ASSESSMENT OF INTEROCEPTION IN JORDANIAN PATIENTS WITH CHRONIC LARYNGEAL SYMPTOMS: IMPLICATIONS FOR BRAIN-LARYNX INTERACTION

Interoception is the brain's capacity to perceive and regulate internal physiological signals, plays a vital role in emotional regulation and symptom perception. Although cognitive-affective processes are implicated in voice disorders, the specific mechanisms linking impaired body awareness to chronic laryngeal symptoms remain poorly understood. We investigated whether patients with chronic laryngeal symptoms exhibit maladaptive interoceptive patterns that amplify symptom severity. This case-control study enrolled 440 participants (220 symptomatic patients with chronic laryngeal symptoms ≥6 months and 220 healthy controls) from Jordanian hospitals. Interoceptive awareness was assessed using the Multidimensional Assessment of Interoceptive Awareness-Version 2 (MAIA-2), a validated 37-item instrument measuring eight dimensions of body awareness. Laryngeal cognitive-affective processes were evaluated using the Laryngeal Cognitive-Affective Tool (LCAT), which quantifies symptom-specific anxiety and hypervigilance. Patients with chronic laryngeal symptoms demonstrated significantly lower interoceptive awareness across all MAIA-2 subscales compared to controls (p < 0.001), including deficits in noticing body sensations, emotional awareness, and self-regulatory capacity. Symptom-specific anxiety and hypervigilance strongly correlated with maladaptive interoceptive patterns, particularly negative associations with emotional neutrality toward bodily sensations. Regression analyses revealed that symptomatic status independently predicted reduced interoceptive awareness after controlling for demographic factors. These findings validate the neurobiological model of laryngeal dysfunction and suggest that interoceptive training such as mindfulness interventions targeting bodily awareness and emotional regulation may disrupts the maladaptive brain-larynx interaction cycle by enhancing emotional tolerance and self-regulation.