Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness

Abstract

Interoception refers to the sensing of internal bodily changes. Interoception interacts with cognition and emotion, making measurement of individual differences in interoceptive ability broadly relevant to neuropsychology. However, inconsistency in how interoception is defined and quantified led to a three-dimensional model. Here, we provide empirical support for dissociation between dimensions of: (1) interoceptive accuracy (performance on objective behavioural tests of heartbeat detection), (2) interoceptive sensibility (self-evaluated assessment of subjective interoception, gauged using interviews/questionnaires) and (3) interoceptive awareness (metacognitive awareness of interoceptive accuracy, e.g. confidence-accuracy correspondence). In a normative sample (N=80), all three dimensions were distinct and dissociable. Interoceptive accuracy was only partly predicted by interoceptive awareness and interoceptive sensibility. Significant correspondence between dimensions emerged only within the sub-group of individuals with greatest interoceptive accuracy. These findings set the context for defining how the relative balance of accuracy, sensibility and awareness dimensions explain cognitive, emotional and clinical associations of interoceptive ability.

Covert digital manipulation of vocal emotion alter speakers’ emotional states in a congruent direction

“…Similarly, it is interesting to speculate about the small minority of participants who actually detected the manipulation. If we assume a matrix of conflicting evidence in the task (from interoceptive signals and exteroceptive feedback), it is possible that their performance can be explain by individual differences in emotional sensitivity and awareness (27,28).…”

Feeling, learning from and being aware of inner states: interoceptive dimensions in neurodegeneration and stroke

“…Cardiac interoception tasks, which assess sensing of one's own heartbeats [5,10,11], offer robust evidence on three relevant dimensions: accuracy (behavioural precision in tracking cardiac signals [3]), learning (improvement of behavioural accuracy after feedback [11]), and awareness (metacognitive processes underlying confidence about one's own performance [3]). These dimensions rely on distributed networks critically engaging the insular cortex (IC), the anterior cingulate cortex (ACC) and the somatosensory cortex (SC) [2,12], while interactions between interoceptive and high-level functions are mediated by IC projections to the ACC, the orbitofrontal cortex (OFC), the amygdala and the hippocampus (HP) [3,4,11,[13][14][15][16][17][18].…”

“…These dimensions rely on distributed networks critically engaging the insular cortex (IC), the anterior cingulate cortex (ACC) and the somatosensory cortex (SC) [2,12], while interactions between interoceptive and high-level functions are mediated by IC projections to the ACC, the orbitofrontal cortex (OFC), the amygdala and the hippocampus (HP) [3,4,11,[13][14][15][16][17][18].…”

Changes in interoceptive processes following brain stimulation

“…body perception questionnaire). In a recent study, Garfinkel and co-workers [4] investigated these three levels of processing and could demonstrate that significant correlations between dimensions emerged only within the subgroup of individuals with higher IAc. They suggest that the relative balance of accuracy, sensibility and awareness dimensions could explain cognitive, emotional and clinical associations of interoceptive ability.…”

“…Referring to the study of Garfinkel et al [4], IAc might be the core ability within the construct of interoception underpinning other interoceptive measures. Individuals differ substantially in measures of IAc, the ability to consciously perceive signals arising from the body.…”