Interoceptive Breathing Perception With Anxiety

Anxiety is considered a core human emotion that can help to keep us safe from impending threat. However, when excessive, it can become maladaptive and impair wellbeing rather than preserve it. Interoception (i.e. the perception of bodily sensations) has emerged as a key process linked to anxiety, sharing vast neural and physiological substrates. Respiration, as a salient and experimentally manipulable interoceptive modality, provides a tractable window for investigating this relationship. Previous research suggests that anxiety may differentially influence responses to respiratory stimuli such as inspiratory resistances and hypercapnia (i.e. elevated carbon dioxide), although findings are mixed and depend on how interoceptive sensitivity is defined and measured. The current project examined how anxiety is related to subjective measures of sensitivity towards two different interoceptive modalities (inspiratory resistance and hypercapnia) across a spectrum of anxiety levels. A total of 75 participants were recruited through the University of Otago. All participants completed self-report measures of anxiety and related measures. Participants then underwent two breathing perception tasks involving graded increases in inspiratory resistance and hypercapnia respectively. Perceptual responses were recorded using visual analogue scales and data were analysed in STATA using linear mixed effects regression models to assess the variance associated with anxiety status, stimulus level and their interaction, alongside exploratory correlation analyses. Results indicated that anxiety was associated with increased overall affective ratings, but not sensory ratings. Furthermore, anxiety did not influence participants’ sensitivity to changes in stimulus intensity for either inspiratory resistance or hypercapnia. Exploratory analyses also revealed that breathing-related interoceptive sensitivity was not associated with self-reported physical activity, self-efficacy, depression, or subjective interoceptive awareness. Overall, these findings suggest that anxiety is primarily associated with overall affective appraisal of interoceptive signals, rather than the scaling of perception across stimulus intensities. This dissociation provides insight into mechanisms linking interoception and anxiety severity, highlights potential markers for anxiety vulnerability, and may inform the development of targeted interventions that focus on modifying affective responses to bodily sensations. Future research should further investigate the neural and causal mechanisms underlying these effects, as well as the therapeutic potential of resistance- and hypercapnia-based breathing interventions.