Exploring the role of interoception in anxious traits and symptoms

Introduction: Interoception, the ability to sense internal bodily signals, has been increasingly linked to anxiety, yet the mechanisms underlying this relationship remain largely unknown. This study explored the associations between multiple dimensions of interoception and anxiety-related traits and symptoms in a non-clinical adult sample.

Methods: A total of 305 participants completed self-report measures assessing interoceptive beliefs, attention, and perceived interoceptive accuracy, alongside measures of anxiety-related traits and symptoms. A subsample (n = 103) additionally completed laboratory-based heartbeat perception tasks to assess interoceptive accuracy, confidence, and insight via heartbeat counting and detection tasks.

Results: Correlational analyses revealed that anxiety-related traits were significantly associated with self-reported interoceptive difficulties. Novel associations between intolerance of uncertainty and interoception were observed, including negative correlations with interoceptive insight, bodily trust, and increased tendency to worry about discomforting internal sensations. Anxiety symptom severity was linked to self-reported increased attention to bodily signals, reduced bodily trust, and lower perceived accuracy. However, no significant relationships were observed between the heartbeat perception task measures and anxiety-related traits, symptoms, or self-reported interoceptive abilities.

Discussion: Findings support the conceptualisation of interoception as a multidimensional construct, demonstrating interoceptive accuracy and interoceptive beliefs as distinct constructs. Results align with emerging evidence that anxious traits are more closely related to subjective beliefs and interpretations of bodily signal than to behavioural interoceptive accuracy. These findings contribute to theoretical models of anxiety by highlighting interoceptive beliefs and attentional processes, rather than accuracy, as key factors warranting further investigation in clinical contexts.