Abstract
It has been suggested that individual differences in interoception (the perception of the body’s internal state) can be divided into three distinct dimensions: interoceptive accuracy (performance on objective tests of interoceptive accuracy), interoceptive sensibility (self-reported beliefs concerning one’s own interoception) and interoceptive awareness (a metacognitive measure indexed by the correspondence between interoceptive accuracy and interoceptive sensibility). Research conducted under this model underscores the importance of interoceptive awareness for a variety of disorder-specific and transdiagnostic symptoms. However, the clinical importance of interoceptive awareness means that this aspect of interoception warrants further scrutiny, and such scrutiny suggests that revision of the three-dimensional model of interoception is necessary. In this theoretical paper, we outline such a revision, highlighting a need to distinguish not only how interoception is measured (objective measures vs. self-report), but also what is measured (accuracy vs. attention). The model refines how individual differences in interoception are categorised, with important consequences for the measurement of interoceptive awareness. Such a revision may help researchers to identify the strengths and weaknesses in interoception observed across clinical conditions, and to isolate clinically relevant individual differences.
Highlights
Theories linking individual differences in interoception to individual differences in cognitive ability and affective function, and to physical and mental health, are becoming increasingly common (e.g. Brewer, Happé, Cook, & Bird, 2015; Garfinkel, Seth, Barrett, Suzuki, & Critchley, 2015; Khalsa et al, 2018; Murphy, Catmur, & Bird, 2018c; Quattrocki & Friston, 2014)
Perhaps the most well-known model (Garfinkel et al, 2015) proposes that interoception is a three-dimensional construct, comprising (1) interoceptive accuracy; (2) interoceptive sensibility; and (3) interoceptive awareness
Adoption of this model by a number of empirical studies has resulted in increased recognition of the importance of interoceptive awareness, with the correspondence between interoceptive accuracy and interoceptive sensibility emerging as a clinically relevant feature across a number of different disorders (Garfinkel et al, 2016; Paulus & Stein, 2006, 2010; Rae, Larsson, Garfinkel, Psychon Bull Rev (2019) 26:1467–1471
Summary
Theories linking individual differences in interoception (perception of the body’s internal state; Craig, 2003; Khalsa et al, 2018) to individual differences in cognitive ability and affective function, and to physical and mental health, are becoming increasingly common (e.g. Brewer, Happé, Cook, & Bird, 2015; Garfinkel, Seth, Barrett, Suzuki, & Critchley, 2015; Khalsa et al, 2018; Murphy, Catmur, & Bird, 2018c; Quattrocki & Friston, 2014). Interoceptive sensibility is concerned with one’s self-reported beliefs regarding one’s “dispositional tendency to be internally self-focused and interoceptively cognisant” (Garfinkel et al, 2015) and is typically measured using questionnaire measures such as the Porges Body Perception Questionnaire (BPQ; Porges, 1993) or confidence ratings during a task of interoceptive accuracy (Ehlers, Breuer, Dohn, & Fiegenbaum, 1995).
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