Individuals differ in their awareness of afferent information from within their bodies, which is typically assessed by a heartbeat perception measure of 'interoceptive accuracy' (IAcc). Neural and behavioural correlates of this trait have been investigated, but a theoretical explanation has yet to be presented. Building on recent models that describe interoception within the free energy/predictive coding framework, this paper applies similar principles to IAcc, proposing that individual differences in IAcc depend on 'precision' in interoceptive systems, i.e. the relative weight accorded to 'prior' representations and 'prediction errors' (that part of incoming interoceptive sensation not accounted for by priors), at various levels within the cortical hierarchy and between modalities. Attention has the effect of optimizing precision both within and between sensory modalities. Our central assumption is that people with high IAcc are able, with attention, to prioritize interoception over other sensory modalities and can thus adjust the relative precision of their interoceptive priors and prediction errors, where appropriate, given their personal history. This characterization explains key findings within the interoception literature; links results previously seen as unrelated or contradictory; and may have important implications for understanding cognitive, behavioural and psychopathological consequences of both high and low interoceptive awareness.This article is part of the themed issue 'Interoception beyond homeostasis: affect, cognition and mental health'.

Interoceptive sensitivity is an essential component of recent models of 'the self'. Increased focus on the self (e.g. self-observation in a mirror) can enhance aspects of self-processing. We examined whether self-observation also enhances interoceptive sensitivity. Participants performed a heartbeat detection task while looking at their own face in a mirror or at a black screen. There was significant improvement in interoceptive sensitivity in the mirror condition for those participants with lower interoceptive sensitivity at baseline. This effect was independent of the order of conditions, gender, age, body mass index, habitual exercise and changes in heart rate. Our results suggest that self-observation may represent a viable way of manipulating individuals' interoceptive sensitivity, in order to directly test causal relations between interoceptive sensitivity and exteroceptive self-processing.

Background‘Self-objectification’ is the tendency to experience one's body principally as an object, to be evaluated for its appearance rather than for its effectiveness. Within objectification theory, it has been proposed that self-objectification accounts for the poorer interoceptive awareness observed in women, as measured by heartbeat perception. Our study is, we believe, the first specifically to test this relationship.Methodology/Principal FindingsUsing a well-validated and reliable heartbeat perception task, we measured interoceptive awareness in women and compared this with their scores on the Self-Objectification Questionnaire, the Self-Consciousness Scale and the Body Consciousness Questionnaire. Interoceptive awareness was negatively correlated with self-objectification. Interoceptive awareness, public body consciousness and private body consciousness together explained 31% of the variance in self-objectification. However, private body consciousness was not significantly correlated with interoceptive awareness, which may explain the many nonsignificant results in self-objectification studies that have used private body consciousness as a measure of body awareness.Conclusions/SignificanceWe propose interoceptive awareness, assessed by heartbeat perception, as a measure of body awareness in self-objectification studies. Our findings have implications for those clinical conditions, in women, which are characterised by self-objectification and low interoceptive awareness, such as eating disorders.

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