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Brain Structure and Function

, Volume 214, Issue 5–6, pp 451–463

First Online: 21 May 2010Received: 08 December 2009Accepted: 21 April 2010


We review the literature on interoception as it relates to depression and anxiety, with a focus on belief, and alliesthesia. The connection between increased but noisy afferent interoceptive input, self-referential and belief-based states, and top-down modulation of poorly predictive signals is integrated into a neuroanatomical and processing model for depression and anxiety. The advantage of this conceptualization is the ability to specifically examine the interface between basic interoception, self-referential belief-based states, and enhanced top-down modulation to attenuate poor predictability. We conclude that depression and anxiety are not simply interoceptive disorders but are altered interoceptive states as a consequence of noisily amplified self-referential interoceptive predictive belief states.

KeywordsAnxiety Depression Interoception Insula Belief Alliesthesia  Download fulltext PDF

Author: Martin P. Paulus - Murray B. Stein


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