Interoception and Mental Health — A Roadmap

The Roadmap is the consensus statement produced by the Interoception Summit 2016, organised by Sahib Khalsa at the Laureate Institute for Brain Research in Tulsa. LIBR was founded in 2009 by the William K. Warren Foundation — the Tulsa oil-family foundation whose other large Oklahoma project is the Saint Francis Health System. Khalsa holds an MD/PhD from the Medical Scientist Training Program at the University of Iowa, completed his psychiatry residency at UCLA (serving as Chief Resident in the Anxiety Disorders Clinic), and joined LIBR in 2015 as Director of Clinical Studies, where he has built the institute's interoception programme. The twenty-four-author list is the field — Critchley from Brighton, Garfinkel from Sussex, Paulus from LIBR and UCSD, Stephan from Zurich, Stein from UCSD, Adolphs from Caltech, Mehling from UCSF — and the paper's authority comes from being the document the field agreed to.

Published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging in June 2018, the piece is a synthesising review that does two specific kinds of work. First, it proposes a unified nomenclature: the three-way distinction between interoceptive accuracy (the behavioural-task measure, e.g. heartbeat-detection score), interoceptive sensibility (subjective self-report on questionnaires), and interoceptive awareness (the metacognitive correspondence between the two) — a framework worked out by Garfinkel and Critchley from 2015 on and canonicalised here. Second, it lays out a research agenda for psychiatric disorders organised around interoceptive dysfunction, with specific predictions for anxiety, depression, eating disorders, addiction, and somatic-symptom presentations.

The piece sits as the secondary citation point that organises the post-2018 clinical interoception literature. Where Craig 2002 named the construct and Critchley 2004 gave it a measurement paradigm, the Roadmap codified the vocabulary the next generation of clinical work would use. Almost every post-2018 paper on interoception in mental health cites it, and the accuracy / sensibility / awareness distinction is now the standard.

The stake is field-organisational. LIBR convened the summit because the field had grown rapidly after 2010 without unified terminology; researchers were measuring different things and calling them the same word. The Roadmap is a coordination artefact, written by a coalition with no individual commercial position to defend but a shared interest in the field being able to talk to itself. It functions as a roadmap in the sense the title claims — read it for the vocabulary and the open questions, not for new findings.