Discrepancies between dimensions of interoception in autism: Implications for emotion and anxiety

Emotions and affective feelings are influenced by one's internal state of bodily arousal via interoception. Autism Spectrum Conditions (ASC) are associated with difficulties in recognising others' emotions, and in regulating own emotions. We tested the hypothesis that, in people with ASC, such affective differences may arise from abnormalities in interoceptive processing. We demonstrated that individuals with ASC have reduced interoceptive accuracy (quantified using heartbeat detection tests) and exaggerated interoceptive sensibility (subjective sensitivity to internal sensations on self-report questionnaires), reflecting an impaired ability to objectively detect bodily signals alongside an over-inflated subjective perception of bodily sensations. The divergence of these two interoceptive axes can be computed as a trait prediction error. This error correlated with deficits in emotion sensitivity and occurrence of anxiety symptoms. Our results indicate an origin of emotion deficits and affective symptoms in ASC at the interface between body and mind, specifically in expectancy-driven interpretation of interoceptive information.