag und Herzarrhythmien-Eine Labor-Feldstudie an Patienten mit Herzphobie (Perception of hearbeat and cardiac arrhythmias-A laboratory-field study of patients with cardiac phobia). In: Nutzinger D.O., Pfersman D., Welan T., and Zapotoczky H.G. (Eds). Herzphobie (1987), Enke, Stuttgart 84-91
68. Hayes P.E., and Schulz S.C. Beta-blockers in anxiety disorders. Journal of Affective Disorders 13 (1987) 119-130
69. Herbert B.M., and Pollatos O. Interoceptive sensitivity, feelings and behavorial control. Zeitschrift für Neuropsychologie 19 (2008) 125-137
70. Herbert B.M., Pollatos O., and Schandry R. Interoceptive sensitivity and emotion processing: An EEG study. International Journal of Psychophysiology 65 (2007) 214-227
71. Hibbert G.A. Ideational components of anxiety. British Journal of Psychiatry 144 (1984) 618-624
72. Hirschmann S., Dannon P.N., Iancu I., Dolberg O.T., Zohar J., and Grunhaus L. Pindolol augmentation in patients with treatment-resistant panic disorder: A double-blind, placebo-controlled trial. Journal of Clinical Psychopharmacology 20 (2000) 556-559
73. Hoehn-Saric R., McLeod D.R., Funderburk F., and Kowalski P. Somatic symptoms and physiologic responses in generalized anxiety disorder and panic disorder: An ambulatory monitor study. Archives of General Psychiatry 61 (2004) 913-921
74. Hoehn-Saric R., Schlund M.W., and Wong S.H. Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder. Psychiatry Research 131 (2004) 11-21
75. James W. What is emotion?. Mind 19 (1884) 188-205
76. Jones G.E. Perception of visceral sensations: A review of recent findings, methodologies, and future directions. In: Jennings J.R., Ackles P.K., and Coles M.G.H. (Eds). Advances in Psychophysiology (1994), Jessica Kingsley Publishers, London 55-191
77. Kadish A., and Passman R. Mechanisms and management of paroxysmal supraventricular tachycardia. Cardiology in Review 7 (1999) 254-264
78. Karsdorp P.A., Kindt M., Rietveld S., Everaerd W., and Mulder B.J. False heart rate feedback and the perception of heart symptoms in patients with congenital heart disease and anxiety. International Journal of Behavioral Medicine 16 (2009) 81-88
79. Katkin E.S. Blood, sweat, and tears: Individual differences in autonomic self-perception. Psychophysiology 22 (1985) 125-137
80. Katkin E.S., Morell M.A., Goldband S., Bernstein G.L., and Wise J.A. Individual differences in heartbeat discrimination. Psychophysiology 19 (1982) 160-166
81. Knapp-Kline K., and Kline J.P. Heart rate, heart rate variability, and heartbeat detection with the method of constant stimuli: slow and steady wins the race. Biological Psychology 69 (2005) 387-396
82. Lange C. Om Sindsbevaegelser et Psyko-Fysiologisk Studie (1885), Kronar, Copenhagen
83. Lesch K.P., Bengel D., Heils A., Sabol S.Z., Greenberg B.D., Petri S., et al. Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science 274 (1996) 1527-1531
84. Lessmeier T.J., Gamperling D., Johnson-Liddon V., Fromm B.S., Steinman R.T., Meissner M.D., et al. Unrecognized paroxysmal supraventricular tachycardia. Potential for misdiagnosis as panic disorder. Archives of Internal Medicine 157 (1997) 537-543
85. Liberman S.E., and Allen G.J. Anxiety sensitivity, state anxiety, and perceptions of facial emotions. Journal of Anxiety Disorders 9 (1995) 257-267
86. Lorberbaum J.P., Kose S., Johnson M.R., Arana G.W., Sullivan L.K., Hamner M.B., et al. Neural correlates of speech anticipatory anxiety in generalized social phobia. Neuroreport 15 (2004) 2701-2705
87. Ludewig S., Geyer M.A., Ramseier M., Vollenweider F.X., Rechsteiner E., and Cattapan-Ludewig K. Information-processing deficits and cognitive dysfunction in panic disorder. Journal of Psychiatry & Neuroscience 30 (2005) 37-43
88. Ludwick-Rosenthal R., and Neufeld R.W. Heartbeat interoception: A study of individual differences. International Journal of Psychophysiology 3 (1985) 57-65
89. Malizia A.L., Cunningham V.J., Bell C.J., Liddle P.F., Jones T., and Nutt D.J. Decreased brain GABA(A)-benzodiazepine receptor binding in panic disorder: Preliminary results from a quantitative PET study. Archives of General Psychiatry 55 (1998) 715-720
90. McCaffery J.M., Bleil M., Pogue-Geile M.F., Ferrell R.E., and Manuck S.B. Allelic variation in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and cardiovascular reactivity in young adult male and female twins of European-American descent. Psychosomatic Medicine 65 (2003) 721-728
91. McCrank E., Schurmans K., and Lefcoe D. Paroxysmal supraventricular tachycardia misdiagnosed as panic disorder. Archives of Internal Medicine 158 (1998) 297
92. McNally R.J. Anxiety sensitivity and panic disorder. Biological Psychiatry 52 (2002) 938-946
93. Souza M.E., Rodrigues C., Souza M.M., Vinade E., Coitinho A., Choi H., et al. Involvement of the serotonergic type 1A (5-HT1A) receptor in the agranular insular cortex in the consolidation of memory for inhibitory avoidance in rats. Behavioural Pharmacology 12 (2001) 349-353
94. Meuret A.E., Wilhelm F.H., and Roth W.T. Respiratory biofeedback-assisted therapy in panic disorder. Behavior Modification 25 (2001) 584-605
95. Montoya P., Schandry R., and Muller A. Heartbeat evoked potentials (HEP): Topography and influence of cardiac awareness and focus of attention. Electroencephalography and Clinical Neurophysiology 88 (1993) 163-172
96. Munjack D.J., Crocker B., Cabe D., Brown R., Usigli R., Zulueta A., et al. Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. Journal of Clinical Psychopharmacology 9 (1989) 22-27
97. Nagai M., Kishi K., and Kato S. Insular cortex and neuropsychiatric disorders: A review of recent literature. European Psychiatry 22 (2007) 387-394
98. Naring G.W., and van der Staak C.P. Perception of heart rate and blood pressure: The role of alexithymia and anxiety. Psychotherapy and Psychosomatics 63 (1995) 193-200
99. Nunes J.S., and Marks I.M. Feedback of true heart rate during exposure in vivo. Archives of General Psychiatry 32 (1975) 933-936
100. O'Brien W.H., Reid G.J., and Jones K.R. Differences in heartbeat awareness among males with higher and lower levels of systolic blood pressure. International Journal of Psychophysiology 29 (1998) 53-63
101. Olatunji B.O., Deacon B.J., Abramowitz J.S., and Valentiner D.P. Body vigilance in nonclinical and anxiety disorder samples: Structure, correlates, and prediction of health concerns. Behavior Therapy 38 (2007) 392-401
102. Oppenheimer S.M., Gelb A., Girvin J.P., and Hachinski V.C. Cardiovascular effects of human insular cortex stimulation. Neurology 42 (1992) 1727-1732
103. Papageorgiou C., and Wells A. Social self-perception: Effects of false heart rate feedback in socially anxious subjects. 25th Annual Conference of the British Association for Behavioural and Cognitive Psychotherapies (1997) Canterbury, U.K
104. Pauli P., Marquardt C., Hartl L., Nutzinger D.O., Holzl R., and Strian F. Anxiety induced by cardiac perceptions in patients with panic attacks: A field study. Behaviour Research and Therapy 29 (1991) 137-145
105. Paulus M.P., and Stein M.B. An insular view of anxiety. Biological Psychiatry 60 (2006) 383-387
106. Pennebaker J.W. The physiology of physical symptoms (1982), Springer, New York
107. Pennebaker J.W., Gonder-Frederick L.A., Stewart H., Elfman L., and Skelton J.A. Physical symptoms associated with blood pressure. Psychophysiology 19 (1982) 201-210
108. Perez Benitez C.I., Shea M.T., Raffa S., Rende R., Dyck I.R., Ramsawh H.J., et al. Anxiety sensitivity as a predictor of the clinical course of panic disorder: A 1-year follow-up study. Depression and Anxiety 26 (2009) 335-342
109. Peterson R.A., and Reiss S. Anxiety Sensitivity Index Manual (1987), International Diagnostic Systems, Worthington, OH
110. Pollard G., and Ashton R. Heart rate decrease: A comparison of feedback modalities and biofeedback with other procedures. Biological Psychology 14 (1982) 245-257
111. Pollatos O., Gramann K., and Schandry R. Neural systems connecting interoceptive awareness and feelings. Human Brain Mapping 28 (2007) 9-18
112. Pollatos O., Herbert B.M., Kaufmann C., Auer D.P., and Schandry R. Interoceptive awareness, anxiety and cardiovascular reactivity to isometric exercise. International Journal of Psychophysiology 65 (2007) 167-173
113. Pollatos O., Kirsch W., and Schandry R. Brain structures involved in interoceptive awareness and cardioafferent signal processing: A dipole source localization study. Human Brain Mapping 26 (2005) 54-64
114. Pollatos O., Kirsch W., and Schandry R. On the relationship between interoceptive awareness, emotional experience, and brain processes. Brain Research. Cognitive Brain Research 25 (2005) 948-962
115. Pollatos O., and Schandry R. Accuracy of heartbeat perception is reflected in the amplitude of the heartbeat-evoked brain potential. Psychophysiology 41 (2004) 476-482
116. Pollatos O., Schandry R., Auer D.P., and Kaufmann C. Brain structures mediating cardiovascular arousal and interoceptive awareness. Brain Research 1141 (2007) 178-187
117. Pollatos O., Traut-Mattausch E., Schroeder H., and Schandry R. Interoceptive awareness mediates the relationship between anxiety and the intensity of unpleasant feelings. Journal of Anxiety Disorders 21 (2007) 931-943
118. Pollock R.A., Carter A.S., Amir N., and Marks L.E. Anxiety sensitivity and auditory perception of heartbeat. Behaviour Research and Therapy 44 (2006) 1739-1756
119. Rauch S.L., Savage C.R., Alpert N.M., Fischman A.J., and Jenike M.A. The functional neuroanatomy of anxiety: A study of three disorders using positron emission tomography and symptom provocation. Biological Psychiatry 42 (1997) 446-452
120. Reiss S. Pavlovian conditioning and human fear-An expectancy model. Behavior Therapy 11 (1980) 380-396
121. Reiss S., and McNally R.J. Expectancy model of fear. In: Reiss S., and Bootzin R.R. (Eds). Theoretical issues in behavior therapy (1985), Academic Press, New York 107-121
122. Richards J.C., and Bertram S. Anxiety sensitivity, state and trait anxiety, and perception of change in sympathetic nervous system arousal. Journal of Anxiety Disorders 14 (2000) 413-427
123. Richards J.C., Cooper A.J., and Winkelman J.H. Interoceptive accuracy in nonclinical panic. Cognitive Therapy and Research 27 (2003) 447-461
124. Richards J., Edgar L., and Gibbon P. Cardiac acuity in panic disorder. Cognitive Therapy and Research 20 (1996) 361-376
125. Schachter S., and Singer J.E. Cognitive, social, and physiological determinants of emotional state. Psychological Review 69 (1962) 379-399
126. Schandry R. Heartbeat perception and emotional experience. Psychophysiology 18 (1981) 483-488
127. Schandry R., Bestler M., and Montoya P. On the relation between cardiodynamics and heartbeat perception. Psychophysiology 30 (1993) 467-474
128. Schandry R., Sparrer B., and Weitkunat R. From the heart to the brain: A study of heartbeat contingent scalp potentials. The International Journal of Neuroscience 30 (1986) 261-275
129. Schmidt N.B., Lerew D.R., and Trakowski J.H. Body vigilance in panic disorder: Evaluating attention to bodily perturbations. Journal of Consulting and Clinical Psychology 65 (1997) 214-220
130. Schmidt N.B., Mitchell M.A., and Richey J.A. Anxiety sensitivity as an incremental predictor of later anxiety symptoms and syndromes. Comprehensive Psychiatry 49 4 (2008) 407-412
131. Shahidi S., and Baluch B. False heart-rate feedback, social anxiety and self-attribution of embarrassment. Psychological Reports 69 (1991) 1024-1026
132. Spielberger C.D., and Lushene E. State Trait Anxiety Inventory (STAI) (1966), Consulting Psychologists Press, California
133. Stein M.B., Simmons A.N., Feinstein J.S., and Paulus M.P. Increased amygdala and insula activation during emotion processing in anxiety-prone subjects. The American Journal of Psychiatry 164 (2007) 318-327
134. Steptoe A., and Vogele C. Individual differences in the perception of bodily sensations: The role of trait anxiety and coping style. Behaviour Research and Therapy 30 (1992) 597-607
135. Stewart S.H., Buffett-Jerrott S.E., and Kokaram R. Heartbeat awareness and heart rate reactivity in anxiety sensitivity: A further investigation. Journal of Anxiety Disorders 15 (2001) 535-553
136. Story T.J., and Craske M.G. Responses to false physiological feedback in individuals with panic attacks and elevated anxiety sensitivity. Behaviour Research and Therapy 46 (2008) 1001-1008
137. Sturges L.V., and Goetsch V.L. Psychophysiological reactivity and heartbeat awareness in anxiety sensitivity. Journal of Anxiety Disorders 10 (1996) 283-294
138. Sturges L.V., Goetsch V.L., Ridley J., and Whittal M. Anxiety sensitivity and response to hyperventilation challenge: Physiologic arousal, interoceptive acuity, and subjective distress. Journal of Anxiety Disorders 12 (1998) 103-115
139. Suhara T., Yasuno F., Sudo Y., Yamamoto M., Inoue M., Okubo Y., et al. Dopamine D2 receptors in the insular cortex and the personality trait of novelty seeking. Neuroimage 13 (2001) 891-895
140. Telch M.J., Valentiner D.P., Ilai D., Petruzzi D., and Hehmsoth M. The facilitative effects of heart-rate feedback in the emotional processing of claustrophobic fear. Behaviour Research and Therapy 38 (2000) 373-387
141. Tracy J., Goyal N., Flanders A., Weening R., Laskas J., Natale P., et al. Functional magnetic resonance imaging analysis of attention to one's heartbeat. Psychosomatic Medicine 69 (2007) 952-960
142. Tyrer P. Current status of beta-blocking drugs in the treatment of anxiety disorders. Drugs 36 (1988) 773-783
143. Tyrer P., Lee I., and Alexander J. Awareness of cardiac function in anxious, phobic and hypochondriacel patients. Psychological Medicine 10 (1981) 171-174
144. Vaitl D. Interoception. Biological Psychology 42 (1996) 1-27
145. Van der Does W.A.J., Antony M.M., Ehlers A., and Barsky A.J. Heartbeat perception in panic disorder: A reanalysis. Behaviour Research and Therapy 38 (2000) 47-62
146. Van der Does W.A.J., van Dyck D.R., and Spinhoven P. Accurate heartbeat perception in panic disorder: Fact and artefact. Journal of Affective Disorders 43 (1997) 121-130
147. Veltum L., and Goetsch V. Heart rate reactivity and accuracy of heartbeat estimation in anxiety sensitivity. Meeting of the Association for Advancement of Behavior Therapy (1991)
148. Wells A. Cognitive therapy of anxiety disorders: A practical guide (1997), Wiley Blackwell, Chichester, England
149. Wells A., and Papageorgiou C. Social phobic interoception: effects of bodily information on anxiety, beliefs and self-processing. Behaviour Research and Therapy 39 (2001) 1-11
150. White T.W., Holmes D.S., and Bennett D.H. Effects of instructions, biofeedback, and cognitive activities on heart rate control. Journal of Experimental Psychology. Human Learning and Memory 3 (1977) 477-484
151. Williamson D.A., and Blanchard E.B. Heart rate and blood pressure biofeedback: II. A review and integration of recent theoretical models. Biofeedback and Self-Regulation 4 (1979) 35-50
152. Williamson J.W., Nobrega A.C., McColl R., Mathews D., Winchester P., Friberg L., et al. Activation of the insular cortex during dynamic exercise in humans. The Journal of Physiology 503 (1997) 277-283
153. Wright C.I., Martis B., McMullin K., Shin L.M., and Rauch S.L. Amygdala and insular responses to emotionally valenced human faces in small animal specific phobia. Biological Psychiatry 54 (2003) 1067-1076
154. Yuan H., Yan H.M., Xu X.G., Han F., and Yan Q. Effect of heartbeat perception on heartbeat evoked potential waves. Neuroscience Bulletin 23 (2007) 357-362
155. Zoellner L.A., and Craske M.G. Interoceptive accuracy and panic. Behaviour Research and Therapy 37 (1999) 1141-1158
156. Zwanzger P., Baghai T., Schule C., and Rupprecht R. Treatment of mitral valve prolapse and panic disorder with metoprolol. The World Journal of Biological Psychiatry 1 (2000) 124-125