Interoceptive Sensitivity and Emotional Experience

Interoceptive Sensitivity and Self-Reports of Emotional Experience – free full-text /PMC1224728/ – Sep 2005

I’m interested in how my anxiety relates to my EDS, so I plowed through this long article. It appears that “interoceptive sensitivity” (which is usually extreme in people with EDS) seems to be not just a discrete biomarker but also a driver of anxiety (a strong arousal focus).

People differ in the extent to which they emphasize feelings of activation or deactivation in their verbal reports of experienced emotion, termed arousal focus (AF).

Two multimethod studies indicate that AF is linked to heightened interoceptive sensitivity (as measured by performance on a heartbeat detection task).  

People who were more sensitive to their heartbeats emphasized feelings of activation and deactivation when reporting their experiences of emotion over time more than did those who were less sensitive.

This relationship was not accounted for by several other variables, including simple language effects.

Implications for the role of interoception in experienced emotion and the validity of self-reported emotion are discussed.

Above is the abstract, below are annotations from the full article.

Several influential models speculate that explicit, direct access to bodily cues is necessary for the experience of emotion. The purpose of this article is to examine the link between interoceptive access and reports of experienced emotion—specifically, the extent to which people emphasize arousal when reporting their experiences over time, or arousal focus (AF; Feldman, 1995; )

In doing so, we shed light on the role of interoception in experienced emotion, describe a novel paradigm for the treatment of self-report data, and provide incremental validity for self-reports of experienced emotion.

Arousal as a Property of Affective Judgments

Activation is a ubiquitous property of affective judgments. Usually, when individuals report on their own experiences of emotion, part of what they report is feeling energized and attentive on the one hand versus relaxed and sleepy on the other.

Factor analytic studies of self-reported mood repeatedly have found activation or arousal as a descriptive component of such self-reports,

Arousal also emerges as a crucial property when judging the emotion of others, such as when judging the emotion in the facial expressions of others.

Activation is even a component of the language that is used to communicate emotion. Degree of arousal, in part, characterizes the adjectives that make up self-report scales of emotional experience.

Arousal and the Experience of Emotion

In psychological science, it is often assumed that arousal is essential to the experience of emotion: People perceive emotional feelings in their bodies.

The architectures of the central and peripheral nervous systems produce undifferentiated or ambiguous patterns of autonomic and visceral activity that are not sufficient to produce specific feeling states, suggesting that feelings of anger, fear, and so on do not derive their phenomenological character from specific patterns of somatovisceral activity.

Moreover, different measures of autonomic, somatic, or cortical arousal tend not to correlate highly with one another, such that “arousal” is not a unitary phenomenon.

Obviously, patterns of autonomic and somatic responses relate in some way to feeling active and alert, slowed down and sleepy, or angry or sad, but there is no simple, one-to-one correspondence.

Although information from the body does not automatically translate into feelings, and people are susceptible to misperception, people can, at times, detect specific information in their bodies, and this sensitivity may be in some way related to the experience of emotion.

There is considerable intra- and interindividual variation in the ability to accurately perceive internal bodily states. People are more sensitive to their somatovisceral states in some situations (e.g., during exercise) than in others (e.g., during rest).

The biological consequences of having EDS or JHS (Joint Hypermobility Syndrome) predispose us to be more aware of our internal bodily (somatovisceral) states.

More importantly for our concerns, some people are more accurate in their ability to detect explicit cues to autonomic arousal, like heartbeat.

It has been argued that access to such somatovisceral information is the substrate for the subjective experience of feelings in humans (for a review, see Craig, 2002).

Afferent information from the body that is needed for homeostasis (like information about temperature, pain, autonomic status, etc.) is re-represented in the anterior insular cortex and other parts of a larger system (including anterior cingulate cortex, limbic motor areas, and orbital frontal cortex) thought to be responsible for the subjective experience of feelings in humans

In particular, right anterior insular cortex seems to mediate attention to and explicit awareness of internal bodily cues. Individuals who are more interoceptively sensitive to their heartbeats show greater insular activation than those who are less sensitive

If such explicit representation of bodily cues is one basis for subjective feeling states, then individuals who are more sensitive to their somatovisceral cues will differ in the feelings that they experience and report compared with those who are less sensitive.

Interoception and the Experience of Emotion

In psychology, interoception is usually defined as visceroperception or detecting signals arising from the inner organs.

General interoceptive sensitivity is typically indexed using performance on a heartbeat detection task, where participants judge whether an external stimulus (a tone) is coincident (or not) with their heartbeats.

The ability to detect heartbeats can be correlated with the ability to detect changes in other autonomically innervated organs, although this is not always the case.

Studies examining the link between interoception and the experience of emotion have generally examined whether better heartbeat detection translates into greater intensity of self-reported emotional experience, with inconsistent results.

The inconsistent link between interoception and reports of experienced emotion may be due to two factors.

1. The first has to do with the conceptualization and measurement of heartbeat detection performance. Most studies that examine the link between heartbeat detection and the experience of emotion categorize participants into good versus poor heartbeat detectors.

Sensitivity is defined as an observer’s ability to accurately detect the presence or absence of target information, here the presence (or absence) of heartbeats, and specifically whether they are coincident (or not) with tones delivered during a heartbeat detection task

Sensitivity varies because of differences in perceptual abilities, among other things.

2. The inconsistent link between interoception and reports of experienced emotion may also have resulted from conceptualization and measurement of experienced emotion. Most studies have examined the link between heartbeat detection and explicit ratings of the intensity of emotion experience. 

Meta-Analytic Summary

Both Studies 1 and 2 tested the relationships between heartbeat detection performance and a host of emotional experience–related variables—most importantly, the relationship to AF.

General Discussion

Several of the most influential emotion theories of the past century have assumed that direct and explicit detection of arousal cues plays a crucial role in the experience of emotion.

Although there is growing evidence that somatovisceral information from the body influences thoughts, feelings, and behaviors in a bottom-up way (Berntson, Sarter, & Cacioppo, 2003), empirical evidence consistently linking interoception to the experience of emotion has remained elusive.

In this article, we report a consistent link between one form of interoceptive access (heartbeat detection sensitivity) and feelings of activation and deactivation as they are implicitly communicated in self-reports of experienced emotion (that is, AF indices computed on data compiled during several weeks of experience sampling).

In our studies, participants described their moment-to-moment feelings by rating a series of emotion-related adjectives on standard Likert-type scales, and their ratings were treated as behaviors from which implicit information was extracted.

This emphasis on arousal-related experience was related to participants’ interoceptive sensitivity as indexed by their performance on a heartbeat detection task across two studies:

The more that an individual was able to accurately perceive his or her own heartbeat well enough to correctly judge the temporal relationship between them and a set of delivered tones, the more that individual emphasized feelings of activation and deactivation in emotion reports during the experience-sampling procedure.

The relation that we observed between AF and heartbeat detection sensitivity was specific and precise.

Interoceptive sensitivity displayed a specific relationship to AF.

individuals who were more sensitive to their heartbeats showed a specific attention or emphasis to the arousal-based properties of words only when reporting on their own subjective emotional states.

Interoception and the Experience of Emotion

Our findings suggest the intriguing hypothesis that direct and explicit attention to and representation of interoceptive cues is more important to the emotional experiences of some individuals than to the experiences of others.

This seems obvious to me, but in these scientific studies, researchers are looking for consistency in their results. In general, such research has always sought to prove something by calculating some sort of average response.

But averages hide variability.

Among 10 people reporting a result, like the efficacy of a medication on a scale of 1 to 10, completely different scenarios can result in an average response of “5” :

  1. 5 people report “1” and the other 5 report “10” with no values in between.
    This would happen if a medication worked very well for half the people and not at all for the other half. (I suspect this is often the case, but it’s hidden in the statistics.)
  2. 5 people report “4” and the others report “6”.
    This happens if the medication is somewhat effective for everyone.

Some individuals incorporated feelings of activation and deactivation into their reports of experienced emotion, whereas others did so to a lesser extent.

Everyone reported conscious feelings, but the properties of those feelings differed in a way that was related to their heartbeat detection performance.

The implication, then, is that one static, nomothetic theory of emotional experience may not apply equally to everyone.

Bravo! Here they are willing to state what most patients are only too aware of: all these “standards of care” that are being developed for various aspects of healthcare are dangerously mistaken because we are all individuals, not averages.

Incremental Validity for Self-Reports of Emotional Experience

Our findings not only provide validity for the link between interoceptive sensitivity and experienced emotion, then, but they also provide much-needed incremental validity for self-reports of emotional experience.

First, these are some of the first findings to show that information implicitly contained in self-report ratings (i.e., the extent to which people focus on a property of their experience when reporting it) is associated with a behavioral variable (heartbeat sensitivity).

Second, many of the studies that provide validity evidence for self-reports of emotional experience have examined concurrent relationships between self-reports and validity variables.

Construct Validity of AF

Our findings also provide evidence for the validity of AF as a new individual difference variable.

When verbally reporting their feeling states, people can use the same emotion words very differently.

Is this a surprise to anyone? How you describe anything in your environment depends on your cultural background, your history, your sensitivity, your language, your vocabulary,  and countless other factors.

For example, anxious is characterized as an activated, unpleasant state. Yet, the word anxious can be used to communicate a feeling of anticipation, emphasizing high activation (as in “I am anxious to do this”); a feeling of nervousness, emphasizing both activation and displeasure; or a feeling of displeasure (as in “I am upset”).

Nonetheless, we have provided a plausible explanation for why greater sensitivity to heartbeats is related to an emphasis on activation and deactivation in self-reports:

Feelings drive the verbal report such that self-reports of emotional experience contain information about how people feel.

Unexpectedly, AF was related to the response style that participants used during the heartbeat detection task.

Specifically, individuals who emphasized activation and deactivation more during the self-report process had an increasingly cautious or strict criterion for saying “yes, the tones match my heartbeats.”

it suggests that individuals with higher AF seemed to be using a judgment strategy designed to decrease false alarms and increase correct rejections, although it is not clear why they would do so.

In general, a respondent’s judgment criterion is influenced by three factors:

(a) his or her beliefs about the base rates of the event,

(b) the goals that she or he has when making a judgment about the event and

(c) the perceived severity and consequences of a miss or false alarm

The Scientific Value of Interoception

We found that interoceptive sensitivity was related to real-world reports of experience.

This counters the concern, raised by Dworkin (2000), that conscious visceral perception is nothing more than a fragile laboratory curiosity.

It also quells the concern that sensitivity is rarely meaningful in relation to other psychological variables (cf. Vaitl, 1996).

I guess that means that research on humans must account for variations in the “feelings” of participants, which is apparently ignored in almost all studies.


this report has made an important advance in our understanding and measurement of experienced emotion.

By relying on what people tell us about their experiences and analyzing those phenomenological reports for information that they implicitly contain, we have established an important link between interoceptive sensitivity and reports of experienced emotion.

First, our findings suggest the intriguing hypothesis that interoceptive cues may be more important to the experience of emotion for some individuals than for others.

Second, our findings provide bounded incremental validity for self-reports of emotional experience. They offer important empirical evidence to support those who already believe that self-reports are valid and to challenge skeptics who are quick to dismiss self-reports as unscientific.

Psychological measures are not inherently valid or invalid—it is how they are used that matters.

None of the findings reported here were based on participants’ beliefs about their own abilities. Interoceptive sensitivity was indexed by an objective heartbeat detection procedure.

Finally, our findings contribute to a developing research program that attempts to leverage verbal reports of experienced emotion to learn something about the processes related to the experiences themselves.

They suggest that it may be possible to offer evidence for what people feel by examining how they represent their feelings.

I’m surprised this is a scientific finding when we all know that what people say about how they feel is actually how they feel. But scientists have a hard time with the vast variety of human responses in their studies.

Humans are simply not “standard”:

they don’t have “standard” reactions and
they don’t give “standard” verbal responses.

Simply observing the patterns in what people say about their feelings over time may provide an empirical basis to begin understanding the processes by which people come to verbally represent their feelings and, perhaps someday, how they generate those feelings in the first place.

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