School of Psychology, Keynes College, University of Kent.
Department of Psychology, City, University of Stirling.
J Abnorm Psychol. 2018 Aug;127(6):612-622. doi: 10.1037/abn0000370.
Quattrocki and Friston (2014) argued that abnormalities in interoception-the process of representing one's internal physiological states-could lie at the heart of autism, because of the critical role interoception plays in the ontogeny of social-affective processes. This proposal drew criticism from proponents of the alexithymia hypothesis, who argue that social-affective and underlying interoceptive impairments are not a feature of autism per se, but of alexithymia (a condition characterized by difficulties describing and identifying one's own emotions), which commonly co-occurs with autism. Despite the importance of this debate for our understanding of autism spectrum disorder (ASD), and of the role of interoceptive impairments in psychopathology, more generally, direct empirical evidence is scarce and inconsistent. Experiment 1 examined in a sample of 137 neurotypical (NT) individuals the association among autistic traits, alexithymia, and interoceptive accuracy (IA) on a standard heartbeat-tracking measure of IA. In Experiment 2, IA was assessed in 46 adults with ASD (27 of whom had clinically significant alexithymia) and 48 NT adults. Experiment 1 confirmed strong associations between autistic traits and alexithymia, but yielded no evidence to suggest that either was associated with interoceptive difficulties. Similarly, Experiment 2 provided no evidence for interoceptive impairments in autistic adults, irrespective of any co-occurring alexithymia. Bayesian analyses consistently supported the null hypothesis. The observations pose a significant challenge to notions that interoceptive impairments constitute a core feature of either ASD or alexithymia, at least as far as the direct perception of interoceptive signals is concerned. (PsycINFO Database Record
夸特罗基和弗里斯顿（2014）认为，内脏感知异常——即代表自身内部生理状态的过程——可能是自闭症的核心所在，因为内脏感知在社交情感过程的发生发展中起着至关重要的作用。这一观点遭到了述情障碍假说支持者的批评，他们认为，社交情感和潜在的内脏感知障碍本身并不是自闭症的特征，而是述情障碍（一种难以描述和识别自身情绪的状态）的特征，述情障碍通常与自闭症同时发生。尽管这一争论对于我们理解自闭症谱系障碍（ASD）以及内脏感知障碍在精神病理学中的作用非常重要，但直接的实证证据仍然稀缺且不一致。实验 1 在 137 名神经典型个体的样本中，考察了自闭症特征、述情障碍和标准心跳跟踪内脏感知准确性（IA）测量中的 IA 之间的关联。在实验 2 中，对 46 名自闭症成年人（其中 27 名具有明显的述情障碍）和 48 名神经典型成年人进行了 IA 评估。实验 1 证实了自闭症特征和述情障碍之间的强烈关联，但没有证据表明其中任何一个与内脏感知困难有关。同样，实验 2 也没有发现自闭症成年人存在内脏感知障碍，无论是否伴有述情障碍。贝叶斯分析一致支持零假设。这些观察结果对内脏感知障碍构成自闭症或述情障碍核心特征的观点提出了重大挑战，至少就内脏感知信号的直接感知而言是如此。
