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Professor Sarah Garfinkel

Prof Sarah Garfinkel

Professor Sarah Garfinkel (PhD)

Honorary Professor of Clinical and Affective Neuroscience
T: +44 (0)1273 678584
Location: Room 211 Trafford Centre for Medical Research, University of Sussex, Brighton, BN1 9RR




The research of Professor Sarah Garfinkel centres on body-brain interactions underlying emotion and cognition. For example, she investigates how individual differences in interoception (detection of internal bodily sensations) can influence emotion and memory. Based in Psychiatry, she also determines how aberrant bodily and neural mechanisms can contribute to symptom maintenance in psychiatric conditions such as Anxiety, PTSD, Autism and Schizophrenia. She has a particular interest in the heart, such as heart-brain interactions underlying the gating of fear responses.

In each stage of her career Sarah has received extensive training in a number of diverse techniques, including memory and pharmacology (PhD, University of Sussex), psychiatry and neuroimaging (University of Michigan) and autonomic affective neuroscience (BSMS with Hugo Critchley). Together, these techniques provide her with the tools to pursue an integrative approach combining functional imaging (fMRI) with cardiovascular monitoring/manipulation to investigate body-brain interactions in emotion and cognition. 



How can deficits in bodily processing contribute to alternations in emotion processing? Current research by Sarah includes individual differences in interoception, focusing on detection of the heart. She demonstrates that there are dissociable dimensions of interoception, with people’s belief in their ability (interoceptive sensibility) dissociable from their actual ability (interoceptive accuracy) and their metacognitive insight (interoceptive awareness). To further understand links between the body and emotion, she demonstrates deficits in interoceptive accuracy in individuals with Autism, in the context of elevated interoceptive sensibility in this population. Moreover, the discrepancy between these interoceptive dimensions predicts anxiety. This work has implications for bodily awareness training as a therapeutic strategy in people with Autism Spectrum Conditions to potentially aid emotion processing and decrease anxiety. On-going work is also exploring the neural correlations of disrupted interoceptive dimensions in Schizophrenia using fMRI.

Sarah uses autonomic monitoring in combination with functional neuroimaging to investigate brain-body interactions. For example, in a recent study, the mechanisms through which anger can impede decision making was investigated using beat-to-beat blood pressure monitoring. Both subliminal anger cues and elevated blood pressure reduced neural activation in visual and attention areas, such as the cuneus (A) and parietal cortex (B), and this reduction in activation predicted impaired reaction time during decision making.

As part of the ERC grant awarded to Professor Hugo Critchley, Sarah is investigating how cardiac timing can alter the processing of fear, with implications for understanding mechanisms underlying Anxiety. Together with Hugo Critchley, Dora Duka, and Georgina Heron (PhD student), Sarah is pursuing how individual differences in interoception can underlie craving and maladaptive decision making. Other ongoing projects with Dora include the effect of alcohol on interoception. In collaboration with Marco Bozzali, Elena Makovac and Hugo Critchley, Sarah is using carotid stimulation in conjunction with fMRI to investigate the impact of baroreceptors on brain and resultant effects on emotion processing, noticeably fear. 

Selected publications

Critchley, Hugo D and Garfinkel, Sarah N (2017) Interoception and emotion. Current Opinion in Psychology, 17. pp. 7-14. ISSN 2352-250X

Ewing, Donna L, Manassei, Miranda, Gould van Praag, Cassandra, Philippides, Andrew O, Critchley, Hugo D and Garfinkel, Sarah N (2017) Sleep and the heart: interoceptive differences linked to poor experiential sleep quality in anxiety and depression. Biological Psychology, 127. pp. 163-172. ISSN 0301-0511

Azevedo, Ruben T, Garfinkel, Sarah N, Critchley, Hugo D and Tsakiris, Manos (2017) Cardiac afferent activity modulates the expression of racial stereotypes. Nature Communications, 8. a13854. ISSN 2041-1723

Garfinkel, Sarah N, Manassei, Miranda F, Hamilton-Fletcher, Giles, In den Bosch, Yvo, Critchley, Hugo D and Engles, Miriam (2016) Interoceptive dimensions across cardiac and respiratory axes. Philosophical Transactions B: Biological Sciences, 371 (1708). 2016.0014. ISSN 0962-8436

Garfinkel, Sarah N, Tiley, Claire, O'Keeffe, Stephanie, Harrison, Neil A, Seth, Anil K and Critchley, Hugo D (2016) Discrepancies between dimensions of interoception in autism: implications for emotion and anxiety. Biological Psychology, 114. pp. 117-126. ISSN 0301-0511

Garfinkel, Sarah N and Critchley, Hugo D (2016) Threat and the body: how the heart supports fear processing. Trends in Cognitive Sciences, 20 (1). pp. 34-46. ISSN 1364-6613

Garfinkel, Sarah N, Eccles, Jessica A and Critchley, Hugo D (2015) The heart, the brain, and the regulation of emotion. JAMA Psychiatry, 72 (11). pp. 1071-1072. ISSN 2168-622X

Critchley, Hugo D and Garfinkel, Sarah N (2015) Interactions between visceral afferent signaling and stimulus processing. Frontiers in Neuroscience, 9 (286). ISSN 1662-4548

Garfinkel, Sarah N, Zorab, Emma, Navaratnam, Nakulan, Engels, Miriam, Mallorquí-Bagué, Núria, Minati, Ludovico, Dowell, Nicholas G, Brosschot, Jos F, Thayer, Julian F and Critchley, Hugo D (2015) Anger in brain and body: the neural and physiological perturbation of decision-making by emotion. Social cognitive and affective neuroscience. nsv099. ISSN 1749-5016

Garfinkel, Sarah N, Seth, Anil K, Barrett, Adam B, Suzuki, Keisuke and Critchley, Hugo D (2015) Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology, 104. pp. 65-74. ISSN 0301-0511. 

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