Interoception.
Loosely speaking, “Interoception” refers to the processes by which the brain senses and represents information from the peripheral body. Many researchers have articulated the need for a more refined ontology within Interoceptive Science.
helpful RESOURCES
INTroductory readings:
How do you feel? (cited 2,935 times) and How do you feel – now? (cited 3,191 times); These two papers by Bud Craig (2002; 2009) are often credited as having re-popularized research on interoception.
“Interoception and Mental Health: A Roadmap” - Khalsa et al (2018); This article overviews points of consensus among scholars attending the 2016 Laureate Institute for Brain Research Interoception Summit.
“The Interoceptive Mind: From Homeostasis to Awareness” - Tsakiris & De Preester (2018); This edited volume overviews several lines of ongoing research related to interoception.
Facets of interoception:
Many authors have argued that interoception can be be considered to have several dissociable facets. The following papers describe common models of interoceptive facets (and include information about measurement).
“Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness” - Garfinkel et al (2015)
“Interoception and emotion” - Critchley & Garfinkel (2017)
“An Approach to Mapping the Neurophysiological State of the Body to Affective Experience” - Kleckner & Quigley (2014); pg. 276-277
“Classifying individual differences in interoception: Implications for the measurement of interoceptive awareness” - Murphy, Catmur, & Bird (2019)
relevant Anatomy:
“Evidence for a Large-Scale Brain System Supporting Allostasis and Interoception in Humans” - Kleckner et al (2017)
“The pathways of interoceptive awareness” - Khalsa, Rudrauf, Feinstein & Tranel (2009)
“Neural Systems supporting Interoceptive Awareness” - Critchley et al (2004)
“Visceral Influences on brain and behavior” - Critchley & Harrison (2004)
measurement — overview:
Research on interoceptive processes has largely relied on empirical data from healthy human subjects, clinical samples, and animal models. Each of these data sources, however, exhibit key limitations.
Firstly, the ascendance and central processing of peripheral signaling is infamously difficult to manipulate and measure non-invasively in humans. Most studies on interoception have thus utilized the passive measurement of pulsatile signals from the heart, lungs, and gut (e.g., using ECG, piezoelectric sensors, or EMG). Some researchers have employed creative pharmacological manipulations, although findings from these studies are inherently limited by the often volatile and nonspecific actions of pharmacological agents.
Secondly, while clinical models have provided invaluable insight into interoceptive processes, some of the most theoretically relevant conditions (e.g., sympathectomy, vagotomy, or dysautonomia) remain exceedingly rare.
Thirdly, while animal models of interoceptive pathways have garnered major insight, the generalizability of these models are often poor. Empirical work has demonstrated significant heterogeneity in relevant interspecific anatomy (e.g., in limbic cytoarchitecture and connectivity) suggesting differences in the central processing of peripheral afference cross-species. More work needs to be done to parse apart species-general and species-specific adaptations in order to best understand the evolution of interoceptive processes, and their manifestation in humans.
measurement — Cardiac interoception:
Some classics:
Most research on cardiac interoception uses either (1) self-report measures, (2) tracking tasks, or (3) signal detection tasks (see readings on ‘Facets of Interoception’ listed above)
Examples of self-report measures include the MAIA, the BAQ, the BPQ, and the ISQ
The most commonly used tracking task is the Shandry Heartbeat Counting Task
The most commonly used signal detection task is the Whitehead Heartbeat Detection (HBD) task or a variant thereof (e.g., see Brener-Kluvitse method and Method of Constant Stimuli).
Important interpretive caveats for using counting or signal detection methods:
“I feel it in my finger: Measurement device affects cardiac interoceptive accuracy” - Murphy et al (2019)
“Methodological recommendations for a heartbeat detection-based measure of interoceptive sensitivity” - Kleckner et al (2015)
“Visceral Perception versus Visceral Detection: Disentangling Methods and Assumptions” - Pennebaker & Hoover (1984)
“Effects of heartbeat feedback on beliefs about heart rate and heartbeat counting: A cautionary tale about interoceptive awareness” - Ring et al (2015)
“Towards a psychophysics of interoceptive processes: the measurement of heartbeat detection” - Brener & Ring (2016)
“Heartbeat counting is unrelated to heartbeat detection: A comparison of methods to quantify interoception” - Brener & Ring (2018)
“The heartbeat counting task largely involves non-interoceptive processes: Evidence from both the original and an adapted counting task” - Desmedt, Luminet, & Corneillle (2018)
Novel techniques:
Webcam based (remote) photoplethysmography; coming soon (method similar to this)
Heartbeat evoked potential (e.g., Petzschner et al 2019)
measurement — interoception beyond the heart:
Studies investigating the relationship between facets of interoception across modalities (e.g., cardiovascular, respiratory, gastric) have produced mixed findings (some examples below). Additionally, some modalities (e.g., for humoral systems) have yet to be fully explored.
"Multichannel Investigation of Interoception: Sensitivity Is Not a Generalizable Feature" - Ferentzi et al (2018)
"Interoception across Modalities: On the Relationship between Cardiac Awareness and the Sensitivity for Gastric Functions" - Herbert et al (2012)
"An investigation of interoceptive processes across the senses" - Garfinkel et al (2017)
"Interoceptive dimensions across cardiac and respiratory axes" - Garfinkel et al (2016)
"Interoception and Inflammation in Psychiatric Disorders" - Savitz & Harrison (2018)
"A psychology of the human brain-gut-microbiome axis" - Allen et al (2017)
Interoception & Predictive Coding:
"Interoceptive predictions in the brain" - Barrett & Simmons (2015)
"The hierarchical basis of neurovisceral integration" - Smith et al (2017)
"An active inference approach to interoceptive psychopathology" - Paulus, Feinstein & Khalsa (2019)
“'Bodily precision': a predictive coding account of individual differences in interoceptive accuracy” - Ainley et al (2016)
“Unravelling the Neurobiology of Interoceptive Inference” - Allen (2020)