INTEROCEPTION AND THE EXPECTATION–EXPERIENCE MISMATCH IN PAIN PERCEPTION

Pain is a multidimensional experience that includes not only sensory but also emotional and cognitive components. Interoception, defined as the perception and processing of internal bodily signals, plays an important role in the evaluation of pain and may contribute to anxiety when these signals are misinterpreted. This study aimed to investigate the relationship between interoceptive sensitivity, anxiety, and pain perception in healthy individuals. Twelve females and eleven males (age 25 years) were included in the study. Participants completed standardized questionnaires assessing trait anxiety and state anxiety. Interoceptive sensitivity was assessed using a heartbeat perception task during electrocardiographic recording at three unknown time intervals. Pain perception and expected pain intensity were measured using a visual analog scale during cold pressor test. Statistical analyses included ANOVA and correlation analyses. The results demonstrated that individuals with higher interoceptive sensitivity reported significantly greater perceived pain intensity, while paradoxically expecting lower levels of pain. Higher levels of trait anxiety were associated with stronger pain and were positively related to interoceptive sensitivity. No significant differences were observed in pain expectation based solely on pain tolerance or interoceptive sensitivity. These findings suggest that interoceptive sensitivity plays a key role in pain perception and anxiety even in healthy individuals. The discrepancy between expected and experienced pain may represent a protective cognitive mechanism. Limitations of the study include a relatively small sample size and limited precision in the measurement of interoceptive sensitivity. Future research should involve clinically diverse populations to further clarify these relationships. Supported by Cooperatio Neurosciences.