E3 PreliminaryModerate confidencePEM not requiredMethods-PaperPeer-reviewedMachine draft
The Interoceptive Sensitivity and Attention Questionnaire: Evaluating Aspects of Self-Reported Interoception in Patients With Persistent Somatic Symptoms, Stress-Related Syndromes, and Healthy Controls.
Bogaerts, Katleen, Walentynowicz, Marta, Van Den Houte, Maaike et al. · Psychosomatic medicine · 2021 · DOI
Quick Summary
This study tested a new questionnaire called the ISAQ that measures how aware people are of signals from their own body—like heart rate, breathing, or pain—and how much attention they pay to uncomfortable bodily sensations. Researchers compared how people with ME/CFS, fibromyalgia, panic disorder, and other conditions scored on this questionnaire compared to healthy people. They found that people with ME/CFS and fibromyalgia were more sensitive to neutral body signals and paid more attention to unpleasant sensations than healthy controls.
Why It Matters
This study provides a validated tool for measuring interoceptive awareness in ME/CFS patients, which may help researchers understand whether altered body-signal perception contributes to symptom burden or perpetuation in ME/CFS. The finding that ME/CFS patients show heightened sensitivity to both neutral and unpleasant body sensations suggests interoceptive dysregulation may be relevant to symptom amplification in the condition.
Observed Findings
- ME/CFS and fibromyalgia patients scored significantly higher on sensitivity to neutral bodily sensations (F1) compared to healthy controls (p=.009 for CFS/FM).
- ME/CFS and fibromyalgia patients scored significantly higher on attention to unpleasant bodily sensations (F2) compared to healthy controls (p=.002 for CFS/FM).
- Panic disorder patients showed the highest scores on F2 (p<.001 vs controls) and F3 difficulty disengaging (p<.001 vs controls), with F2 scores higher than all other patient groups.
- The ISAQ demonstrated three distinct, clinically differentiating subscales rather than measuring a single homogeneous interoceptive construct.
Inferred Conclusions
- Interoceptive sensibility is multidimensional, with distinct adaptive and maladaptive aspects that vary across patient populations.
- ME/CFS and fibromyalgia patients show a similar pattern of heightened interoceptive sensitivity and attention compared to healthy controls, suggesting a shared pathophysiological mechanism related to body-signal processing.
- The ISAQ is a reliable, clinically relevant tool for measuring and distinguishing different aspects of interoceptive awareness across somatic and stress-related conditions.
Remaining Questions
- Does heightened interoceptive sensitivity in ME/CFS represent a primary dysfunction or a secondary adaptation to illness?
- What is the longitudinal relationship between ISAQ scores and ME/CFS symptom severity, disability, or treatment outcomes?
What This Study Does Not Prove
This study does not establish whether increased interoceptive sensitivity causes ME/CFS symptoms or results from them (direction of causality remains unclear). The questionnaire measures self-reported interoception, which may differ from objective interoceptive ability. Cross-sectional design prevents conclusions about whether interoceptive changes precede, accompany, or follow ME/CFS onset.
Tags
Symptom:PainFatigue
Method Flag:Weak Case DefinitionExploratory OnlyMixed Cohort
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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