Interoception in anxiety, depression, and psychosis: a review
Open accessAbstract
Research has examined the relationship between interoception and anxiety, depression, and psychosis; however, it is unclear which aspects of interoception have been systematically examined, what the combined findings are, and which areas require further research. To answer these questions, we systematically searched and narratively synthesised relevant reviews, meta-analyses, and theory papers (total n = 34). Existing systematic reviews and meta-analyses (anxiety n = 2; depression n = 2; psychosis n = 0), focus on cardiac interoceptive accuracy (heartbeat perception), and indicate that heartbeat perception is not systematically impaired in anxiety or depression. Heartbeat perception might be poorer in people with psychosis, but further evidence is needed. Other aspects of interoception, such as different body systems and processing levels, have been studied but not systematically reviewed. We highlight studies examining these alternative bodily domains and levels, review the efficacy of interoception-based psychological interventions, and make suggestions for future research. Funding: Wellcome Trust UK.
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Performance on cardiac interoceptive tasks appears influenced by external factors such as beliefs about heart rate, time estimation, and task instruction, which may confound observed effects.
“Performance on these tasks appears influenced by external factors such as beliefs about heart rate, time estimation, and task instruction, which may confound observed effects [67, 72].”
From Neural correlates of altered interoception in depressive and anxiety disorders: a systematic review and meta-analysis (2026) · cites this paper as [67]
The Interoception in anxiety section (page unavailable) says beliefs about heart rate and the ability to estimate time can bias heartbeat-counting performance. It lists task instructions as a moderator examined in a meta-analysis, but does not establish that instructions influenced performance or confounded the observed effects. (LLM, conf=0.85)
Experimental — accuracy not yet measuredCommonly used cardiac interoceptive measures, particularly heartbeat perception tasks, show issues concerning validity and reliability.
“Related to task variability, commonly used cardiac interoceptive measures, particularly heartbeat perception tasks, show issues concerning validity and reliability.”
From Neural correlates of altered interoception in depressive and anxiety disorders: a systematic review and meta-analysis (2026) · cites this paper as [67]
The Interoception definition and assessment section says cardiac heartbeat perception is the most commonly used measure and that existing interoceptive measures have limitations. The Interoception in anxiety section identifies biases in heartbeat counting that raise validity concerns. The paper does not establish a reliability problem with the commonly used cardiac tasks; its call for reliability research concerns initial findings from newer procedures. (LLM, conf=0.84)
Experimental — accuracy not yet measuredImprovements in interoceptive sensibility following these practices are associated with increasing insula responsiveness and reductions in anxiety and depressive symptoms.
“Improvements in interoceptive sensibility following these practices are associated with increasing insula responsiveness and reductions in anxiety and depressive symptoms [65–67], highlighting a potential mediatory role.”
From Neural correlates of altered interoception in depressive and anxiety disorders: a systematic review and meta-analysis (2026) · cites this paper as [67]
The section on interoception-based interventions (page unavailable) reports improved interoceptive ability after treatment in three of four relevant studies, reduced anxiety or depressive symptoms in some studies, and mediation of reduced depression by self-reported interoceptive ability in two. It does not report increasing insula responsiveness or establish an association linking all three changes. (LLM, conf=0.88)
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- Authors
- Jenkinson, P. M., Fotopoulou, A., Ibañez, A., & Rossell, S.
- Affiliations
- Cairnmillar Institute (AU)
- University College London (GB)
- Swinburne University of Technology (AU)
- Corresponding author
- Jenkinson, Paul M.
- Venue
- eClinicalMedicine
- Publisher
- Elsevier BV
- Published
- 2024-07
- Volume
- 73
- Pages
- 102673
- ISSN
- 2589-5370 (ISSN-L)
- PMC
- PMC11169962
- OpenAlex
- W4399206143
- Cited by
- 47
- References
- 78
- Citations by year
- 2026: 29 · 2025: 12 · 2024: 6
- FWCI
- 3.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- EClinicalMedicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Wellcome Trust
- National Institute on Aging (R01AG057234, R01AG075775)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- interoception, anxiety, depression, psychosis, heartbeat perception, body awareness
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