Interoceptive Ability Research Articles

Interoceptive ability moderates the effect of physiological reactivity on social judgment.

Social judgments-that others are kind or cruel, well intentioned, or conniving-can ease or disrupt social interactions. And yet a person's internal state can alter these judgments-a phenomenon known as affective realism. We examined the factors that contribute to, and mitigate, affective realism during a stressful interview. Using data collected between 2015 and 2019, we hypothesized and found that individuals' ability (N = 161; 57.6% female; 57.6% European American, 13.6% African American, 13.6% Asian American, 6.4% Latinx, 6.0% biracial, and 2.8% that identified with none or 1 + of the races presented; Mage = 19.20 years) to accurately perceive their own internal sensations (i.e., heartbeats) influenced whether they attributed their own heightened stress reactions (i.e., sympathetic nervous system reactivity) to the behavior of two impassive interviewers. Participants who were poor heartbeat detectors perceived their interviewers as less helpful, polite, or professional, and more apathetic, judgmental, and aggressive when experiencing heightened levels of cardiovascular sympathetic nervous system reactivity during their interview. Being aware of one's internal state may be one pathway to reducing bias in social perceptions in circumstances where such biases may lead us astray. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effect of 10-week long yoga training on interoceptive abilities: cross-sectional and longitudinal investigation of cardiac and gastric accuracy

Based on their characteristics, it is likely that mind–body techniques develop interoception, the perception of bodily state. Nevertheless, findings on mindfulness, meditation, yoga, and body scan techniques are inconclusive. Additionally, the methodological scope is not exhaustive, neither in terms of the intervention nor the applied measure of interoception. This study investigated for the first time the effect of regular yoga training on cardiac and gastric perceptual ability (measured with the mental heartbeat tracking task and the water load task, respectively). With the involvement of 90 female university students (yoga group n = 57, control group n = 33) we did not find any connection between baseline heartbeat perception score and gastric fullness. Moreover, the applied 10-week-long regular yoga training did not develop any of the measured interoceptive abilities. We conclude that yoga might develop other abilities than these specific sensations. Very probably, the measured cardiac and gastric perceptual abilities do not represent bodily sensations in general. It would be worth to investigate, however, the effect of longer yoga training on interoception.

Interoception in the Determination of Reaction Times and Pulse Amplitude Sensitivity

Interoception is the awareness of changes of sensation within the body. Over the years, interoception has been analyzed in the context of the perception of visceral activity and its effects on emotional regulation. There is little to no knowledge of how the interoceptive ability of an individual affects physical parameters such as Reaction Time (RT). Measures such as the MAIA-2 have been used to rank an individual’s interoceptive ability. The Multidimensional Assessment of Interoceptive Awareness (MAIA) is an 8-scale state-trait questionnaire with 37 items to measure multiple dimensions of interoception by self-report. Participants (n = 29, x̄ = 21.4 years) in the study first completed the MAIA-2 and a series of tests to extrapolate measures of RT [ms], Reaction Time Variability (RTV) [ms], and the minimum differentiable pulse amplitude (lower limen) [um] of two stimuli. RT and RTV scores were compared to subscales scores of Noticing, Self-regulation, and Body-Listening. Non-Distracting, Non-Worrying, and Attention Regulation were compared to lower limen scores. External cues for these measures were presented with the Brain Gauge from Cortical Metrics. No correlations were found between the RT, RTV, lower limen, and their respective MAIA-2 categories. Clusters of data are evident for certain categories (i.e. RTV), however, they may be influenced by the age composition of the sample. Though there are no conclusive results, further post-testing along with more variable samples could reveal connections between self-perception and interactions with the environment.

Understanding Interoception and Its Importance in Body and Mind Functions: A Review

Interoception, the sensing of the body’s internal sensations, contributes to numerous aspects of human’s cognitive and affective abilities. Interoception mechanisms ensure physiological health through the coordination of homeostatic reflexes and allostatic responses. This review presents how deeply interoception controls our daily motivational behaviors and associated affective and emotional feelings. Since its discovery at the twilight of the 19th century, relentless research and experimental work have pushed far back the borders of interoception. Concept enrichment is still to find its limits: from its role in balancing and maintaining the energy-efficiency of the integrity and health of the body (homeostasis) to its emotional importance in learning, motivation and decision making, the field of interoception doesn't stop extending. Scientific measuring of interoceptive effects is also making fulgurant progress, though accuracy and relation between self-awareness and interoceptive attention are still to be fine-tuned. In addition, the review also addresses impairment caused by interoceptive deficiencies (alexithymia), commenting research and group experiments made in physical, emotional and physiological fields. Open questions are raised about whether interoception is a unitary function as well as about the ways to reduce individual weak interoceptive abilities, such as training and meditation. In conclusion, the signaling, sensing, and detection of bodily states are implicated in physical and mental well-being. Interoception research contributes to understanding into the dynamic interactions between body, brain, and mind.

Interoception, alexithymia, and anxiety among individuals with alcohol use disorder.

Interoception (i.e., the ability to recognize bodily signals), alexithymia (i.e., the inability to recognize emotional states) and negative affect (i.e., unpleasant feelings such as anxiety) have been associated with alcohol use disorder (AUD). Previous research suggests that interoception may underlie alexithymia, which in turn may be associated with negative affectivity. However, this remains to be empirically tested. This study investigates whether alexithymia mediates the association between interoception and anxiety and whether this association differs across individuals with AUD and a healthy control (HC) comparison group. The AUD group consisted of 99 participants enrolled in an 8-week abstinence-based inpatient treatment program. The HC group included 103 healthy individuals. The heartbeat counting task (HCT) was used to assess interoception (cardiac interoceptive accuracy). The Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia. The Brief Symptom Inventory (BSI) was used to assess anxiety. The moderated mediation model with interoception as the predictor, alexithymia as the mediator, and negative affect (i.e., state anxiety) as the dependent variable was tested. The analysis showed that the conditional indirect effect of interoception on anxiety via alexithymia was significant for individuals with AUD [ab = -0.300, bootstrap 95% CI = (-0.618, -0.088)], as well as for HCs [ab = -0.088, bootstrap 95% CI = (-0.195, -0.014)]; however, the conditional indirect effect significantly differed across HCs and individuals with AUD. Namely, the mediated effect was greater among individuals with AUD compared to the HC group. The results suggests that interoceptive impairment contributes to greater negative affect (i.e., state anxiety) via alexithymia especially for individuals with AUD. Improving emotion recognition via therapeutic methods focused on strengthening interoceptive abilities could improve outcomes for individuals receiving treatment for AUD.

Listen to Your Heart – Studying Heartbeat Detection and Emotional Intelligence

Abstract: Perception of emotions is at the basis of scientific literature about emotions and is considered a crucial emotional function in the Mayer and Salovey hierarchical model of Emotional Intelligence. The perception of bodily signals plays an important role in the perception of one’s own and others’ emotions. Thus, the first aim of this study was to verify if interoceptive ability, referred to as the ability to perceive bodily signals or autonomic self-perception, is related to individuals’ emotional abilities measured with the MSCEIT ( Mayer-Salovey-Caruso Emotional Intelligence Test, 2002 ). Results evidenced a positive relationship between total EI and experiential area scores (perceiving emotions and sensations) and interoceptive performance scores. A second aim was to investigate if the artificial augmentation of the cardiac perception improved performances in the same tasks. Results showed that the augmented perception of the heartbeat signal did not influence any performance in MSCEIT’s subtests. We concluded that there is a significant relationship between EI and interoceptive ability but that the artificial augmentation of the perception of bodily signals does not influence MSCEIT performances.

The Effects of Internal Focus of Attention and Interoceptive Abilities on Golf Putting Performance

AbstractAn internal focus on movement interferes with automated movement execution, but physical sensations may not diminish performance. We hypothesized that interoception—a perception of the inner workings of the body—is associated with maintaining performance under internal focus. Eighteen competitive swimmers with high interoceptive ability and nine controls with no sports experience executed a golf putting task under pressure and no‐pressure tests, while the direction of attentional focus was manipulated. We recorded electroencephalograms and electrocardiograms during the task in three attentional conditions (i.e., sensation‐focus, movement‐focus, and no‐focus instruction). Interoceptive accuracy was evaluated by a heartbeat counting task and interoceptive sensibility was obtained using the Multidimensional Assessment of Interoceptive Awareness questionnaire. Results showed that internal focus on movement led to lower performance compared to the no‐focus instruction in both groups, whereas focusing on physical sensations did not change performance. Higher interoceptive sensibility predicted better performance when focusing on movement. These results suggest that higher interoceptive ability may prevent performance deterioration due to an internal focus toward movement.

Interoception and the musical brain: Evidence from cross-sectional and longitudinal behavioral and resting-state fMRI study.

Musical training has been linked to enhanced interoceptive abilities and increased resting-state (RS) functional connectivity (FC) within the interoceptive brain network. We aimed to replicate and extend these findings with a unique cross-sectional and longitudinal study design. Professional musicians and matched individuals with no prior musical experience (training group) were recruited. Participants underwent RS fMRI scans and completed heartbeat counting and discrimination tasks outside of the scanner (time point 1). The training group additionally had RS scans and interoception tests repeated after a 6-month-long keyboard course training (time point 2). We found no evidence for increased interoceptive abilities in professional musicians relative to non-musicians, nor did we observe any improvements in interoception over the course of musical training. RS FC analysis revealed increased FC within the sensorimotor network in professional musicians compared to the training group at the first time point with no change in FC over time in the Training group. These findings challenge the view that musical training may improve interoceptive abilities. Yet, the results suggest that musical training is related to increased communication within the sensorimotor RS network, which consists of some hubs important for interoceptive processing (namely pre- and postcentral gyri and supplementary motor area).

Increasing familiarity with the heartbeat counting task does not affect performance

BackgroundInteroception is typically defined as the processing and perception of internal signals. A common evaluation of interoceptive abilities is the heartbeat counting task, during which participants count their heartbeats over a period of time. It has been argued recently, however, that performance in this task may reflect processes other than cardiac sensation. ObjectiveThis study aimed to: 1) observe heartbeat counting task performance changes across multiple repetitions of the task; and 2) compare performance in the heartbeat counting task with that for a visual counting task to investigate generalised propensities for how uncertain stimuli are reported. MethodsSeventy-nine healthy participants performed seven blocks each of the heartbeat and visual counting tasks. Scores for each of the tasks were compared across blocks to identify any change in performance. Performance in the two tasks was then correlated. The study was preregistered at https://doi.org/10.17605/OSF.IO/GWAB7. ResultsHeartbeat counting task performance did not change over blocks. In contrast, scores for the visual counting task reduced over time. A positive correlation was seen between performance in the two tasks (ρ(79) = .27). ConclusionHeartbeat counting task performance is stable across repetitions of the task, not changing with increasing familiarity. This suggests that non-interoceptive factors, such as beliefs, may be involved. The correlation between the heartbeat and visual counting tasks may point to a general propensity in counting uncertain stimuli across sensory domains. Together, these results raise questions about the interpretation of the heartbeat counting task as a measure of interoception.

Heartbeat counting accuracy is enhanced in blind individuals.

Blind individuals have superior abilities to perform perceptual tasks that rely on exteroceptive information, since visual deprivation is associated with heightened cross-modal plasticity. However, it is unknown whether neuroplasticity after visual loss also affects interoception, that is, the sensations arising from one's inner organs that convey information about the physiological state of the body. Herein, we examine the influence of blindness on cardiac interoception, which is an interoceptive submodality that has important links to emotional processing and bodily self-awareness. We tested 36 blind and 36 age- and sex-matched sighted volunteers and examined their cardiac interoceptive ability using the heartbeat counting task. The results showed that blind individuals had significantly higher accuracy in perceiving their heartbeat than did individuals in a matched sighted control group. In contrast, there were no significant differences between the groups in the metacognitive dimensions of cardiac interoception or the purely physiological measurement of heart rate, thereby underscoring that the improved accuracy likely reflects a superior perceptual sensitivity to cardiac interoceptive signals in blind individuals. We conclude that visual deprivation leads to an enhanced ability to count one's own heartbeats, which has important implications for the study of the extent of cross-modal plasticity after visual loss, understanding emotional processing in blind individuals, and learning how bodily self-awareness can develop and be sustained in the absence of visual experience. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A case for emojis, more or less: An analysis of word and emoji expressivity in text messaging for high and low alexithymia levels

The impact of alexithymia on verbal and non-verbal expressivity was investigated in one of the most prevalent mediums for present-day human interacting, smartphone text messaging. The variety of words and emojis used to express negative, neutral and positive feelings was compared between people with higher and lower levels of alexithymia measured by the Perth Alexithymia Questionnaire, controlling for covariates anxiety and depression. Verbal expressivity was not impacted by higher levels of alexithymia, for total scores nor by subscale. Non-verbal expressivity for high-level alexithymia showed differences in variety of emoji on two subscales: compared to low-level alexithymia, higher scores on difficulty describing negative feelings used greater variety of emojis when describing negative feelings, while higher scores on externally oriented thinking used less variety of emojis when describing positive feelings. This may be related to greater and lesser interoceptive ability. Further research is warranted. Findings support facet-level over total scores analyses in informing more nuanced understandings of the impacts of alexithymia in interpersonal communication. They suggest that text messaging may attenuate the impacts of the verbal deficits associated with higher-level alexithymia and that emoji use may be more sensitive to specific alexithymic difficulties in particular valence contexts.

Interoceptive abilities facilitate taking another’s spatial perspective

Information can be perceived from a multiplicity of spatial perspectives, which is central to effectively understanding and interacting with our environment and other people. Interoception, the sense of the physiological state of our body, is also a fundamental component contributing to our perception. However, whether the perception of our inner body signals influences our ability to adopt and flexibly change between different spatial perspectives remains poorly understood. To investigate this, 90 participants completed tasks assessing multiple dimensions of interoception (interoceptive sensibility, cardiac interoceptive accuracy and awareness) and the Graphesthesia task to assess tactile spatial perspective-taking and its flexibility. The results revealed that higher cardiac interoceptive awareness is associated with greater consistency in adopting a perspective decentred from the self. Second, higher cardiac interoceptive accuracy was associated with slower and less accurate performance in switching from a decentred to an egocentred perspective. These results show that interoceptive abilities facilitate decentred spatial perspective-taking, likely reflecting stronger perceived boundaries between internal states and the external world.

The roles of inflammation, affect, and interoception in predicting social perception

“Sickness behavior” is an orchestrated suite of symptoms that commonly occur in the context of inflammation, and is characterized by changes in affect, social experience, and behavior. However, recent evidence suggests that inflammation may not always produce the same set of sickness behavior (e.g., fatigue, anhedonia, and social withdrawal). Rather, inflammation may be linked with different behavior across contexts and/or across individuals, though research in this area is under-developed to-date. In the present study (n = 30), we evaluated the influence of affective context and individual differences in difficulty detecting bodily sensations (i.e., interoceptive difficulty) on social perception following an inflammatory challenge. Inflammation was induced using the influenza vaccine and inflammatory reactivity was operationalized as changes in circulating levels of interleukin-6 (IL-6) before the vaccine and approximately 24 h later. Twenty-four hours after administration of the influenza vaccine, we manipulated affective context using a well-validated affect misattribution task in which participants made trustworthiness judgments of individuals with neutral facial expressions following the rapid presentation of “prime” images that were positive or negative in affective content. Interoceptive difficulty was measured at baseline using a validated self-report measure. Results revealed significant interactions between inflammatory reactivity to the influenza vaccine and affective context on social perception. Specifically, individuals with greater inflammatory reactivity were more biased by affective context when judging the trustworthiness of neutral faces. In addition, interoceptive difficulty and affective context interacted to predict social perception such that individuals with greater interoceptive difficulty were more biased by affective context in these judgments. In sum, we provide some of the first evidence that inflammation may amplify the saliency of affective cues during social decision making. Our findings also replicate prior work linking interoceptive ability to the use of affect-as-information during social perception, but in the novel context of inflammation.

Reduced Interoception Abilities in Patients with Restless Legs Syndrome.

Restless legs syndrome (RLS) is a complex sensorimotor disorder occurring with a typical circadian fashion. Association with additional features, like alexithymia and nocturnal compulsive behaviors further complicates the framework. To assess interoception in RLS. A total of 25 RLS patients and 28 controls underwent the heartbeat tracking task (interoceptive accuracy [IAC]). RLS symptoms' frequency, disturbance and duration, nocturnal behaviors, interoceptive awareness (IAW), alexithymia, depressive and anxiety symptoms were also collected. RLS patients showed significant lower IAC (P = 0.0003) and IAW (P = 0.012), and reported more nocturnal eating behaviors (P < 0.001). IAC positively correlated with IAW (R = 0.32), and negatively correlated with age (R = -0.58). Nocturnal eating behavior negatively correlated with IAC (R = -0.44) and IAW (R = -0.50). RLS patients presented reduced interoceptive abilities correlating with higher nocturnal eating behaviors. Future studies are needed to explore the role of interoception in RLS pathophysiology, also in relation to other sensorimotor aspects.

Interoception: Where do we go from here?

In recent years, there has been a significant rise in interest in interoception, the processing of internal bodily signals. This interest has been coupled by increased concerns regarding the measurement and conceptualisation of interoception. Focusing on cardiac interoceptive accuracy, I outline what I believe to be the most pressing issues in the field of interoception-specifically the continued reliance on the heartbeat counting task. I then provide an overview of what I believe to be more general limitations concerning how we measure and conceptualise individual differences in interoception and suggestions for a way forward. Specifically, I believe that by moving beyond single measurements, establishing optimal levels of interoceptive accuracy, and refocusing from accuracy to propensity, we may be able to uncover the real-life relevance of interoceptive abilities.

Emotional Dysfunction and Interoceptive Challenges in Adults with Autism Spectrum Disorders.

People with autism spectrum disorder (ASD) frequently show impaired sensory processing in different senses, including the interoceptive system. Recent findings suggest that interoception is a fundamental component of emotional experience and that impaired interoception is associated with alexithymia. This study aims to explore the association and interrelation between interoceptive confusion, alexithymia, and the capacity for emotional regulation among a sample of 33 adults with ASD compared to a control group of 35 adults with neurotypical development and its mutual impact. The participants answered a series of questionnaires addressing these three variables. The results showed (1) significant differences between the groups in all dimensions, with dysfunctional emotional regulation, impaired interoception, and alexithymia in the ASD group, (2) significant correlations between interoceptive confusion, emotional clarity, and alexithymia in the ASD group but only positive correlations between interoceptive confusion and alexithymia in the CG, and (3) that emotional clarity, alexithymia, and autism explain 61% of the variance in interoceptive confusion. These results are in line with previous studies and suggest that training interoceptive ability may enhance emotional clarity and reduce alexithymia among those diagnosed with ASD, with significant implications in the planning of treatment.

Cardiac interoception in patients accessing secondary mental health services: A transdiagnostic study.

Abnormalities in the regulation of physiological arousal and interoceptive processing are implicated in the expression and maintenance of specific psychiatric conditions and symptoms. We undertook a cross-sectional characterisation of patients accessing secondary mental health services, recording measures relating to cardiac physiology and interoception, to understand how physiological state and interoceptive ability relate transdiagnostically to affective symptoms. Participants were patients (n=258) and a non-clinical comparison group (n=67). Clinical diagnoses spanned affective disorders, complex personality presentations and psychoses. We first tested for differences between patient and non-clinical participants in terms of cardiac physiology and interoceptive ability, considering interoceptive tasks and a self-report measure. We then tested for correlations between cardiac and interoceptive measures and affective symptoms. Lastly, we explored group differences across recorded clinical diagnoses. Patients exhibited lower performance accuracy and confidence in heartbeat discrimination and lower heartbeat tracking confidence relative to comparisons. In patients, greater anxiety and depression predicted greater self-reported interoceptive sensibility and a greater mismatch between performance accuracy and sensibility. This effect was not observed in comparison participants. Significant differences between patient groups were observed for heart rate variability (HRV) although post hoc differences were not significant after correction for multiple comparisons. Finally, accuracy in heartbeat tracking was significantly lower in schizophrenia compared to other diagnostic groups. The multilevel characterisation presented here identified certain physiological and interoceptive differences associated with psychiatric symptoms and diagnoses. The clinical stratification and therapeutic targeting of interoceptive mechanisms is therefore of potential value in treating certain psychiatric conditions.

Interoceptive differences in elite sprint and long-distance runners: A multidimensional investigation.

Interoception, the process of detecting and interpreting bodily sensations, may facilitate self-regulation and thereby play a crucial role in achieving elite performance in competitive sports. However, there is a lack of research conducted in world-class athletes. In the present research, two studies examined self-reported (interoceptive sensibility) and behavioural (interoceptive accuracy) interoception in elite (top 100 ranking) sprint and long-distance runners, and non-athletes. Study 1 used the Multidimensional Assessment of Interoceptive Awareness Questionnaire. Sprinters reported having better regulation of attention to internal sensations, greater emotional awareness, better self-regulation, and reported a greater propensity to listen to their body for insight, than distance runners. Compared to non-athletes, sprinters and distance runners had more bodily trust, attention regulation, and self-regualtion. Additionally, elite athletes reported lower emotional awareness, self-regulation, and body listening. Study 2 examined cardioception using two tasks: The Heartbeat Counting Task, and The Heartbeat Detection Task. Elite and non-elite runners performed the tasks under two conditions; in silence, and whilst listening to pre-recorded crowd noise that simulated the live sounds of spectators during a sporting event. Sprinters and distance runners were able to maintain heartbeat detection accuracy when distracted, whereas non-athletes could not. Across both tasks, compared to non-athletes, sprinters and distance runners were more confident than non-athletes in their interoceptive percept. Additionally, elite athletes compared to non-elite athletes were less accurate when counting their heartbeat and were characterised by a higher interoceptive prediction error. Athletic populations have altered interoceptive abilities.

Alexithymic characteristics and interoceptive abilities are associated with disease severity and levels of C-reactive protein and cytokines in patients with inflammatory bowel disease.

Alexithymia and atypical gut-brain signaling have been linked to the pathophysiology of inflammatory bowel disease (IBD). We herein assessed IBD patients' alexithymia levels and interoceptive abilities, and detected potential correlations with psychological distress, symptom severity and disease activity, and inflammation indices. Adult IBD outpatients and healthy controls were recruited. Alexithymia was assessed using the Toronto Alexithymia Scale, interoceptive accuracy using the Heartbeat Counting Test (cardiac interoception) and the Water Load Test-II (gastric interoception), and interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). Forty-one patients with Crohn's disease (CD), 16 with ulcerative colitis (UC), and 50 healthy controls were included. In CD patients, the level of externally oriented thinking and total alexithymia score were correlated with disease activity (P=0.027 and P=0.047, respectively), while in UC patients difficulties in identifying emotions were linked to disease activity (P=0.007). In CD patients, the Noticing, Not-Worrying and Emotional Awareness MAIA subscale score were correlated with C-reactive protein levels (P=0.005, P=0.048 and P=0.005), the Noticing subscale score with interleukin (IL)-1β levels (r=-0.350, P=0.039), the Not-Distracting subscale score with IL-6 levels (r=-0.402, P=0.017), and the Emotional Awareness subscale score with IL-1β (r=-0.367, P=0.030) and IL-6 (r=-0.379, P=0.025) levels. Finally, in UC patients, the Not-Worrying subscale score was significantly associated with IL-6 levels (r=-0.532, P=0.049), while difficulties in identifying emotions were linked to IL-8 levels (r=0.604, P=0.022). Emotional and interoceptive processing is associated with IBD disease activity, suggesting a potential implication for IBD pathophysiology.

Supplemental Material for Interoceptive Ability Moderates the Effect of Physiological Reactivity on Social Judgment

Supplemental Material for Interoceptive Ability Moderates the Effect of Physiological Reactivity on Social Judgment