Making sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy

Forkmann, Thomas; Scherer, Anne; Meessen, Judith; Michal, Matthias; Schächinger, Hartmut; Vögele, Claus; Schulz, André

doi:10.1016/j.ijpsycho.2016.09.019

Cited by 122 publications

(105 citation statements)

References 52 publications

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“…It was found that, although both tasks yielded reliable accuracy measures, heartbeat counting scores were unrelated to heartbeat detection scores in this sample of university students. This evidence adds to previous findings that heartbeat counting scores are uncorrelated with heartbeat detection scores on two‐alternative forced‐choice tasks (Forkmann et al, ; Kandasamy et al, ; Knoll & Hodapp, ; Phillips et al, ; Schulz et al, ; Weisz et al, ).…”

Section: Discussionsupporting

confidence: 81%

“…However, the observation that approximately half the participants (8/17) whose PS were 5 0.80 failed to meet the statistical criteria for classification as heartbeat detectors suggests that their PS were based on processes other than heartbeat counting students. This evidence adds to previous findings that heartbeat counting scores are uncorrelated with heartbeat detection scores on two-alternative forced-choice tasks (Forkmann et al, 2016;Kandasamy et al, 2016;Knoll & Hodapp, 1992;Phillips et al, 1999;Schulz et al, 2013;Weisz et al, 1988).…”

Section: Discussionsupporting

confidence: 78%

“…Thus, cases for the validity of both the HBC and six‐interval HBD measures have been presented by proponents of these methods while questions of their validity have been raised by critics of each of the methods. Some investigators have reported that performance on the HBC task is related to HBD performance on two‐alternative forced‐choice tasks (Hart, McGowan, Minati, & Critchley, ; Knoll & Hodapp, ), but others have found performance on the two tasks to be uncorrelated (Forkmann et al, ; Kandasamy et al, ; Phillips et al, ; Schulz, Lass‐Hennemann, Sutterlin, Schachinger, & Vogele, ; Weisz et al, ), also see Knoll & Hodapp () . In this context, the current experiment was undertaken in order to clarify the extent to which the HBC task (Schandry, ) and the six‐interval HBD task (Brener et al, ) measure the same or different abilities.…”

Section: Introductionmentioning

confidence: 99%

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

2018

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Recent research has identified individual differences in interoceptive sensitivity as a key source of variation in action, cognition, and emotion. This research has relied heavily on a single method for assessing interoceptive sensitivity: the accuracy of counting heartbeats while at rest. The validity of this method was assessed here by comparing the heartbeat counting (HBC) performance of 48 individuals with their heartbeat detection (HBD) performance. The HBC task required participants to report the numbers of heartbeats counted during brief signaled periods and indexed cardioceptive accuracy by the difference between the numbers of reported and actual heartbeats. In the HBD task, participants indicated the temporal location of heartbeat sensations relative to the onset of ventricular contraction. On each trial, they judged whether heartbeat sensations were or were not simultaneous with brief tones presented at one of six fixed delays following R waves of the ECG. In this method, cardioceptive accuracy or precision was indexed by variability in the temporal locations, relative to the R wave, of tones judged to be simultaneous with heartbeat sensations. Although intratask correlations indicated that each method yielded reliable scores, intertask correlations showed that HBC scores were unrelated to HBD scores. These results, which indicate that heartbeat detection and heartbeat counting are distinct processes, raise important questions about the assessment of interoceptive sensitivity and the involvement of this attribute in the psychological processes that have been associated with it on the basis of their correlations with HBC performance.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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

2018

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“…Recent functional connectivity studies have also shown that connectivity of the insula at rest [Chong et al, 2016] and during task (Kuehn et al, 2016] is related to IA measured outside of the scanner. Interestingly, objective measures of IA are not always correlated with subjective measures of IS [Ceunen et al, 2013;Forkmann et al, 2016;Garfinkel et al, 2015;Khalsa et al, 2008;Meessen et al, 2016;Mehling, 2016;Whitehead et al, 1977]. For example, depression is associated with reduced IA (heartbeat detection accuracy) [Limmer et al, 2015;Pollatos et al, 2009] but increased self-reported IS [Grossi et al, 2017;Limmer et al, 2015], a dissociation that has also been found in autism spectrum disorder [Garfinkel et al, 2016].…”

Section: Introductionmentioning

confidence: 99%

Neural correlates of interoception: Effects of interoceptive focus and relationship to dimensional measures of body awareness

Stern

Grimaldi

Muratore

et al. 2017

Human Brain Mapping

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Interoception has been defined as the sensing of the physiological condition of the body, with interoceptive sensibility (IS) characterizing an individual's self-reported awareness of internal sensation. IS is a multidimensional construct including not only the tendency to be aware of sensation, but also how sensations are interpreted, regulated, and used to inform behavior, with different dimensions relating to different aspects of health and disease. Here we investigated neural mechanisms of interoception when healthy individuals attended to their heartbeat and skin temperature, and examined the relationship between neural activity during interoception and individual differences in self-reported IS using the Multidimensional Scale of Interoceptive Awareness (MAIA). Consistent with prior work, interoception activated a network involving insula and sensorimotor regions but also including occipital, temporal, and prefrontal cortex. Differences based on interoceptive focus (heartbeat vs. skin temperature) were found in insula, sensorimotor regions, occipital cortex, and limbic areas. Factor analysis of MAIA dimensions revealed 3 dissociable components of IS in our dataset, only one of which was related to neural activity during interoception. Reduced scores on the third factor, which reflected reduced ability to control attention to body sensation and increased tendency to distract from and worry about aversive sensations, was associated with greater activation in many of the same regions as those involved in interoception, including insula, sensorimotor, anterior cingulate, and temporal cortex. These data suggest that self-rated interoceptive sensibility is related to altered activation in regions involved in monitoring body state, which has implications for disorders associated with abnormality of interoception.

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“…Research supports that interoception is a multi-faceted construct (Forkmann et al, 2016;Garfinkel, Seth, Barrett, Suzuki & Critchley, 2015;Khalsa et al, 2018), and scholars typically distinguish between three domains: interoceptive accuracy (IAcc), which describes the objective detection and tracking of internal bodily sensations with behavioural measures such as heartbeat perception tasks (e.g. Schandry, 1981;Whitehead, Drescher, Heiman & Blackwell, 1977); interoceptive sensibility (IS) which refers to self-reported awareness of internal bodily sensations via questionnaires (e.g.…”

mentioning

confidence: 99%

Reduction of auditory input improves performance on the heartbeat tracking task, but does not necessarily enhance interoception

Todd

Hina

Aspell

2019

Preprint

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Word Count: 198Abstract Previous research utilising a between-subjects design indicates that the use of noisedampening ear-protectors might enhance interoceptive accuracy (IAcc). In the present study, we further examined this effect using a repeated-measures, within-participants design, and investigated potential mechanisms that might explain the effect. 50 participants completed the heartbeat tracking task (HTT) with and without the use of ear-protectors, in a counterbalanced order. Participants were asked to count the number of heartbeats occurring in five discrete time intervals of 25, 35, 45, 55 and 95 seconds, without feeling for a manual pulse.HTT scores were significantly higher when ear-protectors were worn, and the improvement in performance was greatest for participants with lower baseline IAcc. Participants also performed more consistently across the five trials when wearing the ear-protectors. The earprotectors were associated with significantly increased self-reported heartbeat audibility, concentration, and task-related confidence, and decreased levels of distractibility. Heartbeat audibility was also correlated with HTT performance when the ear-protectors were worn. The exteroceptive nature of the feedback from the ear-protectors therefore precludes the utility of this manipulation to assess causal hypotheses related to changes in IAcc. However, it may serve as a simple, non-invasive paradigm to assess the effects of externalised interoceptive signals. Highlights• Ear-protectors elicit an improvement in performance on the heartbeat tracking task • This improvement is greatest for participants with lower baseline accuracy • The improvement is associated with the auditory perception of the heartbeat • Prior use of ear-protectors did not result in later enhanced performance on the control condition without ear-protectors.

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Making sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy

Cited by 122 publications

References 52 publications

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

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

Neural correlates of interoception: Effects of interoceptive focus and relationship to dimensional measures of body awareness

Reduction of auditory input improves performance on the heartbeat tracking task, but does not necessarily enhance interoception

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