Interoceptive dimensions across cardiac and respiratory axes

Abstract

Interoception refers to the sensing of signals concerning the internal state of the body. Individual differences in interoceptive sensitivity are proposed to account for differences in affective processing, including the expression of anxiety. The majority of investigations of interoceptive accuracy focus on cardiac signals, typically using heartbeat detection tests and self-report measures. Consequently, little is known about how different organ-specific axes of interoception relate to each other or to symptoms of anxiety. Here, we compare interoception for cardiac and respiratory signals. We demonstrate a dissociation between cardiac and respiratory measures of interoceptive accuracy (i.e. task performance), yet a positive relationship between cardiac and respiratory measures of interoceptive awareness (i.e. metacognitive insight into own interoceptive ability). Neither interoceptive accuracy nor metacognitive awareness for cardiac and respiratory measures was related to touch acuity, an exteroceptive sense. Specific measures of interoception were found to be predictive of anxiety symptoms. Poor respiratory accuracy was associated with heightened anxiety score, while good metacognitive awareness for cardiac interoception was associated with reduced anxiety. These findings highlight that detection accuracies across different sensory modalities are dissociable and future work can better delineate their relationship to affective and cognitive constructs. This article is part of the themed issue ‘Interoception beyond homeostasis: affect, cognition and mental health’.

The neurobiology of interoception in health and disease

“…[18][19][20] Indeed, these two tasks are widely and principally used to indicate accuracy, although empirical assessments often use only one of the methods as a sole proxy for interoceptive ability, with the majority of the current work dependent on the heartbeat-tracking task. [21][22][23][24] The two cardiac interoceptive tasks tap into different processes, 25 with the tracking task based on the sensing of internal physiological information, but also potentially amenable to higher order influences such as knowledge about heartrate; 26 and the discrimination task requiring coupling information proceeding from exteroceptive and interoceptive channels. 10,27 Both tasks share similar and distinct functional architecture.…”

“…29 Moreover, performance on these two cardiac tasks can diverge, 30 and the relationship between heartbeat perception and other bodily axes of interoception, such as respiration and gut, is scarce and inconsistent. 25,31,32 Therefore, the generalizability of findings derived from the heartbeat-tracking task is questionable. From an IPP perspective, sensory evidence or predictions related to certain modalities may be weighted more heavily than that of other modalities.…”

Heartbeat counting is unrelated to heartbeat detection: A comparison of methods to quantify interoception

“…In other words, a third variable 1 We do not deal here with evidence for a general interoceptive sensitivity or, if it exists, whether cardioceptive sensitivity is a valid index of this general sensory characteristic. However, several researchers have presented evidence on this issue, (e.g., Garfinkel et al, 2016;Herbert & Pollatos, 2012;Kollenbaum, Dame, & Kirchner, 1996;Steptoe & Noll, 1997;Whitehead & Drescher, 1980). (e.g., attention, effort) may be responsible for the relationship reported between HBC performance and HEP amplitudes.…”

Interoception beyond homeostasis: affect, cognition and mental health

“…Despite recent advances [29,30,32], there is consensus that interoception research must develop a more grounded measurement model, applicable across disciplines, that permits a fuller characterization of the links between different interoceptive systems, if interoception is to maintain its growing status within psychology. This ambitious aim necessitates wide-ranging, dedicated and systematic theoretical and methodological enquiries into (i) horizontal relations across interoceptive modalities, (ii) hierarchical relations in interoceptive processing, and (iii) causal relations between objective interoception, subjective experience and metacognitive awareness, instead of mere correlations between them.…”