Interoceptive Ability is Unrelated to Mental Health Symptoms: Evidence From a Large Scale Multi-Domain Psychophysical Investigation
Banellis, L.; Nikolova, N.; Fischer Ehmsen, J.; Courtin, A. S.; Vejlo, M.; Tyrer, A.; Bohme, R.; Bavato, F.; Hoogervorst, K.; Fardo, F.; Allen, M. G.
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Interoception--the sensing and perception of the internal viscera--is widely cast as a transdiagnostic mechanism linking brain-body interaction to mental illness. Prevailing models propose that altered interoceptive ability reflects a core liability underlying diverse psychiatric symptoms. We tested this hypothesis in a large community sample (N = 547) using psychophysically optimised tasks spanning cardiac and respiratory domains, combined with hierarchical Bayesian modelling and comprehensive symptom profiling. Contrary to this central prediction, objective interoceptive sensitivity, precision, and metacognitive insight were largely unrelated to general symptom burden or specific mental health dimensions. In contrast, self-reported interoceptive sensibility showed moderate associations with symptoms, but semantic similarity analyses suggest these reflect conceptual rather than mechanistic overlap. These findings challenge the prevailing view that objective interoceptive sensitivity is a broad marker of psychopathology, prompting a reconsideration of how we measure interoception in mental health research.
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