Year: 2025
Type: article
Abstract: Anxiety is one of the most common and debilitating mental health disorders, and is related to changes in interoception (perception of bodily states). While anxiety is more prevalent in women than men, gender differences in interoception-anxiety associations are often overlooked. Here, we examined gender-specific relationships between anxiety and interoception in the breathing domain, utilising multicentre data pooled from four study sites (N = 175; 51% women). State anxiety scores were quantified via the Spielberger State-Trait Anxiety Inventory, and breathing-related interoceptive dimensions via an inspiratory load task to quantify sensitivity, decision bias, metacognitive bias (confidence in interoceptive decisions), and metacognitive insight (congruency between performance and confidence). Regression analyses revealed a significant negative relationship between state anxiety and metacognitive bias (β = -0.28; p = 0.01) and insight (β = -0.09; 95% highest density interval [HDI] in a hierarchical Bayesian regression = [-0.18, -0.004]) across the whole sample, while state anxiety did not relate to interoceptive sensitivity nor decision bias. While no mean interoceptive effects relating to gender were observed, the relationship between anxiety and metacognitive insight towards breathing was driven by women (women: β = -0.18; HDI = [-0.31, -0.05]; men: β = 0.02; HDI = [-0.12, 0.15]) with a significant interaction effect (β difference = -0.20; HDI = [-0.37, -0.01]), which did not hold for trait anxiety nor depression measures. In summary, state anxiety was associated with decreased metacognitive bias across all participants, while decreased interoceptive insight was only associated with anxiety in women but not men. Therefore, treatment programmes focusing on interoceptive metacognitive bias may be useful for all anxiety patients, while interoceptive insight might represent a specific treatment target for women with anxiety.
Source: European Journal of Neuroscience
DOI: 10.1111/ejn.16672
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,560
Funders: University of Otago, Wellcome Trust, NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research, National Institute for Health and Care Research, Dunhill Medical Trust, University of Oxford, European Commission, Royal Society Te Apārangi, Oxford University Hospitals NHS Foundation Trust, Universität Zürich, René und Susanne Braginsky Stiftung, Horizon 2020 Framework Programme, NIHR Oxford Biomedical Research Centre, H2020 Marie Skłodowska-Curie Actions
Awards: G1057119940, G1263470990, G128649688, Wellcome Centre for Integrative Neuroimaging, G1950370287, G2189472788, G2361269703, G2650583865, G3360301568, G339059223, G3460568115, G3909578932, G418762381, G434337789, G4524064234, G4590856093, Improving self-awareness: Manipulating the neural substrates of self-belief, G4937468798, The interoceptive link between anxiety and breathing perception, G5219700674, G5316666912, G5574962401, G5974447885, G6079445891, G6864992491, G7358480839, G750724275, Wellcome Centre for Integrative Neuroimaging, G7697233543, G7771074704, The interoceptive link between anxiety and breathing perception, G8799150800, G911470398, G942133152
OpenAlex ID: W4406325313