title: Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness.
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.
authors.affiliation: Psychiatry, Brighton and Sussex Medical School, UK; Sackler Centre for Consciousness Science, University of Sussex, UK. Electronic address: s.garfinkel@bsms.ac.uk.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Garfinkel
authors.affiliation: Sackler Centre for Consciousness Science, University of Sussex, UK; Department of Informatics, University of Sussex, UK.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Seth
authors.affiliation: Sackler Centre for Consciousness Science, University of Sussex, UK; Department of Informatics, University of Sussex, UK.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Barrett
authors.affiliation: Sackler Centre for Consciousness Science, University of Sussex, UK; Department of Informatics, University of Sussex, UK.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Psychiatry, Brighton and Sussex Medical School, UK; Sackler Centre for Consciousness Science, University of Sussex, UK.
authors.forename: Hugo D
authors.initials: HD
authors.lastname: Critchley
mesh_terms: D000328:Adult; D001364:Awareness / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D065812:Interoception / Q000502:physiology*; D008297:Male; D012649:Self Concept; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety; Emotion; Interoception; Metacognition; Perception; Predictive coding