On the generalised embodiment of pain: how interoceptive sensitivity modulates cutaneous pain perception

Individual differences in interoceptive sensitivity are associated with differences in reported intensity of emotional experience, vulnerability to anxiety and mood disorder and capacity for emotional self-regulation. Enhanced sensitivity to autonomic state is often accompanied by increased autonomic reactivity. Here we tested the hypothesis that healthy people classified as more interoceptively sensitive, by their performance of a heartbeat monitoring task, will demonstrate enhanced perception of pain. We further explored whether this effect is associated with a greater physiological reactivity to the pain stimuli. Using an algometer, cutaneous pressure pain was applied to the thenar eminence in 60 healthy participants. Heart rate variability and respiratory activity were recorded concurrently. We observed significant relationships between heightened interoceptive sensitivity and both enhanced sensitivity and decreased tolerance to pain. These effects were accompanied by a more pronounced parasympathetic decrease and a change in sympathovagal balance during pain assessment in the high, compared to the low, interoceptively sensitive group. Our study provides novel evidence that interoceptive sensitivity is associated with the experience and tolerability of pain in conjunction with reactive changes in autonomic balance.