We face a lot of external stimulations from the external environments in our daily lives. We have to integrate effectively with our own internal bodily sensations with the external environmental stimuli in order to achieve an optimal functioning. The ability to integrate and process internal signals originating from ourselves internally is known as interoception. It is important for us to develop the self-other boundary, social skills and facilitates the interaction between our own embodied selves and the external environment. Accumulating evidence suggests that individuals with clinical and subclinical psychopathologies such as autism spectrum disorders have associated impairments in interoceptive accuracy. Moreover, individuals with autism spectrum disorders and subthreshold autistic symptoms are characterized by significant impairments in social communications and emotion expression (such as alexithymia). Dr. Raymond Chan’s team from the Neuropsychology and Applied Cognitive Neuroscience (NACN) Laboratory, CAS key Laboratory of Mental Health, Institute of Psychology has recently showed that interoceptive accuracy significantly differs between typically-developing preschool children, adolescents and adults. Alexithymia may also serve as an important node connecting interoceptive deficits, self-awareness, and empathic performance in individuals with autistic traits, i.e., sharing similar but less severe impairments in social and communicative skills comparing to clinically diagnosed cases of autism, also exhibit both alexithymia and interoceptive-exteroceptive sensory integration impairments.

In order to further examine such an issue, Dr. Raymond Chan’s team has developed the Interoception-Exteroception Synchronicity Judgement (IESJ) task to specifically examine participants’ interoceptive accuracy, exteroceptive accuracy, and the balancing score that reflected the ability to allocate attention between interoceptive and exteroceptive signals. They administered the IESJ task and the Heartbeat Tracking Task (HTT) as well as a set of self-report scales to 119 typically-developing youths. They then classified participants to 30 individuals with low level of autistic traits and 33 individuals with high level of autistic traits for subsequent data analysis. Their results showed that individuals with low level of autistic traits exhibited comparable interoceptive accuracy, exteroceptive accuracy, and balancing scores as the individuals with high level of autistic traits. However, it is noteworthy that alexithymia, rather than autistic traits, was correlated with lower interoceptive accuracy and interoceptive sensibility.

Taken together, these findings provide insight into the relationships between autistic traits, interoceptive-exteroceptive sensory integration and alexithymia. The IESJ task was shown to be a valid task to specifically capture interoceptive-exteroceptive sensory integration in individuals with autistic traits and even in clinical cases with autistic spectrum disorders. Future application of this task may help clarify how interoceptive signals are processed in clinical cases with autism spectrum disorders or other clinical cases with impairments in interoceptive-exteroceptive sensory integration.

This study was supported by a grant form National Science Foundation China and the CAS Key Laboratory of Mental Health, Institute of Psychology.

The paper is now available online on 20 July 2021 from Journal of Autism and Developmental Disorders: 

Yang, H. X., Zhou, H. Y., Zheng, H., Wang, Y., Wang, Y. Y., Lui, S. S. Y., Chan, R. C. K.* (2021). Individuals with autistic traits exhibit heightened alexithymia but intact interoceptive-exteroceptive sensory integration. Journal of Autism and Developmental Disorders.

Related paper:
-Yang, H. X., Hu, H. X., Zhang, Y. J., Wang, Y., Lui, S. S. Y., Chan, R. C. K.* (2021).A network analysis of interoception, self-awareness, empathy, alexithymia, and autistic traits. European Archives of Psychiatry and Clinical Neuroscience.
-Yang, H. X., Zhou, H. Y., Wei, Z., Wan, G. B., Wang, Y., Wang, Y. Y., Yang, T. X., Lui, S. S. Y., Chan, R. C. K.* (2021). Multidimensional interoception and autistic traits across life stages: Evidence from a novel eye-tracking task. Journal of Autism and Developmental Disorders.

LIU Chen
Institute of Psychology
Chinese Academy of Sciences
Beijing 100101, China.
E-mail: liuc@psych.ac.cn