Making Sense of Sensation: A model of Interoceptive Attribution and Appraisal with Clinical applications

Interoception provides a link between bodily states and cognitive and affective processes across both unconscious and conscious domains. While previous research linking interoception to mental health has predominantly focused on interoceptive accuracy, attention, self-beliefs, and insight, we argue that the higher-order interpretation of perceived bodily signals plays a fundamental and underexplored role in this relationship. We propose a model delineating two higher-order processes—interoceptive attribution and appraisal—which contextualise and facilitate the interpretation of interoceptive sensations that reach conscious awareness. We outline key factors that modulate attention, attribution, and appraisal, and evidence the relevance of this model to anxiety-related mental health conditions. Given that these processes are accessible to cognition, they represent an important target for existing psychotherapeutic interventions. We integrate these interventions within our framework, highlighting their potential to enhance interoception-based therapeutic approaches.