Interoception in anxiety, depression and psychosis: A review of current knowledge and recommendations for future research

Resumen

There has been growing interest in interoception (broadly defined as the sense of the physiological state of the body) as a transdiagnostic factor contributing to mental health, wellbeing and psychopathology. Thus, we systematically searched and reviewed evidence regarding the role of interoception in anxiety, depression and psychosis. Integrated throughout are insights from individuals with mental health and wellbeing lived experiences. We first consider evidence from existing systematic reviews and meta-analyses, which provide a robust synthesis of current evidence. Existing reviews in anxiety and depression have focused exclusively on cardiac interoceptive accuracy (i.e., heartbeat perception). Contrary to expectation, these meta-analyses indicate that cardiac interoceptive accuracy is not impaired in anxiety or depression. There are no existing systematic reviews or meta-analyses of interoceptive processing in psychosis. An existing narrative review of only four empirical studies examining interoception in psychosis suggests that cardiac accuracy may be poorer in people with psychosis, but further evidence is needed to draw firm conclusions. Other aspects of interoception such as different body systems (e.g., respiration) or processing levels (e.g. afferent interoceptive signals, self-reported interoceptive abilities, and metacognitive insights into one’s interoceptive ability) have not been systematically reviewed or meta-analysed. Thus, we highlight studies using methods that examine these alternative bodily domains and levels, and present findings that suggest the presence of interoceptive dysfunction in anxiety, depression and psychosis. We also explore the efficacy of interoception-based psychological interventions. Evidence suggests that these interventions can improve interoception in anxiety and depression with some evidence of symptom improvement, although existing studies are extremely heterogeneous with methodological issues that limit these findings. We make recommendations for future research, including the need for more comprehensive interoceptive assessments, longitudinal and intervention research, investigating the relationship between interoceptive problems and the ability to engage in everyday behaviours, and exploring cultural factors in the relationship between interoception and mental health.

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Cómo citar (APA 7)

Jenkinson, P., Fotopoulou, A., Ibanez, A., & Rossell, S. (2023). Interoception in anxiety, depression and psychosis: A review of current knowledge and recommendations for future research. https://doi.org/10.31234/osf.io/2kpwv