Hippocampal Contextualization of Interoception Toward a Contextual Account of Bodily Experience

Interoception refers to the processing and representation of internal bodily signals, including cardiac, respiratory, visceral, and autonomic states. Contemporary models increasingly conceptualize interoception within predictive processing frameworks, according to which bodily sensations are continuously interpreted through hierarchical generative models that aim to minimize prediction error. Within these frameworks, the subjective meaning and affective salience of bodily sensations are determined not solely by sensory input itself, but also by prior expectations, contextual information, and emotional relevance. The present thesis proposes the Hippocampal Contextualization of Interoception Model (HCIM), a theoretical framework suggesting that hippocampal-dependent contextual processing may contribute to the interpretation of bodily sensations by integrating interoceptive information with environmental context and previous experience. The model does not propose that the hippocampus generates or directly detects primary interoceptive signals. Rather, it hypothesizes that hippocampal contextual representations may contribute to determining the meaning assigned to bodily sensations under different environmental and emotional conditions. This framework is particularly relevant to trauma-related psychopathology, including post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD), in which disturbances in contextual processing and bodily awareness may coexist. The HCIM proposes two potential pathways through which disrupted contextualization may contribute to altered interoceptive experience. In hypervigilant presentations, bodily sensations associated with previous threat may retain threat-related meaning despite changes in the current environment. In dissociative presentations, bodily signals may instead become insufficiently integrated with representations of the present self and environmental context. By integrating findings from interoception research, hippocampal neuroscience, predictive processing, and trauma literature, the HCIM provides a testable theoretical account of how bodily sensations may acquire context-dependent meaning. The model generates predictions for future behavioral, clinical, and neuroimaging research examining whether hippocampal-dependent contextual processing contributes to flexible interpretation of bodily states across changing environmental conditions. Accordingly, the HCIM is presented as a theoretical framework to be empirically tested rather than as an established neurobiological mechanism.