Interoceptive performance is unrelated to mental health symptoms in a large multi-domain psychophysical investigation

📄 Publisher’s version
🐙 Data and code

Authors

Leah Banellis, Niia Nikolova, Jesper Fischer Ehmsen, Arthur S. Courtin, Melina Vejlø, Ashley Tyrer, Rebecca A. Böhme, Francesco Bavato, Kelly Hoogervorst, Francesca Fardo, Micah G. Allen

Abstract

Interoception—the sensing and perception of internal viscera—is widely cast as a transdiagnostic mechanism linking brain–body interaction to mental illness. Prevailing models propose that altered interoceptive performance is associated with psychiatric vulnerability across a range of symptoms. Here we tested this hypothesis in a large cross-sectional community sample using psychophysically optimized tasks (N = 456 cardiac, N = 245 respiratory), with hierarchical Bayesian modeling and comprehensive symptom profiling. Contrary to this prediction, objective interoceptive performance metrics spanning sensitivity, precision and metacognition were largely unrelated to mental health dimensions across linear, categorical and network-based models. By contrast, self-reported interoceptive sensibility showed moderate associations with symptoms, but semantic similarity analyses suggest that these reflect higher-order interpretative or affective beliefs rather than interoceptive processing. These findings challenge prevailing views that objective interoceptive sensitivity is a broad marker of psychopathology, prompting reconsideration of how we measure and interpret interoception in mental health research.