Investigating Interoceptive Beliefs in Individuals With Endometriosis

BACKGROUND: Research has indicated that individuals experiencing chronic pain differ in their ability to sense and interpret signals arising from inside the body, termed interoception. It is unclear whether differences in interoception exist for those with endometriosis, a common condition where pain is a major symptom. METHODS: This study aimed to investigate whether interoceptive beliefs are altered in individuals with a diagnosis of endometriosis compared to those without, and whether pain experienced by those with endometriosis predicted interoceptive beliefs. Interoceptive beliefs were assessed in 247 participants with endometriosis and 98 participants without the condition. Those with endometriosis also reported their experience of dysmenorrhea, dyspareunia, dyschezia, and chronic pelvic pain. RESULTS: Individuals with endometriosis reported that they noticed more internal signals but had reduced trust in these signals and were more worried by them. They also reported that they try to distract themselves from internal sensations more than those without endometriosis. Increased pain intensity predicted higher scores in one facet of interoceptive beliefs, such that higher levels of pain were associated with higher awareness of internal sensations in individuals with endometriosis. CONCLUSIONS: These results indicate that those with endometriosis differ in their interoceptive beliefs and that these differences may be influenced by their pain experience. Given these findings largely align with changes observed in other conditions marked by pain, it is possible that interoceptive changes may represent a transdiagnostic characteristic across individuals experiencing pain. SIGNIFICANCE: This study addresses previously conflicted findings in the literature, providing a clearer picture of the changes in interoceptive beliefs present in people with endometriosis. Developing a stronger understanding of interoceptive functioning in this unique population may lead to opportunities to develop stronger interventions targeting bodily sensations in pain management in those with the condition.