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Interoceptive awareness (IA) is associated with emotional experience, the processing of emotional stimuli, and activation of brain structures that monitor the internal visceral and emotional state of the organism. Alexithymia is characterized by difficulties in identifying and describing one's emotions and externally oriented thinking (EOT) and reflects impairments in emotional awareness and the regulation of emotions. This study examined the relationship between alexithymia and IA in a healthy population of N=155 persons. A well-validated heartbeat perception task to measure interoceptive awareness, the Toronto Alexithymia Scale (TAS-20) and a depression questionnaire (BDI-2) were administered to 88 women and 67 men. IA was inversely associated with all features of alexithymia in the whole sample. When considering sex differences, IA turned out to be a relevant negative predictor for the EOT subscale only in men. This large sample investigation in a nonclinical population indicates that IA represents a relevant negative predictor for alexithymia.

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The ability to cognitively regulate emotional responses to aversive events is essential for mental and physical health. One prerequisite of successful emotion regulation is the awareness of emotional states, which in turn is associated with the awareness of bodily signals [interoceptive awareness (IA)]. This study investigated the neural dynamics of reappraisal of emotional responses in 28 participants who differed with respect to IA. Electroencephalography was used to characterize the time course of emotion regulation. We found that reappraisal was accompanied by reduced arousal and significant modulation of late neural responses. What is more, higher IA facilitated downregulation of affect and was associated with more pronounced modulation of underlying neural activity. Therefore, we conclude that IA not only advances the consolidation of somatic markers required for guiding individual behaviour but also creates processing advantages in tasks referring to these bodily markers.