Stephan_FHUMNEUR2016.pdf (2.09 MB)
Allostatic self-efficacy: a metacognitive theory of dyshomeostasis-induced fatigue and depression
journal contribution
posted on 2023-06-09, 04:14 authored by Klaas E Stephan, Zina M Manjaly, Christoph D Mathys, Lilian A E Weber, Saee Paliwal, Marc Tittgemeyer, Stephen M Fleming, Helene Haker, Anil SethAnil Seth, Frederike H Petzschner, Tim GardThis paper outlines a hierarchical Bayesian framework for interoception, homeostatic/allostatic control, and meta-cognition that connects fatigue and depression to the experience of chronic dyshomeostasis. Specifically, viewing interoception as the inversion of a generative model of viscerosensory inputs allows for a formal definition of dyshomeostasis (as chronically enhanced surprise about bodily signals, or, equivalently, low evidence for the brain's model of bodily states) and allostasis (as a change in prior beliefs or predictions which define setpoints for homeostatic reflex arcs). Critically, we propose that the performance of interoceptive-allostatic circuitry is monitored by a metacognitive layer that updates beliefs about the brain's capacity to successfully regulate bodily states (allostatic self-efficacy). In this framework, fatigue and depression can be understood as sequential responses to the interoceptive experience of dyshomeostasis and the ensuing metacognitive diagnosis of low allostatic self-efficacy. While fatigue might represent an early response with adaptive value (cf. sickness behavior), the experience of chronic dyshomeostasis may trigger a generalized belief of low self-efficacy and lack of control (cf. learned helplessness), resulting in depression. This perspective implies alternative pathophysiological mechanisms that are reflected by differential abnormalities in the effective connectivity of circuits for interoception and allostasis. We discuss suitably extended models of effective connectivity that could distinguish these connectivity patterns in individual patients and may help inform differential diagnosis of fatigue and depression in the future.
History
Publication status
- Published
File Version
- Published version
Journal
Frontiers in Human NeuroscienceISSN
1662-5161Publisher
FrontiersExternal DOI
Volume
10Page range
550Department affiliated with
- Informatics Publications
Research groups affiliated with
- Sackler Centre for Consciousness Science Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2016-11-30First Open Access (FOA) Date
2016-11-30First Compliant Deposit (FCD) Date
2016-11-30Usage metrics
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