The relationship between self-reported interoception and anxiety: A systematic review and meta-analysis

Abstract

Interoception, the processing of internal bodily sensations, is associated with various mental health conditions. In particular, anxiety is often considered to be the prototypical interoceptive disorder. However, empirical evidence is mixed, with meta-analytic work reporting no relationship between anxiety and cardiac interoceptive accuracy. Less explored, however, are the mixed results relating to anxiety and self-reported interoception. This meta-analysis of 71 studies explored the relationship between self-report measures of interoception and anxiety. Across 12 measures (20 subscales), anxiety was associated with increased negative evaluations of, frequency of, and sensitivity to, bodily signals. Anxiety was also associated with greater (negative) attention to bodily signals, and difficulties describing bodily signals and emotions. However, anxiety was not associated with the use of bodily signals to inform emotions (e.g., noticing emotionally induced bodily signals). Results are discussed considering the overlap between anxiety and interoception questionnaires, the lack of specificity of certain measures, and the potential confound of individual differences in questionnaire interpretation. We also discuss limitations of anxiety measures and the clinical relevance of findings.