Interoceptive trait prediction error (ITPE)

Introduced in Seth & Friston (2016) to operationalize a stable individual-differences version of interoceptive prediction error, distinct from the trial-by-trial prediction errors posited by the core interoceptive-inference model. Computed as the gap between:

• objective interoceptive accuracy — performance on a standard heartbeat-detection-task, and
• subjective interoceptive sensibility — self-reported confidence/questionnaire measures of one’s own interoceptive ability.

Autism findings

A study cited in Seth & Friston (2016) found autistic individuals show both (i) reduced objective interoceptive accuracy and (ii) increased subjective interoceptive sensibility relative to controls — the combination yielding a larger ITPE than in controls. Across both autistic and control participants, ITPE magnitude correlated with self-reported anxiety, echoing Paulus & Stein’s earlier (non-Bayesian) proposal linking anxiety to interoceptive prediction error.

Complications

• Autism frequently co-occurs with alexithymia (difficulty identifying/describing one’s own emotions); one cited study found atypical interoception tracked alexithymia rather than autism per se, without directly testing ITPE — leaving open how cleanly ITPE dissociates from alexithymia.
• Findings on the direction of subjective interoceptive-sensibility change in autism are inconsistent across studies (at least one finds decreased subjective body awareness), which the paper attributes to autism’s broad heterogeneity resisting single-process explanations. The dedicated review, DuBois et al. (2016), names that dissenting study — Fiene & Brownlow (2015), a large-effect decrease in body/thirst awareness — plus a qualitative hyposensitivity finding (Elwin et al. 2012), and reads the ASD literature overall as tending toward hyporeactivity. So the ITPE’s elevated-sensibility premise (from Garfinkel et al. 2016) is one of two directions the sensibility literature runs, and it is untested whether the discrepancy story survives when sensibility is low rather than high. See autism-interoception.

The source, first-hand (Quadt et al. 2018)

Seth & Friston (2016) cite the ITPE; Quadt, Critchley & Garfinkel (2018) state it from the group that produced it, and are more precise about what it is and does. The ITPE derives from “a propensity to believe one is interoceptively proficient despite relatively poor interoceptive accuracy” — the self-report measure (e.g. the BPQ) functioning as a prior (a belief about general aptitude), against which metacognitive accuracy is the moment-to-moment confidence–accuracy correspondence. Individuals with elevated ITPE had heightened trait anxiety — and, crucially, this held in both an autistic population and healthy controls (Garfinkel et al. 2016), so the ITPE is a trans-population correlate of anxiety, not an autism-specific one.

This is what lets the review reconcile the otherwise mixed anxiety literature (see interoceptive-psychopathology): interoceptive accuracy is elevated in some anxiety studies, reduced in others, null in others still, but the accuracy–sensibility discrepancy is the stable predictor. The ITPE is thus offered as consistent with Paulus & Stein’s proposal that anxiety pathogenesis involves “noisy interoceptive input in combination with noisily amplified self-referential interoceptive predictive belief states” — the prior (high sensibility) overweighted relative to poor sensory evidence (low accuracy).

Relation to the wider taxonomy

ITPE is conceptually adjacent to — but not identical with — the accuracy/sensibility/awareness distinctions already tracked in interoceptive-taxonomy (Farb et al.’s seven-construct breakdown) and flagged as a terminology-in-flux area on interoceptive-sensitivity. Where Garfinkel et al. treat accuracy and sensibility as separate axes to be measured and reported independently, ITPE explicitly combines them into a single discrepancy score and gives that discrepancy theoretical status as a predictive-coding quantity (a stable, trait-level “prediction error”), rather than treating over/under-confidence as merely an interesting correlational pattern.