Measures Of Interoceptive Accuracy Research Articles

Extreme weight conditions impact on the relationship between risky decision-making and interoception

Anorexia nervosa (AN) and obesity (OB) lie on the two ends of the broad spectrum of extreme weight conditions (EWC). Both disorders entail the constant risk to one's body integrity. Importantly, risk-taking is supported by internal signals, the perception of which is typically distorted in EWC. In this study, we sought to characterize in EWC: (i) risky decision-making by contrasting situations in which people process bodies or neutral objects and (ii) the relationship between interoceptive ability and risky decision-making. In a between-subject design, participants with AN restricting type, participants with class 2 OB, and two groups of matched healthy controls (HC) (total N = 160) were administered either the Balloon Analogue Risk Task (BART) or a modified version of it by using a body-related stimulus as a cue in the place of the balloon. Moreover, we collected a measure of interoceptive sensibility and a measure of interoceptive accuracy. Results showed that, when analysing the global population as a continuum based on the BMI, the risk propensity decreased as a function of increased BMI, only for the task involving a body-related stimulus. Moreover, while HC risk propensity toward a body-related stimulus correlated with interoceptive sensibility, such correlation was absent in participants with AN. Individuals with OB, on the opposite pole, showed mixed interaction between interoception and risky decision-making in both tasks. These findings add one more tile to understanding these complex pathologies in the EWC spectrum, opening up future differential rehabilitation scenarios.

Short-term fasting induced changes in HRV are associated with interoceptive accuracy: Evidence from two independent within-subjects studies

Previous research suggested increased cardiac interoceptive accuracy after 24-h food-deprivation by means of the heartbeat tracking task. The present study investigated if 16-h of voluntary fasting shows similar effects and whether changes in interoceptive accuracy are accompanied by changes in autonomic function. In two independent within-subjects studies two measures of interoceptive accuracy, the heartbeat tracking task and the heartbeat discrimination task were applied. In study 1 (n = 24) and study 2 (n = 72) vagally-mediated HRV increases and heart rate decreases were observed. Stronger effects of fasting on vagally-mediated HRV went along with a higher interoceptive accuracy increase in the heartbeat tracking task. Furthermore, the fasting associated changes in interoceptive accuracy in both tasks were significantly associated, suggesting that these tasks are suitable to track changes in cardiac interoception. Taken together, fasting of 16-h might be suitable to increase participants’ parasympathetic efference, thereby facilitating interoception.

Does contingent biofeedback improve cardiac interoception? A preregistered replication of Meyerholz, Irzinger, Withöft, Gerlach, and Pohl (2019) using the heartbeat discrimination task in a randomised control trial

Meyerholz, Irzinger, Withöft, Gerlach, and Pohl (2019) reported on a comparably large effect (d = 1.21) of a contingent biofeedback procedure on cardiac accuracy as assessed by the heartbeat tracking task. However, this task has recently been criticized as a measure of interoceptive accuracy. We aimed to replicate this finding by using the well-validated heartbeat discrimination task and to compare the biofeedback with a deep breathing and a control condition (viewing a film clip). The trial was preregistered at open science framework (https://osf.io/9fxn6). Overall, 93 participants were randomized to one of the three conditions and the heartbeat discrimination task was presented prior and after the 20-minutes training sessions. The study had a power of .86 to detect a medium-sized effect in the biofeedback group and a power of .96 to detect a medium-sized interaction of intervention group and time. A general tendency for improvement in heartbeat detection accuracy was found across intervention groups (d = 0.19, p = .08); however, groups did not differ significantly. In particular, there was no significant interaction of intervention group and time (f = .00, p = .98) and no reliable effect for the biofeedback group (d = 0.15, p = .42). One limitation is that a different, but well-validated task was used to quantify interoceptive accuracy. This study suggests that biofeedback might not improve interoceptive accuracy in the cardiac domain, but effects seem to depend on the specific task applied.

Comment on “Zamariola et al. (2018), Interoceptive Accuracy Scores are Problematic: Evidence from Simple Bivariate Correlations”—The empirical data base, the conceptual reasoning and the analysis behind this statement are misconceived and do not support the authors’ conclusions

A recent paper by Zamariola and colleagues is widely cited as an authority on the invalidity of the Heartbeat Counting Task as a measure of interoceptive accuracy. Given the widespread interest in this field, it is essential that papers about methods are conceptually sound. However, only one of the authors’ four criticisms appears substantiated - that people count too few heartbeats. Their arguments about “simple bivariate correlations” and their finding that interoceptive accuracy and heart rate correlate, depend on ‘spurious correlations’ arising from the overlooked point that interoceptive accuracy is a ratio. Moreover, scrutiny of the authors’ data shows that their fourth criticism (that interoceptive accuracy is lower on longer trials) is confounded by differences in mean heart rate between trials. We present data from our own labs to refute it. We draw the authors’ and editors’ attention to these issues and trust that they will reconsider these erroneous conclusions.

Sense it and use it: interoceptive accuracy and sensibility in suicide ideators

BackgroundInteroceptive deficits have been found to be associated with suicidal ideation and behavior. However, an objective measure of interoceptive accuracy has not been investigated in participants with suicide ideation, by now. This study aimed at investigating interoceptive accuracy and sensibility in persons with and without suicide ideation (SI) while controlling for severity of depressive symptoms.MethodNinety-five participants (age: M = 34.8, SD = 11.6, n = 56 female [58.9%]; n = 51 patients with a Major Depressive Disorder and n = 44 healthy participants) were assessed for interoceptive accuracy and sensibility, depression and SI.ResultsTwenty-five participants (26%) reported SI. They showed interoceptive accuracy comparable to persons without SI (t = −.81, p = .422), but significantly lower interoceptive sensibility. After controlling for severity of depressive symptoms in a hierarchical linear regression analysis, most associations between interoceptive sensibility and SI disappeared.ConclusionResults suggest that suicide ideators do not lack the ability to perceive their own bodily signals but they feel less able to use them in a way that is advantageous for them. Differences between suicide ideators and non-ideators appear to be largely driven by depressive symptoms (depression bias).

Relationship between interoception and emotion regulation: New evidence from mixed methods.

Interoception is the ability to perceive one's inner bodily feelings and is thought to be associated with the capacity of recognising and experiencing emotions. Previous research on interoception and emotion regulation has presented limitations arising from the low reliability of the interoceptive measurement and provided inconsistent results. The current study used a mixed method approach to investigate this relationship from the individuals' perspective. In the first phase (quantitative), questionnaires assessing interoceptive sensibility, the subjective, self-reported ability to perceive internal states, were administered to 100 healthy participants. In the second phase (qualitative), individual semi-structured interviews were conducted with nine participants. The interviews were analysed using the Interpretative Phenomenological Analysis. Three main dimensions were explored with open questions: 1) Perception of internal bodily states; 2) Emotion regulation; 3) Potential relationship between bodily states perception and emotion recognition and regulation. Findings revealed that people with low interoceptive abilities show more difficulties in verbalizing their feelings and in decreasing the impact of emotions generated by negative experiences in daily life LIMITATIONS: The generalization of the results is limited by the specific age and gender of the recruited sample. Responses of the participants supported recent evidence regarding the lack of reliability of the heartbeat counting task as a measure of interoceptive accuracy, however interviews sustained the importance of recognising the bodily states in order to be able to understand and regulate emotions.

The heartbeat counting task largely involves non-interoceptive processes: Evidence from both the original and an adapted counting task

The heartbeat counting task (HCT) is among the most frequently used measures of interoceptive accuracy (i.e., IAcc). Growing concerns, however, have been raised regarding the validity of this task, as well as the validity of the IAcc scores that are derived from it. In the present study, healthy participants (N = 123) performed both the original task and an adapted version of it that stressed the importance of reporting only their perceptually felt heartbeats. In the original task, we found that participants report relying on three different strategies (i.e., detection of heartbeats in a specific body location, detection of heartbeats in a diffuse way and heart rate estimation) to complete the task. In the adapted task, we found that IAcc scores are drastically reduced (about 50%) when asking participants to avoid relying on non-interoceptive signals and to only report the heartbeats they perceive. These findings confirm that the HCT task is largely contaminated by the influence of non-interoceptive processes. Implications of these findings for research on interoception are discussed.

Impaired Interoceptive Accuracy in Semantic Variant Primary Progressive Aphasia.

Interoception (the perception of internal bodily sensations) is strongly linked to emotional experience and sensitivity to the emotions of others in healthy subjects. Interoceptive impairment may contribute to the profound socioemotional symptoms that characterize frontotemporal dementia (FTD) syndromes, but remains poorly defined. Patients representing all major FTD syndromes and healthy age-matched controls performed a heartbeat counting task as a measure of interoceptive accuracy. In addition, patients had volumetric MRI for voxel-based morphometric analysis, and their caregivers completed a questionnaire assessing patients' daily-life sensitivity to the emotions of others. Interoceptive accuracy was impaired in patients with semantic variant primary progressive aphasia relative to healthy age-matched individuals, but not in behavioral variant frontotemporal dementia and nonfluent variant primary progressive aphasia. Impaired interoceptive accuracy correlated with reduced daily-life emotional sensitivity across the patient cohort, and with atrophy of right insula, cingulate, and amygdala on voxel-based morphometry in the impaired semantic variant group, delineating a network previously shown to support interoceptive processing in the healthy brain. Interoception is a promising novel paradigm for defining mechanisms of reduced emotional reactivity, empathy, and self-awareness in neurodegenerative syndromes and may yield objective measures for these complex symptoms.

Striking Discrepancy of Anomalous Body Experiences with Normal Interoceptive Accuracy in Depersonalization-Derealization Disorder

BackgroundDisembodiment is a core feature of depersonalization disorder (DPD). Given the narratives of DPD patients about their disembodiment and emotional numbing and neurobiological findings of an inhibition of insular activity, DPD may be considered as a mental disorder with specific impairments of interoceptive awareness and body perception.MethodsWe investigated cardioceptive accuracy (CA) of DPD patients (n = 24) as compared to healthy controls (n = 26) with two different heartbeat detection tasks (“Schandry heartbeat counting task” and “Whitehead heartbeat discrimination task”). Self-rated clearness of body perception was measured by questionnaire.ResultsContrary to our hypothesis, DPD patients performed similarly to healthy controls on the two different heartbeat detection tasks, and they had equal scores regarding their self-rated clearness of body perception. There was no correlation of the severity of “anomalous body experiences” and depersonalization with measures of interoceptive accuracy. Only among healthy controls CA in the Schandry task was positively correlated with self-rated clearness of body perception. Depersonalization was unrelated to severity of depression or anxiety, while depression and anxiety were highly correlated. Anxiety and depression did not modify the associations of depersonalization with interoceptive accuracy.ConclusionsOur main findings highlight a striking discrepancy of normal interoception with overwhelming experiences of disembodiment in DPD. This may reflect difficulties of DPD patients to integrate their visceral and bodily perceptions into a sense of their selves. This problem may be considered an important target for psychotherapeutic treatment approaches.