Testing the independence of self-reported interoceptive accuracy and attention

Abstract

It has recently been proposed that measures of the perception of the state of one’s own body (“interoception”) can be categorised as one of several types depending on both how an assessment is obtained (objective measurement vs. self-report) and what is assessed (degree of interoceptive attention vs. accuracy of interoceptive perception). Under this model, a distinction is made between beliefs regarding the degree to which interoceptive signals are the object of attention and beliefs regarding one’s ability to perceive accurately interoceptive signals. This distinction is difficult to test, however, because of the paucity of measures designed to assess self-reported perception of one’s own interoceptive accuracy. This article therefore reports on the development of such a measure, the Interoceptive Accuracy Scale (IAS). Use of this measure enables assessment of the proposed distinction between beliefs regarding attention to, and accuracy in perceiving, interoceptive signals. Across six studies, we report on the development of the IAS and, importantly, its relationship with measures of trait self-reported interoceptive attention, objective interoceptive accuracy, confidence in the accuracy of specific interoceptive percepts, and metacognition with respect to interoceptive accuracy. Results support the distinction between individual differences in perceived attention towards interoceptive information and the accuracy of interoceptive perception.

The relationship between heartbeat counting and heartbeat discrimination: A meta-analysis

“…However, it is notable that there are differences in the assessment of interoceptive sensibility and awareness for the HDT and HCT; for example, 1) far fewer trials are used for the HCT (typically 3-6) compared to the HDT (typically 15-60) thus reducing the reliability of the HCT accuracy, sensibility and awareness indices, and 2) the analysis strategy for calculating interoceptive awareness differs for the HCT and HDT. Whilst HDT interoceptive awareness is usually calculated using Receiver Operating Characteristic (ROC) curves (but see Palser, Fotopoulou, Pellicano, and Kilner (2018) for an alternative method for calculating HDT interoceptive awareness), confidence-accuracy correlations are generally used to calculate interoceptive awareness for the HCT (but see Murphy et al (2020) for an alternative scoring method for calculating HCT interoceptive awareness). In terms of the relationship between these aspects of interoception, confidence ratings for the HCT and HDT (indexing interoceptive sensibility) are often correlated with one another, but the strength of this association has been found to vary substantially across studies, with Forkmann et al (2016) reporting a relatively low correlation (r = 0.348) and Garfinkel et al (2015) reporting a much stronger correlation (r = 0.711).…”

Impact of cardiac interoception cues and confidence on voluntary decisions to make or withhold action in an intentional inhibition task

“…Interoceptive accuracy. Interoceptive accuracy, reflecting objective interoceptive performance, was calculated using an in-house Matlab script according to the trial-by-trial ratio of perceived to actual heartbeats, with two equations: (1 -(nbeats real -nbeats reported ) / nbeats real ) ('standard' accuracy), and (1 -(nbeats real -nbeats reported ) / (nbeats real + nbeats reported ) / 2) ('alternative' accuracy) 26,27,42 . For each accuracy method, the ratios for the six trials were averaged to give a mean heartbeat tracking score.…”

“…The 'standard' accuracy calculation is appropriate only in cases where participants do not estimate more than 2x the number of real heartbeats. When participants do substantially overestimate, the 'alternative' accuracy calculation is more appropriate 26,27 . One participant was a substantial over-estimator, according to this heuristic: we therefore report 'standard' accuracy scores for the remaining 40 participants, and 'alternative' accuracy scores for the full sample of 41 participants.…”

“…Interoceptive awareness and insight. Interoceptive awareness and insight, reflecting metacognitive perception of one's interoceptive accuracy performance, were calculated using an in-house Matlab script, according to two approaches: a discrepancy index between the participant's accuracy and confidence scores (using 'standard' accuracy scores), and the Pearson correlation between interoceptive accuracy and confidence rating on each trial (using 'alternative' accuracy scores) 26,27 . To calculate the discrepancy index (insight), confidence ratings were converted from a 0 to 10 scale to a percentage (confidence rating / 10), then an absolute difference score calculated for each trial ('standard' accuracy -confidence), which was averaged across the six trials.…”

“…We describe the discrepancy index as 'interoceptive insight' and the correlation measure as 'interoceptive awareness' , following the original terminology of the authors who introduced these methods 26,27 . An insight discrepancy score of 0 indicates high interoceptive metacognition, with optimum alignment of accuracy and confidence (accuracy exactly matches confidence rating).…”