Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness

TLDR

Interoception, the sensing of internal bodily changes, is linked to cognition and emotion, yet inconsistent definitions and measurements have prompted the development of a three‑dimensional model. The study empirically tests the dissociation among interoceptive accuracy, sensibility, and awareness. Using a normative sample of 80 participants, the authors measured interoceptive accuracy with heartbeat‑detection tasks, sensibility with self‑report questionnaires, and awareness via confidence‑accuracy correspondence, demonstrating that the three dimensions are distinct. Accuracy was only partially predicted by awareness and sensibility, and significant correspondence among dimensions appeared only in participants with the highest accuracy, underscoring the need to consider the balance of accuracy, sensibility, and awareness when linking interoception to cognition, emotion, and clinical outcomes.

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.