Knowing your own heart - distinguishing interoceptive accuracy and awareness

Garfinkel et al. categorize three different aspects of the internal bodily sensing (interoception) that informs our interactions with the external world, focusing on heartbeats - whose frequency and intensity vary with the degree of our emotional arousal (calm, anticipating, fearful, excited, etc.).

Highlights

• Interoception refers to the signalling and perception of internal bodily sensations.

• We validate a three dimensional construct of interoception.

• This comprises: interoceptive accuracy, sensibility and awareness (metacognition).

• These interoceptive dimensions represent dissociable interoceptive processes.

• Interoceptive accuracy serves as the core (central) construct.

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.