Sarah N. Garfinkel
The wiki had been citing Garfinkel’s distinctions since its taxonomy pages were built, always by name and never first-hand: the accuracy / sensibility / awareness three-way split (interoceptive-taxonomy, interoceptive-sensitivity) and the interoceptive trait prediction error (interoceptive-trait-prediction-error) are both hers, and both are load-bearing across the clinical and measurement pages. The Khalsa roadmap named her among its ~24 authors without giving her a page (it gave one to Critchley); Quadt, Critchley & Garfinkel (2018) is the first paper in raw/ she authors that the wiki reads directly, so the page is created now under the load-bearing-figure convention (as with Schandry, Katkin, Ehlers, Craske).
Knowing your own heart: the dissociation the field runs on
Garfinkel et al.’s (2015) tripartite framework is the single most-used measurement vocabulary in this wiki:
- Interoceptive accuracy — objective performance on a behavioural test (heartbeat tracking/discrimination).
- Interoceptive sensibility — subjective belief about one’s own interoceptive ability (questionnaire, or rated confidence).
- Interoceptive (metacognitive) awareness — the correspondence between the two: insight into how good one actually is.
Its power is that the three routinely come apart — someone can believe they are attuned to their body (high sensibility) while performing at chance (low accuracy), a mismatch invisible to any single “interoceptive awareness” score. Farb et al. (2015) push back on her use of the word “awareness” for the metacognitive quantity (they reserve it for reportability and propose “coherence” instead) — a genuine, recorded terminology conflict, not a disagreement about the underlying constructs. See interoceptive-taxonomy for all three nomenclatures side by side.
The ITPE: the discrepancy as a clinical quantity
Garfinkel’s second load-bearing idea is to give the accuracy–sensibility gap theoretical status. In autism she finds low accuracy paired with elevated sensibility — an enlarged interoceptive trait prediction error — and the ITPE, not accuracy alone, predicts trait anxiety across both autistic and control participants. This is what lets the review reconcile the mixed anxiety literature (accuracy is sometimes up, sometimes down; the discrepancy is the stable correlate), and it is the empirical anchor for the predictive-coding reading of anxiety as noisy interoceptive input amplified by mis-set self-referential priors (with Paulus & Stein).
The cardiac cycle as a probe
A separate strand: the Sussex group’s use of cardiac timing — whether a stimulus lands on systole (baroreceptors firing) or diastole — to show the visceral state is an input to cognition, not a backdrop. Fear stimuli at systole are processed differently; cardiac afferent signals modulate memory and even the expression of racial stereotypes (Azevedo et al. 2017). This is the second-dimension “influence” level of interoception made experimental.
Placement
Garfinkel anchors the Sussex/Brighton axis with hugo-critchley (her long-standing collaborator and co-author on nearly all of the above) and is allied with anil-seth on the predictive side of feedforward-vs-predictive-interoception. Where olga-pollatos and rainer-schandry represent the measure-accuracy-and-correlate-it tradition, Garfinkel’s contribution is to insist the single measure is three, and that the relationships among them — especially the accuracy/sensibility discrepancy — are where the clinical signal lives. Her caution about the heartbeat-tracking task’s generalizability (in Quadt et al.) puts her, unusually for a heavy user of the task, on the pro-caution side of is-the-heartbeat-counting-task-valid.