Alexithymia mediates the relationship between interoceptive sensibility and anxiety
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A number of empirical and theoretical reports link altered interoceptive processing to anxiety. However, the mechanistic understanding of the relationship between the two remains poor. We propose that a heightened sensibility for interoceptive signals, combined with a difficulty in attributing these sensations to emotions, increases an individual's vulnerability to anxiety. In order to investigate this, a large sample of general population adults were recruited and completed self-report measures of interoceptive sensibility, trait anxiety and alexithymia. Results confirmed that the positive association between interoceptive sensibility and trait anxiety was partially mediated by alexithymia, such that those most at risk for clinically significant levels of trait anxiety have both significantly higher levels of interoceptive sensibility and alexithymia. A subsequent factor analysis confirmed the independence of the three measures. Altered interoceptive processing in combination with alexithymia, increased the risk for anxiety above and beyond altered interoceptive processing alone. We suggest that a heightened sensibility for interoceptive signals, combined with a difficulty in attributing these sensations to emotions, leaves these sensations vulnerable to catastrophizing interpretation. Interventions that target the attribution of bodily sensations may prove valuable in reducing anxiety.
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Several studies in the neurotypical literature support the conclusion that ALX contributes to anxiety through uncertainty about internal states.
“Several studies in the neurotypical literature support this conclusion (see Palser et al., 2018; Pandey et al., 2011).”
From Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools. (2020) · cites this paper as Palser et al., 2018
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- Authors
- Palser, E. R., Palmer, C. E., Galvez-Pol, A., Hannah, R., Fotopoulou, A., & Kilner, J. M.
- Affiliations
- University of London (GB)
- University College London (GB)
- Corresponding author
- Palser, Eleanor R.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-09-13
- Volume
- 13
- Issue
- 9
- Pages
- e0203212
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6136731
- OpenAlex
- W2891076048
- Cited by
- 86
- References
- 77
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 12 · 2023: 10 · 2022: 12 · 2021: 18 · 2020: 9 · 2019: 8
- FWCI
- 6.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Economic and Social Research Council (505674)
- European Research Council (ERC-2012-STG GA313755)
- 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
- alexithymia, interoceptive sensibility, trait anxiety, mediation, interoception, bodily sensations, emotion attribution, catastrophizing, anxiety vulnerability
- MeSH terms
- Adolescent, Adult, Affective Symptoms, Aged, Anxiety, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Models, Psychological, Personality, Psychological Tests, Risk Factors, Young Adult, Interoception
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