How do interoceptive accuracy, attention, and sensibility separately contribute to emotional experience in clinical and non-clinical groups?

Accuracy tracks emotional intensity, but not always in the expected direction

Interoceptive accuracy is measured by tasks that ask people to count their own heartbeats or detect internal signals without taking their pulse. In a study of 250 healthy young adults, poorer heartbeat-detection accuracy predicted more intense high-arousal emotions during an acute psychosocial stressor [4]. That is a counterintuitive result: people who were less accurate at reading their bodies reported stronger emotional reactions, not weaker ones.

A different pattern appears in children. Among 23 children with overweight or obesity and age-matched normal-weight controls, interoceptive accuracy was significantly lower in the overweight group, and lower accuracy was inversely correlated with emotional eating in both groups [1]. Here, poorer body-signal detection went together with more eating driven by emotions, consistent with the adult stress finding that low accuracy can accompany heightened emotional responding.

Accuracy also appears to matter for how emotions are processed after body-focused attention. In 114 participants including healthy controls and patients with behavioral variant frontotemporal dementia, Parkinson's disease, and Alzheimer's disease, a brief interoceptive priming task enhanced recognition of negative facial emotions in healthy controls, but this enhancement was selectively disrupted in bvFTD and Parkinson's patients [5]. Only the bvFTD group showed impaired interoceptive accuracy, suggesting that accuracy is one route by which body states prime emotion—but not the only one, since Parkinson's patients showed disrupted emotional priming without an accuracy deficit.

Sensibility and beliefs shape how people regulate and interpret emotion

Interoceptive sensibility is the self-reported side of interoception—how much a person says they notice, avoid, or trust bodily sensations. In 55 fibromyalgia patients and 55 matched healthy controls, patients reported a stronger tendency both to notice and to avoid unpleasant body sensations [3]. Sensibility and psychopathology each explained about 30 percent of the variance in emotion-regulation skills among fibromyalgia sufferers, and alexithymia—difficulty identifying and describing feelings—was related to sensibility and emotion regulation in controls but not in patients [3]. That split suggests sensibility's link to emotional processing may operate differently once chronic pain and distress are present.

In the healthy adult stress study, interoceptive beliefs—evaluations of whether bodily signals are valuable or dangerous—were the only interoceptive facet that moderated the match between physiological arousal and reported emotional arousal [4]. Less positive beliefs were associated with more intense high-arousal emotions. This is a moderation finding, not proof of causation: beliefs changed how tightly body and emotion moved together, while accuracy and sensibility did not show that moderating role in the same models.

Attention is the least tested of the three

None of these studies directly measured interoceptive attention as a separate construct. The overweight/obesity study assessed accuracy and sensibility but not attention [1]; the fibromyalgia study focused on sensibility [3]; the stress study examined accuracy, sensibility, and beliefs [4]; and the neurodegeneration study manipulated body-focused priming but did not isolate attention as an individual difference [5]. The non-clinical dissociation study examined accuracy and sensibility in relation to dissociative experiences but, according to its available summary, did not address attention [2].

So the honest answer to how attention contributes separately is that these studies do not tell us. Attention may be folded into what sensibility questionnaires capture—noticing body sensations is partly an attentional act—but that is an interpretation, not a measured result here. Distinguishing attention from accuracy and sensibility would require designs that manipulate or measure attention on its own.

Clinical groups show the same facets working differently

Across clinical and non-clinical groups, the same interoceptive facet can carry different emotional weight. In fibromyalgia, sensibility explained a substantial share of emotion-regulation variance and alexithymia behaved differently than in controls [3]. In neurodegenerative disease, interoceptive priming of emotion was preserved in Alzheimer's patients but disrupted in bvFTD and Parkinson's, with only bvFTD showing impaired accuracy [5]. In children with overweight or obesity, accuracy was lower and emotional eating higher than in normal-weight peers, yet the inverse accuracy–emotional-eating correlation held in both groups [1].

In non-clinical samples, the picture is similarly facet-specific. Healthy adults showed accuracy and beliefs predicting stress-related emotional intensity, with beliefs doing the moderating work [4]. A non-clinical study of dissociative experiences reported that reduced interoceptive accuracy and sensibility were linked to altered bodily and emotional self-related experience [2]. Taken together, these findings suggest that accuracy, sensibility, and beliefs are separable contributors—each with its own pattern—rather than a single interoceptive capacity, while attention's separate role remains an open question.

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