Interoception Assessment: Dilemmas and Practical Solutions
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3 Types of Interoception Assessments
Objective Measures
These are measures that aim to make a quantifiable measure of our inner experience. For example, the heartbeat detection test is a widely used test by researchers where they hook a participant up to a heartbeat monitor, and they ask the participant to count their heartbeats within a certain duration of time, whether it’s 30 seconds or 60 seconds. Then the researchers compare how accurate that person was at counting their heartbeats compared to what the researchers measured on the heartbeat monitor. The closer the number of beats counted is to what researchers measured, the higher the level of interoceptive awareness.Pros: Objective measure that can provide raw score or data.
Cons: There is more to interoception then just your heartbeat (so can we generalize your ability to count your heart to how aware you are of muscle tension or bladder fullness?); Interoception does not typically involve having someone tell you what sensation to attend to (can you figure out what sensation is important to pay attention to in real life?); Interoceptive Awareness involves the ability to notice and connect body signals which the latter is not captured by objective measures.
Subjective or Self-Report Measures
As the name implies, these are measures such as questionnaires or interviews that seek to gain information from the person themself and that person is asked to report on their inner experience.Pros: A benefit of this type of measure is that it seeks to gain information from the person that knows best about their own personal inner experience. Whenever possible, when we’re seeking that same information from my clients. we of course, want them to be sharing as much as they can possibly share about their own inner experience. And so, these self-reports can be really helpful.
Cons: The main drawback is that these subjective measures are really not quantifiable. They can’t really give you a solid number that’s measurable, but they do give really great qualitative information.
If you are looking for a useful tool in helping you to gain insight into your client’s inner experience, check out the newly revised Comprehensive Assessment of Interoceptive Awareness. This assessment contains 3 sub-tests, two of which are self-report measures: The Interoceptive Awareness Interview & The Assessment of Self-Regulation.
Caregiver Report or Observation
We use these measures for my clients that might not be at a point in time where they can reflect and tell us about their inner experience. So, we’re doing our best guesses at trying to understand some of the outward things that we see them doing and thinking about that through an Interoception lens. For example, if my client’s having toileting accidents, seeing that through an Interoception lens and considering could those toileting accidents be partly due to an underlying Interoception piece? Could my client be not noticing those body signals or misunderstanding those body signals telling them when they need to go pee or poop?. Really looking at all of the observations that we see and thinking about them through an Interoception lens to try to get one step closer to understanding the deep whys behind what it is that we see in our
Pros: Encourages caregivers/observers to consider interoception as one of the underlying factors that could be creating a barrier to participation.
Cons: Can we accurately capture the inner experience of someone other than ourselves? That remains to be better understood.
If you are looking for a useful tool in helping you to gain insight into your client’s inner experience, check out the newly revised Comprehensive Assessment of Interoceptive Awareness. This assessment contains 3 sub-tests, one of which is a caregiver questionnaire: The Caregiver Questionnaire of Interoceptive Awareness.