Self-Reported Interoceptive Accuracy and Attention Do Not Interact to Predict Depression and Anxiety Symptoms: A Conceptual Replication Across Two Independent Samples

Abstract

Dysfunctional interoception is increasingly being recognized as a risk factor for depression and anxiety. However, results remain mixed. Emerging research suggests that particular interoceptive phenotypes may be differentially pathogenic. The current studies aimed to evaluate the degree to which self-reported interoceptive accuracy and attention predict depression and anxiety symptoms, as well as to test the interaction between accuracy and attention. Participants (study 1: N = 170, M = 20.34 years, 69% female, 64% White; study 2: N = 826, M = 38.04 years, 49% female, 58% White) self-reported interoceptive accuracy and attention using the Interoceptive Accuracy Scale and Body Perception Questionnaire, respectively. Participants also reported depression and anxiety symptoms using the Hospital Anxiety and Depression Scale. In both studies, lower interoceptive accuracy and more interoceptive attention predicted higher depression and anxiety symptoms. In neither study did accuracy interact with attention to predict depression or anxiety symptoms. These results provide evidence that self-reported interoceptive accuracy and attention are independent predictors and do not interact to predict depression and anxiety symptoms.

Keywords

interoception depression anxiety mental health

Get full access to this article

View all access options for this article.

References

Adams

K. L.

Edwards

Peart

Ellett

Mendes

Bird

Murphy

(2022). The association between anxiety and cardiac interoceptive accuracy: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 140, 104754. https://doi.org/10.1016/j.neubiorev.2022.104754

Adler

N. E.

Epel

E. S.

Castellazzo

Ickovics

J. R.

(2000). Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy, white women. Health Psychology, 19(6), 586–592. https://doi.org/10.1037/0278-6133.19.6.58

Bandelow

Michaelis

(2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327–335. https://doi.org/10.31887/DCNS.2015.17.3/bbandelow

Benau

E. M.

(2023). Self-reported interoceptive accuracy and interoceptive attention differentially correspond to measures of visual attention and self-regard. PeerJ, 11, e15348.

Blickle

Klüpfel

Homola

G. A.

Gamer

Herrmann

M. J.

Störk

Gelbrich

Heuschmann

P. U.

Deckert

Pham

Menke

(2024). Heart rate variability, interoceptive accuracy and functional connectivity in middle-aged and older patients with depression. Journal of Psychiatric Research, 170, 122–129. https://doi.org/10.1016/j.jpsychires.2023.11.044

Brand

Petzke

T. M.

Witthöft

(2022). The differential relationship between self-reported interoceptive accuracy and attention with psychopathology. Schwerpunkt: Neue Ideen und Anregungen aus der Interozeptionsforschung, 51(3–4), 165–175. https://doi.org/10.1026/1616-3443/a000678

Brenes

G. A.

(2007). Anxiety, depression, and quality of life in primary care patients. Primary Care Companion to the Journal of Clinical Psychiatry, 9(6), 437–443. https://doi.org/10.4088/pcc.v09n0606

Cabrera

Kolacz

Pailhez

Bulbena-Cabre

Bulbena

Porges

S. W.

(2018). Assessing body awareness and autonomic reactivity: Factor structure and psychometric properties of the Body Perception Questionnaire-Short Form (BPQ-SF). International Journal of Methods in Psychiatric Research, 27(2), e1596. https://doi.org/10.1002/mpr.1596

Chentsova-Dutton

Y. E.

Dzokoto

(2014). Listen to your heart: The cultural shaping of interoceptive awareness and accuracy. Emotion, 14(4), 666–678. https://doi.org/10.1037/a0036193

10.

Clemente

Murphy

(2024). The relationship between self-reported interoception and anxiety: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 167, 105923. https://doi.org/10.1016/j.neubiorev.2024.105923

11.

Davies

C. D.

McGrath

P. B.

Hale

L. R.

Weiner

D. N.

Tolin

D. F.

(2019). Mediators of change in capnometry guided respiratory intervention for panic disorder. Applied Psychophysiology and Biofeedback, 44(2), 97–102. https://doi.org/10.1007/s10484-018-9424-2

12.

Desmedt

Van Den Houte

Walentynowicz

Dekeyser

Luminet

Corneille

(2022). How does heartbeat counting task performance relate to theoretically-relevant mental health outcomes? A meta-analysis. Collabra: Psychology, 8(1), 33271. https://doi.org/10.1525/collabra.33271

13.

Donohue

J. M.

Pincus

H. A.

(2007). Reducing the societal burden of depression. Pharmacoeconomics, 25(1), 7–24. https://doi.org/10.2165/00019053-200725010-00003

14.

Douglas

B. D.

Ewell

P. J.

Brauer

(2023). Data quality in online human-subjects research: Comparisons between MTurk, Prolific, CloudResearch, Qualtrics, and SONA. PLoS One, 18(3), e0279720. https://doi.org/10.1371/journal.pone.0279720

15.

Dunn

B. D.

Dalgleish

Ogilvie

A. D.

Lawrence

A. D.

(2007). Heartbeat perception in depression. Behaviour Research and Therapy, 45(8), 1921–1930. https://doi.org/10.1016/j.brat.2006.09.008

16.

Dunn

B. D.

Stefanovitch

Evans

Oliver

Hawkins

Dalgleish

(2010). Can you feel the beat? Interoceptive awareness is an interactive function of anxiety- and depression-specific symptom dimensions. Behaviour Research and Therapy, 48(11), 1133–1138. https://doi.org/10.1016/j.brat.2010.07.006

17.

Dunne

Flores

Gawande

Schuman-Olivier

(2021). Losing trust in body sensations: Interoceptive awareness and depression symptom severity among primary care patients. Journal of Affective Disorders, 282, 1210–1219. https://doi.org/10.1016/j.jad.2020.12.092

18.

Eggart

Lange

Binser

M. J.

Queri

Müller-Oerlinghausen

(2019). Major depressive disorder is associated with impaired interoceptive accuracy: A systematic review. Brain Science, 9(6), 131. https://doi.org/10.3390/brainsci9060131

19.

Eggart

Valdés-Stauber

(2021). Can changes in multidimensional self-reported interoception be considered as outcome predictors in severely depressed patients? A moderation and mediation analysis. Journal of Psychosomatic Research, 141, 110331. https://doi.org/10.1016/j.jpsychores.2020.110331

20.

Ferentzi

Horvath

Koteles

(2019). Do body-related sensations make us feel better? Subjective well-being is associated only with the subjective aspect of interoception. Psychophysiology, 56, e13319. https://doi.org/10.1111/psyp.13319.

21.

Gabriele

Spooner

Brewer

Murphy

(2022). Dissociations between self-reported interoceptive accuracy and attention: Evidence from the Interoceptive Accuracy Scale. Biological Psychology, 168, 108243. https://doi.org/10.1016/j.biopsycho.2021.108243

22.

Garfinkel

S. N.

Seth

A. K.

Barrett

A. B.

Suzuki

Critchley

H. D.

(2015). Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology, 104, 65–74. https://doi.org/10.1016/j.biopsycho.2014.11.004

23.

Garfinkel

S. N.

Tiley

O’Keeffe

Harrison

N. A.

Seth

A. K.

Critchley

H. D.

(2016). Discrepancies between dimensions of interoception in autism: Implications for emotion and anxiety. Biological Psychology, 114, 117–126. https://doi.org/10.1016/j.biopsycho.2015.12.003

24.

Greenberg

Chitnis

Louie

Suthoff

Chen

S.-Y.

Maitland

Gagnon-Sanschagrin

Fournier

A.-A.

Kessler

R. C.

(2023). The economic burden of adults with major depressive disorder in the United States (2019). Advances in Therapy, 40(10), 4460–4479. https://doi.org/10.1007/s12325-023-02622-x

25.

Harshaw

(2015). Interoceptive dysfunction: Toward an integrated framework for understanding somatic and affective disturbance in depression. Psychological Bulletin, 141(2), 311–363. https://doi.org/10.1037/a0038101

26.

Heim

Bobou

Tanzer

Jenkinson

P. M.

Steinert

Fotopoulou

(2023). Psychological interventions for interoception in mental health disorders: A systematic review of randomized-controlled trials. Psychiatry and Clinical Neurosciences, 77(10), 530–540. https://doi.org/10.1111/pcn.13576

27.

Jenkinson

P. M.

Fotopoulou

Ibañez

Rossell

(2024). Interoception in anxiety, depression, and psychosis: A review. eClinicalMedicine, 73. https://doi.org/10.1016/j.eclinm.2024.102673

28.

Johnston

Pollard

Hennessey

(2000). Construct validation of the hospital anxiety and depression scale with clinical populations. Journal of Psychosomatic Research, 48(6), 579–584. https://doi.org/10.1016/S0022-3999(00)00102-1

29.

Khalsa

S. S.

Adolphs

Cameron

O. G.

Critchley

H. D.

Davenport

P. W.

Feinstein

J. S.

Feusner

J. D.

Garfinkel

S. N.

Lane

R. D.

Mehling

W. E.

Meuret

A. E.

Nemeroff

C. B.

Oppenheimer

Petzschner

F. H.

Pollatos

Rhudy

J. L.

Schramm

L. P.

Simmons

W. K.

Stein

M. B.

. . . Interoception Summit 2016 participants (2018). Interoception and mental health: A roadmap. biological psychiatry. Cognitive Neuroscience and Neuroimaging, 3(6), 501–513. https://doi.org/10.1016/j.bpsc.2017.12.004

30.

Ma-Kellams

(2014). Cross-cultural differences in somatic awareness and interoceptive accuracy: A review of the literature and directions for future research. Frontiers in Psychology, 5, 1379. https://doi.org/10.3389/fpsyg.2014.01379

31.

Ma-Kellams

Prentice

Spooner

Murphy

(2024). Demographic differences in interoception. In Murphy

Brewer

(Eds.), Interoception. Springer.

32.

Meuret

A. E.

Rosenfield

Hofmann

S. G.

Suvak

M. K.

Roth

W. T.

(2009). Changes in respiration mediate changes in fear of bodily sensations in panic disorder. Journal of Psychiatric Research, 43(6), 634–641. https://doi.org/10.1016/j.jpsychires.2008.08.003

33.

Meuret

A. E.

Rosenfield

Seidel

Bhaskara

Hofmann

S. G.

(2010). Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity. Journal of Consulting and Clinical Psychology, 78(5), 691–704. https://doi.org/10.1037/a0019552

34.

Meuret

A. E.

Ritz

(2010). Hyperventilation in panic disorder and asthma: empirical evidence and clinical strategies. International Journal of Psychophysiology, 78(1), 68–79. https://doi.org/10.1016/j.ijpsycho.2010.05.006

35.

Murphy

Brewer

Plans

Khalsa

S. S.

Catmur

Bird

(2020). Testing the independence of self-reported interoceptive accuracy and attention. Quarterly Journal of Experimental Psychology, 73(1), 115–133. https://doi.org/10.31234/osf.io/fqgu4

36.

Murphy

Catmur

Bird

(2019). Classifying individual differences in interoception: Implications for the measurement of interoceptive awareness. Psychonomic Bulletin & Review, 26(5), 1467–1471. https://doi.org/10.3758/s13423-019-01632-7

37.

Ottley-Porter

Adams

K. L.

Brewer

Murphy

(2025). Minimal impact of sensation-related items on the association between alexithymia and self-report measures of interoception. Personality and Mental Health, 19(4), e70048. https://doi.org/10.1002/pmh.70048

38.

Palser

E. R.

Palmer

C. E.

Galvez-Pol

Hannah

Fotopoulou

Kilner

J. M.

(2018). Alexithymia mediates the relationship between interoceptive sensibility and anxiety. PLoS One, 13(9), e0203212. https://doi.org/10.1371/journal.pone.0203212

39.

Paulus

M. P.

Stein

M. B.

(2010). Interoception in anxiety and depression. Brain Structure & Function, 214(5–6), 451–463. https://doi.org/10.1007/s00429-010-0258-9

40.

Pollatos

Traut-Mattausch

Schandry

(2009). Differential effects of anxiety and depression on interoceptive accuracy. Depression and Anxiety, 26(2), 167–173. https://doi.org/10.1002/da.20504

41.

Porges

(1993). Body perception questionnaire. Laboratory of Developmental Assessment, University of Maryland.

42.

Prentice

Murphy

(2022). Sex differences in interoceptive accuracy: A meta-analysis. Neuroscience and Biobehavioral Reviews, 132, 497–518. https://doi.org/10.1016/j.neubiorev.2021.11.030

43.

Quadt

Garfinkel

S. N.

Mulcahy

J. S.

Larsson

D. E. O.

Silva

Jones

A. M.

Strauss

Critchley

H. D.

(2021). Interoceptive training to target anxiety in autistic adults (ADIE): A single-center, superiority randomized controlled trial. eClinicalMedicine, 39, 101042. https://doi.org/10.1016/j.eclinm.2021.101042

44.

Spinhoven

P. H.

Ormel

Sloekers

P. P. A.

Kempen

G. I. J. M.

Speckens

A. E. M.

Van Hemert

A. M.

(1997). A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychological Medicine, 27(2), 363–370. https://doi.org/10.1017/S0033291796004382

45.

Suksasilp

Garfinkel

S. N.

(2022). Towards a comprehensive assessment of interoception in a multi-dimensional framework. Biological Psychology, 168, 108262. https://doi.org/10.1016/j.biopsycho.2022.108262

46.

Terlizzi

E. P.

Zablotsky

(2024). Symptoms of anxiety and depression among adults: United States, 2019 and 2022. National Health Statistics Reports, 213, CS353885. https://doi.org/10.15620/cdc/64018

47.

Trevisan

D. A.

Tsheringla

McPartland

J. C.

(2023). On the relation between interoceptive attention and health anxiety: Distinguishing adaptive and maladaptive bodily awareness. Cogent Psychology, 10(1), 2262855. https://doi.org/10.1080/23311908.2023.2262855

48.

Tünte

M. R.

Petzke

T. M.

Brand

Murphy

Witthöft

Hoehl

Weymar

Ventura-Bort

(2024). He who seeks finds (bodily signals): German validation of the Interoceptive Attention Scale (IATS) and its relationship with subclinical psychopathology. Journal of Personality Assessment, 106(6), 787–797. https://doi.org/10.1080/00223891.2024.2316236

49.

U.S. Census Bureau. (2023). Quickfacts: United States. https://www.census.gov/quickfacts/fact/table/US

50.

VandenBos

G. R.

(Ed.). (2007). APA Dictionary of Psychology. American Psychological Association.

51.

von Elm

Altman

D. G.

Egger

Pocock

S. J.

Gotzsche

P. C.

Vandenbroucke

J. P

. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. The Lancet, 370, 1453–1457.

52.

Wittchen

H.-U.

(2002). Generalized anxiety disorder: Prevalence, burden, and cost to society. Depression and Anxiety, 16(4), 162–171. https://doi.org/10.1002/da.10065

53.

Zigmond

A. S.

Snaith

R. P.

(1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB