Title : Association of interoceptive sensibility with anxiety and depression in stroke patients: A cross-sectional study
Abstract:
Background: Anxiety and depression are common yet often underrecognized complications after stroke. Interoceptive sensibility, or sensitivity to internal bodily signals, may influence emotional regulation and symptom perception, making it a potentially important factor in post-stroke psychological distress. However, the association of interoceptive sensibility with anxiety and depression in stroke patients remains insufficiently understood.
Objectives: To examine the association between interoceptive sensibility and anxiety and depression in post-stroke patients, to delineate symptom interactions, and to identify the central symptoms.
Methods: This is a cross-sectional study enrolled 615 stroke inpatients from a tertiary Grade A hospital in Henan Province of China between September 2024 and January 2025. Interoceptive sensibility was measured using the Multidimensional Assessment of Interoceptive Awareness Version 2–Chinese (MAIA-2); anxiety and depression were assessed with the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnare-9 (PHQ-9), respectively. In linear-curve correlation analysis, a total of 11 models (linear, quadratic, composite, and so on) was used to explore the most fitting relationship between interoceptive sensibility and anxiety and depression, while network analysis was employed to investigate the relationships among symptoms and identify central symptoms.
Results: The study found that interoceptive sensibility in stroke patients exhibits an inverted U-shaped quadratic relationship with anxiety (R2?0.025, P?0.05) and depression (R2?0.012, P?0.05). Network analysis of the interoceptive sensibility–anxiety–depression symptom network revealed that “inability to sit still” (GAD5), “feeling bad about yourself” (PHQ6), and “emotional regulation” (AWA) are core symptoms, while “trusting” (TRU) serves as a bridging factor within the network, highlighting key driving and bridging symptoms.
Conclusions: Stroke patients’ interoceptive sensibility showed a nonlinear association with anxiety and depression, and network analysis identified central and bridging symptoms that may be particularly relevant to post-stroke emotional distress. These findings deepen understanding of the psychological structure linking interoceptive sensibility with affective symptoms and suggest potential targets for more individualized and clinically focused emotional assessment and intervention after stroke.
