How are interoceptive attention, awareness, detection, sensibility, and accuracy defined and operationalized across studies?

Objective detection versus self-report: two different kinds of measurement

The clearest split in interoception research is between tasks that measure what a person can actually detect and questionnaires that measure what a person believes or notices. Interoceptive accuracy is the objective side: it is defined as the ability to accurately detect interoceptive information, and it is operationalized with performance tasks such as heartbeat detection [2][4]. Interoceptive sensibility is the self-report side: it is defined as an individual's beliefs about his or her interoceptive abilities, and it is operationalized with questionnaires such as the Multidimensional Assessment of Interoceptive Awareness (MAIA) [2]. Interoceptive attention is also self-reported, but it refers to how much a person notices internal sensations rather than to beliefs about ability [1].

This distinction matters because the two kinds of measurement can diverge. A study using the Interoceptive Attention Scale, designed to match the sensations covered by an existing accuracy questionnaire, found support for a distinction between self-reported interoceptive attention and self-reported interoceptive accuracy [1]. In other words, how much someone says they notice internal sensations is not the same as how accurate they believe they are at detecting them. The same study also found that how people interpreted the questionnaire items altered the associations between measures, suggesting that self-report scores depend partly on what respondents think the questions are asking [1].

Why 'interoceptive awareness' can mean different things in different papers

Interoceptive awareness is the most slippery term because it is used at two levels. In some work it is an umbrella label for the whole set of interoceptive processes, and it is operationalized with a multidimensional self-report measure, the MAIA, which assesses several mind-body components [3]. In other work, interoceptive awareness is used more narrowly to mean the correspondence between objective interoceptive accuracy and subjective interoceptive sensibility [5]. These are not the same construct: one is a broad questionnaire score, the other is a relationship between a task score and a questionnaire score.

The MAIA itself treats awareness as multidimensional rather than a single quantity. A Norwegian validation of the MAIA-2 found that an eight-factor model fit best, meaning the questionnaire is scored as eight separate components rather than one overall awareness number [3]. That structure is consistent with the idea that 'interoceptive awareness' in self-report research is not one thing but a family of related tendencies.

The brain evidence points to separate constructs, not one shared system

If accuracy and sensibility were just two ways of measuring the same underlying ability, they should relate to similar brain systems. A resting-state functional connectivity study found otherwise. Interoceptive sensibility, measured with the MAIA, correlated negatively with functional connectivity of visual regions and positively with two MAIA subscales in the cerebellar resting-state network [2]. Crucially, functional connectivity of the insula, a structure critical for interoceptive accuracy, was not correlated with any MAIA score [2].

The authors interpret this as evidence that the brain areas associated with individual differences in interoceptive sensibility show relatively little overlap with those involved in the accurate detection of interoceptive information [2]. This is a correlational finding in 28 healthy participants, so it indicates that the two constructs have different neural correlates rather than proving they are fully independent. Still, it reinforces the measurement distinction: a self-report score and a detection task are not interchangeable proxies for one another.

What this means when you read an interoception study

The practical consequence is that the label alone does not tell you what was measured. A study reporting 'interoceptive accuracy' is almost certainly reporting a task performance score, such as heartbeat detection [4]. A study reporting 'interoceptive sensibility' is reporting a questionnaire score about beliefs or perceived sensitivity [2]. A study reporting 'interoceptive attention' is reporting how much someone says they notice internal sensations [1]. And a study reporting 'interoceptive awareness' could be reporting either a broad multidimensional questionnaire score [3] or a computed correspondence between task and questionnaire [5].

Because these constructs are operationalized differently, findings about one should not be assumed to transfer to another. The dissociation between self-reported attention and self-reported accuracy [1], and the limited overlap between the brain correlates of sensibility and accuracy [2], both suggest that treating them as a single 'interoception' variable would blur distinct phenomena. The safest reading is to check the measure, not just the term.

Sources used in this answer

Related research questions