The Interoceptive Sensitivity and Attention Questionnaire: Evaluating aspects of self-reported interoception in patients with persistent somatic symptoms, stress-related syndromes and healthy controls

Abstract

Objective To validate the Interoceptive Sensitivity and Attention Questionnaire (ISAQ), a 17-item self-report measure assessing sensitivity and attention to interoceptive signals.

Methods In study 1, exploratory and confirmatory factor analysis was performed in a student convenience sample (n = 1868). In study 2, ISAQ data of a healthy sample (n = 144) and various patient groups experiencing stress-related syndromes [overstrain; n = 63; burnout; n = 37; panic disorder (PD; n = 60)] and/or persistent somatic symptoms in daily life [irritable bowel syndrome (IBS; n = 38); fibromyalgia and/or chronic fatigue syndrome (FM/CFS; n = 151); medically unexplained dyspnea (MUD; n = 29)] were compared.

Results Three subscales were revealed: (F1) sensitivity to neutral bodily sensations, (F2) attention to unpleasant bodily sensations, and (F3) difficulty disengaging from unpleasant bodily sensations. Overall, patients with FM/CFS and patients with MUD scored significantly higher on F1 (p = .009 resp. p = .027) and F2 (p = .002 resp. p < .001) than healthy controls. Patients with PD had higher scores on subscales F2 (p < .001) and F3 (p < .001) compared with healthy controls, as well as higher scores on F2 compared with all other patient groups (p-value PD vs. MUD = .008, all other p-values <.001).

Conclusions Interoceptive sensibility – the self-reported aspect of interoception – is not a homogeneous or unitary construct. The subscales of the ISAQ differentiate healthy controls from patients with persistent somatic and/or stress-related complaints in daily life and distinguish different patient groups. The ISAQ can be used as a concise, reliable, and clinically relevant research tool to further disentangle adaptive and maladaptive aspects of interoceptive ability.