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Allostatic self-efficacy: a metacognitive theory of dyshomeostasis-induced fatigue and depression

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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 Gard
This 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 Neuroscience

ISSN

1662-5161

Publisher

Frontiers

Volume

10

Page range

550

Department affiliated with

  • Informatics Publications

Research groups affiliated with

  • Sackler Centre for Consciousness Science Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2016-11-30

First Open Access (FOA) Date

2016-11-30

First Compliant Deposit (FCD) Date

2016-11-30

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