Commentary on “Autism, oxytocin and interoception”: Alexithymia, not Autism Spectrum Disorders, is the consequence of interoceptive failure

In “Autism, oxytocin and interoception” (Neuroscience and Biobehavioral Reviews 47, 410-430) Quattrocki and Friston present their theory of the role of oxytocin in interoception from multiple perspectives. The arguments contained therein are compelling, and highlight the fact that interoception, and the role of oxytocin in interoception, should receive more research attention. However, in addition to outlining the role of oxytocin in interoception the authors also suggest that Autism Spectrum Disorder (ASD) is a result of a failure of this system. It is this latter claim that we disagree with, instead suggesting that alexithymia, rather than autism, is most accurately characterised as a general failure of interoception. We review positive evidence that alexithymia produces several of the deficits identified as indicating a failure of interoception, and negative evidence that ASD (in the absence of comorbid alexithymia) is associated with these deficits. We highlight implications for the model, for oxytocin research, and for the clinical management of psychiatric conditions more generally.