Within-group variation in interoceptive bias in patients with somatic symptom disorder on a heart rate discrimination task

Le résumé fourni par la source

The persistence of physical symptoms, such as pain, fatigue, and dizziness, has been linked to altered interoception, but the mechanisms remain unclear. This study used a novel psychophysical heart rate discrimination task and self-report measures of interoceptive sensibility and awareness to investigate interoceptive deficits in patients with somatic symptom disorder (SSD) and healthy controls from a predictive processing perspective. Both groups underestimated their heart rate, with no differences on sensory precision and discriminability. Patients with SSD reported lower decision confidence and showed higher between-person variation in interoceptive bias, either under- or overestimating their heart rate. Self-report data revealed reductions on regulatory and trusting facets of interoceptive sensibility, related to symptom reporting. Through a predictive processing lens, the pattern found is consistent with heterogeneous priors combined with higher-level cognitive “immunization” that resists disconfirmatory evidence. This study highlights the need for a broader understanding of interoception in persistent physical symptoms, integrating both higher-order and lower-order interoceptive mechanisms.

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