An investigation into interoception as a transdiagnostic mechanism underpinning anxiety-related disorders

Abstract

Emerging research implicates interoception, the sensing and interpretation of internal bodily signals, as a transdiagnostic mechanism in the development and maintenance of anxiety. Despite growing prominence in research, the mechanisms underlying this relationship remain largely unknown. The present thesis aims to address gaps in the field through the theoretical, systematic, and empirical exploration of the role of interoception across anxiety-related disorders.
Chapter 1 provides a theoretical foundation by exploring the conceptual and methodological issues surrounding the study of interoception in psychological research, setting the stage for the subsequent systematic review and empirical investigation. Chapter 2 presents a systematic review of the existing literature, synthesising evidence on the relationship between interoceptive dimensions and anxiety disorders in adult populations. Data was collected across 37 studies with a total of 3134 participants examining the relationship between interoception and anxiety, including generalised anxiety disorder (GAD), panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and social anxiety disorder (SAD). Studies employed self-report, behavioural, and neuroimaging measures across cardiac, respiratory, and gastrointestinal axes. A narrative synthesis of the findings revealed disorder-specific interoceptive profiles. Panic disorder and GAD were most consistently associated with heightened interoceptive attention and altered accuracy, particularly during threat-related tasks. PTSD and OCD were more strongly linked to maladaptive interoceptive beliefs, including low body trust and difficulties with bodily self-regulation. In chapter 3, an empirical study is presented that investigates the associations between interoceptive dimensions and anxiety-related traits and symptoms in a non-clinical adult sample. Drawing on a large sample (N = 305), including lab-based behavioural data and validated self-report measures, the study reveals associations between interoceptive dimensions, anxiety traits and symptoms, offering empirical support for theoretical models and identifying potential targets for clinical intervention.
Together, these findings offer a novel contribution to the literature by advancing a multidimensional understanding of interoceptive processes across anxiety spectrums, highlighting clinically relevant mechanisms that may inform targeted interventions and future translational research in anxiety. Clinical implications and future directions are discussed.

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Identifiers

ORCID for Lucy Snell: orcid.org/0000-0002-5918-9894

ORCID for Jayne Morriss: orcid.org/0000-0002-7928-9673

ORCID for Gaby Pfeifer: orcid.org/0000-0002-8737-1255

ORCID for Matthew Garner: orcid.org/0000-0001-9481-2226

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