Interoception research 40 years later - Revisiting James Pennebaker's critique

Fourty years ago, James Pennebaker and colleagues criticized five implicit assumptions of interoception research at that time. These addressed the behavioral relevance of perceiving single autonomic response measures, the generalization of interoceptive abilities across organ systems and experimental paradigms, the necessity of excluding the influence of external stimuli from interoception, and the conscious access to visceral activity that is behaviorally relevant. This review revisits these assumptions and examines the extent to which they are still relevant for current interoception research by providing inspiration and challenge for the field. Pennebaker's own response to these issues was an expanded model of symptom perception that emphasized the importance of cognitive biases, personality, and external stimuli, with the potential to better inform behavior in naturalistic settings and clinical practice. The currently renewed interest in interoception profits much from the introduction of brain imaging methods, which provide an opportunity to expand on Pennebaker's perspective and add a new dimension to our understanding of mind-body interactions.