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'.

Keywords: anxiety; body perception; interoception; mindfulness; respiration; somatosensory.

Figure 1.

Metacognitive awareness across the senses. Interoceptive metacognitive awareness was related across cardiac and respiratory axes; thus the propensity to know you are good, or know you are bad at interoceptive detection was stable across these two systems. By contrast, neither of these meta-awareness measures correlated with the exteroceptive control of touch acuity. (Online version in colour.)

Figure 2.

Accuracy was equated across the senses (touch, respiratory, cardiac); nevertheless, individuals were more confident in their respiration performance and had greater metacognitive awareness into their tactile performance.

Figure 3.

Confidence–accuracy correspondence within senses. Only for tactile acuity was there a correspondence between how accurate they were and their average confidence rating, thus indicating that, at the broad group level, subjective and objective dimensions were aligned. By contrast, there was no significant relationship between confidence and accuracy for both respiration and cardiac interoception. (Online version in colour.)

Figure 4.

Relationship of interoception with anxiety. Anxiety symptomatology was negatively related to cardiac metacognitive awareness (i.e. cardiac interoceptive awareness). Thus, the greater insight individuals had into their interoceptive proficiency the lower their anxiety levels. Regarding respiration, actual interoceptive accuracy was the critical predictor, with reduced anxiety associated with greater accuracy in determining the presence of low resistance filters. Each filter represents a resistance of 34 cm H₂O l⁻¹ s⁻¹; thus a lower filter level relates to better performance accuracy. (Online version in colour.)