Mehling Wolf
Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA
Philos Trans R Soc Lond B Biol Sci. 2016 Nov 19;371(1708). doi: 10.1098/rstb.2016.0013. Epub 2016 Oct 10.
Based on prior research, multiple discriminable dimensions of interoception have been defined: awareness, accuracy and sensibility. Some investigators defined interoceptive awareness as metacognitive awareness of interoceptive accuracy, assessed as correspondence between subjective confidence in and objective accuracy of one's heartbeat detection. However, metacognitive awareness has been understood quite differently: 'a cognitive set in which negative thoughts/feelings are experienced as mental events, rather than as the self' or as 'error awareness'. Interoceptive sensibility, defined as self-reported interoception, distinguishes self-reported interoception from objective interoceptive accuracy, but does not differentiate between anxiety-driven and mindful attention styles towards interoceptive cues, a distinction of key clinical importance: one attention style is associated with somatization and anxiety disorders; the other has been viewed as healthy, adaptive, resilience-enhancing. The self-report Multidimensional Assessment of Interoceptive Awareness was developed to differentiate these attention styles. It has been translated into 16 languages and applied in cross-sectional and longitudinal studies. Findings from these applications suggest that differentiating interoceptive sensibility according to attention style and regulatory aspects (i) provides insights into the psychology of interoceptive awareness, (ii) differentiates between clinically maladaptive and beneficial interoceptive attention, and (iii) helps elucidate therapeutic approaches that claim to provide health benefits by training mindful styles of bodily awareness.This article is part of the themed issue 'Interoception beyond homeostasis: affect, cognition and mental health'.
基于先前的研究，已定义了内感受的多个可区分维度：意识、准确性和敏感性。一些研究者将内感受意识定义为对内感受准确性的元认知意识，通过个体对心跳检测的主观信心与客观准确性之间的对应关系来评估。然而，对元认知意识的理解却大不相同：“一种认知状态，其中负面思想/情感被体验为心理事件，而非自我”或“错误意识”。内感受敏感性被定义为自我报告的内感受，它将自我报告的内感受与客观的内感受准确性区分开来，但并未区分对内感受线索的焦虑驱动型和正念关注型，这一区分具有关键的临床重要性：一种关注方式与躯体化和焦虑症相关；另一种则被视为健康、适应性强且能增强复原力的。自我报告的内感受意识多维评估工具的开发就是为了区分这些关注方式。它已被翻译成16种语言，并应用于横断面研究和纵向研究。这些应用的结果表明，根据关注方式和调节方面来区分内感受敏感性：（i）有助于深入了解内感受意识的心理学；（ii）区分临床上适应不良和有益的内感受关注；（iii）有助于阐明那些声称通过训练正念式身体意识来提供健康益处的治疗方法。本文是主题为“超越内稳态的内感受：情感、认知与心理健康”的特刊的一部分。
