Accuracy and awareness of perception: Related, yet distinct (commentary on Herbert et al., 2012)

Herbert and colleagues (2012) state that changes in autonomic activity following a specific type of interoceptive sensation, intensifies general interoceptive awareness. This conclusion is being critically examined and reformulated. A distinction is made between Interoceptive Awareness (IAw) and Interoceptive Accuracy (IAc); awareness not necessarily implying accuracy. Given the heterogeneity of interoceptive sensations, we emphasize to abstain from concluding that heartbeat perception tasks can be considered as a measure of OVERALL IAw or OVERALL IAc until this has been more elaborately investigated. Results are reinterpreted to indicate that homeostatic challenges which lead to an increase in ionotropic cardiac activity, lead to an increased cardioceptive accuracy, and perhaps increased cardioceptive awareness. However, the findings do not provide conclusive evidence that such challenges increase other types of IAc, nor that they increase OVERALL IAw. Furthermore, it remains unclear whether homeostatic challenges leading to negative inotropic cardiac activity, would similarly lead to changes in accuracy of heartbeat perception.