Hugo Critchley

Hugo Critchley
Brighton and Sussex Medical School | BSMS

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493
Publications
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Publications

Publications (493)
Article
Full-text available
Interoception, the sense of the internal physiological state of the body, theoretically underpins aspects of self-representation. Experimental studies link feelings of body ownership to interoceptive perception, yet few studies have tested for association between the sense of agency and interoceptive processing. Here, we combined an intentional bin...
Article
Full-text available
Traditional cognitive linguistic theories acknowledge that human emotions are embodied, yet they fail to distinguish the dimensions that reflect the direction of neural signaling between the brain and body. Differences exist across languages and cultures in whether embodied emotions are conceptualized as afferent (feelings from the body) or efferen...
Article
Full-text available
Rationale Interoception is the signalling, perception, and interpretation of internal physiological states. Many mental disorders associated with changes of interoception, including depressive and anxiety disorders, are treated with selective serotonin reuptake inhibitors (SSRIs). However, the causative link between SSRIs and interoception is not y...
Article
Background Functional seizures (FS), otherwise known as psychogenic nonepileptic seizures (PNES), are a common symptom presenting to neurology and epilepsy clinics. There is a pressing need for further research to understand the neurobiology of FS to develop mechanistically targeted treatments. Joint hypermobility is an expression of variation in c...
Preprint
Full-text available
We present here a unifying framework for affective phenomena: the Human Affectome. By synthesizing a large body of literature, we have converged on definitions that disambiguate the commonly used terms—affect, feeling, emotion, and mood. Based on this definitional foundation, and under the premise that affective states reflect allostatic concerns,...
Conference Paper
Background Fibromyalgia and ME/CFS are multifaceted conditions with overlapping symptoms(1); the pathoaetiological mechanisms are complex and debated(2), however there is a strong association with features of hereditary disorders of connective tissue (hypermobility) and autonomic and inflammatory abnormalities (1,2). Objectives To determine potent...
Preprint
Full-text available
Empirical and theoretical advances in human neuroscience have led to a reappraisal of the relationships between mind, brain and body, the implications of which are particularly relevant to understanding emotions, which is revealed to be embodied owing to the facts that they are on the one hand primarily arise from the internal bodily states control...
Article
Full-text available
Background Spelling errors in documents lead to reduced trustworthiness, but the mechanism for weighing the psychological assessment (i.e., integrative versus dichotomous) has not been elucidated. We instructed participants to rate content of texts, revealing that their implicit trustworthiness judgments show marginal differences specifically cause...
Article
Previous studies indicate that neurophysiological signatures of feedback processing might be enhanced when participants are assigned a low-status position. Error commission and negative feedback can evoke responses in the peripheral (autonomic) nervous system including heart rate deceleration. We conducted an exploratory study to investigate whethe...
Article
Full-text available
Objectives: Autism, attention deficit hyperactivity disorder (ADHD), and tic disorder (Tourette syndrome; TS) are neurodevelopmental conditions that frequently co-occur and impact psychological, social, and emotional processes. Increased likelihood of chronic physical symptoms, including fatigue and pain, are also recognized. The expression of joi...
Article
There is a long history of, and renewed interest in, cardiac timing effects on behaviour and cognition. Cardiac timing effects may be identified by expressing events as a function of their location in the cardiac cycle, and applying circular (i.e. directional) statistics to test cardiac time-behaviour associations. Typically this approach ‘stretche...
Article
The demands of both mental and physical activity are integrated with the dynamic control of internal bodily state. The set of neural interactions that supports autonomic regulation extends beyond afferent-efferent homeostatic reflexes (interoceptive feedback, autonomic action) to encompass allostatic policies reflecting more abstract and predictive...
Article
Full-text available
Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has informed our understanding of the neurobiology of anxiety disorders, but research has been limited by small sample sizes and low statistical power, as well as heterogenous imaging meth...
Article
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Background: Auditory verbal hallucinations (AVH) commonly occur in the context of borderline personality disorder (BPD) yet remain poorly understood. AVH are often perceived by patients with BPD as originating from inside the head and hence viewed clinically as 'pseudohallucinations', but they nevertheless have a detrimental impact on wellbeing....
Article
Full-text available
The symptoms of joint hypermobility extend beyond articular pain. Hypermobile people commonly experience autonomic symptoms (dysautonomia), and anxiety or related psychological issues. We tested whether dysautonomia might mediate the association between hypermobility and anxiety in adults diagnosed with mental health disorders and/or neurodevelopme...
Preprint
Full-text available
Despite the persistent stereotype that autistic individuals are not motivated to seek meaningful social relationships, rates of loneliness among the autistic population are higher than in the non-autistic population. In this two-part, mixed methods study, we sought to 1) quantify the level of distress associated with loneliness in autistic and non-...
Preprint
Full-text available
Objective Emotional states are expressed in body and mind through subjective experience of physiological changes. In previous work, subliminal priming of anger prior to lexical decisions increased systolic blood pressure (SBP). This increase predicted the slowing of response times (RT), suggesting that baroreflex-related autonomic changes and their...
Preprint
Full-text available
Empathy-for-pain states are underpinned by interoception , i.e the central representation of internal states. Cardiac signals occur in a phasic manner; baroreceptor discharges at systole communicate the heartbeats’ strength. These signals modulate pain and emotion processing. We tested whether these phasic interoceptive signals modulate empathy-for...
Article
Individuals vary in their ability to perceive, as conscious sensations, signals like the beating of the heart. Tests of such interoceptive ability are, however, constrained in nature and reliability. Performance of the heartbeat tracking task, a widely used test of cardiac interoception, often corresponds well with individual differences in emotion...
Article
Full-text available
The mind is embodied; thoughts and feelings interact with states of physiological arousal and physical integrity of the body. In this context, there is mounting evidence for an association between psychiatric presentations and the expression variant connective tissue, commonly recognised as joint hypermobility. Joint hypermobility is common, freque...
Article
Full-text available
Fatigue is a common experience in both health and disease. Yet, pathological (i.e., prolonged or chronic) and transient (i.e., exertional) fatigue symptoms are traditionally considered distinct, compounding a separation between interested research fields within the study of fatigue. Within the clinical neurosciences, nascent frameworks position pat...
Article
Full-text available
The goal of this study was to compare brain structure between individuals with generalized anxiety disorder (GAD) and healthy controls. Previous studies have generated inconsistent findings, possibly due to small sample sizes, or clinical/analytic heterogeneity. To address these concerns, we combined data from 28 research sites worldwide through th...
Article
Full-text available
Background Hypermobility is a poorly recognised and understood musculoskeletal disorder thought to affect around 20% of the population. Hypermobility is associated with reduced physiological and psychological functioning and quality of life and is a known risk factor for the development of an anxiety disorder. To date, no evidence-based, targeted t...
Article
Full-text available
Background This trial tested if a novel therapy, Aligning Dimensions of Interoceptive Experience (ADIE), reduces anxiety in autistic adults. ADIE targets the association of anxiety with mismatch between subjective and behavioral measures of an individual's interoceptive sensitivity to bodily signals, including heartbeats. Methods In this superiori...
Article
Introduction The aetiology and pathophysiology of fibromyalgia and ME/CFS are poorly characterised but altered inflammatory, autonomic and interoceptive processes have been implicated. Interoception has been conceptualised as a predictive coding process; where top-down prediction signals compare to bottom-up afferents, resulting in prediction error...
Article
Objectives/Aims Autism is a neurodevelopmental condition characterised by differences in sensory processing, social communication and restricted/repetitive behaviors. Joint hypermobility is a common connective tissue variant, reportedly overrepresented in Autism. Alexithymia is a personality construct characterised by altered emotional awareness wh...
Article
Full-text available
Background The presence of auditory verbal hallucinations (AVH) does not currently feature in the main diagnostic criteria for Borderline Personality Disorder (BPD). However, there is accumulating evidence that a high proportion of BPD patients report longstanding and frequent AVH which constitute a significant risk factor for suicide plans and att...
Article
Depression is characterised by attentional bias to emotional information and dysregulated autonomic reactivity. Despite its relevance to understanding depressive mechanisms, the association between attentional bias and autonomic reactivity to emotional information remains poorly characterised. This study compared behavioural and autonomic responses...
Article
Full-text available
Many interoceptive tasks (i.e. measuring the sensitivity to bodily signals) are based upon heartbeats perception. However, the temporal perception of heartbeats— when heartbeats are felt—varies among individuals. Moreover, the spatial perception of heartbeats— where on the body heartbeats are felt—has not been characterized in relation to temporal....
Preprint
Full-text available
Background: Hypermobility is a poorly-recognised and understood musculoskeletal disorder thought to affect around 20% of the population. Hypermobility is associated with reduced physiological and psychological functioning, quality of life, and is a known risk factor for the development of an anxiety disorder. To date no evidence-based, targeted tre...
Article
Full-text available
The neural representation of a ‘biological self’ is linked theoretically to the control of bodily physiology. In an influential model, selfhood relates to internal agency and higher-order interoceptive representation, inferred from the predicted impact of efferent autonomic nervous activity on afferent viscerosensory feedback. Here we tested if an...
Article
Introduction Pain, fatigue and anxiety are common features of fibromyalgia and ME/CFS and significantly impact quality of life. Aetiology is poorly defined but dysfunctional inflammatory, autonomic and interoceptive (sensing of internal bodily signals) processes are implicated. Objectives To investigate how altered interoception relates to baselin...
Article
Mental processes are recognized to be embodied, hence dependent upon functions of the body. Interoception (i.e., the sense of the internal bodily physiology) underpinning motivational states and emotional feelings, however, are mostly ignored within present sensory-motor accounts of embodiment. The inclusion of interoception within models of embodi...
Article
Interoception, the sense of the body’s internal physiological state, underpins homeostatic reflexes, motivational states, and sensations contributing to emotional experiences. The continuous nature of interoceptive processing, coupled to behavior, is implicated in the neurobiological construction of the sense of self. Aberrant integration and contr...
Article
Background: Fibromyalgia and myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) are poorly understood conditions with overlapping symptoms, fuelling debate as to whether they are manifestations of the same spectrum or separate entities. Both are associated with hypermobility, but this remains significantly undiagnosed, despite impact on...
Article
Full-text available
Tourette syndrome is characterised by ‘unvoluntary’ tics, which are compulsive, yet often temporarily suppressible. The inferior frontal gyrus (IFG) is implicated in motor control, including inhibition of pre-potent actions through influences on downstream subcortical and motor regions. While tic suppression in Tourette Syndrome also engages the IF...
Article
Fear is coupled to states of physiological arousal. We tested how learning and memory of threat, specifically conditioned fear, is influenced by interoceptive signals. Forty healthy individuals were exposed to two threat (conditioned stimuli [CS+], paired with electrocutaneous shocks) and two safety (CS-) stimuli, time-locked to either cardiac vent...
Preprint
Interoception is the sensing of internal bodily signals. Individuals vary in their ability to perceive, as conscious sensations, signals like the beating of the heart. Tests of such interoceptive ability are, however, constrained in nature and reliability. Performance of the heartbeat tracking task, a widely used test of cardiac interoception, ofte...
Article
Several labels, such as neuroticism, negative emotionality, and dispositional negativity, indicate a broad dimension of psychopathology. However, largely separate, often disorder-specific research lines have developed that focus on different cognitive and affective characteristics that are associated with this dimension, such as perseverative cogni...
Preprint
Full-text available
Objective: Autism, attention deficit hyperactivity disorder (ADHD), and tic disorder (Tourette syndrome; TS) are neurodevelopmental conditions that frequently co-occur and impact psychological, social and emotional functioning. Vulnerability to chronic physical symptoms, including fatigue and pain, are also recognised. The expression of joint hyper...
Preprint
Full-text available
Importance: Depression and anxiety are common mood disorders that show higher prevalence in adults with joint hypermobility, a consequence of a constitutional variant of connective tissue structure. In adolescents, an association between mood disorder and hypermobility may enhance the potential understanding of risk factors for emotional disorder a...
Preprint
Full-text available
Interoception is the signaling, perception, and interpretation of internal physiological states. A causal link between serotonin and interoception was tested by a within-participant, crossover, placebo-controlled study. Forty-seven healthy human volunteers were tested on and off a 20mg oral dose of the selective serotonin reuptake inhibitor (SSRI)...
Article
Full-text available
Understanding the association between autonomic nervous system [ANS] function and brain morphology across the lifespan provides important insights into neurovisceral mechanisms underlying health and disease. Resting state ANS activity, indexed by measures of heart rate [HR] and its variability [HRV] has been associated with brain morphology, partic...
Preprint
Full-text available
The majority of interoceptive tasks (i.e. measuring the sensitivity to bodily signals) are based upon the heartbeat sensations perception. However, temporal perception of heartbeats varies among individuals and confidence and spatial perception of heartbeats in relation to temporal judgements have not yet been systematically investigated. This stud...
Preprint
Full-text available
The neural representation of a ‘biological self’ is linked theoretically to the control of bodily physiology. In an infleuntial model, selfhood relates to internal agency and higher-order interoceptive representation, inferred from the predicted impact of efferent autonomic nerves on afferent viscerosensory feedback. Here we tested if an altered re...
Article
Full-text available
The ENIGMA group on Generalized Anxiety Disorder (ENIGMA‐Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega‐analysis of a large number of brain structural scans. In this process, the group was confronted with many methodolo...
Article
Full-text available
Objective Dissociative traits represent a disturbance in selfhood that may predispose to, and trigger, functional seizures (FSs). The predictive representation and control of the internal physiological state of the body (interoception) are proposed to underpin the integrity of the sense of self (“minimal selfhood”). Therefore, discrepancies between...
Article
Full-text available
Knowledge of brain mechanisms underlying self-regulation can provide valuable insights into how people regulate their thoughts, behaviors, and emotional states, and what happens when such regulation fails. Self-regulation is supported by coordinated interactions of brain systems. Hence, behavioral dysregulation, and its expression as impulsivity, c...
Article
Full-text available
Individuals who engage in binge drinking behaviors may show evidence of impaired cognitive function and emotional dysregulation. Impaired empathy, characterized by a reduced ability to understand and respond appropriately to feelings of others, is increasingly recognized for its role in Alcohol Use Disorders (AUD). The present study examined a popu...
Article
Loneliness can be operationalized as the actual or perceived absence of those social relationships that serve to meet basic emotional needs. In contrast to solitude, a chosen state of being without company, loneliness is associated with negative affect and emotional distress. Loneliness can have detrimental effects on mental and physical wellbeing,...
Article
Full-text available
Background Fibromyalgia and ME/CFS are complex disorders with overlapping symptoms; the pathoaetiology and clinical distinction are debated, however inflammatory and autonomic abnormalities are observed. Objectives To investigate the role of inflammatory and autonomic nervous system responses in mechanisms of pain and fatigue in fibromyalgia and M...
Preprint
Full-text available
Several labels such as neuroticism, negative emotionality and dispositional negativity indicate a broad dimension of psychopathology. However, largely separate research lines have developed, often disorder-specific, that focus on different cognitive and affective characteristics that are associated with this dimension, such as perseverative cogniti...
Conference Paper
INTRODUCTION: Fibromylagia and ME/CFS are chronic, disabling, often poorly understood conditions, with overlapping systemic physical and psychological symptoms. Inflammatory abnormalities are reported. We seek to clarify how inflammation contributes to pain and fatigue in these conditions and relationship with dysautonomia. METHODS: Fifty-seven par...
Conference Paper
Fibromylagia(FM) and ME/CFS are chronic, disabling conditions that share physical and cognitive symptoms. Both are poorly understood and associated with inflammatory abnormalities, autonomic problems, and joint hypermobility-an indicator of variant connective tissue, classified as hypermobile Ehlers Danlos Syndrome(hEDS) and Hypermobility Spectrum...
Article
Full-text available
Interoceptive signals concerning the internal physiological state of the body influence motivational feelings and action decisions. Cardiovascular arousal may facilitate inhibition to mitigate risks of impulsive actions. Baroreceptor discharge at ventricular systole underpins afferent signalling of cardiovascular arousal. In a modified Go/NoGo task...
Preprint
The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodolo...
Article
Autism symptomology has a profound impact on cognitive and affective functioning, yet we know relatively little about how it shapes patterns of ongoing thought. In an exploratory study in a large population of neurotypical individuals, we used experience sampling to characterise the relationship between ongoing cognition and self-reported autistic...
Preprint
Full-text available
Objectives: To understand the relevance of symptomatic hypermobility and related connective tissue variants to the expression of symptoms in Fibromyalgia and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The study further tested if specific subfactors within the diagnostic classification of hypermobility predict clinical presentation...
Preprint
Fear is coupled to states of physiological arousal. We tested how learning and memory of threat, i.e. conditioned fear, is influenced by interoceptive signals. Forty healthy individuals were exposed to two threat (CS+, paired with electrocutaneous shocks) and two safety (CS-) stimuli, specifically time-locked to either cardiac ventricular systole (...
Article
Perseverative cognition (i.e. rumination and worry) describes intrusive, uncontrollable, repetitive thoughts. These negative affective experiences are accompanied by physiological arousal, as if the individual were facing an external stressor. Perseverative cognition is a transdiagnostic symptom, yet studies of neural mechanisms are largely restric...
Preprint
Full-text available
Background: Interoception, the sensing of information about the internal physiological state of the body, is proposed to be fundamental to normal and abnormal affective feelings. We undertook a cross-sectional characterisation of cardiac interoception in patients accessing secondary mental health services to understand how interoceptive abnormaliti...
Article
Full-text available
Advances in digital technology have a profound impact on conventional healthcare systems. We examine the trailblazing use of online interventions to enable autonomous psychological care which can greatly enhance individual- and population-level access to services. There is strong evidence supporting online cognitive–behavioural therapy and more eng...
Preprint
Full-text available
Background: Fibromyalgia is characterised by chronic widespread pain. Quality of life is further reduced by autonomic and cognitive symptoms, including subjective brain-fog and dissociative experiences. Although an association with joint hypermobility suggests variant connective tissue is a factor in both fibromyalgia and dysautonomia, the mechanis...