Research gap at a glance
- Question: When interoceptive and exteroceptive sensitivity, over-responsivity and threat-related attention are measured with matched tasks in the same people, does interoceptive dysfunction predict psychopathology beyond a general sensory-precision or threat-attention factor?
- Why it matters: If a general sensory factor explains the associations, transdiagnostic interoception claims describe one instance of a broader sensory dysfunction, and treatments aimed specifically at bodily signals may be aiming too narrowly.
- Theme: Clinical
- Status: open
What the wiki already knows
- Sensory over-responsivity to innocuous exteroceptive stimuli in 11,210 children was transdiagnostically associated with depression, anxiety, OCD and ADHD, prospectively predicted later anxiety and prodromal psychosis, and carried a salience and sensorimotor connectivity signature (Schwarzlose et al. (2023), Sensory over-responsivity (SOR)).
- That evidentiary shape parallels the interoceptive mid-insula marker, and the study measuring interoceptive and exteroceptive over-responsivity in the same sample has not been run (Interoceptive psychopathology, Nord et al. (2021)).
- Panic patients and phobics, but not controls, show attentional bias to physical threat; whether attending to the body and attending to external threat cues are one mechanism or two is untested (Attentional bias to threat).
- In autism, the defining sensory atypicalities are exteroceptive, and a prediction-failure account would predict effects on both sides of the skin (Interoception in autism (ASD)).
- Interoceptive confidence correlated with auditory confidence as strongly as with other interoceptive channels (Banellis et al. (2026)).
What would answer it
- In one large sample spanning symptom levels, measure interoceptive (cardiac, respiratory) and exteroceptive (tactile, auditory) thresholds, over-responsivity and threat-related attentional bias with matched paradigms, then use latent-variable models to test whether a shared sensory factor accounts for their associations with anxiety and other symptoms and whether interoceptive measures retain unique predictive value.
Connections
- Raised on: Interoceptive psychopathology, Sensory over-responsivity (SOR), Attentional bias to threat, Interoception in autism (ASD)
- Related concepts: Sensory over-responsivity (SOR), Attentional bias to threat, Exteroception Boundary, Salience network, Interoceptive psychopathology
- Related debates: Is interoception domain-general or organ-specific?
Interoceptive psychopathology files Schwarzlose et al. (2023) as a double-edged gift. It shows that the logic of a transdiagnostic sensory marker is not unique to interoception, which lends the whole enterprise credibility. It also raises a specificity problem the interoceptive literature has not raised on itself: an exteroceptive feature predicts the same broad psychopathology through the same salience machinery.
The same question appears in older material. Attentional bias to threat records Ehlers’s evidence that panickers attend faster to physical-threat cues, but the paradigms use shocks and threat words, not the body, and the page notes that no source tests whether internal and external versions are one mechanism. The Salience network is the obvious shared candidate, and nobody has connected the behavioural bias to it.
The design needs matched tasks across the Exteroception Boundary, so that differences in instrument quality do not masquerade as differences in channel. Do cross-channel interoceptive self-reports reflect the body or response style? makes the parallel point for confidence and discrepancy scores, where an exteroceptive control is likewise the missing comparison.