Journal article
Allostatic self-efficacy: a metacognitive theory of dyshomeostasis-induced fatigue and depression
- Abstract:
- 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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 2.8MB, Terms of use)
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- Publisher copy:
- 10.3389/fnhum.2016.00550
Authors
- Publisher:
- Frontiers Media
- Journal:
- Frontiers in Human Neuroscience More from this journal
- Volume:
- 10
- Article number:
- 550
- Publication date:
- 2016-11-15
- Acceptance date:
- 2016-10-14
- DOI:
- EISSN:
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1662-5161
- Language:
-
English
- Keywords:
- Pubs id:
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1278604
- Local pid:
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pubs:1278604
- Deposit date:
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2022-09-12
- ARK identifier:
Terms of use
- Copyright holder:
- Stephan et al.
- Copyright date:
- 2016
- Rights statement:
- © 2016 Stephan, Manjaly, Mathys, Weber, Paliwal, Gard, Tittgemeyer, Fleming, Haker, Seth and Petzschner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
- Licence:
- CC Attribution (CC BY)
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