Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness

Biological Psychology

Volumn 104, Issue , 2015, Pages 65-74

  Garfinkel, Sarah N ^a,b   Seth, Anil K ^b   Barrett, Adam B ^b   Suzuki, Keisuke ^b   Critchley, Hugo D ^a,b  

^a BRIGHTON AND SUSSEX MEDICAL SCHOOL   (United Kingdom)

^b UNIVERSITY OF SUSSEX   (United Kingdom)

Author keywords

Anxiety; Emotion; Interoception; Metacognition; Perception; Predictive coding

Indexed keywords

ADULT; ARTICLE; AUDITORY STIMULATION; CONTROLLED STUDY; CORRELATIONAL STUDY; FEMALE; HEARTBEAT DISCRIMINATION TASK; HEARTBEAT TRACKING TASK; HUMAN; HUMAN EXPERIMENT; INTEROCEPTIVE ACCURACY; INTEROCEPTIVE AWARENESS; INTEROCEPTIVE SENSIBILITY; MALE; NORMAL HUMAN; PERCEPTION; PSYCHOLOGIC TEST; QUESTIONNAIRE; STIMULUS RESPONSE; TASK PERFORMANCE; AWARENESS; COGNITION; EMOTION; HEART RATE; INTEROCEPTION; PHYSIOLOGY; SELF CONCEPT; YOUNG ADULT;

ADULT; AWARENESS; COGNITION; EMOTIONS; FEMALE; HEART RATE; HUMANS; INTEROCEPTION; MALE; SELF CONCEPT; SURVEYS AND QUESTIONNAIRES; YOUNG ADULT;

EID: 84916618649     PISSN: 03010511     EISSN: 18736246     Source Type: Journal    
DOI: 10.1016/j.biopsycho.2014.11.004     Document Type: Article

References (75)

1. Asmundson G.J., Sandler L.S., Wilson K.G., Norton G.R. Panic attacks and interoceptive acuity for cardiac sensations. Behaviour Research and Therapy 1993, 31(2):193-197. pii: 0005-7967(93)90071-2.
2. Barrett A.B., Dienes Z., Seth A.K. Measures of metacognition on signal-detection theoretic models. Psychological Methods 2013, 18(4):535-552. 10.1037/a0033268.
3. Barttfeld P., Wicker B., McAleer P., Belin P., Cojan Y., Graziano M., et al. Distinct patterns of functional brain connectivity correlate with objective performance and subjective beliefs. Proceedings of the National Academy of Sciences of the United States of America 2013, 110(28):11577-11582. 10.1073/pnas.1301353110.
4. Bogaerts K., Notebaert K., Van Diest I., Devriese S., De Peuter S., Van den Bergh O. Accuracy of respiratory symptom perception in different affective contexts. Journal of Psychosomatic Research 2005, 58(6):537-543. 10.1016/j.jpsychores.2004.12.005.
5. Brener J., Kluvitse C. Heartbeat detection - Judgments of the simultaneity of external stimuli and heartbeats. Psychophysiology 1988, 25(5):554-561. 10.1111/j.1469-8986.1988.tb01891.x.
6. Cameron O.G. Visceral sensory neuroscience: Interoception 2001, Oxford University Press, New York, USA.
7. Ceunen E., Van Diest I., Vlaeyen J.W.S. Accuracy and awareness of perception: Related, yet distinct (commentary on Herbert et al., 2012). Biological Psychology 2013, 92(2):426-427. 10.1016/j.biopsycho.2012.09.012.
8. Cheesman J., Merikle P.M. Priming with and without awareness. Perception & Psychophysics 1984, 36(4):387-395. 10.3758/Bf03202793.
9. Cheesman J., Merikle P.M. Distinguishing conscious from unconscious perceptual processes. Canadian Journal of Psychology 1986, 40(4):343-367.
10. Clark A. Whatever next? Predictive brains, situated agents, and the future of cognitive science. Behavioral and Brain Sciences 2013, 36(3):181-204. pii: S0140525X12000477. 10.1017/S0140525X12000477.
11. Craig A.D. How do you feel? Interoception: The sense of the physiological condition of the body. Nature Reviews Neuroscience 2002, 3(8):655-666. 10.1038/Nrn894.
12. Craig A.D. Human feelings: Why are some more aware than others?. Trends in Cognitive Sciences 2004, 8(6):239-241. pii: S1364661304001032. 10.1016/j.tics.2004.04.004.
13. Craske M.G., Lang A.J., Tsao J.C., Mystkowski J.L., Rowe M.K. Reactivity to interoceptive cues in nocturnal panic. Journal of Behavior Therapy and Experimental Psychiatry 2001, 32(3):173-190. pii: S0005-7916(01)00033-7.
14. Critchley H.D., Wiens S., Rotshtein P., Ohman A., Dolan R.J. Neural systems supporting interoceptive awareness. Nature Neuroscience 2004, 7(2):189-195. 10.1038/Nn1176.
15. Critchley H.D., Eccles J., Garfinkel S.N. Interaction between cognition, emotion, and the autonomic nervous system. Handbook of Clinical Neurology 2013, 117:59-77. pii: B978-0-444-53491-0.00006-7. 10.1016/B978-0-444-53491-0.00006-7.
16. Damasio A.R., Tranel D., Damasio H.C. Somatic markers and the guidance of behavior: Theory and preliminary testing. Frontal lobe function and dysfunction 1991, Oxford University Press, New York, (pp. xv, 427p.). H.S. Levin, H.M. Eisenberg, A.L. Benton (Eds.).
17. Dienes Z., Berry D. Implicit learning: Below the subjective threshold. Psychonomic Bulletin & Review 1997, 4(1):3-23. 10.3758/Bf03210769.
18. Dienes Z., Perner J. A theory of implicit and explicit knowledge. Behavioral and Brain Sciences 1999, 22(5):735.
19. Dunn B.D., Galton H.C., Morgan R., Evans D., Oliver C., Meyer M., et al. Listening to your heart: How interoception shapes emotion experience and intuitive decision making. Psychological Science 2010, 21(12):1835-1844. 10.1177/0956797610389191.
20. Dunn B.D., Stefanovitch I., Evans D., Oliver C., Hawkins A., Dalgleish T. Can you feel the beat? Interoceptive awareness is an interactive function of anxiety- and depression-specific symptom dimensions. Behaviour Research and Therapy 2010, 48(11):1133-1138. 10.1016/j.brat.2010.07.006.
21. Ehlers A., Breuer P., Dohn D., Fiegenbaum W. Heartbeat perception and panic disorder - possible explanations for discrepant findings. Behaviour Research and Therapy 1995, 33(1):69-76. 10.1016/0005-7967(94)E0002-Z.
22. Ernst J., Boker H., Hattenschwiler J., Schupbach D., Northoff G., Seifritz E., et al. The association of interoceptive awareness and alexithymia with neurotransmitter concentrations in insula and anterior cingulate. Social Cognitive and Affective Neuroscience 2013, 10.1093/scan/nst058.
23. Fairclough S.H., Goodwin L. The effect of psychological stress and relaxation on interoceptive accuracy: Implications for symptom perception. Journal of Psychosomatic Research 2007, 62(3):289-295. 10.1016/j.jpsychores.2006.10.017.
24. Fleming S.M. Relating introspective accuracy to individual differences in brain structure (vol 329, pg 1541, 2010). Science 2012, 336(6082). 670-670.
25. Fleming S.M., Weil R.S., Nagy Z., Dolan R.J., Rees G. Relating introspective accuracy to individual differences in brain structure. Science 2010, 329(5998):1541-1543. 10.1126/science.1191883.
26. Galvin S.J., Podd J.V., Drga V., Whitmore J. Type 2 tasks in the theory of signal detectability: Discrimination between correct and incorrect decisions. Psychonomic Bulletin & Review 2003, 10(4):843-876. 10.3758/Bf03196546.
27. Garfinkel S.N., Critchley H.D. Interoception, emotion and brain: New insights link internal physiology to social behaviour. Commentary on: "Anterior insular cortex mediates bodily sensibility and social anxiety" by Terasawa et al. (2012). Social Cognitive and Affective Neuroscience 2013, 8(3):231-234. 10.1093/Scan/Nss140.
28. Garfinkel S.N., Barrett A.B., Minati L., Dolan R.J., Seth A.K., Critchley H.D. What the heart forgets: Cardiac timing influences memory for words and is modulated by metacognition and interoceptive sensitivity. Psychophysiology 2013, 50(6):505-512. 10.1111/Psyp.12039.
29. Garfinkel S.N., Tiley C., O'Keeffe S., Critchley H.D. Disassociating interoceptive focus and interoceptive accuracy in asperger's syndrome. Psychosomatic Medicine 2013, 75(3). A161-A161.
30. Green D.M., Swets J.A. Signal detection theory and psychophysics 1966, Wiley, New York.
31. Gu X.S., Hof P.R., Friston K.J., Fan J. Anterior insular cortex and emotional awareness. Journal of Comparative Neurology 2013, 521(15):3371-3388. 10.1002/Cne.23368.
32. Hart N., McGowan J., Minati L., Critchley H.D. Emotional regulation and bodily sensation: Interoceptive awareness is intact in borderline personality disorder. Journal of Personality Disorders 2013, 27(4):506-518.
33. Herbert B.M., Muth E.R., Pollatos O., Herbert C. Interoception across modalities: On the relationship between cardiac awareness and the sensitivity for gastric functions. PLoS ONE 2012, 7(5.). 10.1371/journal.pone.0036646.
34. Herbert B.M., Blechert J., Hautzinger M., Matthias E., Herbert C. Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite 2013, 70:22-30. 10.1016/j.appet.2013.06.082.
35. Howard M.W., Bessette-Symons B., Zhang Y.F., Hoyer W.J. Aging selectively impairs recollection in recognition memory for pictures: Evidence from modeling and receiver operating characteristic curves. Psychology and Aging 2006, 21(1):96-106. 10.1037/0882-7974.21.1.96.
36. Katkin E.S., Reed S.D., Deroo C. A methodological analysis of 3 techniques for the assessment of individual-differences in heartbeat detection. Psychophysiology 1983, 20(4). 452-452.
37. Kepecs A., Uchida N., Zariwala H.A., Mainen Z.F. Neural correlates, computation and behavioural impact of decision confidence. Nature 2008, 455(7210):U227-U255. 10.1038/Nature07200.
38. Khalsa S.S., Rudrauf D., Damasio A.R., Davidson R.J., Lutz A., Tranel D. Interoceptive awareness in experienced meditators. Psychophysiology 2008, 45(4):671-677. 10.1111/j.1469-8986.2008.00666.x.
39. King J.R., Dehaene S. A model of subjective report and objective discrimination as categorical decisions in a vast representational space. Philosophical Transactions of the Royal Society B-Biological Sciences 2014, 369(1641). 10.1098/rstb.2013.0204.
40. Knoll J.F., Hodapp V. A comparison between 2 methods for assessing heartbeat perception. Psychophysiology 1992, 29(2):218-222. 10.1111/j.1469-8986.1992.tb01689.x.
41. Lane R.D. Neural substrates of implicit and explicit emotional processes: A unifying framework for psychosomatic medicine. Psychosomatic Medicine 2008, 70(2):214-231. 10.1097/Psy.0b013e3181647e44.
42. Lange C.G., James W. The emotions 1967, Hafner Publishing Co., New York/London, (edited by Knight Dunlap - Reprinted).
43. Lenggenhager B., Azevedo R.T., Mancini A., Aglioti S.M. Listening to your heart and feeling yourself: Effects of exposure to interoceptive signals during the ultimatum game. Experimental Brain Research 2013, 230(2):233-241. 10.1007/s00221-013-3647-5.
44. Mandler G., Mandler J.M., Uviller E.T. Autonomic feedback - the perception of autonomic activity. Journal of Abnormal and Social Psychology 1958, 56(3):367-373. 10.1037/H0048083.
45. Mcfarland R.A. Heart-rate perception and heart-rate control. Psychophysiology 1975, 12(4):402-405. 10.1111/j.1469-8986.1975.tb00011.x.
46. Medford N., Critchley H.D. Interoception and psychopathology. Phenomenological Neuropsychiatry, How Patient Experience Bridges Clinic with Clinical Neuroscience 2014, Springer, New York, in press. A.L. Mishara, P. Corlett, P. Fletcher, A. Kranjec, M.A. Schwartz (Eds.).
47. Paulus M.P., Stein M.B. An insular view of anxiety. Biological Psychiatry 2006, 60(4):383-387. 10.1016/j.biopsych.2006.03.042.
48. Paulus M.P., Stein M.B. Interoception in anxiety and depression. Brain Structure & Function 2010, 214(5-6):451-463. 10.1007/s00429-010-0258-9.
49. Payne R.A., Symeonides C.N., Webb D.J., Maxwell S.R.J. Pulse transit time measured from the ECG: An unreliable marker of beat-to-beat blood pressure. Journal of Applied Physiology 2006, 100(1):136-141. 10.1152/japplphysiol.00657.2005.
50. Phillips G.C., Jones G.E., Rieger E.J., Snell J.B. Effects of the presentation of false heart-rate feedback on the performance of two common heartbeat-detection tasks. Psychophysiology 1999, 36(4):504-510. 10.1017/S0048577299980071.
51. Podsiadlo P., Michel M., Critchley K., Srivastava S., Qin M., Lee J.W., et al. Diffusional self-organization in exponential layer-by-layer films with micro- and nanoscale periodicity. Angewandte Chemie-International Edition 2009, 48(38):7073-7077. 10.1002/anie.200901720.
52. Pollatos O., Gramann K., Schandry R. Neural systems connecting interoceptive awareness and feelings. Human Brain Mapping 2007, 28(1):9-18. 10.1002/Hbm.20258.
53. Pollatos O., Traut-Mattausch E., Schroeder H., Schandry R. Interoceptive awareness mediates the relationship between anxiety and the intensity of unpleasant feelings. Journal of Anxiety Disorders 2007, 21(7):931-943. pii: S0887-6185(06)00232-5. 10.1016/j.janxdis.2006.12.004.
54. Porges S. Body perception questionnaire: Laboratory of development assessment 1993, University of Maryland.
55. Schaefer M., Egloff B., Gerlach A.L., Witthoft M. Improving heartbeat perception in patients with medically unexplained symptoms reduces symptom distress. Biological Psychology 2014, 101:69-76. pii: S0301-0511(14)00154-9. 10.1016/j.biopsycho.2014.05.012.
56. Schandry R. Heart beat perception and emotional experience. Psychophysiology 1981, 18(4):483-488. 10.1111/j.1469-8986.1981.tb02486.x.
57. Schulz A., Lass-Hennemann J., Sutterlin S., Schachinger H., Vogele C. Cold pressor stress induces opposite effects on cardioceptive accuracy dependent on assessment paradigm. Biological Psychology 2013, 93(1):167-174. 10.1016/j.biopsycho.2013.01.007.
58. Seth A.K. Interoceptive inference, emotion, and the embodied self. Trends in Cognitive Sciences 2013, 17(11):565-573. pii: S1364-6613(13)00211-8. 10.1016/j.tics.2013.09.007.
59. Seth A.K., Critchley H.D. Extending predictive processing to the body: Emotion as interoceptive inference. Behavioral and Brain Sciences 2013, 36(3):227-228. 10.1017/S0140525X12002270.
60. Seth A.K., Dienes Z., Cleeremans A., Overgaard M., Pessoa L. Measuring consciousness: Relating behavioural and neurophysiological approaches. Trends in Cognitive Sciences 2008, 12(8):314-321. pii: S1364-6613(08)00151-4. 10.1016/j.tics.2008.04.008.
61. Seth A.K., Suzuki K., Critchley H.D. An interoceptive predictive coding model of conscious presence. Frontiers in Psychology 2011, 2:395. 10.3389/fpsyg.2011.00395.
62. Sherrington C.S. The integrative action of the nervous system 1948, Cambridge Univ. Press, Cambridge, UK.
63. Shields S.A., Mallory M.E., Simon A. The body awareness questionnaire - reliability and validity. Journal of Personality Assessment 1989, 53(4):802-815. 10.1207/s15327752jpa5304_16.
64. Snodgrass M., Shevrin H. Unconscious inhibition and facilitation at the objective detection threshold: Replicable and qualitatively different unconscious perceptual effects. Cognition 2006, 101(1):43-79. 10.1016/j.cognition.2005.06.006.
65. Suzuki K., Garfinkel S.N., Critchley H.D., Seth A.K. Multisensory integration across exteroceptive and interoceptive domains modulates self-experience in the rubber-hand illusion. Neuropsychologia 2013, 51(13):2909-2917. 10.1016/j.neuropsychologia.2013.08.014.
66. Terasawa Y., Shibata M., Moriguchi Y., Umeda S. Anterior insular cortex mediates bodily sensibility and social anxiety. Social Cognitive and Affective Neuroscience 2013, 8(3):259-266. 10.1093/Scan/Nss108.
67. Tsakiris M., Tajadura-Jimenez A., Costantini M. Just a heartbeat away from one's body: Interoceptive sensitivity predicts malleability of body-representations. Proceedings of the Royal Society B-Biological Sciences 2011, 278(1717):2470-2476. 10.1098/rspb.2010.2547.
68. van den Bergh O., Winters W., Devriese S., van Diest I., Vos G., de Peuter S. Accuracy of respiratory symptom perception in persons with high and low negative affectivity. Psychology & Health 2004, 19(2):213-222. 10.1080/08870440410001675627.
69. Werner N.S., Peres I., Duschek S., Schandry R. Implicit memory for emotional words is modulated by cardiac perception. Biological Psychology 2010, 85(3):370-376. 10.1016/j.biopsycho.2010.08.008.
70. Werner N.S., Schweitzer N., Meindl T., Duschek S., Kambeiz J., Schandry R. Interoceptive awareness moderates neural activity during decision-making. Biological Psychology 2013, 94(3):498-506.
71. Whitehead W.E., Drescher V.M. Perception of gastric contractions and self-control of gastric-motility. Psychophysiology 1980, 17(6):552-558. 10.1111/j.1469-8986.1980.tb02296.x.
72. Whitehead W.E., Drescher V.M., Heiman P., Blackwell B. Relation of heart-rate control to heartbeat perception. Biofeedback and Self-Regulation 1977, 2(4):371-392. 10.1007/Bf00998623.
73. Wiebking C., de Greck M., Duncan N.W., Heinzel A., Tempelmann C., Northoff G. Are emotions associated with activity during rest or interoception? An exploratory fMRI study in healthy subjects. Neuroscience Letters 2011, 491(1):87-92. 10.1016/j.neulet.2011.01.012.
74. Wiens S., Palmer S.N. Quadratic trend analysis and heartbeat detection. Biological Psychology 2001, 58(2):159-175. 10.1016/S0301-0511(01)00110-7.
75. Wiens S., Mezzacappa E.S., Katkin E.S. Heartbeat detection and the experience of emotions. Cognition and Emotion 2000, 14(3):417-427.