Interoception in Health and Disease: Theoretical and Methodological Considerations

Engaging with the external world around us is supported in part by interoception, the brain’s continual monitoring of the physiological condition of the body. In recent years, interoception research has garnered much attention in neuroscience and psychology as a potential mechanism to understand how our brains function in health and in disease. Under recent models, such as predictive coding accounts of interoception, these ongoing interoceptive processes have been proposed to support allostasis, which is the brain’s anticipation and adaptation of the physiological environment in order to meet future demands before they become urgent. Aberrant interoceptive processing can occur across different syndromes and has been linked to the allostatic-interoceptive network, a large-scale domain-general network including brain regions such as the anterior cingulate cortex, insula, and orbitofrontal cortex. In this chapter, we review the definitions and theoretical accounts of interoception. Next, we explore the multifaceted nature of interoception by reviewing the various ways in which interoception has been measured. Further, we propose considerations for designing interoceptive protocols, as well as appropriateness of measures based on study populations. Finally, we consider evidence for the transdiagnostic value of interoceptive measures across various clinical syndromes, including neurodevelopmental, psychiatric, neurological, and neurodegenerative conditions. By investigating common and divergent profiles of interoception across a range of syndromes, we will be able to refine synergistic models of brain health and disease.